Six Upper Teeth Left After Gum Disease. What Are My Options?

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I had a two-year battle with gum disease that left me with six upper teeth remaining. The teeth are unevenly spaced from tooth loss and disease. My dentist recommends dental implants, but implants are expensive, and they do not resolve the spacing issue. I am not against implants, but the thought of going into debt for them makes me anxious. Maybe I need to take more time to find affordable implants and dentures. I already wear an uncomfortable dental flipper and understand I can get a partial denture or another flipper. I have a lot of teeth to replace, but at 62 years old, with longevity in my family, I must do something about my missing teeth. My thoughts are scattered. What are your suggestions? Are dental implants my only option? – Antoinette from Austin, TX

Antoinette

Thank you for contacting Dr. Brooksher’s office. Dr. Brooksher would need to examine your teeth and gums and take a 3-D T scan to determine your treatment options. Still, we can advise you on how to find a dentist to manage your case and give you a healthy, attractive smile.

Are Dental Implants Your Only Option?

It is unlikely that dental implants are your only option. Still, your treatment options depend on several factors, including:

  • Your oral health
  • The condition of your remaining teeth
  • Your jawbone volume and quality
  • The sizes of your remaining teeth
  • The extent of spacing between your teeth

Schedule a Consultation with a Cosmetic and Implant Dentist

We recommend searching for a dentist concerned about the function and appearance of your teeth and smile. You will benefit from a highly sympathetic dentist with advanced training in these areas:

  • Cosmetic dentistry
  • Dental implants
  • Occlusion and bite
Diagram of snap-on dentures. Dental implants are in the lower jawbone, and a denture with attachments in the base is hovering above the gumline.

A snap-on denture is an affordable option for dental implants

Although saving natural teeth is a dentist’s priority, affordable implant dentures can restore your smile if your remaining teeth do not support your long-term oral health. The dentist will explain options for natural-looking teeth replacement that complement your facial features and personality. An implant bridge may be an option for you.

Dr. Steven Brooksher, a Baton Rouge accredited cosmetic dentist and Fellow of implantology, sponsors this post.

My Implant Denture Makes My Lips Look Bulky

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Should permanent dentures (all on four) be placed with the anterior teeth 2 to 3 mm from the gum line, or should they follow the gum line? Is this a standard procedure or the dentist’s choice? I have bulky lips from a denture that protrudes. I’m doing some research and figuring out what to do next and whether I can trust my dentist. – Thanks, Demetrius from NJ

Demetrius,

Before we answer your question, we want to define the gumline. As shown in the picture to the right, the gumline is the edge where the gum meets a tooth. Consider some examples:

  • If a tooth is extracted, there is no longer a gumline.
  • If a tooth is replaced with a dental implant, the gumline is the edge that meets the dental crown.
  • If all your teeth are missing and you receive a complete denture, the gumline is the edge of the pink, gum-colored acrylic that meets the false tooth.

We defined the gumline because it is impossible to place a dental implant at that location.

You’re probably referring to where a dentist places teeth near the jawbone ridge beneath the denture.

Complete removable denture

When you receive a complete removable denture, your dentist should place the denture’s front lower teeth directly over the bony ridge. If the denture is too far forward, it will tilt back when you bite anything with your front teeth.

All-on-4 dental implants

Denture above dental implants ready to be screwed on

All-on-4 implant denture

An implant-retained denture, such as All-on-4, is secure and won’t tilt when you bite. The placement of denture teeth 2-3 millimeters from the ridge, as you described, is close enough within range for a removable denture or an implant denture.

Aesthetics and facial appearance are essential for natural-looking results. But measurements alone should not determine where a dentist places your denture. Advanced cosmetic dentists make a wax model of the denture for you to try in before the lab completes the acrylic version. The wax model lets your dentist evaluate how the implant denture affects your facial features, lip, speech, and the overall function of your mouth.

Adjusting your denture to soften the appearance of your lips

If you already have your implant denture, your dentist can remove it and reset the teeth. If the problem persists and your dentist can’t resolve it, you can schedule a consultation with an advanced cosmetic dentist for recommendations. Your dentist may charge a fee to reset the teeth, but if you’ve already expressed satisfaction, they might do it without cost.

 

Dr. Steven Brooker, a Baton Rouge Fellow of implant dentistry, sponsors this post. Dr. Brooksher is accredited by the International Congress of Oral Implantologists.

 

 

I get a migraine before dental appointments

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Before every dental appointment, I get a migraine headache. I know this is anxiety, but I can’t stop myself from getting headaches. Of course, I can’t drive myself to the dentist either when I have a migraine. This has been going on for 2 years, during which I have only seen a dentist once.  Last week, I saw a dentist for an urgent appointment because my denture broke. The dentist warned me to fix it promptly to avoid an emergency. My anxiety level is over the top, and I cannot think clearly enough to know if I can trust this dentist for a new implant denture or if I need to look elsewhere. Where do I start? Thank you. Aaron from Chicago

Aaron – We suggest that you find a dentist who caters to anxious patients. Find two or three dentists with whom you can schedule a consultation. But ensure the dentists are also skilled with dental implants.

Schedule the consultations without mentioning the kind of dental treatment you need. Explain your anxiety and listen to and watch how each dentist responds to determine which one might be best for your needs.

Diagram of a snap-on denture. The denture is hovering above the jawbone that has two dental implants in it.

Affordable dental implants will secure your dentures

Ask each dentist what they do to help patients relax. If sedation dentistry is available, find out what levels of sedation the dentists offer and what you can expect from each level. If oral conscious sedation is an option, you will be able to take a small amount of anti-anxiety medication before your appointment.

Tell the dentist about your migraines. Depending on the sedation type, you may need to arrange transportation to and from your appointments.  And when you receive implant dentures, you can expect to be sedated for the surgery.

There are ways to help you maintain good oral health and to get the dental care you need. Finding the right dentist to meet your needs will get you back on track.

 

Steven Brooksher, DDS, is a cosmetic and Fellow of implant dentistry in Baton Rouge, LA. Read about his credentials and visit his smile gallery. It will help you determine what to look for in a dentist in your area.

My snap-on denture bone graft failed

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I agreed to two dental implants for a lower snap-on denture. My dentist said my jawbone had shrunk from having all my teeth missing for 15 years, so he needed to do bone grafting. We waited two months, and then during my second follow-up appointment, my dentist said that the bone graft failed. I am disappointed that I must start the process all over. I know my dentist has placed implants for at least a hundred patients. Although I didn’t think about it before, I wonder if he is not is good with bone grafting. Although I like my dentist, I hate the thought of another bone graft failure. I don’t know what to ask you, but I’m nervous and want some insight into the issue. – Thank you. Isaac from TN

Hello, Isaac,

Thank you for contacting our office.

We understand your concern and hesitation. Although many dentists have implant training and place implants frequently, fewer dentists have lots of bone grafting experience.

It is good that your dentist is upfront with you and did not try to place your implants anyway. Any implant denture—including a snap-on denture—requires good bone support. Otherwise, both the graft and implant will fail.

What to Do After Bone Graft Failure

Diagram of a snap-on denture. The denture is hovering above the jawbone that has two dental implants in it.

Healthy bone grafting will help secure your affordable implant denture

If you have experienced bone graft failure and are hesitant about letting your dentist try again, consider these options:

  • Talk to your dentist about your concerns – It may be easier to decide what to do if you ask your dentist how much bone grafting experience he has acquired over the years. You can also ask if your dentist knows what caused the bone grafting failure and what he will to do prevent it from recurring.
  • Ask for a referral – You can ask your dentist to refer you to a periodontist (implant specialist) or an oral surgeon for grafting and implant placement.
  • Get a second opinion – You can get a second opinion from a dentist with advanced implantology training who regularly performs bone grafting procedures.

Each time you experience bone graft failure, you must wait for the grafting sites to heal before another attempt. Weigh the pros and cons and do what you think is best for your oral health. Best wishes for a resolution and being able to enjoy your new implant denture.

Steven Brooksher, DDS is a cosmetic and implant dentist in Baton Rouge, LA. Read about his credentials and visit his smile gallery. It will help you determine what to look for in a dentist in your area.

 

Are All-on-4 Implants Really My Only Option?

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Last month, I had a consultation with a dentist about stabilizing my dentures. They don’t have to be perfectly stable, but I do not want them sliding around anymore. The dentist recommends all on 4 implants. When he told me the cost, I told him that is way out of my budget, and I will have to explore my options. He quickly said that there are no other options because I’ve worn dentures too long. He said that his rate is among the best I will find. Is it possible that all on 4 could be the only way a patient could qualify for implant dentures? If so, I will forget about getting implants and accept my dentures as they are. Thank you. – Brett from TN

Brett,

Thank you for contacting our office.

You mentioned that you had a consultation with this dentist. Based on your description, it seems that you did not have an exam, CT scan, or any x-ray for the dentist to decide that All-on-4 implants are your only option. And that is puzzling. Be careful with this dentist.

If you have worn dentures for many years, you have some jawbone shrinkage. But an implant dentist can build up the bone with grafting to ensure the implants have plenty of support.

What Type of Implant Dentures Can You Receive?

The American Academy of Implant Dentistry clearly explains the types of dental implants available. But a dentist can define your treatment options only after these steps:

  • Reviewing your medical and dental histories
  • Examining your teeth and gums
  • Reviewing a CT scan

Affordable Implant Dentures

Diagram of snap-on dentures. Dental implants are in the lower jawbone, and a denture with attachments in the base is hovering above the gumline.

A snap-on denture is an affordable alternative to All-on-4

A snap-on denture or a denture retained with mini-implants is more affordable than the All-on-4 technique. Those affordable options use as few as two dental implants. Although more implants will improve a denture’s stability, your treatment costs will increase.

And not every patient qualifies for All-on-4. We recommend that you look for an implant dentist with extensive post-graduate training and schedule an appointment for an exam. The dentist will explain your treatment options. A conscientious dentist will discuss the pros and cons of each option but will not insist that you receive a specific type of treatment—or any treatment at all.

 

Steven Brooksher, DDS, is a  Baton Rouge cosmetic  dentist and Fellow of International Congress of Oral Implantologists. Read about his credentials and visit his smile gallery. It will help you determine what to look for in a dentist in your area.

Extract Remaining Teeth for Dentures? 6 Facts to Help You Decide

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I have advanced tooth decay and gum disease. My two center front teeth are healthy, and after a visit with the periodontist, he says that those two teeth are likely the only ones he can save. I have a cheap bulky partial, and I have an underbite. My dentist thinks that removing the two teeth and getting a complete denture would be healthier than partial dentures. I got a second opinion, and the dentist said that he could do either option, and it’s up to me. I guess that a full denture would look better than a partial. I’m asking a couple of dentists online for their help. My budget is limited, and I’m concerned about that too. But I’ve learned my lesson about neglecting my teeth, so although I’m not too fond of debt, if I need a loan to correct the situation, I’ll apply for financing.  Is it best to have my center front teeth removed or to get partial dentures around them? Thanks. Timothy from Huntsville, AL

Timothy,

For an accurate diagnosis and treatment options, Dr. Brooksher would need to examine your teeth personally and do x-rays.  We’ll give some principles based on your description of your oral health. But we can give you some principles that might help.

Save Your Teeth or Extract Them for Dentures?

The factors below and talking with your dentist can help you decide if you want to keep your teeth or get full dentures.

1. It’s usually best to save healthy natural teeth

When your natural teeth are healthy and won’t compromise your oral health, it’s usually best to save them. Replacing teeth with a removable appliance—a partial or full denture—has many disadvantages. The denture can move or slide if it’s not anchored, and it won’t be comfortable.

2. When few teeth remain, they are under stress

If you only have two upper teeth that are healthy, the force from your lower teeth when you bite and chew puts stress on the upper teeth. Pressure on the teeth can weaken them internally, even if they appear healthy on the outside.

3. A full upper denture increases comfort

Suction keeps a full upper denture in place, and it moves less than a lower denture. It’s more comfortable than a partial denture, and it’s easier to eat and chew with it.

4. A well-made upper denture is healthy for other teeth

A well-made upper removable denture is gentle on lower teeth. If you have a severe underbite, the force or impact of chewing can put stress on lower teeth.

5. When all your teeth are missing, your jawbone is affected

Teeth stimulate the jawbone, so when all your teeth are missing, the stimulation stops, and your body resorbs the bone. After 10 to 20 years, you’ll lack enough jawbone to support your facial muscles, and your face will sag and make you look older. The missing bone will make it difficult—if not impossible—to keep a lower denture in place. But you will still have some suction for an upper denture.

6. Implant-supported dentures increase function and comfort

Diagram of a snap-on denture. The denture is hovering above the jawbone that has two dental implants in it.

Affordable dental implants will secure your dentures

Your dentist can tell you if you’re a candidate for an implant-supported partial denture or an implant-supported denture. Either option might exceed your budget, but implants stimulate your jawbone to prevent further shrinkage. Your denture won’t slip around, and it will be comfortable to eat and speak with it.

Again, Dr. Brooksher hasn’t completed your oral exam or seen your x-rays, so you’ll have to rely on a local dentist for accurate diagnosis and treatment options.

Steven Brooksher, DDS of Baton Rouge sponsors this post. Dr. Brooksher is an accredited cosmetic dentist and a fellow of the International Congress of Oral Implantologists.

Diabetes and Dental Implants – How to Choose Your Dentist

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My mom has type 1 diabetes and is recovering from severe gum disease. The teeth that she hasn’t lost are weak and rotten. I’m afraid for her health. I’ve suggested that she gets dentures and two mini implants. She is concerned about her diabetes because she’s already had a foot infection that was hard to control. Is type 1 diabetes a reason not to get dental implants, or are there certain precautions we can take? Thanks. Ada from Montgomery, AL

Ada,

Although type 1 diabetes is a risk factor, it’s not a reason to avoid dental implants. Precautions start with the dentist’s protocol to assess risk factors for each patient with careful diagnostic work. Your mom’s diabetes must be well-controlled to prevent the condition from interfering with the implant healing process.

Selecting an Implant Dentist for Patients with Diabetes

We recommend scheduling at least two appointments with a dentist who is a fellow of the Academy of Implant Dentistry or the International Congress of Oral Implantologists. Also, look for a dentist with advanced training in cosmetic dentistry to get natural-looking dentures for your mom. What can you expect from a dentist with these credentials?

  • Medical and dental histories review – After thoroughly reviewing the histories, an implant dentist will be aware of all risk factors, including type 1 diabetes. The factors help determine if dental implants are an option.
  • 3D CT scan – Oral anatomy is clearly defined on the scan to show how and where your dentist will place the implants.
  • Digital placement – Digital navigation helps your dentist during implant surgery. Although the surgery is minor, a dentist must position the implants in the optimal location to promote healthy healing.
  • Restoration – A dentist with a fellowship in implantology will perform the surgery and restore your mother’s missing teeth with dentures. If one doctor completes both procedures, it eliminates miscommunication that sometimes occurs between a dentist and an oral surgeon. And it will save your mom extra fees that she would pay to an oral surgeon.
Diagram of a snap-on denture. The denture is hovering above the jawbone that has two dental implants in it.

Affordable dental implants will secure your dentures

As few as two implants can stabilize dentures. Mini implants or snap-on dentures will give your mom’s dentures some stability and help limit jawbone loss. Standard implants increase stability. And the stability will increase with the number of implants she receives. You can help her achieve a successful outcome by researching top implant dentists in the area.

Steven Brooksher, DDS is a cosmetic and implant dentist in Baton Rouge, LA. Read about his credentials and visit his smile gallery.

Need Teeth Extracted Before Dentures? 3 Facts to Consider Before Visiting an Oral Surgeon

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I hate the thought of wearing dentures at 50, but most of my teeth are missing. The few that are left have deep decay. The drama with my teeth comes from years of neglect when I was younger. Now I’m stable and can afford to do something about my teeth and smile. I guess I have a little less anxiety about dental appointments than when I was younger, but I’m concerned about having any type of surgery. I’m wondering if I should see an oral surgeon first and get the remaining teeth pulled or if I should go to a dentist and let him refer me to an oral surgeon. Thanks. Brad from AR

Brad,

There dentists who can do both—extract your teeth and provide you with dentures. Extractions before dentures are not complicated, and many general dentists do both.

  • Search online for a dentist with at least several years of experience.
  • Call their offices and ask how the dentist handles cases when a patient needs extractions before dentures.
  • The office representative’s answer will explain if the dentist completes extractions and provides dentures.
  • If you choose a dentist who refers patients to an oral surgeon for extractions, he or she will coordinate your care.

Relieving Your Anxiety

As you call dental offices, ask an additional question: What does the dentist do to calm anxious patients? Many dentists are gentle and successful in helping patients relax and receive painless treatment. Others offer sedation dentistry, which is anti-anxiety medication—varying in different strengths depending on your anxiety and the procedure you’ll receive.

Some Advice on Stabilizing Your Dentures

A common source of anxiety about dentures is fear of them clicking, sliding around, or falling out. If your budget allows, consider stabilizing your dentures with dental implants.

What Are Implants?

Diagram of a snap-on denture. The denture is hovering above the jawbone that has two dental implants in it.

Affordable dental implants will secure your dentures

Implants are small screws that are embedded in your jawbone like tooth roots. But when all your teeth are missing, implants are used to support your denture. Your implant dentist can attach an arch of replacement teeth—or a denture—to at least two dental implants.

Benefits of Implant Overdentures

  • Minimize denture movement. Dental implants anchor a denture. And with four to six implants, you’ll have minimal movement with your denture, and it will feel more like your natural teeth. It’s much easier to bite and chew food with stable implant overdentures.
  • Preserve your facial features. You’re only 50 years old. The longer you wear dentures, the more your jawbone will shrink. Natural teeth stimulate the bone and prevent it from shrinking. But dentures don’t stimulate your jawbone; they put pressure on it and make it shrink faster. Dental implants rescue your jawbone from shrinking away and making your face sag prematurely.
  • Provide a better experience overall. Most fears about wearing dentures are related to how much they will move and shift in your mouth and how they will look. Cosmetic dentists are skilled at providing dentures that look like natural teeth.

If you search for and find an implant dentist with cosmetic dentistry skills, it will erase most—if not all—your worries about dentures.

Take time to find a dentist who will correctly and beautifully restore your smile.

Steven Brooksher, DDS is a cosmetic and implant dentist in Baton Rouge, LA. Read about his credentials and visit his smile gallery. It will give you ideas on what to look for in a dentist in your area.