dental bridge Archives - Atlanta Dental Implants

Can You Bond a Maryland Bridge to Porcelain Crowns?

Posted on December 19, 2020 by writeradmin.

Is it possible to bond a Maryland Bridge to porcelain crowns? I have two dental implants and the tooth between them needs to be extracted. I’d like to place a Maryland Bridge between them.

Brooke

Dear Brooke,

Technically, the answer is yes. You can place a Maryland Bridge on porcelain crowns. However, I wouldn’t recommend it. Even under ideal circumstances, a Maryland Bridge has trouble staying in place. It will bond better to tooth enamel than it will to bond to the porcelain you have on your porcelain crowns. Plus, very few dentists know how to bond to porcelain.

In addition to that, it requires grooves to be placed to help them stay in place. For that portion, the dentist is now having to bond to metal in that place which is even harder than bonding to porcelain. This is risky for you and could be a profound waste of money including damaging the porcelain on the adjacent crowns.

It would have been better if the dentist had planned ahead of time. When you have two dental implants and a tooth between them he or she should have anticipated you may at some point lose the tooth in between them. With that in mind, they could have placed the dental implants where the abutments are parallel and use screw-retained dental crowns. Then, when you lose the middle tooth the crowns can be removed and a dental bridge put it its place.

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

How Long Can I Wait to Get a Dental Implant?

Posted on May 30, 2020 by writeradmin.

I only recently got dental insurance. I’ve been going to the dentist anyway, but being cautious about what type of work I had done. Mostly I kept up with my checkups and cleanings. Quite a few years ago, a dentist put a crown on a tooth that needed a root canal treatment and put the crown on before doing the root canal. Because I wasn’t in pain anymore, he opted not to do the root canal through the crown. I’m wondering if that was a bad decision because the tooth under the crown has developed decay. The dentist doesn’t think he can get all the decay so he wants to pull the tooth then replace it with a dental bridge. I’m not crazy about either of those options. I’ve read that a dental implant is a much better option and I don’t really want to crown the other two teeth. I’m guessing my insurance will have a waiting period for either tooth replacement. How long is it safe to get a dental implant placed in the empty space?

Morgan

Dear Morgan,

I am seeing some real warning bells here about your dentist. At the risk of being too blunt, he is coming across to me as either lazy or incompetent. Neither one is a quality I want in a medical practitioner. Let’s start with this tooth extraction. While there are some teeth that can’t be saved, I’d like to at least see him try. He seems a bit too eager to me to just extract a tooth. I’d like you to get a second opinion with a periodontist before moving forward.

Second, you are correct about the right type of replacement as well. A dental implant is a far better tooth replacement than a dental bridge. Again, he is unnecessarily sacrificing tooth structure. Not okay.

As for the original, root canal, he should have done it even after he placed the crown. Many dentists have done root canal treatments trough dental crowns. Your dentist seems in the habit of taking the easy way out.

How Long Can You Wait Before Getting the Dental Implant?

Let’s say you have the worst-case scenario and your tooth cannot be saved. You don’t want to leave the empty space for more than a few days. The other teeth will start to drift and tip into the empty place. The good news is that won’t prevent you from waiting for your dental implant to be covered. Even a dental implant needs a healing period and time for the bone to integrate with the implant. Because of that, a dentist will put a temporary replacement like a dental flipper in there while the area heals.

Bottom line: Get a second opinion from a periodontist. If the tooth absolutely has to be extracted, you can have a flipper placed until your insurance coverage for a dental implant kicks in. I’d also start looking for a better dentist.

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

Dental Implants While on Fosamax

Posted on March 22, 2020 by writeradmin.

I’m on Fosamax and lost a tooth. My dentist doesn’t think I’m a candidate for a dental implant because of that. He’s provided me with a dental flipper (which I hate) until I can decide on a second option. Do you have a recommendation?

Benny

Dear Benny,

One thing you should know upfront. Taking Fosamax does not automatically disqualify you from getting a dental implant. When you take Fosamax and are having a procedure involving bone, it puts you at a slightly greater risk for complications. While the risk is only slight, the complications themselves can be rather serious so I don’t want you to take them lightly.

One thing I recommend if you are concerned is to temporarily suspend taking your Fosamax. You can have your doctor and oral surgeon coordinate with each other in order to make this work for you.

If you don’t want to take the risk, you could always get a dental bridge. The downside to this is it will require you two adjacent teeth to be ground down. If they are healthy, you may not want that.

Who Should Do Your Dental Implant

I am not going to suggest that you have your current dentist do the implant procedure. He is obviously uncomfortable with it. I don’t know if that is because he doesn’t do a lot of dental implants or because he doesn’t like things that have greater risks.

Especially in your situation, I’d want to make sure you find someone who has a lot of expertise in the dental implant procedure. That would mean they have done extensive post-doctoral training on implants, they can do the surgery themselves, and have a lot of experience. Ask about their success rate. It should be at least 98%.

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

Missing Lateral Incisor

Posted on February 24, 2020 by writeradmin.

I’m missing a lateral incisor. Growing up it was always embarrassing to me. Then my teeth shifted and looked weird and it became even more embarrassing. Now, I’m a young adult and am finally able to get my mouth in order. I just finished up with orthodontics. My dentist provided me with a dental flipper while I decided what I wanted to do. He’s suggesting a dental bridge, but my understanding is that it affects three teeth, right?

Kelly

Dear Kelly,

Let’s start with your dentist’s recommendation. You are correct that a dental bridge will affect three teeth. It consists of a false tooth suspended between two dental crowns. This means the adjacent teeth will have to be ground down in order for a crown to fit on them. If one or both of the adjacent teeth needed work, this would be a good solution. However, if they are both healthy, I’m going to recommend you go a different direction. It’s always better to keep healthy tooth structure.

The Best Tooth Replacement Option

If you want to know what the best tooth replacement option for your situation, I would recommend you get a dental implant. As you can see from the picture above, it provides a prosthetic tooth root and comes the closest to having a healthy natural tooth. So, why didn’t your dentist recommend that instead of a bridge? I”m just guessing here, but it is likely he isn’t as familiar placing dental implants as he is a dental bridge.

A dental implant is an advanced procedure and not as many dentists do it as will do a dental bridge. It is always better if you can find someone who can do the surgery as well as the implant crown. So, look for someone with surgical skills and advanced training in restorative dentistry. Look at Dr. Pumphrey’s training to get an idea of what you want.

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

Allergic to Titanium in Dental Implants

Posted on August 31, 2019 by writeradmin.

I’ve lost two teeth due to a car accident. The accident also left me with burns on my arm and shoulder. At the moment I do not feel attractive at all. My dentist put in a dental flipper at first just so my teeth wouldn’t drift, but I need a permanent replacement. I hear dental implants are the best and I want the best. From what I can see, they’re all made of titanium, which I have an allergy to. What is my next best option if I can’t have the dental implants?

Beatrice

Dear Beatrice,

I am very sorry for all you have been through. You have suffered so much. Fortunately, I think I have a great solution for you. Let’s say there was a worst-case scenario and you were not a good candidate for dental implants. In that case, the next best thing would be to get a dental bridge. Though, if your two lost teeth are adjacent to one another, that would mean you’d need a four-unit bridge. The more units you add to a bridge, the greater the stress on your teeth and greater risk of problems.

The good news is, you can still get dental implants, which will be a far superior treatment. There are metal-free dental implant options. Instead of getting titanium implants, you can get zirconia.

Zirconia is very strong and is dubbed ceramic steel. The main reason dentists are still using the titanium implants is because of the longevity of data we have with them. Because they’ve been in use for decades, we know they have a great lifespan. We have no evidence the zirconia options don’t. They just haven’t been around as long.

Your current dentist may not do them, but you will be able to find a dentist or periodontist who does. They’re out there and doing just fine.

Cosmetic Considerations with Dental Implants

You mentioned not feeling attractive at the moment. That’s perfectly normal given what you’ve been through. This may be the time to give yourself a little boost. Once the crowns for your dental implants are completed, the color is permanent. I generally encourage people to whiten their teeth before getting the porcelain crowns.

Teeth whitening is an affordable way to make your smile look years younger both quickly and affordably. Then, your crowns can be made the new brighter color. It will give you a smile you will be proud to share with the world.

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

Mom’s Teeth Falling Out

Posted on June 8, 2019 by writeradmin.

My mom is 83. I have recently taken over her care. I was appalled at the conditions of her nursing home my siblings had her in. I’d been out of the country for about 7 years. I’ve moved her into my home and have a nurse here for her. One thing I’m not sure what to do about is the condition of her teeth. She recently had two teeth just fall out. I’m wondering if I should get her two dental bridges (because they are in different parts of her mouth) or two dental implants. I know the implants are superior, but they are way more expensive. All my money is currently going to her nurse. Are there affordable implant options or is the bridge the better way to go at this point?

Drew

Dear Drew,

First, I just want to say that the care you are giving your mother does you credit. I’m sure she’s much more comfortable with you. As for her dental care, I’m a little concerned because it sounds like her teeth are just falling out. This suggests she has very advanced periodontal disease. Your first priority will be to get that under treatment or she will continue to lose teeth. Get her in to see a good periodontist who can treat both her gum disease and her missing teeth.

Yes, dental implants are a superior treatment, however, if she’s losing her teeth you may end up with her needing a full-mouth reconstruction. This can cost between $20-$40 thousand dollars. While there are some affordable dental implant options, I don’t think you will need this for your mother.

The biggest benefit to implants is the prevention of facial collapse. This is the gradual loss of jawbone. However, at your mother’s age, this is not likely to be a big issue.

Replacing Your Mother’s Missing Teeth

I’m not going to recommend a bridge, though. A bridge puts pressure on the remaining teeth and that is the last thing your mother needs right now. My recommendation to you is going to be a special type of denture. Cu-Sil Dentures, leave space for remaining healthy teeth.

If she ends up losing one of those teeth it will simply be a matter of closing that space and adding another false tooth.

Best of luck to you and your mother.
This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Can You Get Titanium-Free Dental Implants?

Posted on May 3, 2019 by writeradmin.

I have serious metal allergies, including dental cement and even titanium which I hear is rare. My dentist said because of that I cannot get dental implants. Instead, he wants me to get a five-unit bridge. I’m really not crazy about this idea. Do I have no other option?

Greg

Dear Greg,

Yes, there are metal-free dental implants. However, you may have to go to a different dentist to get one. Based on your metal allergies, you would likely be better served with a dentist willing to do some research to work around the limitations you have. It doesn’t sound like your current dentist is willing to think outside the box.

These dental implants are made from zirconia. It is quite strong and is nicknamed liquid steel. Some dentists still steer away from them because they haven’t been around as long. There isn’t as much documentation as to how long they last, though I don’t think you’d have anything to worry about.

I wouldn’t recommend a five-unit bridge for three reasons. One, it will put a lot of undue pressure on the anchor teeth, putting them at risk. Two, those teeth will be unnecessarily ground down even though they are likely perfectly healthy. Three, if one part of the bridge is damaged or fails, the entire unit will have to be replaced.

Cosmetic Considerations with Dental Implants

The implant crowns can be made to match any color, so they can blend in naturally with your natural teeth. However, their color will be permanent. If you’ve even considered getting your teeth whitened, it will save you money to do it before your porcelain crowns are made for your implants.

You don’t have too. However, if you decide to have teeth whitening done at a later date, only the natural tooth structure will whiten. That will require you to have the dental crowns re-made to get them to match. This creates an additional cost that would be unnecessary if you whiten first.

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

Implant Overdentures Cost

Posted on November 12, 2018 by writeradmin.

I have a two tooth bridge on my left side and the same on my right. Originally, the left was only a one tooth bridge, but the other tooth came loose. Now, I feel the bridge loose again. I’m concerned that will mean another lost tooth. I doubt I’ll be able to get a larger bridge. He warned me losing any more teeth will mean dental implants. What I want to know is if it’s significantly cheaper to get an overdenture instead of straight implants?

Kevin

Dear Kevin,

While it’s possible you are losing another tooth, it could also be a simple solution like the dental bridge just coming loose. Possibly there’s decay underneath as well. Either one of those problems is much more affordable than replacing the tooth. So, as much as you dread hearing the worst case scenario, go in soon in case it’s an easier fix. If you put it off, it will become the worst case scenario.

To answer your question, you should be aware that prices vary from dentist to dentist and from the area of the country you live. I’ll give you a low to high on everything. Just be careful not to go for the cheapest price for the sake of cheap. Getting poorly done or cheap dental implants will end up costing significantly more. It’s an advanced procedure and you want a dentist with the post-doctoral training and skill necessary to do it correctly.

Cost of Implant Overdentures Versus Individual Dental Implants

An individual dental implant can cost anywhere from $2,000 to $6,000 dollars. Going with a full arch, that’s about 14 teeth. The total cost is anywhere from $28,000 to $84,000.

A straight removable denture generally costs about $2,500. While that’s a significant monetary “savings”, the cost to your health is a lot more. You’ll be left with facial collapse in about ten or so years.

Implant overdentures save you money while preventing the worst side effects of dentures. They can be anywhere from $1,000 to $3,000 per tooth for the implant fixture. You can usually fix a denture with anywhere from 4-6 implants, so that would range from $4,000 to $18,000 for the implants and around $2,500 for the dentures.

You would definitely come off better financially with the implant overdentures, without any of the downsides of dentures, which are significant.

I hope this helps.
This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Bone Grafting Failure

Posted on August 3, 2018 by writeradmin.

I went to an experienced implant dentist. He’s done hundreds. When he first went to do the implants he stopped and told me I’d need bone grafting done because my bone was too thin. We scheduled it and he did the grafting procedure. After a healing time, he went back in to do the implants and said that my bone was still too thin. Now he’s recommending a dental bridge for me instead. Did I make a mistake going to a dentist? He’s so experienced I thought it was safe.

Alicia

Dear Alicia,

Who should place your dental implants?

Truthfully, if you’d have gone to a periodontist or oral surgeon, you probably wouldn’t have faced this problem. I’m not saying your dentist isn’t a good implant dentist. In fact, he’s been very upfront with you and is obviously trying to do the right thing.

Some dentists would have placed the implants anyway to save themselves the embarrassment of admitting failure. The implants would have failed, but not right away and you wouldn’t have known why.

You had an honest dentist. It’s very likely he’s a skilled implant dentist and had many successful cases. Bone grafting is a completely different ballgame. He’s likely not as experienced with that particular procedure. It’s great that he’s expanding his skills. In fact, it’s important that all professionals continually learn and increase their skill set. And, we’ve all got to start somewhere with those new skills.

Where Do You Go From Here?

You have a couple of options. Neither is a right or wrong choice.

Choice One: Go with a Dental Bridge

You could follow your dentist’s recommendation and go ahead and get a dental bridge. You wouldn’t have to worry about bone grafting or doing another implant surgery and you’d have an acceptable tooth replacement option.

Choice Two: See an Oral Surgeon and Get the Implants

It will require starting over. You’ll still have to have the bone grafting done. But, when it’s all over, you’ll have a permanent tooth replacement without placing dental crowns on your adjacent teeth.

I hope this helps. This blog is brought to you by Atlanta Periodontist Dr. David Pumphrey.

Will My Dental Implants Rust?

Posted on July 21, 2018 by writeradmin.

I lost a visible tooth and need to get it replaced. I keep hearing dental implants are the best replacement, but the idea of putting metal in my body worries me. Will the implant start to rust and make me sick?

Laura

Dear Laura,

Metal-free Zirconia Dental Implants in three shapes

Zirconia is metal-free and dubbed “ceramic steel”

The most common dental implants are made of titanium, which has a fantastic biocompatible track record. Because of their TiO2 (titanium oxide) layer, these aren’t like other metals and are extraordinarily resistant to rusting. This is the same material used in things such as hip and joint replacements. There have been decades of use with minimal problems. So, I’d say you’re perfectly safe getting the titanium implants.

However, there’s no absolute guarantee that oxidation won’t take place. There are too many factors. If you are concerned, you do have options.

Options to Metal-Based Dental Implants

Your first option is not to get a dental implant at all. You could get a dental bridge. They won’t require any metal, especially if you decide on an all-porcelain crown. However, that also means placing crowns on the two adjacent teeth. If there’s nothing wrong with them, that means grinding down healthy tooth structure. Something which is rarely recommended.

Your second option is to get a metal-free dental implant. These are made from zirconia and is very strong. In fact, its nickname is ceramic steel. However, there are drawbacks. This technology is newer, which means two things. One, we don’t have the amount of research we do with titanium implants to tell you they’ve been used successfully for decades. Two, they have to be handled differently and not all dentists know the newer techniques required.

Dental Implant Failure

Unless you have a severe metal allergy, your biggest concern about dental implants shouldn’t be the material base as much as the dentist who places them. You want an experienced dentist with a high success rate. Dental implant failure is real. You don’t want to invest all that time and money on such an advanced procedure with an inexperienced dentist to save money only to have the whole thing fail and you have to start over.

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