Dental Implants While Using Fosamax

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I had to have a lateral incisor removed. I wanted to get a dental implant, but my oral surgeon said that I might want to consider something else like a dental bridge because I am on Fosamax. Do you know if I should get something like an Encore Bridge or a Maryland Bridge. I don’t know if I can have a normal bridge with the anchor tooth being a front tooth. Are you aware of situations like this? I will admit that I am disappointed about the dental implant. But, what can’t be helped, can’t be helped. I need to figure something out, though, because I am using a dental flipper right now and hate it.

Percy

Dear Percy,

An image of both titanium and zirconia dental implants

I have some good news for you. If you really want a dental implant, it is possible with some precautions taken and an understanding of the risks. First, the risks. There is a slightly increased risk of bone problems when you have oral surgery while on Fosamax. While I said a slightly enhanced risk, don’t discount the risk because if they happen, they will be serious. A way to get around this is to temporarily suspend taking the Fosamax for the surgery and then resume it at the appropriate time. It would take coordination between your dental implant dentist and the oral surgeon. Also, make sure it is your dentist who plans the dental implant placement and not the oral surgeon.

If you decide you do not want to take the risk with the dental implant or suspend the Fosamax, then a dental bridge is your next best option. I would let your dentist choose which type of bridge, though. This is because you want him or her doing the type of bridge that they are the most comfortable with. That way you know they are skilled at doing it. You can get a regular bridge. A front tooth has been used as an anchor tooth many times. Though, obviously, the dental implant is the better option.

One other consideration. If you are unhappy with the color of your teeth, the time to get teeth whitening done would be before you get either the dental implant or the bridge. This is because the color of your dental crown cannot be updated once it is completed. This way the crowns can be made to match the updated color of your teeth.

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

Replacing Congenitally Missing Lateral Incisors

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My daughter has congenitally missing lateral incisors. Now that she is starting high school, she is quite embarrassed by her baby teeth when she smiles. Our dentist suggested that we extract her teeth and get braces to close up the space. I am afraid that will look weird. Can you tell me if there are any other options?

Dolores

Dear Dolores,

a smile with missing lateral incisors

Missing Lateral Incisors

 

I am glad you wrote. Your dentist is giving you very bad advice. I’m glad you picked up on the fact that it would look quite weird if you followed through with his guidance. As you can see from the image above, this girl had done what your dentist is suggesting for your daughter. As you can see, it does not look normal. In fact, it looks downright vampiric.

The baby teeth do need to come out, but I don’t suggest you use traditional braces. Instead, I think your daughter would be more comfortable with Invisalign. These use clear aligners. None of her friends will even know she is having her teeth adjusted. Then, once the space is opened up enough to fit adult-sized teeth, you can get her the replacement teeth she needs.

 

invisible braces

Invisalign Invisible Braces

 

The best tooth replacement is a dental implant. However, you will have to wait until her jaw is fully developed for that. In the meantime, she can use a temporary tooth replacement in order to hold the spot open for when she is ready for something more permanent. A dental flipper is inexpensive and will serve her well until she is old enough for the dental implants.

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.

 

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.

Tooth Replacements for Hockey Players

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Can you tell me what the best tooth replacement is? I’m a hockey player and have lost two teeth this season. I want something pretty sturdy in case I get hit in the mouth again. This just hasn’t been my season.

Bran

Dear Bran,

hockey player with a missing tooth

I am sorry to hear you have been having a rough season. Hockey is a tough sport as it is. When it comes to replacing teeth, the usual answer is the best tooth replacement option is a dental implant. However, your circumstance is a tad more complicated than most because your replacement tooth is likely to get hit again.

A dental implant is the premiere tooth replacement because it mimics your natural tooth’s engineering with a root form and a crown. However, when you break a tooth you are not as likely to take the root of your tooth with it. A dental implant, because of the way they are bonded with the crown is the opposite. If you lose the crown there is a good chance the implant will do some damage to your surrounding bone. We don’t want to risk that.

However, you do want the root form there in order to ensure you don’t start having bone resorption in the area, which will make it harder to get an implant later.

My suggestion is you have the root form of the implants placed, which will preserve your bone in that area, but delay the dental crowns until you are done with your hockey career. Some dentists even do same day crowns, which will speed that process up when the time comes. That doesn’t mean that you have to keep gaps in your smile.

I’d like to suggest you get something inexpensive, such as a dental flipper. These can fill in the gaps, but will come out easily if you are hit in the mouth again. This way there is no serious damage done to your jaw, which could require reconstructive surgery.

Best of luck to you and I hope next season is a winner for you!
This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Should I Wait Until COVID-19 Passes to Get a Tooth Extracted?

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I’ve had a fractured tooth but was putting off getting the crown. Now there is an abscess. I heard we’re supposed to put off dental care until after the quarantine is over. Do I wait on this? I’m absolutely miserable. Now my face is starting to swell. Can I just take antibiotics? What is your recommendation?

Pam

Dear Pam,

Woman holding her jaw in pain in need of an emergency dentist.

The directive is to avoid the dentist for routine procedures, depending on the state in which you reside. However, in this case, you are not dealing with anything routine. This would be in the category of emergency dental care. I wouldn’t put off getting this dealt with. Your face is already swelling, which means it has spread past your gums. If it reaches your heart, lungs, or brain it will become life-threatening quickly.

Antibiotics and Dental Infections

As for using antibiotics as a solution without seeing the dentist, that won’t work. They are used as a temporary means of getting the infection under control, but will not rid your body of the infection completely. Instead, you’ll feel better for a while, but when the antibiotics are completed, your infection will blow back up. This is because as the infection spreads through the pulp of your tooth, the pulp dies and is no longer receiving any blood flow. Without blood flow, there is no way for the antibiotic to reach the root causes of the infection.

The only true way to remove a dental infection is for the dentist to go in there and physically removed the infected tissue. There are two ways to do this. The first is with a root canal treatment. The dentist will remove the infected pulp and usually cover the tooth with a crown because it will become brittle and need protection. The depth and location of the fracture on your tooth may determine whether or not this is a possible solution for you.

Your second option is to have the tooth extracted. However, that complicates the issue because you’ll need to replace that tooth. The ideal replacement would be a dental implant. Given the current pandemic, you’d likely have to wait on that until things calm down. You can temporarily get a dental flipper to hold it in place.

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

Dental Flipper for Straight Teeth?

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I have some crooked teeth. One of them sticks out more than the others as well. I don’t want to spend years in painful and ugly braces. I’d be happy if they just looked straight. Would a dental flipper work for me in that case?

Danae

Dear Danae,

In your situation, you have two good options and one so-so option; however, a dental flipper isn’t one of them. This is used as a temporary tooth replacement. It won’t make any of your other teeth look different.

Options for Straight Teeth Without Traditional Braces

Option One: Snap-on Smile

image of snap-on smile

This is the so-so option I mentioned above. It may be what you were thinking of when you said a dental flipper. Snap-on Smile fits over your teeth and will make them look straight. They are not going to be a stunning smile, though. They’ll just be okay. Also, because they fit over your teeth, they can look a bit bulky. This will especially be an issue for you because you have a tooth which you said sticks out.

Option Two: Porcelain Veneers

A single porcelain Veneer being placed on a tooth

Porcelain veneers will also cause your teeth to look straight without actually straightening them. When done by a skilled cosmetic dentist, they can provide you with a stunning smile makeover.

This is the go-to procedure for celebrities who want that Hollywood smile. They’re quite versatile and can change the shape, size, and color of your teeth simultaneously.

Option Three: Invisalign

a side by side comparison of traditional braces and Invisalign on someone's teeth

Braces compared to Invisalign

These will actually straighten your teeth. Using a sophisticated software program that carefully plans out your treatment, they can work in about half the time as traditional braces. Another benefit is their comfort. You won’t have to wear any painful metal wires and brackets.

Plus, they use clear aligners which are invisible even at a conversational distance. Because of that, some people call them invisible braces. Unlike porcelain veneers, you won’t need an expert cosmetic dentist. Any dentist who has invested in the technology can provide them for you.

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

How Long Until a Dental Implant Can Be Placed?

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I’m trying to make some big decisions about a tooth. I had a dental crown done months ago which my dentist now thinks probably should have had a root canal treatment done, but now that there’s a crown it can’t be. He’s suggesting pulling the tooth and doing a dental bridge. I’m getting a second opinion to see if there is another option. I think if I do have to lose the tooth, I’d rather get a dental implant. However, I’ve just now gotten dental insurance and all procedures require a one year waiting period. Will my teeth start to shift in that long of a time period?

Kevin

Dear Kevin,

An image of a dental implant crown being placed in three stages

I’m a little concerned about the dentist you’re seeing. If you need a root canal treatment, you need one. It doesn’t matter if you have a crown. Saving the tooth is the priority. I’m glad you’re getting a second opinion. If at all possible, a tooth should be saved.

I also agree that a dental implant is a better option than a dental bridge, especially for a single tooth. To get a bridge would require both adjacent teeth be ground down for dental crowns. This is a waste of healthy tooth structure.

I’m not sure your dentist is looking out for your best interest as much as what is most convenient for him.

Getting a Dental Implant

Worst case scenario, your tooth has to be extracted. With a waiting period, my suggestion is you get a temporary replacement, like a dental flipper, until the waiting period passes. Even if you were to get the dental implant surgery right away, there is still a waiting period while the surgical site heals and the bone has time to integrate around the dental implant.

Once the healing is done, your dentist will place a dental crown on the implant. It’s like having a healthy, natural tooth again.

Dentists will place something there to hold the space open, just like you can do while you wait on your insurance.

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