Problems with Dental Implant Procedure

Posted on by .

I wanted to get a single dental implant. My dentist felt there wasn’t enough bone in the area after doing his diagnostics and told me I could either get bone grafting done to have the implant or get a dental bridge. I really wanted the implant, plus I didn’t want to crown two healthy teeth so I opted for the bone grafting. We did that and after the healing time we went to do the implants. But, he told me the bone grafting didn’t work and is now suggesting I go ahead and get the bridge. Two surgeries later and I’m still without a dental implant. He actually has a good reputation for implants so I’m kind of surprised. Should I have gone to an implant specialist?

Stacey

Dear Stacey,

A dental implant diagram

Technically, there isn’t a recognized specialty in dental implants. It is up to the dentist how much training they receive as well as whether they’ll do the whole procedure or divvy it up with an oral surgeon. It is possible your dentist is very good with the implant procedure but just now learning how to do the bone grafting aspect. It is tricky and everyone starts somewhere.

What I like about your dentist is his integrity. Some dentists, with more pride than integrity, would have gone ahead and placed the implant so you wouldn’t have known they don’t have bone grafting down yet. Then, after a period of time, your dental implant would have failed and there’d be no way to tie it to his error. He kept that from happening to you.

Getting Your Dental Implant

You basically have two choices at this point. You can go ahead and get the dental bridge or you can do the bone grafting and dental implant procedure again. Getting a dental bridge is a perfectly acceptable solution. However, as you noted, it does require placing crowns on two perfectly healthy teeth in your particular case.

If getting the implant is important to you, I’d ask your dentist for a recommendation for a good oral surgeon to re-do the procedures for you. One word of caution. After your bone grafting procedure is done and healed, visit the dentist again for him to decide on the best placement of the implant. He and the oral surgeon need to communicate before the implant surgery in order to ensure it gets placed in the correct position.

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

Crown Doesn’t Match

Posted on by .

I don’t know what to do. I had to get a dental crown on front tooth. My dentist can’t seem to get them to match. The first one was way too dark. The next one was way too white. The third one is close. I thought I could live with it and he bonded it one but now every time I look in the mirror I feel like my smile looks fake. Am I being too picky? My dentist said if I really want to do it again he will.

Candace

Dear Candace,

Dr. Cheek looking at computer visuals

The tendency for most patients in your situation is to finally just settle for a crown that doesn’t look quite right. If this is a front tooth, however, even a slight variation in the color between the crown and adjacent teeth will be noticeable to others and will make the crown look fake.

Your dentist seems to be very ethical and is doing everything he can to make this right. I just think he is in over his head. Matching a single dental crown to a front tooth is a highly developed skill. Additionally, the dentist has to have a great working relationship with artistic skill. Their relationship needs to be very communicative where they understand one another the way best friends would.

An expert cosmetic dentist will do try-ins to make sure it matches perfectly. I don’t think your dentist has the expertise necessary and didn’t even know about temporary try-in pastes.

Another method being used very effectively to match crowns on front teeth is photography. Using sophisticated camera equipment designed for taking dental photographs, the dentist will start by taking a photograph of a standard shade tab of a shade that is close to the shade of your natural teeth. The shade tab will be put up against your natural teeth and photographed, and this photograph will be sent to the ceramist as a guide in re-creating the natural color of the tooth. Then, if the crown provided by the ceramist doesn’t match perfectly, that crown is tried in on the tooth and a new photograph is taken. The ceramist then will be able to see, in the lab, exactly what color modifications need to be made to get it to match perfectly. Your typical family dentist won’t have this type of photographic equipment.

So what do you do if your dentist doesn’t have the skills necessary? Your dentist is willing to keep trying. If you are willing to let him, you can. However, it’s likely he’ll never get it quite right. You could have a conversation with him and tell him you think it would be better if he transferred your information to a dentist with more expertise and the tools necessary to do it properly.

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

Her Dentist Said Everything Is Fine, But it’s NOT!

Posted on by .

I’m hoping you can give me some guidance. I’ve never had a cavity before so I don’t know what a cavity feels like but am wondering if I’ve developed my first one. I had a check-up just a month ago and my dentist said everything looked fine, so it would have to be pretty new. It is a bit hard to describe but feels a bit like someone is pulling my back teeth and then letting go. It only lasts a short time, but it is distracting and I don’t want to ignore if anything is wrong. My husband says I grind my teeth when I’m sleeping. Could that be it? Or is this what a cavity feels like?

Miranda

Dear Miranda,

a woman holding her jaw from TMJ pain

I know you said everything was fine at your last check-up, but if you are a tooth grinder, everything is not fine. I’m worried you are not getting adequate care. Some discount clinics only focus on cavities and don’t pay attention to important issues such as gum disease, bruxism (teeth grinding and clenching) or other occlusion issues such as TMJ Disorder. Overlooking these things can cause serious long-term problems.

I haven’t examined you and wish I had an x-ray to look at, but what you are describing does not sound like decay to me. The two possibilities that come to mind immediately are gum disease or damage from the grinding. Either one of these would need to be dealt with and the sooner the better.

If You Are Grinding Your TEeth

Grinding your teeth is an urgent matter, especially if you’ve been doing it for a while. You can end up cracking your teeth or grinding them down to nubs. This will cause you to need a full mouth reconstruction which requires placing a porcelain crown on every tooth.

There is a simple fix for this which can save your teeth. Your dentist can make a custom-fitted night guard. This will protect your teeth from the grinding as well as pressure if you clench. It’s much better to get a night guard than to leave your teeth unprotected and end up having to spend tens of thousands of dollars crowning every tooth.

If You Have Gum Disease

Gum disease is also serious. If left untreated, your teeth will eventually fall out. Then you’ll need expensive tooth replacement options, such as dental implants.

As I said earlier, I’m not sure you’re getting adequate care from your current dentist. I’d like you to see another one, sooner rather than later.

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

Disastrous Full-Mouth Reconstruction

Posted on by .

My dentist suggested I get crowns on all my teeth in order to open my bite. While he did that, I now can’t close my lips without putting forth effort. It’s caused massive dry mouth. I talked to my dentist and he said it’s just a matter of time before I get used to the new bite and if I don’t he can grind them down to their normal size which defeats the whole purpose of me spending all that money to begin with. Do you have any suggestions for me?

Ben

Dear Ben,

blonde woman giving a thumbs up in a dental chair

Your dentist has done you a great disservice. It could even be called malpractice. When your lips don’t close when at rest, it is called lip incompetence. This is one of the chief things to avoid when doing a full-mouth reconstruction.

When opening a bite, it needs to be done first temporarily so you can avoid permanent issues, such as you’re facing. Ideally, a dentist would first build up the back teeth with composite to test how far the bite could open. Some dentists may do this with temporary crowns. The downside to that option is you have now committed to having dental crowns, which may not be ideal. The patient would wear the temporaries to ensure they’re comfortable with the new opening.

The bite should never, never be opened to the point of lip incompetence. Your lips should come together naturally when your mouth is at rest.

The Danger of Dry Mouth

Our saliva was designed to be on the front lines in the battle against decay. It contains powerful bacteria fighting minerals. If you have dry mouth, your saliva isn’t getting an opportunity to do its job. You’ll begin to see a dramatic increase of decay, which can destroy your oral health.

Your dentist has to make this right. I mentioned earlier what he’s done is malpractice. Here’s what I’m going to suggest you do to remedy this. First, go to him and let him know about the lip incompetence. He should be willing to re-do them and it should be free of charge. This time make sure he does temporaries first to ensure the bite isn’t opened too much.

If he’s unwilling, you’re going to have to get tough. First, go to an expert cosmetic dentist to get a second opinion. Don’t tell them who did the work, in case they’re friends. Once the second dentist has said this is a problem, you can go back and tell him what another dentist said. Sometimes the opinion of a peer will sway a dentist because he doesn’t want to look bad. If he’s still unwilling to make this right you’re going to have to take him to court for malpractice. Then, you can take the money from the damages to get this fixed.

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

TMJ Problem or Cavity

Posted on by .

I’ve never had a cavity before so I don’t know what they feel like. Lately, I’ve been having pain at the back of my mouth with a couple of my molars. It comes and goes. I thought it might be a cavity but I was asking a friend about it and she said that hers was that way because of TMJ problems from grinding her teeth. I know I do that because my dentist said I do. So, how do I know if my problem is a cavity or TMJ?

Alana

Dear Alana,

An illustration with a close up of a TMJ Joint
The Temporomandibular Join

I will say first I am more than a little concerned your dentist told you that you were grinding your teeth but didn’t explain the importance of it being dealt with or suggest a treatment.

The grinding of your teeth will wear them down to little nubs until you’ll either need them crowned or they will begin to crack. Additionally, it will begin to wear down your the joint that is the center of TMJ Disorder.

He should have suggested you wear a nightguard. This is such a simple fix. He custom fits a special nightguard for you to wear while you sleep. Most people who grind their teeth, do so at night and don’t realize it is happening. Wearing the guard protects your teeth from the grinding motion.

Leaving TMJ Causes Untreated

If you don’t get a nightguard, eventually you will need what is known as a full-mouth reconstruction. This means every tooth will have to be crowned. It is a very expensive procedure and only a handful of dentists have the training necessary to do it right.

Simple prevention now will save you a fortune.

Cavity or TMJ

As to your original question. The only real way to know if you have a cavity is to go in and have it checked. Your dentist will do x-rays as well as a physical examination.

The earlier you catch a cavity the better. A filling is better than a crown. A crown is better than an extraction and tooth replacement.

My recommendation is you go in to see your dentist and eliminate a cavity. From there find a TMJ dentist who will give you the proper solution for your grinding.

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

Dentist Said to Crown Instead of Veneer My Teeth

Posted on by .

I’m really disappointed right now. I’d been looking forward to getting my teeth re-done for a while. I’ve always wanted a pretty smile. I’d been saving up for four years. When I finally was sure I had enough, I went to my dentist. He said porcelain veneers don’t work and what I should get is dental crowns. I don’t want to get those. I have perfectly healthy teeth. Plus, I’ve seen some patients who’ve had crowns at my clinic and I’ve never been impressed with how they’ve looked. It’s not what I was hoping for with my new smile. Do porcelain veneers work?

Lucy

Dear Lucy,

a porcelain veneer being placed
Porcelain veneers are a great option for smile makeovers

Your dentist is wrong. Porcelain veneers work. In fact, they are the go-to procedure when you want a beautiful smile makeover. My suspicion is the reason your dentist is trying to steer you away from this is his lack of experience.

Doing smile makeovers isn’t something taught in dental school. Instead, a dentist needs to invest post-doctoral time studying them. In fact, the best dentists will always keep up with their field. You definitely don’t want a dentist who does the bare minimum of their required continuing education. You want a dentist who is passionate about their field and keeps up with the latest developments.

Getting Your Smile Makeover

If you want a beautiful smile, you’re going to have to go to a different dentist– one who has invested time studying cosmetic dentistry.

The trick here is there isn’t a recognized specialty in cosmetic dentistry, so anyone who calls themselves a cosmetic dentist is simply a general dentist who offers cosmetic services.

So, how do you separate the ones who do a good job from those who just get average (or worse) results? I’d start by looking at their smile gallery. This should be a page on their website which has before and after pictures of cases they’ve done. You may want to call and double check they’re showing cases the dentist has done and not just stock photos, though.

If you don’t like what you see there, move on. If you do like the type of results they get, take one additional step. Check their reviews. It’s always helpful to see what patients who have actually been to their practice think of the experience.

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