dental implant Archives - West Seneca Dentist

Should My Dentist Pay for My Bone Grafting?

Posted on December 23, 2022 by writeradmin.

About ten years ago, I had a tooth extracted. Recently, I went in because I wanted to see about replacing that tooth with a dental implant instead of the removable partial denture I’ve been using. My dentist told me there has been significant bone loss and I will need to have some bone grafting done in order to get the dental implant. Since then, I have learned that there was a procedure he could have done in order to preserve that bone, but he never did it or even offered it to me. Is it reasonable to ask him to cover the cost of the bone grafting?

Mandy

Dear Mandy,

I am glad you wrote. The procedure you read about is called an alveolar ridge preservation. Sometimes, it is referred to as a socket preservation. It is a form of bone grafting itself. Ten years ago, when you had your tooth extracted it was a new, emerging procedure. The materials were expensive and there was little research on its efficacy. I am not surprised your dentist did not offer it. Even today, not all dentists do the procedure.

Bone loss is common with tooth extractions. In fact, it is one of the worst side effects of having complete dentures. After ten years or so, patients with full dentures will have lost so much jawbone that they will not even be able to keep their dentures in their mouths, essentially making them a dental cripple. This is known in dental circles as facial collapse.

The only way to prevent this type of bone loss is by placing dental implants. These prosthetic tooth roots signal to your body that you still have teeth and, as a result, it would leave your bone intact. Once that bone is gone, it’s gone. However, in order to have a successful dental implant procedure, you will need bone for the implant to integrate with so it can remain securely retained.

I wouldn’t ask your dentist to cover the cost of your bone grafting, especially given that it was a brand new, unproven procedure at the time.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Dental Implants After Cancer Treatment

Posted on October 26, 2022 by writeradmin.

My sister has been undergoing cancer treatment and it has taken a severe toll on her teeth. She’s even ended up losing a couple. Would dental implants be a good solution for her? I want to get her the best care I can because she is pretty down on herself and how she looks at the moment.

AnnaBelle

Dear AnnaBelle,

It is wonderful that you are trying to help your sister out here. Cancer treatments, while they can extend or even save lives, do so by poisoning the body. It has severe side effects on every system, including your mouth. You could have had perfect teeth that never had an issue before and cancer will bring on tons of cavities and tooth loss. Make sure your sister knows the condition of her teeth is NOT her fault. Hopefully, her dentist has at least provided her with some prescription fluoride treatments to help her through this time.

Oral Issues from Chemotherapy

Changes in taste
Infection
Mouth and gum pain
Mouth sores
Peeling and burning tongue

These types of issues can make it painful to brush your teeth and almost impossible to floss.

Oral Issues from Radiation

Bone disease
Increased tooth decay
Infection
Jaw stiffness
Loss of taste
Mouth sores
Salivary changes (dry mouth, decreased saliva, swollen salivary glands)

In this case, the mouth sores, bone disease, and salivary changes are the most devestating to your oral health. Saliva is one of the most powerful things you have to fight decay. Bone disease can eat away at the bone which is supporting your tooth roots.

Dental Implants for Tooth Loss

Choosing dental implants was a great choice. They are by far the closest thing to having a healthy, natural tooth in her mouth again. You will want to find a dentist with post-doctoral training in dental implants. It will be especially important for your sister that adequate diagnostics are done, including a CT scan to ensure she has enough bone support to retain the implants.

If she’s lost too much bone, it is not a deal breaker, but it will require an additional step. Bone grafting can restore the lost bone in her jaw and enable her to get dental implants for her replacements.

Best of luck to both of you.
This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Diabetes and Dental Implants

Posted on December 30, 2021 by writeradmin.

I have Type 1 diabetes and wanted to get a dental implant for a tooth I am losing. My dentist suggested that I get a bridge instead because diabetes is a contraindication for dental implants. I just wanted to double check that a dental bridge is my best option. Money isn’t an issue.

Craig

Dear Craig,

I want to “correct” something your dentist said. Diabetes is not a contraindication for dental implants. However, it is a big risk factor. My guess is your dentist said that because he is not comfortable placing them. Do not pressure him to do it. If he is hesitant, he does not have the skill set you need.

Look for a dentist with post-doctoral dental implant training and a high success rate. It will be important that you have all pre-procedural diagnostics done, including a CT scan. These are important not just for proper placement of the implants but to ensure that you have enough bone to retain the implants. This is imperative for a successful outcome. You will also need extra precautions throughout the procedure.

If the dentist needs to refer you to an oral surgeon for the implant placement, it is very important that the dentist is the one who determines the placement of the dental implants and not the dentist. Do not let the oral surgeon tell you otherwise.

Follow those precautions and you should be fine.
This blog is brought to you by West Seneca Dentist Dr. Warren Krutchick.

Maryland Bridge as a Temporary Restoration?

Posted on October 12, 2021 by writeradmin.

I would love your advice. I have a 13-year-old son who has a lateral incisor that has always been missing. We’re done with the orthodontics to get everything in the right place. He’s currently too young for a dental implant, but that is what we want to get him eventually. We knew we’d need a temporary tooth replacement. Our dentist suggested a Maryland Bridge, but we’re having a heck of a time with it. Our dentist opted to use the ceramic wings but the next day the bridge fell out. He ordered a different kind of cement and we tried that, but again, the bridge fell out. Now, he’s talking about doing the metal wings. Here are my questions:
First, will the metal wings stay on better? Second, will the metal be visible through his teeth? He’s already self-conscious about his smile.

Monika

Dear Monika,

I think your dentist has good intentions but is in a bit over his head at the moment. One of the things he is struggling with is the bonding technique. The other is understanding the tooth preparation needed for a Maryland Bridge.

If you look at this image to the left, you can see that the tooth has a groove. This is necessary for proper tooth preparation with a Maryland Bridge. Because you didn’t mention it, I wonder if this was done.

Now, to answer your questions. First, will this stay on better? No. In fact, ceramic is a better choice when bonding to tooth structure. Metal does not bond as well. Given his struggle with the bonding technique as it is, I would not hold out much hope the metal will be the solution. Second, will you be able to see the metal through the tooth? Somewhat. It will darken his tooth. Instead of your dentist’s suggestion, I am going to recommend you go in a completely different direction.

Dental Flipper

I don’t consider a Maryland Bridge a temporary tooth replacement. This is because you have to change the structure of your son’s adjacent teeth to accomodate it with those grooves. Then, when it is time to remove the bridge, you’ll have to fill in those grooves with composite bonding.

I am going to suggest you get a dental flipper. This is a true temporary solution. No structural changes will have to be made. No bonding techniques are necessary for your dentist. And the best bit? It’s less expensive! A win-win.

By the way, your choice of a dental implant for him when his jaw is fully developed is a great choice. One word of caution. Make sure whoever you have to do his implant, has extensive post-doctoral training in implants. You don’t want someone inexperienced doing this. It’s a very advanced procedure.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.
Click here to learn about Holistic Dentistry.

Switching from Dentures to Dental Implants

Posted on September 29, 2021 by writeradmin.

I have had dentures for a little over ten years. I am in a better position financially right now and wondered if it was too late for me to switch to dental implants. I have hated my dentures this whole time and would love to get something better.

Maddie

Dear Maddie,

Implant Overdentures

It is never too late to get dental implants. That being said, because of the length of time you have been wearing dentures, you have lost some bone structure in your jaw. One of the side effects of long-term dentures use is what dentists call facial collapse. When your teeth were removed, your body recognized that and immediately began to resorb the minerals in your jawbone to use elsewhere throughout your body. It does this because it realizes you no longer have any teeth in your mouth, so it no longer has to support the roots of those teeth. In a conservation effort, it redistributes those minerals to places where they’ll be better utilized. This has the unfortunate effect of shrinking your jawbone. Usually, around the ten-year mark you will start to notice that your dentures are not as secure. Eventually, you won’t be able to keep them in at all.

That bone structure is necessary to retain the dental implants. This means you will need to have some bone grafting done in order to make sure your implants will be able to be retained. This is an outpatient procedure. Once you’ve had some time for healing, you can then move forward with your dental implants. Your dentist will place between four to ten implants. Once those have integrated with the bone, you will be able to have a new set of denture anchored to it. These are known as implant overdentures.

One of the first things you will notice is how secure they are. But there are other benefits as well. In addition to no slipping or sliding, you will see your chewing capacity go up dramatically. The biggest benefit, however, is that it will protect you from facial collpase. Your body interprets the implant fixtures as the roots of your teeth. As a result, it will keep all of the minerals for your jawbone in place.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Lost Half My Dental Implants

Posted on August 6, 2021 by writeradmin.

I had six dental implants placed in order to help secure some dentures which have been a bit of a nightmare to me. Now that has been its own nightmare. Since having them placed, half of them have already fallen out and it has only been a week. Given this information, I have some questions:

1. I have already paid for all six. Should I expect a refund on the ones that fell out?
2. Should I be concerned about the remaining three?
3. Am I doomed to just having removable dentures?

Gary

Dear Gary,

Implant Overdentures

Wow! This is definitely going in my dental implants horror story file. Under normal circumstances, dental implants only have a 5% failure rate. Even then, the failure usually takes place after a year or so. Your dentist managed a 50% failure rate in under a week. I’d say that is impressive in the worst way possible. There are many ways a dental implant can fail. I’ll list some of them below and then go over some steps you need to take.

Reasons For Dental Implant Failure

Development of infection. In fact, infection is one of the leading causes of dental implant failure.
Diagnostic shortcuts. It is important for a dentist to check whether there is enough bone support to retain the dental implant. If there is not, a bone grafting procedure can build up the bone in order to help you get the dental implants you want.
The use of substandard implant fixtures. Some dentists will purchase cheap dental implants from outside the United States in order to keep their prices low while still keeping their profits up. The problem is these implants often fail.
Incorrect placement of the implant. Dentists and oral surgeons can make a mistake in where they place the implant. One thing to note is if you have to see an oral surgeon to do the surgical part. Make certain it is the dentist and not the surgeon who decides where the implant fixtures will be placed.
Premature loading. This is when your dentist place the dental crown on the implant before it has had time to integrate with the bone completely.

You will need to be examined by someone with expertise in placing dental implants in order to give you some idea why this dental implant failed. As to the answers to your questions, 1. Yes, you should definitely expect a refund on your failed dental implants. In fact, I would ask for a refund on the entire case. 2. Yes, you should be concerned about the remaining implants, which is why I’d like you to get a full refund. 3. You are not necessarily doomed to wearing removable dentures. However, I would not allow this dentist anywhere near your mouth again. Find someone with good post-doctoral training and a high success rate to do the repairs.

You will need a bone grafting procedure in order to make this work. The dental implants that failed will have taken some bone structure with them. That structure will need to be rebuilt in order for you to have a successful case.

This blog is brought to you by West Seneca Dentist Dr. Carl Embury.

Half My Implants Fell Out the First Week

Posted on September 16, 2020 by writeradmin.

I had four dental implants placed this week and two of them have already fallen out. I paid for half the procedure upfront. Should I have to pay the other half with them falling out? Also, is there a way to get this fixed?

Pamela

Dear Pamela,

Should You Be Expected to Pay for those?

No. A pretty basic expectation of dental implants is that they remain in place. According to the National Institute of Health, the failure rate of dental implants is around 5% or less. Your dentist has lost 50% already. To top that off, they fell out in just a few days, not months as normally happens. There is some other factor going on here that needs to be addressed. I’m concerned the other two dental implants will fail as well.

Causes of Dental Implant Failure

Infection. This is often accompanied by fever.
Inadequate bone support, which should have been diagnosed ahead of time.
Substandard implant fixtures. This happens when dentists try to save money buying implants overseas.
Poor placement skill on the part of the dentist.
Putting the crown on the implant before the bone has integrated. This is known as pre-mature loading.
Rejection by the body or medical issues the patient has. These are rare when proper diagnostics are done ahead of time, but can happen.

Where to Go From Here

I want you to get a second opinion from another dentist. Make sure they have post-doctoral training in dental implants and a high success rate. They shouldn’t be offended by those type of questions. If they are, they are likely unqualified. Another thing is to make sure it is a blind second opinion. That means you won’t tell them who did your dental implants, just that you have lost half of them and want to know if they can tell why and the viability of the two remaining implants.

Once you have that, you will be armed with the resources to get this fixed. It is very likely he or she will tell you they are all going to fail. In this case, I don’t just want you to ask for a refund. Instead, you need to have your dentist pay to have this fixed with a dentist of your choosing.

The reason for that is the repair will cost more than the original procedure. This is because it will require an additional procedure. When the implants come out, they leave a hole in the bone, which has to be built back up in order to support any further implants. This is done with a bone grafting procedure.

This blog is brought to you by West Seneca Dentist Dr. Warren Krutchick.

Teeth are Falling Out — Are Dental Implants the Answer?

Posted on June 15, 2020 by writeradmin.

I have an issue lately with my teeth coming loose and falling out. I don’t understand. They don’t have many cavities. I’ve been reading about dental implants. Will they be a good solution for me to have teeth again?

Bernie

Dear Bernie,

I’m very sorry you are going through this. If your teeth are falling out, that means you have substantially advanced periodontal disease, commonly called gum disease. It’s bad enough that it has started eating up the bone structure that supports your teeth. If this gets much further, you will not only lose all your teeth, but will also risk an infection in the bone itself, putting your life at risk. It’s time to see your dentist. He will set up a schedule to get the gums in shape. Depending on the severity, he may feel you need to see a periodontist.

Dental Implants

While dental implants are the top of the line tooth replacement option, they do require healthy gums. As you can see from the picture above, the dental implants will need bone to integrate with it the way they do with the roots of your teeth. If you don’t have enough bone support, the dental implants will fall out just the way your teeth have.

what you’ll need to do is get the gum disease under control. Then, when that is sorted, dental implants will be a fantastic option. Until then, you’ll need to look at some temporary replacements, such as removable partial dentures. What you don’t want to do is just give up on the gums and teeth and get dentures.

The Danger with Dentures

On the right is a woman before facial collapse. On the left is her jaw after facial collapse.

When your teeth are removed, your body recognizes that and immediately begins to resorb the minerals left in your jawbone to use elsewhere in your body. Before you know it, there is no longer enough bone there to even retain dentures. In dental circles, this is known as facial collapse. Not only will this age you in appearance by over a decade, but you will find it impossible to eat all but the softest foods.

Dental implants prevent this by acting as prosthetic tooth roots, signaling to your body that those minerals are still necessary and leaving your bone intact.

This blog is brought to you by West Seneca Dentist Dr. Warren Krutchick.

Dentist Won’t Give Me Implants because of Gum Disease

Posted on May 13, 2020 by writeradmin.

I’ve lost quite a few teeth due to gum disease. I’d like to get dental implants, but my dentist says I can’t because I have advanced gum disease. Instead, he says I have to get removable partial dentures. I’d really rather have the implants to feel like I have secure teeth again. Do you know of any way around this?

Bud

Dear Bud,

While your dentist is technically correct, I hope he meant that you can’t get dental implants right away. First, you’ll need to get your gum disease under control. It is a serious issue and you will continue to lose teeth. I want you to take a peek at the image below. Notice the dental implant is surrounded by bone. It is this bone that held in the roots of your teeth until your gum disease advanced too far and led to severe bone loss. This is why your teeth fell out. They had no support.

Dental implants require that same bone support. While you have a good goal, if you have the implants placed prematurely they will fall out. Infection and inadequate bone support are both leading causes of dental implant failure.

There is Still a Chance for You to Get Dental Implants

If you’re willing to work and do an additional procedure, you can still have the smile you want with dental implants. The first thing you’ll need to do is see a periodontist. They specialize in gum issues and can help you obtain healthy gums again.

Once your gums are healthy, you will likely need to have some bone grafting done in order to build back up the bone structure you’ve lost. Then, you will be a candidate for dental implants. In the meantime, removable partial dentures will be a decent temporary replacement.

Who Should Do Your Implant Procedure?

This is an advanced procedure and not every dentist is qualified to do it. You want a dentist who invests in significant post-doctoral training. For instance, in Dr. Krutchick’s state of New York, a dentist is required to take 10 hours of continuing education per year. That amounts to 200 hours in a ten year period. Dr. Krutchick was honored for taking 2,000 hours. That is ten times the amount required. That is the type of dentist you want to do your implants…or any other big procedure for that matter.

This blog is brought to you by West Seneca Dentist Dr. Warren Krutchick.

Metal Allergies and Dental Implants

Posted on March 19, 2020 by writeradmin.

I have need of a dental implant for a lateral incisor I’m losing. The problem I have is I’m horribly allergic to most metals. I can’t even wear watches or anything with metal that would contact my skin, like buttons. Does this mean I need to get a dental bridge? I don’t like the idea of grinding down tooth structure unnecessarily. Maybe there’s another procedure I don’t know about?

Kaylie

Dear Kaylie,

I have fantastic news for you! You have two very good options that will not require a different procedure. Dental implants are possible for patients with dental allergies.

Option One: Titanium Implants

While titanium is a metal, it is very biocompatible and it is extraordinarily rare to have an allergy to it, even among those with metal allergies. However, if you’re worried, your doctor can arrange to test you specifically for a titanium allergy. If you are not allergic you can go ahead and get the titanium implants.

Option Two: Zirconia Implants

These are metal-free and made from zirconia, which has been nicknamed ceramic steel. It is strong enough to replace a tooth root. Not all dentists are working with the materials yet. If it turns out you’re allergic to titanium, you may want to look for a dentist who has extensive training in dental implants, who also considers themselves either a metal-free dentist or a holistic dentist.

Titanium Versus Zirconia Implants: Which is Better?

It isn’t that one has been definitively shown to be better than another. If that is the case, why aren’t more dentists availing themselves of the metal-free option? The answer is simply that the titanium implants have been around longer. That means we have hard data on their longevity. One day we may have that same longevity on the zirconia implants. We may even discover they’re better than their metal counterparts. Until then, each dentist has to decide for themselves which they’re comfortable using with their patients.

This blog is brought to you by West Seneca Dentist Dr. Warren Krutchick.