EVERYONE DESERVES A HEALTHY,
ATTRACTIVE SMILE

Should I Consider Dental Implants If I Have Gum Disease?

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Schedule a consultation with a periodontist for dental implant replacement

I had gum disease surgery in January. I lost six teeth due to gum disease—three on each side. I have talked to my dentist about partial dentures and dental implants. Braces would help because my teeth shifted after some of them fell off. I am overwhelmed with my choices for teeth replacement. Then, there is the gap between my front teeth. Dental implants are so expensive. I would hate to get them without braces first.  My dentist says it’s ultimately my choice, but I need some direction. I’m not asking you to tell me what to do, but I appreciate your thoughts. Thank you! Laura from NM

Laura,

Deciding if dental implants are right for you requires weighing the pros and cons of other options. While dental implants are the ideal solution for missing teeth, other options might be a better fit depending on the condition of your teeth, oral health, and budget. Below are factors that can influence your treatment options:

  • Your Oral Health: Your gum and bone health must support dental implants and other forms of tooth replacement.
  • Condition of Existing Teeth: The strength and condition of your remaining teeth will be considered.
  • Jawbone Strength: The volume and quality of your jawbone are crucial for implant placement.
  • Remaining Teeth Size: The size of your existing teeth can impact the restoration plan.
  • Spacing Between Teeth: The extent of gaps between your teeth will influence whether you need orthodontics before replacing teeth.

Consult a Periodontist and Cosmetic Dentist

A periodontist is a gum, teeth, and bone specialist who accurately evaluates your oral health and ability to get dental implants.

We also recommend finding a dentist who prioritizes aesthetics and functionality. Ideally, you want a dentist with advanced training and experience in:

  • Cosmetic Dentistry: Expertise in creating beautiful, natural-looking smiles.
  • Dental Implants: Proven success rate in restoring implants.
  • Occlusion and Bite: Understanding proper bite alignment for optimal function.

A periodontist and cosmetic dentist can coordinate your care. They might recommend dental implant bridges to replace missing teeth while preserving healthy ones. Additionally, implant dentures may be an option and a cost-effective solution for restoring your smile if your teeth are unsavable.

Dr. David Pumphrey, an Atlanta periodontist, sponsors this post.

How Much Time Do I Have to Get Dental Implants Before My Face Collapses?

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How long after teeth extractions will I experience facial collapse? I have 15 teeth remaining and have surgery scheduled to remove all the teeth in July. I’m concerned about facial collapse and wonder how much time I have to get dental implants before my facial muscles have no support. I feel a little pressured by the dentist I saw to get immediate implants. However, I explained why that’s not an option for me. I can plan for dental implants, though. How much time do I have? Thanks, April

 

April,

Although a dentist may recommend removing all your teeth rather than restoring them, have you seen another dentist for a second opinion? A comprehensive exam and CT scan are required to determine whether any of your remaining teeth are savable.

How Long After Teeth Extractions Will You Experience Facial Collapse?

When all your teeth are missing, facial collapse occurs within ten to twenty years. However, if you plan to get dental implants, we encourage you to get them as soon as your budget allows. Dental implants prevent bone shrinkage and minimize the need for grafting procedures to stabilize your implants.

What If You Experience Facial Collapse?
If you experience facial collapse, it is usually reversible with bone grafting. A periodontist will measure your bone volume to determine whether it will support dental implants or how much grafting you need. After four to twelve months of bone graft healing, your jawbone can support dental implants and dentures.

Immediate implant dentures

Immediate implant dentures are placed on the same day as tooth extractions. Some patients still need bone grafting to support the dental implants. Without immediate implants, your jawbone will shrink. However, according to your budget, a periodontist can develop a treatment plan to place dental implants in phases.

Implant dentures

An implant denture helps support facial muscles and prevents future sagging that makes you look older prematurely.

Consult a periodontist for an evaluation of the condition of your teeth and whether they all need extractions. Afterward, the specialist can discuss tooth replacement options.

 

Dr. David Pumphrey, an Atlanta periodontist, sponsors this post.

What Are the Best Dental Implant and Crown Brands and Materials?

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I consulted two dentists for ten dental implants on my upper teeth. I have questions about the best materials for dental implants and crowns. Can you tell me about these brands and materials?

A dental implant with components labeled - crown, abutment, implant screw

Dental implants – Astra brand from the UK. Zirconia implant abutments for better aesthetics

Crowns – Cercon smart ceramic zirconium crowns – isn’t zirconium clear? Is it as strong as PFM crowns? White-colored metal fused to porcelain or gold fused to porcelain. My dentist told me those two metals won’t show a black line at my gumline.

Thank you for your answers. – Clive from IL

Clive,

We understand your concerns. Getting natural-looking results with dental implants and crowns for your upper teeth requires much experience and skill from your periodontist and cosmetic dentist.

What Are the Best Dental Implant and Crown Brands and Materials?

The best dental implant and crown brands and materials are those selected by a periodontist and skilled cosmetic dentist based on your needs. Focusing on the dental crown and dental implant brands and materials rather than the dental artist is a mistake. If you want a beautiful smile but plan to micromanage your cosmetic dentist, you may be disappointed in the results.

Here is an example: You hire an artist for paintings in the hallways of a corporation’s office. You dictate to the artist details like these: which paints and brushes to use, lighting while painting and a specific brand of chair to sit in while doing the work. You would be stifling and distracting the artist. The preference is to choose a skilled artist and allow them to use the tools and materials required to get beautiful artwork.

After researching skilled cosmetic dentists, allow him or her to evaluate the condition of your teeth and understand your smile goals. Trust the dental artist to choose brands and crown materials for a healthy, personalized smile. A periodontist is a dental implant specialist qualified to choose quality implants based on your needs.

Additionally, you cannot learn enough about dentistry, the materials, and the mechanics and demands of your case to determine which brand and materials to request. You must evaluate the manufacturer’s claims, know how the materials work, and consult independent research.

Although you may choose dental materials or brands, would your dentist know the techniques required to use them to your advantage?

It isn’t true that porcelain fused to gold or a white metal won’t show a black line at the gumline. All metals used in crowns are white in color or gold. The line at the gumline may be black instead of gray, but it will still show through because it is the cement line. The bonding technique used with pure ceramic can eliminate the black line. Also, some techniques minimize the dark line, such as cutting the metal back at the margin, but they won’t eliminate it.

Zirconium oxide is high-strength and opaque white (not clear) but can produce highly esthetic results if a dental ceramist covers it with translucent ceramic.

Dr. David Pumphrey, an Atlanta periodontist, sponsors this post.

 

Will I Need Bone Grafting for Dental Implants?

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I think I will need bone grafting for dental implants. I lost most of  Although my family dentist says he can do the implants, I am not confident that he has enough experience. I am not comfortable. How will a dentist determine if I am a candidate for bone grafting? Thank you. Rochelle

 

Rochelle,

Thank you for your inquiry. Your decision to get dental implants will improve your oral health. You are wise to be cautious when choosing an implant dentist.

Will You Need Bone Grafting for Dental Implants?

You will need bone grafting for dental implants if your teeth have been missing for years and you do not have enough bone volume to support implants. Your dentist must take a CT scan to measure your bone volume.

What Is Dental Implant Bone Grafting?

Dental implant bone grafting is a procedure that builds up jawbone volume. When your teeth are missing, your body takes minerals from your jawbone in those areas and uses them elsewhere. As your jawbone shrinks, it will become challenging to support dental implants.

Whether you need implants to replace individual teeth or to support a denture, bone grafting may be required to give implants enough support. The bone grafts need to heal before your dentist places implants.

Bone sources for dental implant grafting

Bone grafting for dental implants can come from your bone—perhaps your hip or below your knee. Other bone sources included a tissue bank or artificial bone.

Are You a Candidate for Dental Implant Bone Grafting?

A dental implant with components labeled - crown, abutment, implant screw

Schedule a consultation with a periodontist for bone grafting

An implant dentist must take x-rays and a CT scan to reveal your oral anatomy, bone volume, and bone health. But you are probably a candidate for implant bone grafting if the following is true:

  • Good oral health
  • Good overall health, including free of gum disease
  • A non-smoker

Consult a Periodontist

Schedule a consultation with two periodontists—specialists with years of post-graduate training in gum disease and dental implants. You can prepare questions and take notes to compare the specialists’ qualifications and whether you liked their interaction with you.

Best wishes.

Dr. David Pumphrey, an Atlanta periodontist, sponsors this post.

Going to Costa Rica for Dental Implants and Have Nothing to Lose

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I’m going to Costa Rica for a dental implant and have nothing to lose. Why pay more after seeing two implant dentists in the U.S. and experiencing dental implant failure twice? I decided to try this out with one implant, and if it works, I return for another. I’m tired of running from implant dentist to periodontist without any success. This drama has been going on for three years. Many American dentists are against dental tourism, but I want to try. I’ve compiled a list of questions for my video consultation. I hope to write again to let you know about my surgery and recovery. I live nowhere near your office, so you can’t convince me to visit your specialist. Thanks. Midge from CO

 

Midge – Dental implants can be more affordable in Costa Rica and other countries than in the U.S. However, you must consider if the savings are worth the commitment and risks. We understand your frustration from dental implant experiences in the U.S., but we encourage caution regardless of your provider’s location.

What to Consider Before Getting Dental Implants Outside of the U.S

A dental implant with components labeled - crown, abutment, implant screw

List questions and schedule consultations before choosing a dental implant provider

Whether you decide to receive dental implants in the U.S. or outside of it, consider the following factors:

  • The education, credentials, and qualifications of the implant surgeon and their team
  • Is your new dental implant team qualified to identify the causes of your previous dental implant failures and resolve them?
  • Will you need bone grafting before getting dental implants? Is the new team skilled in bone graft procedures?
  • The quality of the dental implant fixtures
  • What does the dental practice do to ensure successful implant placement and avoid mistakes?
  • Does the country have strict regulations on dentistry?
  • What is the cost of travel and accommodations?
  • How many follow-up visits require you to return to the country where you received the implants?
  • What would you do if there was a problem with the implants?
  • What would you do if your circumstances changed during treatment and you could not return to Costa Rica for follow-up care?
  • Who will restore your dental implant with a crown?
  • What are your total out-of-pocket expenses?
  • Have you reviewed the Centers for Disease Control and Prevention’s medical tourism guide?

Before choosing a dental implant provider out of the country—or in the U.S.—we recommend thoroughly investigating the provider and its services.

Atlanta periodontist Dr. David Pumphrey sponsors this post.

Will I Need Bone Grafting for Implant Dentures?

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I had never heard of a buccal bone until I told my dentist that I was thinking about getting implants for my denture. My dentist is doing a treatment plan for my dentures and implants. I cannot afford implants right now, so we are doing the work in phases. Although I trust my dentist, I am concerned that he might be adding services that I do not need. My dentist says my buccal bone is thin, and I might need a bone graft before I get implants. Does what my dentist is saying my sense? And how do I know if my buccal bone is thin?

Thank you for your question.

What Is the Buccal Bone?

The buccal bone is a component of the bone structure that contains tooth sockets and supports your teeth.

How Does the Buccal Bone Affect Dental Implant Placement?

You will need enough jawbone volume to support dental implants and stabilize implant denture or hybrid denture. If your buccal bone plate is thin or weak, it will not support dental implants for the long term. Your dentist recommends a bone graft procedure to ensure your implants have enough bone to fuse with and remain stable.

It takes three to four months for a graft to heal before you can receive dental implants. Your dentist will factor that time into your treatment plan.

What If You Refuse a Bone Graft?

If you refuse a bone graft, your dentist or oral surgeon will likely refuse to place dental implants because implants that lack bone volume can loosen or fail. Also, if irritation results in an infection, it threatens your oral health.

How to Know If Your Buccal Plate Is Thin

You can ask your dentist to show you the 3D CT scan of the bone and its thinness. You can send the digital scan to a skilled implant dentist or oral surgeon to examine and give you a second opinion.

 

Atlanta periodontist Dr. David Pumphrey sponsors this post.

My Full-Mouth Reconstruction Went Bad and Wasted $40k

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I got full-mouth reconstruction in 2019. I spent $40,00 on veneers, crowns, and implants. Although my teeth looked good initially, I progressively had problems with them. I was in the dental office almost every month, trying to get my teeth patched up. Now, I have exposed implant screws and cannot eat anything above the consistency of a Ritz cracker. Chewing hurts. So does talking. My mouth is raw, and my heart aches over the condition of my teeth. The dentist wasted my time and money. It is insulting! The dental office moved to an undisclosed location, and I cannot find a trace of him online. Some people say he left the country, but now I don’t know where to begin or who to trust. I don’t have a question, but I am looking for advice on where to start. Thanks. Roz from Michigan

 

Roz,

We are sorry about your dental nightmare and the dentist who ruined your teeth and took your money. Unfortunately, you have no legal recourse, but we can recommend your next steps.

How Can You Find a New Dentist for Implants?

You can find a new dentist for implants and restoring your full-mouth reconstruction by taking the following precautions.

Avoid cheap the cheap route

Dentists whose fees are much lower than the average in your community may use cheap materials or take shortcuts in diagnostics or procedures. Their means of saving you money can cause even more oral health problems.

Look for a specialist

A dental implant with components labeled - crown, abutment, implant screw

Schedule a consultation with a periodontist for dental implant replacement

A periodontist specializes in teeth, gums, and dental implants. Periodontists spend two to three years of training after dental school in tooth replacement with dental implants. Their training sets them apart from general dentists in the ability to diagnose and treat your gums, bone, and remaining teeth.

Insist on careful diagnosis and planning

Whether you choose an implant dentist or periodontist, avoid any provider who does not use a 3D CT scan for diagnosis. The 3D scan identifies your bone volume, dental implant position, and other factors essential to restoring oral health and choosing the best treatment techniques.

Check online patient reviews

Google and Yelp reviews from patients can reveal any clinical problems people have experienced with the specialist or implant dentist. Check reviews thoroughly before selecting a dentist or periodontist.

Schedule consultations

Consult with at least two doctors before choosing one, even if you prefer specialists. Schedule consultations with each doctor before allowing one to replace your failed dental implants and restore your gum health.

You will likely need new dental crowns for your teeth and dental implant crowns. Include an expert cosmetic dentist on your dental team for quality, natural-looking results. Look for an accredited cosmetic dentist or a dentist with post-graduate training in cosmetic dentistry.

Best wishes for a smooth treatment and recovery.

 

Atlanta periodontist Dr. David Pumphrey sponsors this post.

 

Does Bleeding Around My Dental Implant Mean It’s Failing?

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I got two dental implants in late January. Two days ago, I saw slight bleeding around one of the implants. Yesterday, I saw no bleeding, but today I noticed it again. Both times, the bleeding occurred while I was brushing my teeth. I did not brush the implants, though. I use a Waterpik around them. I am worried because I live in MD but am in NJ taking my turn for caregiving for my father. I am concerned that I might be experiencing dental implant failure and will have to find a dentist here that I don’t know. Could something else be wrong other than complete failure? Thank you. Kaleb

Kaleb,

Thank you for contacting Dr. Pumphrey’s office in Atlanta regarding bleeding around your dental implant. We understand your concerns, especially if you are far from your regular dentist. Dr. Pumphrey must examine and x-ray your implant for an accurate diagnosis. Still, we will provide information on bleeding around an implant.

Does Bleeding Around an Implant Mean That It’s Failing?

Dental implant with crown, abutment, and artificial root labeled, for information on bleeding around dental implants from Atlanta periodontist Dr. Pumphrey

Schedule an appointment with a periodontist if you see bleeding around a dental implant

Bleeding around a dental implant is not a sign of dental implant failure within two to three days after surgery. However, if it has been over a week since your dental implant surgery and you notice bleeding around an implant, contact your dentist to report the concern. Even if you are traveling, your dentist may be able to refer you to a periodontist (dental implant specialist) near your current location. Otherwise, search online for an experienced periodontist, checking the doctor’s credentials and patient reviews.

What Are the Signs of Dental Implant Failure?

Signs and symptoms of dental implant failure include the following:

  • Gum or bone infection around the implants
  • Loose implants
  • Numbness or tingling
  • Pain around the dental implants
  • Frequent bleeding

Why Do Dental Implants Fail?

According to a September 2021 article in the American Academy of Implant Dentistry, three reasons for dental implant failure include the following:

  • Peri-implantitis. Gum disease around dental implants destroys gum tissue and bone, causing implants to fail.
  • Parafunctional habits. Nail-biting, teeth grinding, or other oral habits can stress and loosen dental implants.
  • Osseointegration failure. Lack of quality jawbone will prevent the bone from locking with your dental implants.

The article says that you can improve the success rate of your dental implants by providing thorough medical and dental histories. The details will help your implant dentist anticipate potential challenges.

Dental Implant Complications While Traveling

If you experience dental implant complications while traveling, call your dentist. If your dentist cannot refer you to a local specialist, look for an experienced periodontist in the area for a prompt appointment.

Atlanta periodontist Dr. David Pumphrey sponsors this post.

Trying to Pull My Tooth, But It Won’t Dislodge

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I have been trying to figure out how to pull a bottom molar. It doesn’t hurt all the time, but when it hurts, it also gives me a horrible headache, and I get nauseous. I guess I should stop trying to pull the tooth. My jaw is getting sore. I hate going to the dentist, though. If I leave the alone for a while, will it settle down? Thanks. Jason

Jason – Thank you for contacting Pumphrey Periodontics.

You should stop trying to remove your tooth.

Why Can’t You Remove Your Tooth?

Tooth removal at home can be unsuccessful due to these reasons:

  • Deep tooth roots
  • Tooth location
  • Your lack of professional skills and tools and sanitary conditions

Adult tooth removal at home can damage neighboring teeth or the supporting bone. Your attempts can damage your gums and require repair or cause gum infection.

Think about the consequences of removing your tooth at home that may require you to see a dentist anyway, including:

  • Excessive bleeding
  • Infection
  • Incomplete tooth removal
An illustration of a detnal implant between natural teeth

Dental implant

A dentist will first relieve your pain and examine and x-ray the tooth to determine why you have a toothache. It may be that the tooth is infected, in which case a root canal treatment will resolve the issue, and the tooth can be saved.

If the tooth is damaged beyond restoration, it may require removal. If a dentist can save the tooth, they will recommend treatment options, such as a dental bridge or a dental implant. The dentist’s skill and the complexity of the extraction can affect which options the dentist offers you.

Don’t continue to try to extract your tooth. You can damage gum tissue and adjacent teeth. Schedule an urgent appointment with a dentist for an exam and treatment.

 

Atlanta periodontist Dr. David Pumphrey sponsors this post.

Is My Root Canal Tooth Infected Again?

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I am afraid that I will lose my root canal tooth and need a dental implant. My dentist completed a repeat root canal on my upper left first premolar in October 2022, but I think the tooth is infected again. Is that possible? The left side of my face is puffy beneath my eye and around my cheek. It’s not painful yet, but it is uncomfortable. Will I need an extraction and dental implant? Thank you. Kamal from Honolulu

 

Kamal,

Thank you for contacting Pumphrey Periodontics of Atlanta. We understand your concerns about your tooth and whether a dentist can save it.

Is Your Root Canal Tooth Infected Again?

Your root canal tooth may be infected again if it hurts and you have swelling in your gums or face. You may also feel discomfort when you put pressure on the tooth or use it for biting or chewing.

Can a Dentist Save a Repeat Root Canal Tooth?

Whether or not a dentist can save a repeat root canal tooth depends on the tooth’s condition and the extent of the infection. Your dentist may refer you to a root canal specialist if the tooth’s canals are curved and challenging to reach.

Why Would You Need Another Root Canal?

You might need another root canal if your dentist missed a canal while removing the infection or if the canals are challenging to reach. After root canal treatment, your dentist or specialist will prescribe an antibiotic to help your body get rid of the infection.

What If Your Root Canal Tooth Is Not Savable?

Dental implants with separated parts, then in the bone and fasted together

Dental implant

If a root canal tooth is not savable, your dentist may refer you to a periodontist for tooth removal and a dental implant. If your jawbone around the tooth is healthy, you may get a tooth extraction and an implant on the same day. The advantages of same-day implant placement include:

  • Preserves the jawbone
  • Prevents the need for bone grafting later
  • Reduces overall treatment time

A June 2022 Journal of Periodontology article published results from a two-year study of immediate placement for 63 first premolars in patients. Forty-one of the implants that dentists restored were still functional after two years. The long-term survival rate for first premolars requires further studies.

Consult with a Periodontist

If you require tooth removal and a dental implant for your first premolar, we recommend scheduling a consultation with a periodontist (a specialist in teeth, gums, and the jawbone). After an exam and 3-D x-ray, the specialist will explain your treatment options for a dental implant. Each patient’s case is unique.

 

Dr. David Pumphrey, an Atlanta periodontist, sponsors this post.

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