Implant Bridge Does Not Line Up with My Bite

Posted on by .

I recently had two dental implants placed that a dental bridge was attached to on the right side of my bite. The problem I am having is that when I bite down, my right side matches up but my left side does not. Is this a problem in the long run? It is uncomfortable. I talked to my dentist about it and he said it is the surgeon’s problem and fault because he did the work first. Of course he did! How else could the dentist put the restoration on? The surgeon of course says it is the dentist’s fault because he placed the restoration. I don’t know what to do.

Rose

Dear Rose,

A woman grabbing her jaw in pain.

This does need to be fixed. When your bite does not come together properly then it can lead to TMJ Disorder. This can leave you in pain for the rest of your life. I’m a little unclear as to who determined the placement of your dental implants. Whenever you have a dentist and an oral surgeon working on the implant procedure together, it is always the dentist who determines the placement.

If the oral surgeon insisted on determining the placement himself, then he is definitely at fault. It is standard procedure for the dentist to determine the placement, if he violated that he’s to blame. However, if he followed the dentist’s instructions in placement, then it is the dentist who is responsible.

Either way, this needs to be redone. The good news is you definitely deserve a full refund here plus the cost of bone grafting, which we’ll get into in a moment. Once you get that secured, you’ve got to get a different dentist to do this. Unfortunately, you will need bone grafting done first because you will lose bone when they remove the implants. Once the grafting is completed, then you can have the implants done again.

Make sure the person you have do the procedures has a significant amount of post-doctoral training in dental implants. What is taught in dental school is not enough.

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

Sinus Perforation with a Dental Implant

Posted on by .

I had a dental implant placed about six months ago that was recently removed. My oral surgeon suspected there was some bone loss because things weren’t progressing as expected. I haven’t even gotten to go to the dentist yet for the restoration part. Though he perforated the sinus cavity, he said that was normal and it was only a few millimeters. Instead, he believes the problem is the fact that no bone integrated with the implant, which isn’t normal. He said the good news is that it made it easy to remove the implant. He wants to do bone grafting and then try again. Is there anything you think I can do differently this time to improve my odds?

Karen

Dear Karen,

a dental implant diagram

There are a few problems here. The first is that the oral surgeon did not have the dentist determine the placement of the dental implant. It is always the dentist who should determine placement. Before doing anything else, I want you to see a dentist with post-doctoral training in dental implants to look at your case.

A second issue here is the perforation of the sinus cavity. I know he said it was “only” a few millimeters, but that is a HUGE amount in the dental world. It sounds to me like he did not do adequate diagnostics to prevent this. He should have taken x-rays as well as a CT scan to get a good view of the landscape, including a 3-Dimensional view.

Bone grafting can be a good solution if you do not have enough bone to retain a dental implant. Again, though, he should have known this ahead of time by doing adequate diagnostics. Had he done that, your dental implant failure could have been avoided altogether. See a good implant dentist and then you should have an idea where to go from there.

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

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

Posted on by .

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.

 

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

Posted on by .

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

Posted on by .

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.

 

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

Posted on by .

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.

He Yanked Out Her Dental Implant

Posted on by .

I had a dental implant placed and the crown came loose. I called the dentist who placed it and he did an x-ray. He felt the implant was fine and thought the crown was loose so he decided to remove it and rebond it. Unfortunately, when he went to remove it, it stuck so he needed a special tool. When he used that he had to pull pretty hard and the implant came out with it. Is it possible the dentist messed up here? I don’t know how to fix this.

Cammie

Dear Cammie,

Illustration of a dental implant surrounded by natural teeth

Yes, your dentist definitely messed up. I am actually having a hard time figuring out how he could have been so clueless as to pull out your dental implant. If a crown is loose, it would practically fall off. You certainly aren’t going to need a special tool for it. It should have been obvious to him that it was the implant that was loose the whole time.

Reasons for a Loose Dental Implant

There are a few reasons your dental implant could have been loose. One of the main reasons is because an infection developed. However, you didn’t mention any pain, nor did you have a fever. I’d expect one of those to be present if that was the issue. Another reason for a loose implant is premature loading. That could mean that the dental crown was bonded on before the implant was ready. A third reason could be there was never enough bone support to even place a dental implant.

Your dentist should have done diagnostic x-rays, including 3-dimensional ones, to determine that. I am a tad concerned about his diagnostic abilities as he did an x-ray when you mentioned it was loose and he couldn’t tell the implant was the problem.

Getting this fixed will require you to re-do the procedure. However, it will take more than just doing it again. Before another implant can be placed, you’ll need bone grafting done in order for there to be enough bone to retain the implant. Without that, you will end up with another dental implant failure.

In your place, I would demand your dentist pay to have this done correctly. Don’t let him re-do it himself and don’t just agree to a refund, because it will cost more to fix than you paid him. He needs to pay the new dentist and YOU need to be the one who picks the new dentist. You want someone who has done significant post-doctoral training in dental implants. If they need to refer you to an oral surgeon, make sure it is the dentist who determines the placement of your implant.

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

Dentist Placed My Implant Knowing it Would Fail

Posted on by .

I wanted to replace a tooth. My dentist told me I could get a dental implant, which was the procedure I was hoping for. Apparently, when he went in to place the implant he realized there wasn’t enough bone. He placed the implant anyway. When the surgery was over he told about it and said he doesn’t expect it to last and he thinks it should be removed and then he can give me a dental bridge. I really wanted a dental implant though. Also, I don’t think it is right I should be charged for a surgery he knew was going to fail. Am I overreacting?

Callie

Dear Callie,

dental implant diagram

No, you are not overreacting. In fact, your dentist could be in some trouble here. Let’s talk about the legal implications. He said he’d provide a service, which in any reasonable contract would be expected to actually not fall apart. If it does, you’d get a refund. In legal terms, this is called an implied warranty. In a dental implant, this would mean that the implant would be expected to support the crown. He placed the implant knowing it wouldn’t. So, yeah…he owes you a refund.

There are malpractice issues here too. How did he not know there wasn’t enough bone before doing the procedure? There are diagnostics that should have been performed, such as x-rays in order to make certain you are a good candidate. Either he didn’t do proper diagnostics or he didn’t know how to read the diagnostics he did. Then, when he saw the true “landscape”, he still went ahead and placed an implant he knew would fail. That is malpractice.

That isn’t the only problem here. You’re not bound to getting a dental bridge just because he blew the procedure. There is the option of getting some bone grafting done to build up the bone structure you are missing. Then, your jaw will be ready for that dental implant you wanted.

Bottom line. Yes, ask for a refund. If he gives you a hard time, tell him you are happy to speak to the dental board and an attorney about his malpractice. That should change his tune.

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

A Pretty Smile after 23 years in Dentures

Posted on by .

I’ve had removable dentures for 23 years. A friend of mine recently got dental implant dentures. These look so much nicer than my teeth and she can eat anything she wants. Is it too late for me to have a pretty smile? I’ve spent my lifetime embarrassed by it.

Elaine

Dear Elaine,

Older couple with nice smiles

I’m sorry you have been embarrassed by your smile. The great news is it is never too late for you to get a beautiful smile. The key is in the dentist you choose. Doing a smile makeover is not taught in dental school. As a result, it is up to the dentist as to how much post-doctoral training they receive, if any, in creating beautiful smiles. Additionally, there is some natural artistry that is necessary as well, as with any art.

As to the dental implants themselves, because of the length of time you have been in dentures, there will be significant bone loss. That will have to be addressed in order for you to have a successful chance for true retention of your dental implants. The integration with the bone is imperative. The best way to address this is to have a bone grafting done. This will build back up the missing bone that you will need for osseointegration.

Once that is healed, you can have the implants placed. There will be a second period of healing necessary after the implants are placed. From there, you can have your dentures anchored to the new implants. This is known as implant overdentures, sometimes called implant-supported dentures.

Finding the Right Dentist

With the right dentist, you can have a gorgeous smile you will be proud to share with the world. However, choose carefully. The first thing you will want to do is make sure they have the training they need to place dental implants. Take a look at Dr. Cheek’s qualifications to get an idea of the type of training you want in your dentist.

Once you are assured they are qualified to place your implants, be certain to look at their smile gallery. This will give you an idea of what type of results they can provide you when it comes to creating a beautiful smile for you.

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

Implants Fell Out After a Few Days

Posted on by .

I had six dental implants placed. In the week since they’ve been placed, three have fallen out. These are expensive. Should I have to pay for ones that fall out? Do you think the others will fall out? I’ve already paid for 75% of the fee.

Kenneth

Dear Kenneth,

Illustration of a dental implant surrounded by natural teeth

No, you should not have to pay for these dental implants. While it is true that there are times a dental implant will fail for unknown reasons, in general, dental implants have a 95% success rate. Thus far, your dentist is down to 50% and I have little confidence the others will stay in either. Most of the time when an implant fails it is after the load has been placed on them. Yours failed before there was even a load placed on them. The first thing I would want to know is why these three have failed. I’d like you to see another dentist for a second opinion. Do NOT tell them who the dentist was that placed them. Just let them know you have lost them in under a week and want to know if they can diagnostically tell you why.

Some Causes of Dental Implant Failure

  • Lack of bone support. As you can see from the image above, dental implants require bone support for them to be retained. Your dentist should have done enough diagnostics to determine whether or not you had enough bone support. If you didn’t, a bone grafting procedure would have been necessary before proceeding.
  • Incorrect placement of the dental implant fixture. This can also be the result of poor diagnostics.
  • Infection. This can be because of poorly fitting fixture.
  • Using substandard implant fixtures. Some dentists will try to save money by purchasing their dental implant fixtures overseas which have fewer regulations. This usually results in dental implant failure. Though, most often this happens further down the line where the patient may not know it was because of substandard materials.
  • Premature loading. This is when the dentist puts stress on the implant before it has properly integrated with the bone.
  • Medical issues the patient has, though this is not as common and your dentist would warn you ahead of time of any real risk factors.

How to Get this Fixed

Tell your dentist you want a refund. You have a very good case. If he gives you any guff about it let him know you will be speaking to the dental board. That should sober him up some. Unfortunately, you will also need some bone grafting at this point. Take any diagnostics he did with you and the dentist can let you know if you didn’t need the grafting before. If you were good to go and he messed up another aspect of the implants, then he should have to pay for the bone grafting as well. If you already needed it ahead of time, then you’ll just have to go ahead and pay for that.

When you go to have this redone. Look for a dentist with significant dental implant training.

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