Archive for the ‘Dental Implants’ Category

Clear Choice was not my best choice

Saturday, January 30th, 2010

I had all of my teeth extracted a year ago, and need dental implants. I visited a Clear Choice Dental Implants Center near me for a consultation, and I wanted to write and share my experience, to see if other people have had similar experiences, and to warn other potential patients about what to expect.

Everyone at the facility was very nice, and very professional. After an assessment, they told me I was the perfect candidate for dental implants. They quoted me a price of almost $55,000 to do full upper and lower dental implants, which really shocked me! I expected the price to be quite a bit lower, as all of my teeth are already extracted, but they told me that they do not charge anything for the extractions when they are part of the implant procedure. That sounded kind of weird to me, especially because another facility I talked to quoted me at almost half the cost, WITH extractions.

I did not qualify for the financing for the $55,000, so I left the clinic without setting up anything further. Six months later, I let them talk me into a return visit, under the pretense that they could (their words) “significantly reduce” the treatment costs. When I arrived, I discovered that what they ACTUALLY meant was that they wanted to submit my information to a different lending agent, for the full amount of the initial quote. What a waste of my time! I was very upset, and felt that they had deliberately misled me.

Clear Choice has a reputation for using top of the line materials and surgeons, and that is one of the reasons I wanted to talk to them in the first place. But they have priced themselves right out of the market for most people. Dental insurance companies consider them a cosmetic treatment, even when you really need them to restore you ability to eat and communicate normally, and will probably never cover even part of the costs. Even if I had perfect credit and could qualify for the payment plans, what if I lost my job? I just can’t imagine a day when I could justify spending more than a year’s wages, even for something this important.

I know dental implants are the treatment of choice for people in my situation, but I guess I will have to figure out how to make do with dentures. Clear Choice made it clear that they offer NO choice at all.

Britta in Waco

Dear Britta,

You letter says more than I ever could about making good choices for your dental care. I hope you don’t give up! Seek another opinion.

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I need a dental implant to replace an extracted tooth. How long can I wait?

Monday, January 18th, 2010

Hello-
Last month I had a tooth removed, and it seems like the teeth around the space look different now. There are wider gaps between the surrounding teeth and their neighbors, but I can’t believe my teeth could shift in just a month. Should I check with my dentist? We have not set a date for when I will get a dental implant, as I am trying to save up the money to pay cash for it.
Thanks for your help,
Jane from Kissimmee

Dear Jane,
You are right to be concerned. Your teeth almost certainly have shifted in the month since you had your tooth extracted, and you should talk to your dentist about getting a replacement of some kind in as soon as possible. Even a temporary removable partial denture (called a flipper) would be better than nothing.

Spacing issues are the most visually obvious consequence of a missing tooth, but you should also know that the opposing tooth (the tooth that “lines up” with your missing tooth in the opposite jaw) will super erupt in an effort to meet up with the missing tooth. The changes in spacing and in your bite due to shifting teeth could easily cause you to start experiencing problems with your temporomandibular joint, commonly called TMJ.

As you can see, even one missing tooth can have a profound, cascading affect on your overall oral health. Talk to your dentist as soon as possible about alternatives to prevent any more shifting.

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I need an implant, but want to wait.

Tuesday, December 15th, 2009

One of the molars in my lower jaw is going to have to come out. My dentist and my endodontist say there is no help for it, because it has decayed below my gumline. My budget is tight, so I don’t want to get an implant right after the tooth comes out. How long can I wait?

Lily from Tulsa

Dear Lily,

You’re making a good choice to replace your missing tooth with a dental implant. While you do need to give the infection in the socket time to heal, you should not wait too long to get the implant placed.

When a tooth is removed, the teeth that surround the empty socket start moving into that space in just a couple of weeks. The neighboring teeth begin to tip in. The corresponding tooth in your upper jaw (the one that would line up with the missing tooth with your mouth closed, called the “opposing tooth”) will super-erupt. That means that it will grow to try and meet a tooth that is no longer there. These are all natural tooth movements. Your teeth naturally shift so that they are touching each other, and so that they meet when you bite down. That missing tooth can really cause serious problems that could turn into headaches, TMJ issues or serious bite discrepancies. If you let the situation continue too long, your cost to fix the problem goes up a lot. I strongly recommend that you don’t put this off.

Another thing to consider is that the root form of the implant will need time to heal and become integrated with the bone of your jaw. This can take several weeks, on top of the healing time for the infection. In the meantime, then, your dentist should give you some kind of temporary partial denture (called a “flipper”) to wear to keep your other teeth from drifting. When the surgical site has healed, your permanent crown can be placed on the root form.

If you would like to read more about the dental implant procedure, see our website page on dental implants. We also have a page that talks about dental impants vs. bridges that you might find helpful.

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Dental implants and dental insurance

Tuesday, July 28th, 2009

It’s looking like I may need dental implants. But they’re kind of expensive. Will dental insurance help pay for them?
- Gary from Pennsylvania

Gary,
Most dental insurance plans will provide coverage for dental implants, but not much coverage. Their interests are different from your interests. Your interests are to have a restoration that will prevent your jaw from shrinking because of missing teeth, and providing the maximum comfort and function for yourself. Their interest is in saving money and increasing their profitability, which is understandable. So they will usually pay a percentage based on the least expensive option for replacing missing teeth, which is generally a removable appliance. Removable appliances are the most uncomfortable dental restoration, but they consider that your problem, not theirs.

Related links:
Read about the pros and cons of dental implants vs removable partials
Dr. Goldstein discusses the options for replacing missing teeth

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My dental bridge didn’t last

Saturday, July 18th, 2009

I had a bridge replacing one tooth, and it had two more teeth attached. This was done in 2004. In 2007 it came off and my dentist recemented it. Now, in July 2009, it has come off again but he has told me that the tooth that has the crown is dead and I have to surgically have it removed because it is brittle.

Did the crown cause this? What do I do with three teeth missing now? He suggested implants. What do you suggest? HELP. It is very noticeable when I smile.
- Debbie from Wisconsin

Debbie,
If you take good care of a dental bridge, it should last for many years. Five years is a minimum standard set by many insurance companies – if it doesn’t last for five years, they won’t pay any benefits on its replacement. I’m wondering why the bridge came loose after only three years, and why now, after only five years in service it appears to have failed.

I think a second opinion would be a good idea.

But your case illustrates one of the advantages of replacing missing teeth with dental implants. When you have a bridge, there are three teeth involved. If there is any problem with the bridge, you have to re-treat all three teeth. With a dental implant, you don’t touch the adjacent teeth, and the maintenance and long-term care is simpler.

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How should I have a molar replaced?

Monday, June 15th, 2009

I am 55 years old. I had the upper right (next to last tooth) molar removed due to multiple cracks in the tooth. The missing tooth is not noticeable as it is so far back but I’m concerned about the shifting of my upper teeth. I have perfectly straight teeth at this time. None of the tooth replacement options seem ideal to me. What would be your recommendation?
- Denise from Pennsylvania

Dear Denise,
You’re smart to be concerned about the possible shifting of your teeth, because this is a serious issue, especially if you are missing a first molar (that’s the tooth that is second from the back in most people). The teeth on either side tip into the space and the tooth below usually drifts upward some, and it can really mess up your bite. It can cause TMJ disorder and muscle spasms in your chewing muscles because your bite which is supposed to be harmonious doesn’t mesh properly any more. In addition, it can promote loss down the road of the tipped teeth, which are now subject to unnatural stresses. It’s important to get a missing molar replaced before these teeth start to move, which occurs in a matter of weeks.

Of the two replacement options, having a dental implant is the nearest thing to having your own tooth back. The drawback of that is that it is a surgical treatment. But if the teeth next to the missing tooth have large restorations, it would make sense to do a dental bridge, since that will put dental crowns on those teeth, which may be close to needing crowns already anyway.

The most unattractive option is doing nothing, because that could lead to serious other problems down the road.

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Can I get Lumineers when I have a missing tooth?

Saturday, April 11th, 2009

Dr. Goldstein,
I am missing both my lateral incisors. Right now I have a retainer with two fake teeth on it. I wanted to get Lumineers but I don’t know if I can with this retainer. I want the Lumineers to make my smile more full and warm.

- Amanda in New York

Amanda,
Lumineers won’t really work if you have missing teeth – they only work to cover existing teeth. But the good news is that you have a couple of other options, depending on what you want to accomplish.

If you want to change the shape of your existing teeth, then what would probably be best is to have a couple of dental bridges to replace the missing teeth. A dental bridge involves full crowns covering the two teeth adjacent to each missing tooth. If the missing teeth are the lateral incisors, that would mean you would have crowns on both central incisors, the lateral incisors would be false teeth, and the canines would both be crowns. So you would have a whole new smile.

But if you like how the other teeth look and you just want to replace the missing ones so that they blend in with the others, then your best bet would probably be dental implants. That is much more conservative, because nothing would have to be done to your other teeth.

With either treatment, I would recommend teeth whitening first or your remaining teeth, so that you can have the brightest and loveliest smile possible. Then match the new dental work to the new, whiter color. But be sure you go to an excellent cosmetic dentist who is really artistic. Most dentists aren’t really that artistic.

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A bridge or a removable partial denture?

Tuesday, January 27th, 2009

Dr. Goldstein,
Is a 4-tooth bridge or a partial denture for the upper molars better? Which is less costly? What is the least expensive type of cap or crown available that won’t be seem?
- Judy from Illinois

Judy,
You would need a four-tooth dental bridge if you have two missing teeth, side-by-side. In a situation like this, a bridge would be better than a partial denture, and here is why:

The full name would be a “removable partial denture.” This is where false teeth are fastened to a plate, which is then clasped to your teeth. Not only can this be uncomfortable, but if you don’t take great pains to clean them after every time you eat, it can easily promote decay on the spots where the partial attaches.

But you left out the option that I think is really the best, and that is dental implants. Especially if you have two missing teeth side-by-side, the bridge has a drawback in that it now places all the stress for four teeth onto the two teeth that the bridge is attached to. But if you have dental implants, there is no grinding away of those adjacent teeth, and no extra stress put on them. And the implants will require less maintenance and probably a lower risk of failure or complications down the road.

Cost is another issue. Depending on your dentist, the fee for the dental implants and for the bridge are going to be close to the same, or the implants may be somewhat higher. The removable partial will be much cheaper, at least in the short run. It will probably be around half or even one-quarter of the cost of the other options. Of course, if the teeth that are clasped are eventually damaged and then you lose those or need to have them crowned, the removable partial could be the most expensive option in the long run.

Related information:
Click here to read about porcelain veneers.

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My gums are bad. What are my options?

Thursday, October 23rd, 2008

I recently visited my dentist who told me that I have gum disease and if I don’t get dental implants my teeth will eventually fall out. I have an upper partial and I’m also missing some of my lower teeth. He told me it is useless to get my gums fixed if I don’t fix the problem with my teeth. The cost will be between 50 and 70 thousand dollars. I don’t have that kind of money but I also don’t want to get the rest of my teeth pulled and have all dentures, something that I’m considering. There must be other alternatives out there that I’m not aware of. If you can help me with some information I would be very grateful.
- Sheila in Alberta

Sheila,
I’m not sure I understand why your teeth would fall out if you don’t get dental implants. Dental implants are used to replace teeth that are already missing. If I knew more about your case maybe I would understand the connection between the dental implants and your teeth falling out.

And the cost of $50,000 to $70,000 sounds high. I’m confident there must be other options for you. I’d recommend that you visit another dentist or two and get another opinion. But to insure that you get an unbiased second opinion, don’t tell the second dentist anything about what the first dentist wants to do.

I wouldn’t recommend that you have your teeth all taken out and get dentures. If there is any other option, it’s always best to keep your teeth. And dental implants are definitely the best option for replacing missing teeth, though there are other choices.

Relevant links:
Cleveland dental implants
Visit the home page of Cleveland dentist Dr. Jay Goldstein

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