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Should I Switch Implant Dentists?

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I am getting two dental implants. I’m paying a LOT of money for this and am concerned that my dentist may be in over his head for reasons I am about to explain. I have had the teeth extracted and some bone grafting done. Then, my dentist provided me with two different Maryland Bridges as temporary replacements. They’ve fallen off several times each. This has made me wonder if he understands esthetic dentistry. Should I switch dentists in the middle of my procedure to a dentist who has more experience?

Misty

Dear Misty,

Maryland Bridge Diagram

For those who do not know, a Maryland Bridge is a false tooth that is attached to the adjacent teeth with either metal or ceramic wings. I would not consider this a temporary tooth replacement because the adjacent teeth have to be etched and bonded on. If your dentist does not understand how to adequately place this, then I have concerns about two aspects of this. First, I have the same concern you do. If he doesn’t understand how a Maryland Bridge works you are not likely to get an attractive aesthetic result. A second concern is just the dental implant procedure itself. This is quite an advanced procedure. If he cannot do the Maryland Bridge, then I would have concerns about the implants.

You can switch dentists in the middle of a procedure. Your current dentist is ethically obligated to cooperate with your new dentist, including providing him with all the necessary diagnostics and notes that he has on your procedure. You will want to make certain that whichever dentist you go to has post-doctoral implant training. Some training to look for is someone who has been to the Dawson Academy, the Kois Center, or the Las Vegas Institute for Advanced Dental Studies. He will want to examine your implants and make sure they’re placed properly before moving forward. Don’t be surprised if the dentist suggests a different temporary tooth replacement. A dental bridge is the most common recommendation. The good news is that it is much less expensive than the Maryland Bridge.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

 

Gap After Congenitally Missing Tooth

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My daughter is about to graduate high school. Since childhood, she has only one adult of the teeth next to the front one. I think it is called incisor. Our family dentist told us that once it fell out, her other teeth would shift into that space. It sort of did, but not as much as we were expecting. Now there is a gap there. She just doesn’t like to smile and isn’t even interested in getting senior pictures. I mentioned it to my dentist and he said we could just fill in the gap. I’m hesitant to do that because I’m worried it will make the teeth on one side look bigger than the others. Is there a better way to do this?

Petra

Dear Petra,

I am very glad you wrote. It appears this dentist has given you bad advice on two fronts. First, the original advice was not only bad esthetically but for the health of her bite in the long term. Let’s start with esthetics first. The tooth next to her lateral incisor is her canine tooth. It is thick and pointy. The Incisor is thin with a more rounded bottom. There is no way her smile will look balanced and normal trying to interchange those two. It also appears you have more of an artistic eye and common sense than your dentist for his latest suggestion, so I am with you. No, don’t just fill in the gap with dental bonding.

As for the damage to her bite, the canine tooth is also different in its root. It has a much longer, stronger root and handles all the sideways stresses of our teeth. If you move that out of its place, as he allowed, she will have long-term consequences.

Dealing with Congenitally Missing Teeth

Diagram of a dental implant

What should have happened in the beginning is he have you get an inexpensive dental flipper for her to hold that spot open once the tooth came out. Then when she is old enough, you can replace it with a dental implant. As it is now, you will have to use orthodontics to get the teeth back into their proper position. I am going to suggest Invisalign. This will work faster than traditional braces and no one will be able to tell she is straightening her teeth.

From there, get the dental flipper and then have a dental implant placed when her jaw is fully developed. It won’t be that much longer, given her age.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.