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dentistry

Replacing a Front Tooth While on Fosamax

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I had to replace a tooth adjacent to my right front tooth. Right now I have a dental flipper and absolutely hate it. I wanted a dental implant but my dentist said that’s not possible because I take Fosamax. I suggested a dental bridge and he doesn’t want to do that either because it will crown the adjacent teeth which he says are fine. That’s true, but I want to get rid of this flipper. Would an Encore Bridge be an option?

Bruce

Dear Bruce,

Three stages of a dental implant

Can you get a dental implant while on Fosamax?

It is possible to get a dental implant while on Fosamax. Your dentist’s concern has to do with the increased risk of local bone problems when having oral surgery. While the risk is small, the complications are serious. Don’t minimize the risk. One possibility is to temporarily suspend taking Fosamax, under the cooperation of your physician who should oversee this.

If you decide against getting a dental implant, a dental bridge is fine, and a better permanent option for you than a dental flipper. That being said, let your dentist pick the type of bridge. You definitely don’t want to be the first patient he or she has done an Encore Bridge on. Some dentists are your basic bread and butter dentists who can only do the “standard” work. That brings up an important point about your dental implant.

Who Should Place Your Dental Implant?

The concern your dentist mentioned is legitimate, however you should be aware that sometimes a dentist will steer you away from a procedure because they aren’t comfortable or qualified to do it. They don’t want a patient to lose confidence in them so instead they come up with reasons to discourage that particular procedure.

You don’t want to push a dentist into a procedure they are not comfortable doing. This usually ends in disaster.

Dental implants are an advanced procedure. You’re in a high-risk group, so it makes it even more important you have an experienced, qualified dentist to do it for you. Look at Dr. Weiss’ qualifications to get an idea of what type of dentist you are looking for.

Another consideration is cosmetic. You’re talking about matching a single crown to your front teeth. You want someone with the cosmetic skill to make it blend both beautifully and naturally. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry.

In your place, I’d look for an AACD accredited dentist who has a high success rate in dental implants.

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

Safety of Dental Implants from a Dental Student

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I wanted to get a dental implant and spoke with my dentist about it. He said I was a good candidate, but the price he quoted me is beyond what I have. Someone from church mentioned I might be able to get it cheaper at a dental school. I’m all for more affordable, but wanted to double check this was a wise option. Would this be a safe way to get dental implants?

Lizzie,

Dear Lizzie,

Three stages of a dental implant

Going to a dental school will cost less. They do that both to draw patients in for their students to practice on and because you are getting a less experienced caretaker.

It is up to you to weigh the risk versus reward and decide which you think is the most important factor to you.

Dental Implants at Dental Schools

Dental schools are very careful. They are there to teach their students best practices. There is always an instructor there to check the student’s work. All that being said, this is an advanced procedure and even uncomplicated cases, such as yours, still require surgery.

It will be the dental student which implants the prosthetic tooth root. Even expert implant dentists who’ve been doing the work for years will sometimes have a procedure fail.

There are things which can go wrong and although there is an instructor there, it is a matter of whether or not this dentist is skilled at recognizing issues quickly enough to intervene.

Paying for a Skilled Implant Dentist

If you decide you’d rather see an implant dentist with more experience, then you can see if they have in-house payment plans. They may not. But, even when they don’t, dental implants are generally paid for in two phases. First, you would pay for the implant surgery. Then, after a period of healing, you would pay for the dental crown.

If that is still out of reach, there is a medical credit company that could pay the fee to the dentist and allow you to pay it out to them. You can apply for Care Credit online. They have low and even no interest plans. If you have basically good credit, you shouldn’t have a problem.

If it turns out you absolutely cannot have a dental implant, getting a dental bridge, which is simply a false tooth suspended between two dental crowns) is a perfectly acceptable tooth replacement option.

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

Dental Implant Doesn’t Match

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I’m devastated by how my dental implant turned out. I lost a front tooth due to a fall down the stairs. My dentist assured me that he’d be able to give me a new tooth that would help me smile again. The dental implant part is fine, but it doesn’t match my other teeth. It’s way more obvious because it’s a front tooth. I haven’t smiled since the fall. I just don’t know what to do. Can this be fixed or whitened? If not, I’m pretty sure I’ll never smile again.

Misty

Dear Misty,

A diagram of a dental implant

I have two pieces of good news for you. First, this can be fixed. Second, you won’t need to do the dental implant over. However, teeth whitening won’t be your solution for two reasons.

One, teeth whitening only works on natural tooth structure. What would happen is the teeth surrounding the implant crown would whiten but not the crown itself.

Second, even if it could whiten, you wouldn’t be able to get an exact match to your tooth that way. You might get close, but front teeth are very exposed. Any little difference is noticeable.

Matching a Single Implant Crown

Because of that, matching a single front tooth requires an expert cosmetic dentist. Only a small percentage of cosmetic dentists are able to do it well.

In your place, I’d look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have passed stringent oral and written exams on technical skill and knowledge as well as submitted a large number of specific cases they’ve done in order to demonstrate their artistry.

If you don’t have one within a reasonable driving distance, a second option would be to look on mynewsmile.com to find one of their recommended dentists in your state.

Cosmetic dentists from either site can re-do your crown to match the adjacent teeth.

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

3 Facts about Smoking and Dental Implants

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Dental implants can be used to replace individual missing teeth, anchor a dental bridge, or support dentures. But what if you smoke? Does it increase the risk of implant failure, or does it have no effect at all?

How Does Smoking Affect Dental Implants and Oral Health?

Smoking affects your oral health in several ways that directly affect the success of dental implants.

1. Narrows Blood Vessels

Nicotine causes blood vessels to constrict. Whether your nicotine intake comes from smoking cigarettes, chewing tobacco, or vaping, one result is the same—narrow blood vessels that limit the amount of oxygen carried to your oral tissues. And the slower the blood flow and oxygen, the longer and more complicated the healing process will be after dental implant surgery.

2. Reduces Blood Flow

A diagram of a dental implant
Dental implants fuse with the bone

Osseointegration is the process during which your jawbone and dental implants fuse together and form an incredibly strong bond. But healing depends on blood flow. If the bone and dental implants don’t fully integrate, the implants can fail and need to be removed and replaced.

3. Masks Gum Disease

Smoking narrows blood vessels. Narrow vessels are slower to bleed than healthy ones. But bleeding gums are an early sign of gum disease. If this warning sign of gum disease is masked, it will become more difficult to detect. An undetected infection around a dental implant will likely lead to implant failure.

What Does a Recent Study Show?

The results of one study were published in a 2017 article published in the Journal of International Oral Health. The report reveals the following:

  • Studies show that smokers have a higher risk of gum disease, tooth loss, and oral cancer.
  • Smoking is associated with bone loss, poor bone quality, decreased bone height, and peri-implantitis—an infectious gum disease that contributes to bone loss.
  • Bone resorption caused by long-term and frequent smoking increases the risk of dental implant failure.

What Can You Do?

Tell your oral surgeon – If you smoke or use products that contain nicotine, consider and carefully weigh the risks. Tell your oral surgeon that you smoke. It is vital to your oral health and the success of your dental implants that your surgeon knows about this risk.

Heed the advice – You may be advised to stop smoking for a specific period of time before implant surgery and throughout the healing process. If that’s the case, heed the advice. Dental implants are the most expensive form of tooth replacement. Protect your investment.

Get help – If you’re struggling with trying to break the habit, get help. Speak with your medical doctor and ask for advice or treatment that will help you stop smoking before you receive dental implants.

Schedule Consultations

When you’re ready to move forward with replacing your missing teeth, schedule consultations with a least two skilled implant dentists. Compare several factors to help you choose the right provider:

  • Explanation of your treatment options
  • Each dentist’s level of training and experience
  • Your interaction with the dentist and staff and the office environment
  • Cost

This post is sponsored by Dr. Michael Weiss, an accredited cosmetic dentist in Philadelphia, PA.