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Which Dentist Should I Trust?

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I had a dental bridge that went across the front of my mouth. My two canine teeth were the anchor teeth. Then, those became too loose to support the bridge and had to be extracted. At the time, I was going to Comfort Dental. They suggested I replace those teeth with a partial denture. I wasn’t thrilled but did it. I found the partial to be remarkably uncomfortable. Now they are talking about placing mini implants for those teeth, which they said should last me ten years, as well as using a flexible partial for four teeth I am losing on my lower arch. I sort of lost confidence in them so went to get a second opinion. This left me totally confused because this dentist’s plan is totally different. He wants to do three full-sized dental implants that support a bridge. One that is in the center and two on either side of the bridge. He also thinks the bottom teeth need to be dental implants as well. This second option is obviously much more expensive. I’m trying to decide which is better. I’d save money with Comfort Dental, but am not sure I trust them. Do you have a recommendation as you have no skin in the game?

Braden

Dear Braden,

While it is more expensive, I defintely suggest you go with the plan from the second dentist for reasons I’ll explain in a moment. First, I want to talk about why you lost those canine teeth. Using those to support your bridge was a bad idea on the part of Comfort Dental. The twisting forces would lead to those teeth being lost, which is exactly what happened.

Looking at Comfort Dental’s plan, I would not hold out much hope for mini implants to last you ten years. They’re not really designed to do what they’re suggesting. But, let’s say by some miracle that they do last that long. What will you do after that? You can’t just replace dental implants, even mini implants. You have to replace the bone that was lost when they are removed. That means an additional surgery of bone grafting. Only then will you be able to replace them.

Cantilever Bridge Diagram

Let’s look at the engineering principles for the second dentist’s plan. Here you would still have your canines as anchor teeth, so why is this any less dangerous? It is because he is suggesting a third implant placed in the center (where your front teeth would be). How does that help? Because it stablizes the bridge in a way that eliminates the twisting forces that would damage the canine implants. Done this way, your dental implant supported bridge could last you the rest of your life.

What About the Bottom Teeth?

While you can often get away with a removable denture on your top arch because they are held in with suction, your bottom arch depends on the bone ridge to support the denture. The problem with that is the minute your teeth are removed, your body immediately begins resorbing the jawbone to use elsewhere in your body. This has the unfortunate consequence of slowly shrinking your jawbone. In about ten or so years, you will no longer have enough bone left to support a denture. This is known as facial collapse.

Placing dental implants prevents that from happening by having prosthetic roots in your teeth. This signals to your brain that there are still teeth to support and will leave your jawbone intact.

I hope this helps. This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Will Switching to Dental Implants Give Me a Better Smile?

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I’ve been in dentures for about a year and I hate them. Hate isn’t even a strong enough word. They move. It’s impossible to eat the things I love. What I can eat gets stuck in them. It’s humiliating. I think I might have been able to put up with this if my smile looked attractive. In all honesty, my one consolation to myself about needing dentures was that I could finally have a pretty smile…except I don’t. The dentures look fake. I feel like George Washington and his wooden teeth. I’m hoping if I switch to dental implants that I can at least have a beautiful smile. However, I don’t want to spend that fortune if it won’t make a difference. Any advice?

Kelly

Dear Kelly,

Implant overdentures

I have some great news for you with a “but” attached. Getting dental implants can solve all the problems you mentioned above, plus some, BUT, you will probably need to do it with a different dentist. The reason I say that is because your smile could be beautiful even with dentures, though you would still have those other problems. The reason it isn’t beautiful now has to do with the cosmetic skills of your dentist.

My recommendation is you look for a qualified implant dentist who is also a skilled cosmetic dentist. The top cosmetic dentists in the country are AACD accredited, so I’d look for one of those first.

What Can Dental Implants Do for You?

before and after facial collapse

Because your dentures will be anchored to dental implants they will be completely secure. No moving around. Plus, you’ll be able to eat anything you want again.

However, the most important reason to get dental implants instead of removable dentures is the prevention of facial collapse. Once your teeth were removed, your body immediately began resorbing the minerals in your jawbone. This is to use your body’s resources as efficiently as possible. However, the unpleasant result from that is the shrinking of your jawbone. In about ten years or so, you will not only no longer have enough jawbone left to retain your denture, but will look decades older. Dental implants prevent this by signaling to your body that you still have teeth roots that need to be retained. As a result, your body leaves the minerals alone.

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

Are there Soft Dentures?

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Do you know if it is possible to get soft dentures for the upper part? I have complete dentures, but the plate (I think that is what they call it) at the top is hard. Not only is that uncomfortable but sometimes the feeling makes me gag and I can’t even keep them in.

Daisy

Dear Daisy,

Dentures

I am sorry you are dealing with this. Many patients struggle with dentures. Not just with the upper plates, but with the food that gets under them, with the slipping and sliding, and with the difficulty chewing. There are some soft liners that will help patients that have a bony ridge where the lower denture sits. However, there isn’t a soft plate for a denture.

Implant Overdentures Solve this Problem

Illustration of dental implant overdentures

While that may sound disappointing, I do have a solution for you. Your best option is to have some dental implants placed and then have your dentures anchored to them. These are called implant overdentures. This eliminates the problem you have with the plate because the plate is unnecessary. You will find that not only do you not have to worry about the plate, but that your quality of life goes up tremendously. You will even be able to eat whatever you want again, including steak!

One of the most important benefits, however, is the protection to your jawbone. When your teeth were removed, your body began resorbing the minerals in your jawbone perceiving that they were no longer necessary to retain your teeth roots. After ten or so years, there will no longer be enough jawbone left to even retain the dentures you currently have. This is known as facial collapse.

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

 

Why Won’t My Dentures Stay In?

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I am a smidge over 60 years old and have trouble keeping my dentures in, this is true even when I put in the adhesive. They still slip right out of my mouth. Is there anything I can do to keep them in at this point?

Matilda Lynn

Dear Matilda Lynn,

Illustration of dental implant overdentures

I am so sorry you are going through this. You are in a tough spot. However, the good news is that there is a solution for you. I don’t know if the dentist who originally provided the dentures for you had warned you about bone resorption. When your teeth are removed, your body recognizes that and begins resorbing the minerals in your body to use elsewhere. This slowly shrinks your jawbone. Eventually, you lose so much of the bone that you can no longer retain the dentures in your mouth. This is known as facial collapse and why your dentures will not stay in, even with adhesives.

The Solution to Facial Collapse

The first thing you’ll need to do is have bone grafting done. This will build up the missing bone in your jawbone. After this is healed, you have two options.

Your first option is to have new dentures made. Now, you’re only in your 60s, so you should be aware that the cycle of resorption will start over again. Eventually, you’ll be right back to the situation you are in now.

A second option is to get implant overdentures (pictured above). This uses between 4 – 8 dental implants per arch and then anchors a pair of dentures to them.

Benefits of Implant Overdentures

  • Because the implants are prosthetic tooth roots, your body interprets that as you still having teeth and you will no longer have to worry about losing your bone.
  • Your dentures will be completely secure. No more slipping and sliding.
  • You will find your quality of life increases, including your chewing capacity. Even the best-fitting dentures will lower your chewing capacity by 50%. With dental implants, you’ll be able to eat anything you want, including steak.

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

Should I Keep My Last Two Upper Teeth?

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After more problems with my teeth than I care to elaborate on, I am going to be left with most of my lower teeth and only my two front upper teeth. My main question is, would I be better off with removing those two teeth and getting dentures on my upper arch or keep those two teeth and work around them with partials? Those two teeth are healthy, but I cannot get a dentist to give me a good opinion one way or the other. I keep hearing, “Do whatever you want.” But, what I want is to know the best case scenario. I don’t really find the partial dentures very comfortable. I keep them out and mostly chew with those upper two teeth unless it is something that is too difficult for just those. But, if natural teeth are best I can keep doing it.

Ben

Dear Ben,

Illustration of dental implant overdentures

Implant Supported Dentures

You’re in quite a spot. In most circumstances, it is better to save your natural teeth. However, this situation is a bit different. Your upper teeth are going to hit those lower teeth when you’re chewing. Additionally, you are using those teeth more than usual and carrying the duty of the other teeth. I would not expect them to stay healthy at that rate. Dentures will be a little easier on those teeth, so that will work out well for you.

I did say in most circumstances it is better to keep your natural teeth, but that is more urgent if you are talking about lower teeth, not upper teeth. When your lower teeth are removed, it is more serious. This is because when your bottom teeth are removed, your body senses that and begins to resorb the minerals in your jawbone to use elsewhere in your body where you will get more use out of them. The big problem with that is that your jawbone slowly shrinks as a result. If you place dental implants in your lower jaw, it helps to preserve the bone. Without that, you will eventually not have enough jawbone left in on your lower jaw to keep your dentures in.

For upper dentures, that bone is not as essential because they are held in by suction. I would say, in your unique case, you would be better off removing those last two teeth. You’ll be much more comfortable and able to eat a bit better. Of course, getting implant-supported dentures is always better and will increase your quality of life, especially your chewing capacity. But, they are more expensive.

One thing to note. Whether or not you choose the removable dentures or the implant supported dentures, you will want them to be attractive. Make sure you see a dentist who creates beautiful smiles. One easy way to do that is to look on mynewsmile.com, They screen cosmetic dentists for their technical and artistic ability.

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

Will Dentures be Ugly

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I’m losing my teeth. It’s too late to do anything about that, but I’m in a tough spot. I can’t yet afford dental implants, though I am saving up. I need teeth so told my dentist to go ahead and start the process for dentures. He told me I am going not going to be happy with dentures. I”m in tears. Does this mean my smile will be ugly? I know that’s better than no teeth, but I just want to be prepared.

Sylvia

Dear Sylvia,

The way your smile looks depends more on the cosmetic skills of your dentist more than it does on whether you get dentures or dental implants. In reality, when you lose all your teeth, what you get is implant-supported dentures. Your dentist would know that, so this tells me he meant something else when he told you that you wouldn’t be happy with dentures.

The Problem with Dentures

Two profile photos of a woman who experienced jawbone shrinkage and facial collapse, which can be prevented with implant overdentures, available from Philadelphia cosmetic dentist Dr. Michael Weiss.

The results in facial collapse

Even the best fitting dentures will reduce your chewing capacity by 50%. Additionally, there isn’t anything keeping them in so they will move around. The top arch is held in by suction, but also requires a plate to do that. Some people find that difficult to deal with. Those with a sensitive gag reflex find it almost impossible.

The bottom arch simply rests on top of the jawbone. Therein lies the biggest problem with dentures. When your teeth are removed, your body recognizes that. As a result, it begins to slowly resorb the minerals in your jawbone. This shrinks your jawbone. After around ten years, you no longer have enough jawbone left to support your denture. This is known as facial collapse.

If you place dental implants in your jawbone, the prosthetic roots signal to your brain that you need your jawbone to sustain the roots.

I do know you said you couldn’t afford dental implants. As you’re saving up for them, you should be fine. You could start with snap-on dentures which use as few as two dental implants and then work your way up to more. However, there are some options you can use for paying for this you may be unaware of.

Generally, the procedure is paid for in two installments. The first when you have the implants placed. The second, after a period of healing, when they place the dentures. In addition, most dentists are willing to work through Care Credit which is a medical payment plan. This can break up the payments even further for you.

Getting a Beautiful Smile with Dentures

before and after smile makeover

A case done by Dr. Weiss

A great cosmetic dentist can give you a beautiful smile, even with dentures. I would do your research on the dentist before deciding. Your family dentist may not be one who is capable of the artistry and skill necessary to give you a smile you’ll be proud of.

The top of the line cosmetic dentists are AACD accredited. You’ll want one who is also highly trained in dental implants. This way he can plan ahead for when you are able to get the implants you want.

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

Are Implant Overdentures Permanent

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I need to replace my dentures, but this time I’m looking for something that stays put and is permanent. My dentist only does dentures and can’t help me figure out what’s best. I keep hearing dental implants are better than implant overdentures, but overdentures are more affordable. Are the overdentures permanent like the implants?

Morgan

Dear Morgan,

Implant overdentures

Implant overdentures are a combination of dental implants and dentures

I’m afraid you are getting some mixed information. Implant overdentures use dental implants. The reason they are considered more affordable is because with a traditional dental implant you are using a single implant with a dental crown on top. You are talking about replacing every tooth, as I’m assuming you had complete removable dentures. To put a dental implant and crown on every single tooth would have an astronomical cost, as it would require 32 implants.

To make that more affordable implant overdentures use around six dental implants per arch. Then a set of dentures are anchored to the implants. They are definitely permanent and stable. Like all dental implant procedures, their biggest benefit is that they protect you from facial collapse.

Implant Overdentures and Facial Collapse

When your teeth were removed for your dentures, your body recognized you no longer had any teeth roots in your jawbone. In an effort to be efficient, your body begins to resorb the minerals in your jawbone to use elsewhere throughout your body where it perceives the need to be greater.

This has the unfortunate result of shrinking your jawbone. Eventually, you won’t even have enough jawbone left to even keep your dentures in. Getting dental implants prevents this because the implants themselves stand-in for your tooth roots, allowing your body to recognize there are still “teeth” there.

Depending on how long you have had your dentures, you will have lost some jawbone. There is a chance you won’t have enough jawbone left to secure dental implants. If that is the case, you can still get that treatment option; however, you’ll need to have one additional procedure done. Bone grafting can build up the bone loss in order for you to get the best procedure.

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

Can I Get a Beautiful Smile with Dental Implants?

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I’ve had dentures for about ten years. I’ve hated them from the very beginning. They’re unattractive and uncomfortable. Their comfort has been going downhill from the beginning. I’m wondering if dental implants will be better. Will they be more attractive than the dentures? And possibly even fit better?

Kitty

Dear Kitty,

Implant overdentures

A beautiful smile isn’t dependent on whether or not you have dental implants or dentures. What creates the beauty is the skill of the dentist. The other issues you mentioned, however, are specifically a denture issue. Those can be fixed with dental implants. Let’s go over that first, then we’ll talk about how you can be sure they’re beautiful.

When your teeth were removed, your body recognized there were no longer any teeth roots in your mouth. As a result, it began to resorb the minerals in your jawbone in an effort to be as efficient with your body’s resources as possible. This has the unfortunate result of shrinking your jawbone. This is known as facial collapse and why it feels like your dentures no longer fit properly. Eventually, you won’t have enough jawbone left to even retain your dentures.

The dental implants serve as prosthetic tooth roots, thereby letting your body know the minerals in your jawbone are still necessary. This preserves your jawbone.

When you’re talking about full removable dentures, such as you have, you wouldn’t do a one-to-one ratio dental implants to teeth. While you could, it is the “Cadillac” of tooth replacements and would cost a pretty penny. Instead, it’s usually recommended you get implant overdentures, which you see pictured above. This uses dental implants spaced around your arch and anchors your dentures to them. They’ll fit perfectly and be completely secure. You won’t feel uncomfortable with your dentures any more.

Dental Implants after Years of Dentures

You will have to deal with the loss of jawbone you’ve likely experienced after ten years with dentures. In order for the implants to be secure, there needs to be enough bone there to retain them. It’s possible you won’t have enough, but that can be solved with an outpatient bone grafting procedure. This builds up the bone enabling you to get the secure treatment you want.

Getting Beautiful Dental Implants

As I mentioned earlier, the best way to get a beautiful result is with an excellent cosmetic dentist. The best of the best cosmetic dentists are AACD accredited. That’s what I’d look for in your case. In a way, this is a blessing in disguise. It gives you a chance to get a stunning smile, like you see celebrities get.

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

Implant Overdentures with Diabetes

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I’ve had dentures for a few years and really hate them. Now I learned that they’re the worst replacement I could have gotten because they will contribute to my jawbone shrinking. I’d like to get implant overdentures to replace them, but I have Type 1 Diabetes. My dentist said that is a contra-indication for dental implants. If so, what can I do?

Martin

Dear Martin,

Implant overdentures

 

I feel like you haven’t been getting the best dental advice available. Your dentist should have forewarned you about facial collapse when he suggested dentures. He also hasn’t been completely forthright in regard to your question about diabetes. It is not a contra-indication. However, it does put you at a greater risk of implant failure than other patients.

What you’ll need is careful diagnostics previous to your procedure and close monitoring throughout. Make sure they are willing to take more care with you. I want you to see a dentist with significant post-graduate training in the dental implant procedure. Look for someone who’s trained at the Dawson Academy or the Las Vegas Institute of Advanced Dental Studies.

I think it’s also important you go to a dentist who is skilled in both the placement and the restorative (cosmetic) aspect of your case. If they can’t be the same person, they’ll need to work in close communication so there is complete coordination between them to ensure everything goes smoothly.

Benefits of Implant Overdentures

You’ve already mentioned the biggest benefit to implant overdentures. You will no longer have to worry about losing the minerals in your jawbone. Instead, having implants will signal to your brain that those minerals are needed. You will not suffer from facial collapse the way you will if you continue with dentures.

There are other quality of life improvements as well. You won’t ever have to worry about your overdentures slipping or sliding. They will be completely secure. You can eat what you want. You can brush and floss normally. It’s like having a healthy set of teeth again.

Who Should Do the Cosmetic Work?

When it comes to the appearance of your new teeth, you’ll want them to look natural. However, this is also an opportunity to improve the look of your smile at no extra cost. As I said earlier, your dentist should also be skilled in cosmetic work along with the implants. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry. He or she can help you design the smile of your dreams.

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