bone grafting Archives - Atlanta Dental Implants

I’m Losing My Teeth from Gum Disease- Now What?

Posted on November 1, 2021 by writeradmin.

I need some help. I have gum disease. I put off going to the dentist for too long and now I’m actually losing teeth. Where do I go from here? I’ve learned my lesson and will do whatever is necessary! Please, people, don’t let fear of the dentist keep you away. Learn from my mistakes.

Angie

Dear Angie,

Implant overdentures

I am sorry you are experiencing this. It’s hard learning lessons after the fact, isn’t it? However, you’ve shown great courage in admitting your mistakes and looking for a solution. The first thing you will want to do is get your gum disease under control. Maybe it will be possible to save some teeth. But, even if not, you will want healthy gums in order to have the best tooth replacement possible.

Once your gum disease is under control, you will probably need to have some bone grafting done. Your gum disease ate away the bone which is why your teeth started coming out. Bone grafting will build that bone back up so you can have a permanent replacement. After the bone grafting, the next step will be to have dental implants placed. These serve as prosthetic tooth roots. Then after your jaw bone has had time to integrate with the implants, your dentist can anchor a denture to them. This will give you permanent, secure teeth.

Given your dental anxiety, I am certain hearing all that work is making your blood pressure go up and your heart race. I have some good news for you. I’d like you to see a periodontist who is also a sedation dentist. This is sometimes called sleep dentistry and will allow you to get all your dental work done in an anxiety-free/pain-free way.

Let us see your new smile after you get your work completed!
This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey

Should I Switch Dentists Mid Dental Implant Procedure

Posted on October 5, 2021 by writeradmin.

I’ve had two dental crowns for many years that are old and need replacing. I’ve decided to go with dental implants this time because some decay got underneath the gums. He quoted me a little over 9k for both extractions, bone grafting, implants, and crowns. I’ve had the extractions and bone grafting done. After the bone grafting, he placed two Maryland Bridges for me as temporary placements until the time that I have my permanent teeth. Unfortunately, the Maryland Bridges have fallen off four times already, and it has not even been a month yet. This is giving me some doubt as to whether or not this dentist has the cosmetic skills to do this right. Should I switch to a cosmetic dentist for this?

Parker

Dear Parker,

I agree that you have cause to be concerned and not just about the cosmetic aspect of this. Let’s start with this whole Maryland Bridge idea your dentist has. This is not a good temporary replacement. First, in order to bond properly, the structure of the tooth has to be adjusted. Anything that changes the structure of your teeth is not temporary. Second, he doesn’t seem to understand the bonding principles behind this. Bonding is not nearly as advanced as a dental implant procedure. Neither dental implants nor cosmetic dentistry are recognized specialty. In addition, they are not adequately taught in dental school.

I would search for another dentist before getting these implant placed. Look on their website for post doctoral training in dental implants. Then, look at their smile gallery to see what type of results they get. If you like them, you will be okay with the implant crown they make. Your dentist is under an ethical obligationt o provide your new dentist with all your case notes, including the diagnostic results.

On a separate note, the better temporary tooth replacement is a dental flipper. This won’t change any tooth structure and it is significantly cheaper.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

My Husbands Implants are Making Me Sick

Posted on September 19, 2021 by writeradmin.

My husband had dental implants for his implant overdentures. Right now he has the acrylic dentures. Then, he’ll get the permanent dentures made of porcelain. I have chemical sensitivities and there is the strongest rubber smell coming from his dental implants. I have to sleep with the covers over my face. I tried talking to his dentist about it, but the surgeon insists that he needs the titanium implants. I want the metal-free ones. My husband is not too keen on doing everything over, which I understand, but he’s not the one with the sensitivity. I’m sort of alone on this one. Can you help me out?

Selina

Dear Selina,

Implant overdentures

I don’t think the titanium implants are what you are smelling. Titanium is quite inert. One thing you can do to verify what I’m saying is ask your husband’s dentist if you can smell a titanium implant. You will find that they don’t really have a smell, especially a rubber smell. It is possible the acrylic denture is giving off a smell or maybe your husband has food and debris caught underneath the denture. You could purchase a Waterpik to help him get everything out from underneath that denture.

Replacing the implants is not a good idea. In the process of removing them, he’d lose some bone which is what helps to keep the dental implants in. In order to get new dental implants, he’ll have to have an additional procedure, called bone grafting, in order to build that bone back up. Then, after all of that, he will need to start his dental implant procedures over again. I think this is a lot to ask of your husband when it is extraordinarily unlikely that the implants are the problem.

I recommend getting the Waterpik and waiting for the porcelain implant overdentures. You’ll be very likely to not have a problem after that.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphry.

Clear Choice Wants to Extract All My Teeth

Posted on July 21, 2021 by writeradmin.

I have a dental bridge in good condition and one dental implant that needs a crown. I also have two teeth that need replacement. I went to Clear Choice Dental Implant Centers in the hopes of just getting the two implants plus two extra crowns. Instead, they want to extract all my teeth and do an all-on-four dental implant procedure. They kept insisting it was the best option for me and the rest of my teeth are going to go at some point anyway and this is preemptive. I felt really pressured and they were after me to set up the surgery. They even had me put $1500.00 down that day. Now I am having doubts about the whole thing. What do you think? Am I wrong to think I should not follow through with this?

Kelly

Dear Kelly,

All-on-4 Dental Implants

I hear these stories about Clear Choice Implant Centers all the time. High pressure sales and a one-size-fits-all treatment plan. I am going to suggest you get a second opinion. Their explanation that teeth are going to fall out eventually doesn’t wash with me. In fact, I find it ridiculous. We’re all going to die eventually, that doesn’t mean we should hop to it and speed up the process. No. It is best you always try to save as many teeth as possible.

There is no reason for you to get the all-on-four dental implants procedure if you can keep your teeth. It is designed not just for people who have no teeth left, but who have also lost bone support and do not want to have the bone grafting procedure done.

If the remainder of your teeth are healthy, then just go with your original plan of two dental implants and two extra crowns. I think you’ll be better served with a private dentist who will be more invested in your case and not pressure you with corporate sales tactics.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

My Dental Implants Keep Falling Out

Posted on May 6, 2021 by writeradmin.

I was very excited to get my dental implants. However, there are six of them and two of them have fallen out in the first three days. I’ve paid half the fee already and I am a tad worried the others will fall out too. Is this a common situation? Can they be put back in?

Miranda

Dear Miranda,

I am sorry to hear this is happening to you. When dental implants are done by an experienced and trained dentist, the success rate is about 95% and this is for years. In just three days, your dentist has only a 66% success rate. However, as quickly as they’ve fallen out, I’m concerned that the others are going to as well. To answer one of your questions, No, this is not a common situation and should not be happening. The first thing I want you to do is to seek a second opinion from a dentist who is fully trained in dental implants. Look for someone with post-doctoral training. Have them look at your implants and tell you why they failed. This will give you some idea of what to expect with the remainder.

Causes of Dental Implant Failure

Here are some possibilities for your dental implant failure.

Development of infection. This will often happen as a result of implant fixtures that do not fit properly. However, you didn’t mention anything about pain or a fever. Infection is normally accompanied by one or both of these.
Inadequate bone support. If this was the case, your dentist should have caught it before even beginning the surgery. The diagnostic stage should have included quite a few x-rays and hopefully even a CT-scan.
The use of substandard implant fixtures. Some dentists, in an effort to increase profits, will purchase cheaper fixtures from overseas.
Premature loading of the dental crown on the fixtures. There needs to be time for the bone to integrate with implants before adding any real weight and stress to it.
Incorrect placement of the implant on the part of the dentist or oral surgeon.

Once you know why the implants failed, it will give you a better idea of how to move forward. Dental implant failure does not necessarily mean you can’t have implants. Though, doing it again will require an extra procedure. You’ll have to build back up the bone that was lost. This can be done with a bone grafting procedure. If you do decide to try again, and I always recommend dental implants if you’re able, then I highly recommend you go with a different dentist.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Clear Choice Pricing

Posted on April 17, 2021 by writeradmin.

I need some advice. A previous dentist talked me into removing all my teeth. I am haunted by giving in to that because I really feel at least twelve are them were salvageable. I know that is water under the bridge, but it would have saved me the problem I am facing now. That same dentist told me I could just get dentures now and them add dental implants later. Now I am thinking he said that because he doesn’t do dental implants and he wanted the fee for the dentures. They have been a disaster from the beginning. They hurt constantly and I have a horrible gag reflex. At the moment, I only wear them (and then only the top ones) when I have to go in public. I need teeth! I decided to go to a Clear Choice Dental Implant center to learn about the all on four procedure. They said I was a good candidate and quoted me $67,000. Then, when they found out my age offered me a senior citizen discount which brought it down to $53,000. That is a $14,000 difference. Were they overcharging to begin with? It is still too high for me. Is there a better route for me to go?

Elaine

Dear Elaine,

Wow! You have been put through the mill. Let’s start with your old dentist. Let me first say he is one of the laziest dentists I have heard of in a long time. We go into our business in order help take care of teeth. I am sorry he did this to you. All we can do now is salvage the damage as much as possible.

Clear Choice may not be your best option. I would suggest getting a second opinion. Their pricing seems arbitrary to me, and I’m guessing that you could get a lower fee for an all-on-4 dental implant procedure from some other very qualified dental implant dentist. It sounds like they are pricing it with bone grafting in mind. However, the main point of doing an all-on-4 is to work around the need for bone grafting to begin with.

You did not mention how long it has been since your teeth were extracted. If it hasn’t been too long, you may not even need to have bone grafting done. In that case you can go with straight implant overdentures. I would start by having some really good diagnostics done, with an experienced implant dentist, to see what you are dealing with. Once you know how much bone you have you can make some decisions.

If you don’t need bone grafting, get implant overdentures. If you do need bone grafting, you have two choices. First, it is a possibility that you can get the all-on-four procedure done. Just bear in mind if one part of it fails the whole thing will need to be redone. Your other option is to have the bone grafting done and still get the implant overdentures. I would do a good consult first and discuss the pros and cons of each in your specific case before making a decision.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Dental Implants after 30 Years in Dentures

Posted on April 7, 2021 by writeradmin.

I have had dental implants for over 30 years. I was wondering if it were possible to get dental implants after this length of time? I have never had a pretty smile and I would love one.

Carly

Dear Carly,

Implant overdentures

There are two questions here. The first is can you have dental implants. Then you mentioned a pretty smile. Those are two separate issues. Let’s start with the dental implants. As long as you are in good general health, it is possible to get dental implants no matter how long you have been wearing dentures. The one thing the length of time will affect is the amount of bone support you will have for your dental implants. After thirty years, you won’t have much. This will mean you will need one additional procedure so there will be enough support in order to retain your dental implants. This can be done with a bone grafting procedure. Once there has been a healing time for that, you can start on your dental implants.

You won’t actually want a single dental implant for each tooth. That would be way too expensive. Instead, I would suggest you get implant overdentures. With this you will get between four and eight dental implants depending on your budget, and then a new set of dentures will be anchored to each arch. Obviously, the more implants you have the more secure they will be and the more bone preservation you’ll have, but four per arch can do the job.

The second aspect of your question was a pretty smile. Having dentures or dental implants does not determine whether or not your smile will be attractive. That has more to do with the cosmetic skills of the dentist doing the work. Feel free to ask to see sample images of their before and after work before you commit to anything. You’ll also want to make sure they have significant post-doctoral training in implants. Dental school does not give enough training in this field.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Problems with a Sinus Perforation

Posted on February 23, 2021 by writeradmin.

I had an upper molar removed and the root of the tooth had perforated into the sinus cavity. Previously, this tooth had a root canal treatment done because of an infection at the tip. However, I was in so much pain following that treatment that I decided my best course of action was to have it extracted. When the dentist did the extraction, he told me there was still an infection in both the root and the sinus cavity, which does explain all the pain I was in. This is a different dentist than the one who did the original root canal. My new dentist cleaned out the socket, filled the area with bone grafting, and closed everything with stitches. He put me on a round of clindamycin, which is my first time using that particular antibiotic. The pills were for one week and he gave me specific post-care instructions that I have followed carefully. It’s been a little over a week since the antibiotics ran out. This morning, I started having drainage on the side with the problem, along with some tenderness and pain. Is this normal following this type of procedure or should I seek help from my dentist?

Elaine

Dear Elaine,

Thank you for being so thorough. Having all of that information gives me a complete picture. Whatever happened with the first dentist, your second dentist has done everything right. He took all the right steps and prescribed you the correct antibiotic. My thought is, because you probably had that infection in your sinuses and tooth root for quite some time, you will need another round of that antibiotic to really clear things up. So, yes, I’d call the dentist. He will either give you a second round of the same antibiotic or try a different one. Either way, if after you finish that antibiotic, the infection is flaring up yet again, it will be time to do something more drastic.

It may be that some bone got pushed up into your sinus cavity during either of the treatments. In that case, you will want to seek out an ear, nose, and throat surgeon to do an x-ray and evaluate where to go from there. Some dentists can do oral surgery and some can’t. If there are bone fragments there you aren’t dealing with the mouth as much as the nasal category. An ENT is preferred in that case.

Once all that is settled, you will need to talk to your dentist about a good tooth replacement option, such as a dental implant. You want to be completely healed and over this infection, though.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Dentist Pulled Out My Implant

Posted on February 16, 2021 by writeradmin.

I had a dental implant placed. After the crown was put on, it started to feel loose. I called my dentist and he had me come in. Once I did, he said the crown was loose and he was going to remove the crown and then bond it back on. He had a little trouble getting the crown off so he used a special tool. That’s when something went wrong because the crown came completely off. Have you heard of this happening before?

Lindsey

Dear Lindsey,

This is a whole new level of incompetence that you are facing here. When a dental crown is loose, it does not require a special tool. In most cases, they fall off on their own. He should have instantly realized it was the dental implant that was loose and not the crown. So, why did it become loose?

There are a few things that can make a dental implant fail. The first thing that comes to my mind is premature loading. This is when the dental crown is placed before the implant was integrated enough with the bone to completely support it. I could be misreading, but the way your statement sounded was this implant became loose shortly after the dental crown was placed.

Another possibility is you developed an infection at the implant site. However, that is usually accompanied by pain and fever. You didn’t mention either of those so I feel like that might not have been your issue.

A third reason could have been poor placement on the part of the dentist. In your particular case, either scenario one or three are the more likely options. Now the question is, where do you go from here?

Fixing this is going to be harder than just starting over by replacing the implant and waiting for osseointegration. When he removed the fixture, it left a gaping hole where your bone is. That has to be built back up in order for your dental implant to have a chance at retention. In order to build up that bone, you will need an additional procedure known as bone grafting, which adds to your cost.

In your place, I would not merely ask for a refund. You need to demand this dentist pay to get your implant replaced by a dentist of your choosing. This go-round, make sure you use someone who has significant post-doctoral training and experience in handling the implants.

This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Dentist Placed an Implant Without Adequate Bone

Posted on January 2, 2021 by writeradmin.

I had a dental implant placed. Prior to the dental implant surgery, the dentist told me everything was fine. When I woke up from the surgery, he told me that there was not enough bone support when he got in there. Here is the kicker. He placed the dental implant anyway! Now he said he wants to take it out and do a dental bridge. What do I do? Can I get a refund?

Darrell

Dear Darrell,

I think you are going to want more than a refund here. If I understand what you have described correctly, your dentist told you there was enough bone, then when he went in, he realized there wasn’t but placed the dental implant knowing there wasn’t adequate support for it. Is that right? If so, that is malpractice.

If your dentist would have done the proper diagnostics, he would have known there wasn’t enough bone support to retain the implant. That is incompetence. If he did the proper diagnostics and knew there wasn’t enough bone support, yet went forward, that is unethical. He put you through a surgical procedure knowing it would fail and putting you at risk of serious complications.

You don’t have to get a dental bridge. You can still have that dental implant. However, you need to do it with a different dentist and HE needs to pay for it. Don’t just ask for a refund. You are going to need some bone grafting done in order to build up your bone support. This is going to cost you more than what you have already paid this dentist. You also should be the one to pick the dentist to do the repairs, not him. Look for someone with extensive post-doctoral training in dental implants.

This blog is brought to you by Atlanta Dentist Dr. David Pumphrey. We do periodontal treatments.