Should My Husband Get an All-On-Four Dental Implant?

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My husband needs to replace his teeth. Our dentist said that he has lost quite a bit of bone structure and is recommending the all-on-four dental implant procedure. I’ve heard this is a bit of a controversial procedure. Would this be okay for him to get? My husband likes the idea because it means he won’t need the additional procedure of bone grafting. I’m worried because of the controversy behind it. Can you please advise?

Olivia

Dear Olivia,

illustration of the all on four

All-on-Four Dental Implant Procedure

 

One of the problems with the all-on-four procedure is that if one part of the appliance fails, the whole thing has to be redone. This is not an issue with an implant overdenture. If one of your dental implants fails then only that implant will have to be dealt with. If it were me, then I would encourage your husband to go ahead and get the bone grafting procedure done and then get implant-supported dentures instead of the all-on-four.

No matter what he chooses, it is important that the dentist he goes to has post-doctoral training in dental implants. This is quite an advanced procedure and it is not adequately taught in dental school. If something goes wrong, the complications can be quite serious.

Three of the top schools for this are:

  • The Dawson Academy
  • The Las Vegas Institute of Advanced Dental Studies
  • The Kois Center

There are others, but those three are among the most reputable. Make certain the dentist has that training. There are countless dental implant horror stories.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

 

Solution for My Ugly Tooth

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I have a bit of a problem. I got hit with a pool cue right in the front tooth at full force. Don’t ask. It’s been a while and since then the tooth turned an ugly brown. I went to my dentist and he told me most of the root was gone so I would need a dental implant. He also told me I had three back teeth that needed fillings. I can’t afford to have all of that done and fix my ugly tooth. Do you know of anything that will help me?

Penelope

Dear Penelope,

illustration of a dental implant

I am going to suggest that you change dentists for a couple of reasons. One is the root resorption. If your dentist had treated your tooth when it first experienced the trauma, he could have saved the root, which would in turn have saved your tooth. He should have done a root canal treatment. Unfortunately, now that you have no root left, there really isn’t anything that can be done to save the tooth.

This does not necessarily mean you will need to have an expensive dental implant if you cannot afford it. There are other tooth replacement options. This leads me to the second reason to get rid of your current dentist. He or she is legally obligated to give you all your treatment options, even if he prefers other options.

Some possibilities for you include:

  • A dental bridge: This is a false tooth suspended between two dental crowns
  • A removable partial denture: This is just like it sounds. It will clip to your adjacent teeth.
  • A dental flipper: This is your least expensive option. It’s like a cheaper version of the denture.

Find another dentist who has the integrity to look after your oral health and give you all your options. Then, ask him or her to triage the needs so you can start with the most urgent. This can make it easier to deal with financially.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

 

My Husband’s Dental Implants Smell Awful

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My husband recently received implant overdentures. He only has the temporary dentures, which are acrylic. There are porcelain ones being made. Before those are attached, I wanted to reach out to another dentist because I think we need to switch his dental implants from the metal ones to the ceramic ones. There is a horrible smell in his mouth since getting these metal implants. I feel certain I can smell the implants themselves and the metal is reacting with his mouth. I think this will have long term negative effects on him, not to mention how I can’t stand being by his mouth at the moment. But, his dentist thinks there is nothing wrong. I think he just doesn’t offer the non-metal kinds and does not want us going somewhere else. Is there a way I can convince him something is wrong here?

Amanda

Dear Amanda,

Titanium and Zirconia Dental Implants

 

While there is something wrong, I don’t think it is what you’re thinking. The metal dental implants are made from titanium, which not only is biocompatible with decades of data. There has been no data showing any reactivity with titanium. It’s often used as a prosthetic and not just for in dental work. It’s used in other medical procedures too. One example is a hip replacement.

As to the smell, titanium is an inert metal, which means it doesn’t have any real smell. You could even ask the dentist to smell one and you’ll understand what I mean. However, none of that answers your question about the smell. A bad smell is an indication that something is wrong. My first place to look would be the denture used for his implant overdentures. It may have some open gaps that are allowing food and other bacteria to get trapped in there, which would make a horrific smell.

I would try having your husband use something like a WaterPik to help clean out the area. If that is the problem, the smell will go away. He’ll need to be extra tedious with his oral hygiene.

Another possibility for a bad smell is an infection, but that is generally accompanied by other symptoms such as pain and / or fever. I would start with the WaterPik and go from there.

Re-Doing a Dental Implant Procedure

Having him switch to ceramic (zirconia) dental implants is not as simple as taking metal implants out and putting non-metal in. First, he’ll need the surgery to remove the implants. This procedure will remove much of the bone in the area. Because of that, he’ll need a surgery for bone grafting to build back up that bone giving the implants a chance of success. Then, after a period of healing from the grafting, it will be time for the dental implant surgery. That’s three additional surgical procedures to switch these implants. Not an easy thing to ask anyone to do.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

 

Can Dental Implants Replace My Baby Canine Teeth?

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I am sixteen years old and still have baby canine teeth on my top and bottom. Last year, I had the two bottom teeth taken out. For one of the canines, there was an adult tooth growing behind it. Over the last year, it has moved sort of into the right place. The other one did not have an adult tooth behind it so I am stuck with this empty spot. I still have the two baby canine teeth at the top. I don’t want empty spaces in those the way I did with my bottom teeth. Could I take those out and get dental implants so that I have teeth by the time I take my senior pictures?

Camilla

Dear Camilla,

Illustration of a dental implant

One of my questions before going into the solution is why are you having to handle this? Where is your dentist? Your parents? Don’t get me wrong, you are very mature and I am quite impressed at the fact that you are trying to take this on. Your dentist, however, should have dealt with this years ago. Dentists are instructed in exactly what to do in situations like yours.

The first thing you need is a good set of x-rays to see if you have adult canine teeth under there. If you do, dental implants will not be a good solution for you because there won’t be any place to put the implants. If it looks like they can erupt into the correct position, then making a surgical incision into the tissue will help them to erupt properly. Sometimes, they are not in a good position, though. In that case, you will need an orthodontist to help you. The canine tooth is an anchor tooth and very important. If there is too much crowding it would be better to remove a premolar to make room.

Now, let’s say that there are not any teeth to deal with. You will not want to get dental implants right away. Your jaw is still growing. While dental implants are the best tooth replacement, you will have to wait until your jaw is fully developed for them to function properly. In the meantime, you can have your baby canine teeth extracted and have a temporary tooth replacement, such as dental flippers placed, and you will look beautiful for your senior pictures.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Should I Change Dentists in the Middle of this Dental Implant Procedure?

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I went to see my dentist about repairing two teeth. Both are premolars that have had problems over the years and have both been capped. He suggested I have both teeth extracted, have bone grafting done, and then replace them with a dental implant and crown. The cost will be just over $9,000.00. I was fine with the plan but have recently developed some concerns. The bone grafting is done. Now, I’m in a three-month healing period using two temporary tooth replacements. From there, it will be time to place the implants and crowns. I’ve only had the Maryland Bridges for a little over two weeks and they have fallen off three different times. I’m beginning to wonder if this dentist has the skills necessary to do this procedure correctly. Do you think I should be concerned? If so, can I switch dentists in the middle of my procedure?

Mark

Dear Mark,

Titanium and Zirconia Dental Implants

 

Yes, I think you should be concerned. There are a couple of red flags here for me. One is the choice of the “temporary” tooth replacement. A Maryland Bridge requires some tooth preparation for the bonding to hold properly. This preparation would include putting a notch in the tooth to hold the bridge wings. Anything that changes the structure of the tooth is not a temporary restoration. In order to get the tooth back to its original form would require dental bonding to be done. Most dentists would use a true temporary (and much less expensive) option such as a dental flipper.

The second issue here is that your dentist can’t keep the Maryland Bridge in place. This means that even though he or she chose the wrong replacement, they don’t know how it works. That is a huge warning signal to me that they are in over their head with your case. A bridge is not nearly as advanced a procedure as dental implants. If they can’t get this bridge right I would not hold out much hope for your dental implants.

My recommendation is you switch dentists. Find one with post-doctoral training in dental implants. It will not matter that you are in the middle of your procedure. Your dentist is still under an ethical obligation to provide the new dentist with all the notes and diagnostics related to your case.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Dental Implant Disaster

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Several years ago, I had a full-mouth reconstruction. About a third of the teeth were dental implants, but most were just crowned.  I’ve regretted it ever since. At first, my jaw hurt massively as a result, but the dentist insisted I’d get used to it. Now, the dental implants have started falling out. I’ve got a mouth full of nubbed teeth and I can hardly eat. Every time I try to eat anything other than a liquid diet and my mouth starts to bleed. The office tells me that the dentist is now living overseas and took our records with him. When they say “living overseas”, it turns out that they really mean he skipped the country. I am not the only patient struggling with botched work.  Is there anything I can do?

Patricia

Dear Patricia,

Illustration of a dental implant

I am so sorry this happened to you and the other patients with this charlatan. Unfortunately, if he’s truly fled the country then he probably went somewhere that he is out of reach of the law. The only thing you can do is have the case totally re-done. I know that is not what you were wanting to hear at all and I’m sorry to be the one to have to tell you that.

I would make sure that whoever you go to has post-doctoral training in dental implants. A full-mouth reconstruction is quite advanced. As you’ve discovered, if it goes wrong, it goes very wrong. Because you have lost some dental implants, you will need to have some bone grafting done. Otherwise, the new dental implants will not have enough bone there to retain them.

I would explain your situation to whatever dentist you end up with. Dentists are compassionate people and they may allow you to pay this out.

This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

 

Titanium Versus Zirconia Dental Implants

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I currently have two titanium dental implants already placed. I need another implant. Recently, I read that the titanium ones can cause neurological problems in the long term. Is this correct? If so, should I remove the other implants and get all zirconia? I keep hearing dental implants are the best but maybe it is dangerous to have metal in your body.

Raz

Dear Raz,

Titanium and Zirconia Dental Implants

I would be interested to see where you read that titanium can cause neurological problems. I only know of one “source” and that was a natural news site that had zero data to back up the claim. Just the opinion piece. On the flip side of things, we have decades of data where titanium has been used in the body and is very biocompatible.

Metal is a natural and essential part of our body. Think about how much iron you need in your blood to survive. Of course, not all metals are a good idea. For instance, I completely understand why patients would not want silver amalgam fillings, which contain a majority of mercury. Titanium is different. We know it to be safe.

As to what type of dental implants to get, my opinion is you can do either titanium or zirconia. More dentists use titanium, but that is simply because they have been around longer and we have studies that back up their longevity. Zirconia is a much more recent development, so we do not have data on how long they last. They are strong enough. Even if you get the zirconia implant for your new one, I would not switch out the old ones.

When you take out old dental implants, bone follows with it. That will mean that you will not just be able to replace old implants with new ones. You will have to have a bone grafting procedure done. That is an unnecessary expense and risk for dental implants that are working just fine.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Should I Switch Dentists in the Middle of My Implant Procedure?

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I’ve paid my dentist almost $10,000 dollars already and I am worried he is not up for the remainder of the procedure. The price was to cover extractions of teeth #5 and #7, bone grafting, Maryland Bridges as temporary replacements, dental implants, and crowns for each tooth. Thus far, we’ve done the extractions and bone grafting. He’s provided me with the Maryland Bridges but they keep falling off. This worries me not only because it is super inconvenient to have to constantly have to return to the dentist to have my work or repairs done, but also because I’m concerned he just isn’t up for the remainder of this procedure. What do you think? Am I overreacting and fretting over nothing or is there cause for concern?

DeeDee

Dear DeeDee,

Illustration of a dental implant

There is nothing wrong with you switching dentists in the middle of your dental implant procedure. In fact, your dentist is ethically obligated to provide all the labs and diagnostics to the new dentist. Given what you have said, I am actually going to recommend that you do switch for a couple of reasons.

First, he is using a Maryland bridge as a “temporary” tooth replacement. This is not a temporary replacement because in order for it to stay in properly there is a need to make a small groove in your tooth. Anything that changes the structure of your tooth is not temporary. Instead, he should have suggested something like a dental flipper. These are less expensive and don’t necessitate any changes to the teeth.

Second, he wasn’t able to properly bond the Maryland bridge. That is much less of an advanced procedure than the dental implants you need. You need to look for a dentist with dental implant training and experience. That training needs to be post-doctoral.

One other note, the dental implant crowns can be made any color necessary to match your teeth. You should be aware that whatever color is made is permanent. Once it is bonded on, no changes can be made. If you are considering teeth whitening at some point, then I suggest you do it before having your dental implant crown made. This way it will be the right color for the permanent smile you’d like. If you decide to wait until after the crown is placed and then whiten, you will have to replace the crown for it to match.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Can a Dental Implant Fix Her Triangled Teeth?

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I have a complicated case and I am not sure what to do. I have a baby canine tooth that has finally succumbed to decay. That tooth never fell out because my teeth shifted a bit when I was a child after a dentist pulled a baby molar. Now my canine tooth came in but in front of my first and second bicuspids. They’ve formed a sort of triangle. Not only is it embarrassing, but it is nearly impossible to keep thoroughly clean, though I am as diligent as I can be with it. My dentist feels it is too far away and the root system too tangled to use orthodontics to get it in the right place. I do have to remove the baby canine and I just want to have a normal and hopefully attractive smile.

Kelly

Dear Kelly,

dental implant diagram

I would think most dentists, who love their field, would be thrilled to work on a case as complicated as yours. It is possible your dentist feels in over his head with this one. Every dentist goes into the profession with different goals. He may just love being a good bread and butter family dentist and like keeping people’s teeth healthy but not get into all the complicated cosmetic stuff. That’s okay, we need good family dentists.

The only problem for you right now is you need someone with experience in cosmetics. There are a few ways to handle this, but it would take someone looking at your specific bite and x-rays to give you a definitive answer. Here are some possibilities, though.

Options for Fixing This

First, you could extract the baby and adult canine teeth, then use Invisalign to get the opening the right size, along with giving the other teeth proper alignment, and then have a dental implant placed in the area where your canine goes.

Another possibility, if the canine can’t be moved, is to extract it, then have your first bicuspid shaped to look like a canine in the front. That has been done many times with good results.

The key for you, however, it to make sure the dentist you see has the training, experience, and artistry you need to give you a beautiful finished product. I would make sure you look at their smile gallery, which is a sort of brag book for dentists, to see what type of results they get. Then, if they’re good, trust their instinct on the best way to handle this situation.

When Baby Molars are Extracted

I don’t know if you are currently a parent, but I want to tell you how you can avoid this situation with your children. Whoever your pediatric dentist was made a critical error. Baby molars need to stay in place until a child is at least 12 years old. Otherwise, you risk the teeth shifting, which leads to crowding and a complicated bite such as you are facing now.

There are times, however, that a molar cannot be saved. When that is the case, it is imperative the dentist puts a space maintainer in the area in order to keep the teeth in proper alignment. It sounds like your childhood dentist neglected that. Make sure whatever pediatric dentist you have for your children, doesn’t make the same mistake.

I know finding the right dentist will give you a smile you are proud of.
This blog is brought to you by Marietta Dentist Dr. Cristi Cheek.

Costa Rica or ClearChoice?

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I want to save some money and am trying to decide between going to Costa Rica to get dental implants or to use ClearChoice. One of my concerns about is that ClearChoice seems to only want to place all on four dental implants and I’m wondering if I’d be better off with something else. I’ve also heard there is not much follow-up after patients are done there. Getting the work done in Costa Rica is less expensive, even with the travel required. Though, I have several people telling me that it isn’t a good idea to go to Costa Rica for dental care. Yet, a lot of people do it so I’m wondering if it is as bad as my friends are making out. Do you have an opinion?

Luke

Dear Luke,

Implant Overdentures

Let’s start with Costa Rica. They do have a significant amount of dental tourism. Sometimes it works out okay for the patient and sometimes it doesn’t. The big problem is when it doesn’t. Often the situation is pretty bad. Plus, you don’t really have any recourse. One of the things you were concerned about with ClearChoice was their lack of follow-up. What type of follow-up do you think you would get with a foreign country?

Dental implants are one of the most advanced procedures out there. Part of this is because of the potential complications when things don’t work out properly. The implant can be placed on a nerve that causes facial paralysis. Or, it won’t be properly fitted which leads to an infection in your jaw. In some cases, people have lost chunks of their face. Mind you, that type of complication does not happen often, but my point is you want to make sure the dentist working on you is highly trained and not just cheap.

As for ClearChoice, most complaints about them have more to do with their hard sales tactics than their dentistry. The dentists there tend to be decent, skilled dentists. Because they are a corporate model, they are more about the bottom line than the individual patient. This is one of the reasons they have what appears to be the one-size-fits-all approach to what dental implant procedure to use.

If you want the all-on-4 procedure, you should be fine there, though you should insist on some follow-up. Be aware that if one part of the all-on-4 fails, you will have to replace the entire unit.

Before making a decision, I would speak with a private dentist to get his opinion of what will be your best treatment option before making a final decision. You may save money in the long run getting a slightly more expensive procedure that lasts years longer with no complications.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.