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.

MRI and Dental Implants

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I have severe shoulder pain. The next step in finding out what is wrong is for me to get an MRI. I was so relieved we were getting a test that might get to the bottom of it, that I didn’t even think about what it means with me having a dental implant. I know it is made of metal and that is a bad idea for MRIs. Do I need to cancel the test? If so, is there another test I can use to get to the bottom of this pain issue?

Martha

Dear Martha,

illustration of dental implants being placed.

You have asked a great question. The good news is you will be safe to have an MRI, even with a dental implant. It helps to understand how an MRI works. After creating a strong magnetic field, it then uses radio waves and digital software to obtain cross-sectional images of the soft tissue of your body. The danger comes when you have ferromagnetic material in your body.

Dental implants are either made of titanium or zirconia. Most patients are not worried about zirconia because they are metal free. You mentioned yours were made of metal which would mean that they are titanium. Thankfully, titanium is not ferromagnetic. That means you are perfectly safe to have an MRI to find out what is going on with your shoulder.

I hope you get answers soon and can get out of pain. This is one less thing you have to worry about as you look for a prognosis.

This blog is brought to you by Marietta 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.

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.

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.

CT Scans and Dental Implants

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I had a tooth that was lost and am replacing it with a dental implant. My dentist wants to do a CT scan, but I feel like we’ve had enough x-rays at this point. Is the CT scan really necessary?

Penny

Dear Penny,

dental implant diagram

I would recommend you get the CT scan. One thing to be aware of is that a CT scan takes 3-dimensional images. This is important. Your mouth, jaw, and nasal cavity are not flat, like traditional x-rays. Think of it as the difference between a photo and a sculpture.

We get countless inquiries from other dentist’s patients who had their sinus cavity penetrated during the dental implant placement. This is a real risk which is totally preventable. Some dentists try to save money, thereby having lower prices than the next dentist, by skipping the CT-scan. These are often the dentists who end up making an error in judging the depth available to the implant. Some try to get away with this problem by using shorter implants. The problem is those rarely last as long and the patient won’t know why it failed.

If you are going to invest in the best tooth replacement, you want to make certain it has the tools to give it the greatest chance of success. Shortchanging yourself on diagnostics will sabotage those efforts.

There are quite a few causes that lead to dental implant failure. One of them is poor placement on the part of the dentist. Another is poor bone support. This is another issue that can be prevented if proper diagnostics are made.

As you can see from the image above, your dental implant is surrounded by bone. In order for the implant to stay in place, it has to integrate with that bone, which essentially grips it and holds it in place. Without adequate bone, the implant will come loose and fall out.

When you lose a tooth, your body immediately begins resorbing the minerals in the bone where the tooth was. It does this in an attempt to be as efficient as possible with your body’s resources. Depending on how long between the time you lost your tooth and the replacement, you could lose too much bone. For patients who get dentures, this ends up being devastating and ends in facial collapse.

I know it is tough when you have the option of not doing a diagnostic. However, if you were going to skip something, this would not be the test I would skip.

What if you have the CT scan and your dentist tells you that you do not have enough bone support? The good news is that doesn’t mean you cannot get dental implants, you will just need to add one quick additional procedure, bone grafting. This is an outpatient procedure that will build back up the missing bone, enabling you to get the support you need for your new tooth replacement.

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

Is a Maryland Bridge a Good Temporary Restoration?

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My teen daughter has a genetically missing tooth. We’ve had orthodontics done. Our plan when she is old enough is to place a dental implant. In the meantime, we need a temporary replacement. Our dentist suggested a Maryland Bridge. He prepared the teeth and placed the Maryland Bridge. We decided on ceramic wings so they would blend more naturally with her teeth. But, two days later it fell out. Now they are talking about using metal wings. Will this be any better? Will the metal show through? Also, does it damage her teeth to put it on and off later when she gets her dental implant?

Flo

Dear Flo,

Maryland Bridge

Maryland Bridge

First, let me say that choosing a dental implant for your daughter’s permanent replacement is a great idea. It will give her a stable replacement for the remainder of her life. I am less enthusiastic about the “temporary” replacement they chose. My first issue is anything that requires preparation for a tooth or changes the structure of the tooth should not be considered a temporary replacement.

Tooth prepped for a Maryland BridgeHere are the problems your dentist is facing with the Maryland Bridge. The reason the one with ceramic wings fell out is because of inadequate preparation. If you look at the image on the left, you can see a grove in the tooth. In addition to the light preparation your dentist did, this groove would be necessary in order to keep the bridge more secure. That is a permanent structural change to her tooth.

As for whether the metal will be any better, it is actually a worse solution. Metal doesn’t bond to teeth as well as the ceramics. Plus, as you suspected, it will show through the color a bit. The bigger problem here is your dentist probably didn’t do adequate preparation. This is actually going to work in your favor because there hasn’t been too much damage done to her tooth yet.

My suggestion would be to forgo the Maryland Bridge and get a dental flipper. This should have been what they recommended to begin with. It’s much less expensive and will do no damage to your daughter’s tooth.

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

Will Medical Insurance Cover My Dental Implants

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I’ve lost quite a few teeth over the years, several not replaced, and have three dental bridges, all of which are over 30 years old. Because of this, I’ve had a hard time eating. I’d like to replace everything and get a dental implant denture. Will my medical insurance cover this because it is affecting my health?

Stephanie

Dear Stephanie,

Implant Overdentures

Dentists get this question a lot. While it is true that not having teeth affects your overall health, medical insurance almost always has a dental exclusion in their policies. This is unfortunate because while many people have health insurance, not nearly as many have dental insurance. All that being said, you need teeth. If you’re removing or lost all of your teeth, the best replacement would be dental implants. It sounds like you already know that though. What you may not know is how important they are.

Once your teeth are gone, your body senses there are no longer there. Always striving to be efficient with its resources, it will then resorb the minerals, which your jawbone no longer needs to support your teeth, in order to use them elsewhere. Unfortunately, this begins to shrink your jawbone. In as soon as ten years, you’ll start to notice it is hard to keep your dentures in. A short time after that and it will become impossible. This is known in dentistry as facial collapse. Once this happens, you won’t even have denture teeth to eat with. Talk about impacting your health!

The solution to this is having implant-supported dentures, as you’ve expressed. The dental implants signal to your brain you still have teeth. Because of that, it leaves the minerals intact, thereby protecting your jaw.

Paying for Implant Supported Dentures

While your medical insurance won’t cover the cost. There are some ways to make this easier. First, most dentists don’t make you pay for the whole procedure upfront. Instead, you’ll cover the surgical part first. Then, when you’ve had time to heal and the bone has integrated with the implants, your dentist will then do the denture and you can pay the second part.

I realize, for many people even, that can be challenging. Some dentists let you pay it out as you go. Those who don’t almost always offer Care Credit, which is a medical credit card. They’ll pay for your procedure upfront and then you pay them out. They have low-interest payment plans and you get to choose which plan you go with.

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