What Are His Options for Replacing a Missing Lateral Incisor?

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My 17-year-old was born with a missing lateral incisor. Our pediatric dentist said that the canine tooth would eventually fill the space. The dentist was right, but my son’s smile looks weird. He is self-conscious about his smile, and I understand why. We saw another dentist yesterday who recommended braces and a dental implant. Does that make sense or will dental bonding work? – Thanks. Lydia from AL

Lydia,

Repositioning the canine tooth to its proper place, followed by placing a dental implant for the missing tooth, is recommended for a missing incisor. The canine tooth, its substantial size, and long root are designed to absorb sideways chewing forces to protect the back teeth. Allowing this tooth to remain displaced can lead to costly dental problems.

Model of a dental implant with the crown, abutment, and root form labeled

A dental implant is the healthies and most natural-looking way to replace a dental implant.

The canine’s natural bulk and shape make it very difficult to create a normal-looking smile when it substitutes for a lateral incisor, which is a much thinner and more delicate tooth. Attempting to reshape the canine requires excessive tooth reduction, potentially damaging the tooth. Dental bonding or a porcelain veneer is usually inadequate for altering the bulk of the canine. This aesthetic challenge is magnified when the lateral incisor is missing on only one side because the imbalance is more noticeable.

How Do Braces Help with a Missing Incisor?

Correct tooth positioning may require braces to create space for replacing a missing lateral incisor. A healthy smile is important for a teenager’s social development and confidence. Consult a cosmetic dentist with implant dentistry training to discuss your son’s options and the estimated cost.

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

My Dental Implant Crown Color Doesn’t Match My Teeth

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My dentist tried three times to get the color right for my implant crown, but she can’t seem to do it. After the last try, she said I should be pleased with the improvement, but she admitted that the shade was darker than my natural teeth. My dental flipper looked better than the implant crown. My teeth were whitened first, and my dentist said that complicated the color match. Is it common to have these problems with an implant? Would it hurt the implant if another dentist grinds off the crown? – Thanks for your help. Rhylan from NJ

Rhylan,

A skilled restorative implant dentist can grind off the implant crown without damaging the implant. It takes kill and patience to match a dental crown to surrounding teeth. If you have an implant crown or a traditional crown on a front tooth, it is common for a few tries to achieve a perfect match.

Trained cosmetic dentists collaborate with dental ceramists to create a color map for the crown, ensuring it matches the natural tooth. This collaborative approach helps to resolve any color discrepancies. Using digital and physical photos further aids in comparing the dental crown to the natural tooth, instilling confidence in the process.

An artistic restoring dentist takes great care in the color-matching process. They won’t cement the crown without your approval until a perfect match is achieved, ensuring you are completely satisfied with the result.

We recommend consulting an advancing cosmetic dentist who understands tooth shade, tint, and translucence. Cosmetic dentists work with master ceramists to achieve natural-looking results. Your implant crown will blend with the surrounding teeth.

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

Can I Get Dental Implants If I Take Actonel?

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Can I get dental implants if I’m on Actonel for osteoporosis? My upper left front tooth and incisor behind have been missing for 14 years. I had my first consultation with a dentist last week. She is not pressuring me to get dental implants but presented them as an option. I haven’t disclosed my medical history to the dentist yet. However, she said implants need healthy bone, which made me think of the medication. Would Actonel prevent me from getting dental implants? Thanks. Craig from NH

Craig,

Model of a dental implant with the crown, abutment, and root form labeled

Each patient’s case is unique, so you must find an experienced implant dentist or oral surgeon to determine whether you are a candidate for dental implants. However, we will provide general information on whether a person taking Actonel® or other bisphosphonates can get dental implants.

Can You Get Dental Implants While Taking Actonel or Other Bisphosphonates?

If you take Actonel or other bisphosphonates, you may still be a candidate for dental implants. Actonel is a bisphosphonate that treats osteoporosis by slowing down the cells that break down bone tissue. However, an implant dentist, oral surgeon, or periodontist (gum and bone specialist) will take a CT scan of your oral anatomy and review your medical and dental histories to determine if you are a candidate for dental implants.

How Do Bisphosphonates Affect Dental Implants?

Bisphosphonates increase the risk of developing jaw osteonecrosis, which can weaken bone tissue. However, if you are a candidate for dental implants, an implant dentist or specialist may recommend the following:

  • Stop taking bisphosphonates four to six months before dental implant surgery.
  • Avoid the medication while dental implants fuse with your jawbone.
  • Resume the medication when the risk of compromising your dental implants is low.

What Does Research Show for Bisphosphonates and Dental Implants?

The October 2023 issue of Cureus published an article on bisphosphonate-treated patients and dental implants. Researchers recommend careful consideration, management, and bone monitoring for dental implant patients taking bisphosphonates.

A September 2023 Materials (Basel, Switzerland) article cautions that patients taking bisphosphonates have higher dental implant failure risks than patients not taking the medication.

Schedule Dental Implants Consultations

Schedule consultations with implant dentists, periodontists (implant specialists), or oral surgeons if you want dental implants. Tell the doctor that you take Actonel for osteoporosis. Take notes and compare your treatment options from the consultations. However, avoid insisting on dental implants if they are not recommended. If you are not a candidate for dental implants, a skilled cosmetic dentist can give you natural-looking results with alternatives.

 

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

 

Is My Tooth Cracked Beneath a Dental Bridge?

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After my routine hygiene and dental exam last week, my dentist said I needed a new upper left bridge. She said an anchor tooth in the bridge was cracked. I don’t have problems with the bridge, nor have I felt any discomfort. Should I deny a new bridge if I don’t have symptoms? Thank you. Portia

 

Portia,

Your dentist’s diagnosis should accompany an X-ray showing your tooth is cracked. Generally, you would feel sharp pain when biting hard food if a tooth is cracked. Also, it is unusual for a crowned tooth to crack. A crown protects a weak tooth and prevents it from cracking.

We recommend getting a second opinion from an advanced cosmetic dentist without mentioning your dentist’s diagnosis. Ask for an exam and X-ray, but provide as little information as possible. Avoid telling the dentist that you or your dentist think your tooth beneath the bridge is cracked. You might ask if the dentist seeks anything questionable about your upper left teeth.

A dental bridge hovering above dental implants and abutments

Dental implants can anchor a bridge and replace multiple missing teeth in a row

Your situation underscores the advantage of replacing a tooth with a dental implant. If anything goes wrong with a tooth that is a part of a dental bridge, a dentist usually replaces the entire bridge. However, a dental implant stands alone and is not affected if you need dental work on an adjacent tooth.

If your tooth beneath the bridge cracks, a dentist must remove the tooth and extend the bridge to cover the space left after the extraction. Consider getting a dental implant or an implant bridge as an alternative to traditional bridgework to replace missing teeth.

 

Dr. Steven Brooksher, a Baton Rouge accredited cosmetic dentist, sponsors this post.

Is a Recent Toothache a Reason for an Extraction?

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Is a recent toothache a reason for an extraction? I moved here from Connecticut in July, so I haven’t had time to search out a dentist like I want thoroughly. I’ve had a lower jaw and toothache on the back left side of my mouth for two weeks. The pain comes and goes. I went to a nearby dentist who took an x-ray. She said that a molar that already has a filling in it has a large cavity. She recommends pulling the tooth and replacing it with a dental implant.

Does this sound right? I had no idea this was happening with the tooth because the pain started only two weeks ago, and it comes and goes. I haven’t had a throbbing toothache or significant discomfort in other ways. Thanks. – Victoria

Victoria – If the pain in your tooth just started, the tooth has only recently become infected. If a dentist cannot save the tooth, it would be more likely that you would have felt pain months ago. The tooth may be badly broken or decayed, and a dentist may think it is unsavable. Or, the dentist may want to remove the tooth rather than try to save it because of its condition and the time it would take to restore it.

Model of a dental implant with the crown, abutment, and root form labeled

A savable tooth may need root canal treatment,  not extraction and a dental implant

It is best to seek a second opinion without telling the second dentist about the diagnosis from the first dentist. Your independent second opinion should include an X-ray to determine the tooth’s condition. A dentist or endodontist may be able to save the tooth with root canal treatment. Otherwise, you may get a recommendation for an extraction and dental implant.

We advise patients to get second opinions before agreeing to significant treatment that is costly or will impact their oral health. For example, a missing tooth can lead to other concerns, including teeth drifting out of place and creating a need for braces to realign them.

Baton Rouge dentist Dr. Steven Brooksher sponsors this post. Read about his education and training, and learn what he does to provide some of the best dental care in Baton Rouge.

My Implant Dentures Messed Up My Bite

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My implant dentures are too big and messed up my bite. My dentist tried to adjust my bite four times, but it’s not working. The denture doesn’t fit well. Now, my mouth is burning and irritated, and I have hives on my inner lips and gums.  Could I be having an allergic reaction, too? Thanks. Miriam from New Orleans

Miriam,

It is possible to have an allergic reaction to your acrylic denture base. Titanium allergies are rare, but it is possible to react to dental implants. You would need testing to confirm whether you are allergic to denture materials. However, stressful dental visits are sometimes associated with burning mouth syndrome.

Your denture has disrupted your bite.  A dentist must correct it to prevent symptoms of jaw muscle spasms, headaches, and other symptoms of TMJ disorder. We recommend consulting a dentist with advanced training in occlusion and bite. The dentist can ensure upper and lower denture teeth meet correctly when you close your mouth or chew.

Denture above dental implants ready to be screwed on

Denture and implant position can affect your bite

Find a dentist with training from at least one of these dental education centers:

  • Spear Education in Arizona
  • The Dawson Academy in Florida
  • The L.D. Pankey Institute in Florida
  • The Las Vegas Institute for Advanced Dental Studies in Nevada

A disrupted bite can cause ongoing stress, leading to hives and oral irritation. Speak to the second-opinion dentist about your symptoms. The dentist will examine your mouth and denture and review your X-rays to determine whether the position of your denture, implants, or both are causing bite problems. Other factors can cause discomfort, and the dentist can identify them.

Schedule consultations with two dentists to discuss and compare their evaluations and treatment recommendations.

Baton Rouge dentist Dr. Steven Brooksher sponsors this post. Read about his education and training, and learn what he does to provide some of the best dental care in Baton Rouge.

Can a Dentist Save My Loose Implant?

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Last August, I had dental implant surgery. A periodontist placed the implant, and I returned to my regular dentist for a temporary crown. The dentist had difficulty getting the temporary crown on and forced it down. The crown hurt the entire time I had it.

My dentist kept saying everything was okay. He could not see anything wrong. Every time he touched the temporary crown, I felt even more pain, and I think he was afraid to try to remove it. I switched to a new dentist to get the permanent crown because I needed more confidence in my prior dentist. My new dentist says that the implant is loose. I know it is loose due to the trouble with the temporary crown. Can you give me an outside opinion on whether this can be fixed without removing the implant and doing it all over again? Thank you. Demetrius from Ohio

Demetrius,

Thank you for your question.

Can a Dentist Save Your Loose Implant?

A dental implant with the crown, abutment, and root form identified, for information on loose dental implants due to infection

A skilled implant dentist must take digital X-rays and examine your implant before determining whether they can save or remove it. Sometimes, eliminating infection around an implant or adding bone graft material can save it. If a dentist must remove it, you may require bone grafting and healing time before replacing the implant.

Why Do Dental Implants Loosen?

Reasons that a dental implant may loosen include:

  • The crown – The dental crown—not the implant itself—might be loose. If a dentist does not correctly place the crown, pressure can cause it to loosen.
  • Poor placement – If a dentist or surgeon places an implant in the wrong location, it can loosen.
  • Premature loading – Sometimes, pressure from attaching replacement teeth too soon can loosen implants.
  • Smoking – Blood vessels will constrict if you smoke during healing, and your jawbone and implants will not fuse.
  • Patient risks or habits during healing – If you grind your teeth, bite your nails, or deviate from a soft-food diet during the healing process, implants can loosen.
  • Gum disease – Infected tissue around implants can prevent your jawbone from integrating.
  • Lack of bone density – Jawbone supports implants. The implant fixtures won’t fuse to the jawbone if you lack bone density. They can easily loosen.

Select a dentist with advanced training and years of experience with dental implants or who works with a skilled oral surgeon for implant placement. Schedule at least two second-opinion appointments to compare your options.

Baton Rouge dentist Dr. Steven Brooksher sponsors this post. Dr. Brooksher is a Fellow of the International Congress of Oral Implantologists.

Two of My Permanent Teeth Never Erupted

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My permanent upper canine and incisor on the right never erupted. I still have small primary teeth that did not fall out. The teeth look weird because they are so small and don’t match the size of the surrounding teeth. I am 27 years old and trying to progress with my career. Can a dentist make the small teeth look larger, or is it best to get them removed and replaced with dental implants? Thank you – Andreas

Andreas,

Thank you for contacting Dr. Brooksher’s office in Baton Rouge regarding your canine and incisor teeth that never erupted. Dr. Brooksher would need to examine and x-ray your teeth before recommending appropriate treatment.

What Happens When Permanent Teeth Do Not Erupt?

When permanent teeth do not erupt, they may be impacted. An x-ray will help a dentist determine whether the permanent teeth have developed. If not, a dentist can create a treatment plan for dental implants.

Treatment options for permanent teeth that do not erupt

Treatment options for permanent teeth that do not erupt may include the following:

  • A dentist may remove the primary teeth and make an opening for permanent teeth to emerge.
  • A dentist may need to remove the primary teeth and replace them with dental implants. If the bone beneath the primary teeth is healthy, a dentist may place implants and temporary crowns on the same day. Otherwise, you may need a bone graft first.
  • A dentist will ensure you have enough space for a dental implant if primary teeth are absent. Sometimes, you may need orthodontics to make room for a dental implant.

We recommend scheduling consultations with two dentists with advanced training in implantology. Look for credentials from one of the following organizations:

  • International Congress of Oral Implantology
  • International Dental Implant Association
  • American Academy of Implant Dentistry
  • American Board of Oral Implantology

Ensure that each dentist has advanced cosmetic dentistry training to provide you with natural-looking implant crowns.

Baton Rouge dentist Dr. Steven Brooksher sponsors this post. Dr. Brooksher is a Fellow of the International Congress of Oral Implantologists.

 

Why Are My Gums Sore Between Two Teeth?

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My gums are sore between my first and second molar teeth. They hurt worse every time I eat, but the pain goes away within an hour. The pain is getting worse, but it’s limited to my gums. I don’t have any toothaches. My dentist completed an x-ray and said nothing was wrong with my teeth. One tooth is an old root canal tooth, but the gums hurt, not the tooth. My dentist says if the pain continues, he might recommend an extraction. Why would a dentist pull a tooth when the gums hurt? Is my dentist trying to upsell me for a dental implant? – Thank you. Keith from Shreveport

Keith,

Thank you for contacting Dentistry by Brooksher about your gum sensitivity. Dr. Brooksher would need to examine your gums, teeth, and x-rays to identify the source of your discomfort, but we will discuss some causes of gum sensitivity.

What Causes Gum Sensitivity?

Periodontal (gum) disease is often the cause of gum sensitivity and pain. According to the Centers for Disease Control, infection and inflammation from gum disease can cause the following symptoms:

  • A change in partial denture fit
  • A change in the way your teeth fit together
  • Bleeding gums
  • Chronic bad breath
  • Chronic bad taste
  • Gum recession
  • Loose teeth
  • Painful chewing
  • Red gums
  • Sensitive teeth
  • Swollen gums
  • Tender gums
Model of a dental implant with the crown, abutment, and root form labeled

Gum disease treatment can save teeth

You may have gum disease and a deep pocket between your teeth that can trap food particles that cause pain.

Will You Need Tooth Removal?

If your gums are sensitive, most likely you need gum disease treatment, not tooth removal and a dental implant. Even teeth that loosen from gum disease are often savable with root scaling and planing (deep cleaning). We recommend getting a second opinion from an experienced dentist to identify the source of your pain and explain treatment options to resolve it.

Baton Rouge dentist Dr. Steven Brooksher sponsors this post. Dr. Brooksher is a Fellow of the International Congress of Oral Implantologists.

 

Dentist Says an Implant Won’t Fit Where Tooth Is Missing

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My dentist says a dental implant won’t fit well in the space left from a missing tooth. When I was 15, I lost a tooth in an accident while horseback riding. Replacing the tooth was not an option for my parents. Now that I can afford it, I have seriously considered dental implants. My dentist shut me down on the idea, though. He says that my other teeth have shifted, and now the space is too small for an implant. So he wants to put a dental bridge in. He explained the process to me, and I really don’t like the idea of bothering my other teeth if I don’t have to. I would like to know if there is a way for me to get an implant. – Abell

Abell –

Thank you for contacting Dr. Brooksher’s office. We understand your concerns about getting a dental bridge instead of an implant.

Can You Get Implants If Your Teeth Shifted?

Model of a dental implant with the crown, abutment, and root form labeled

A dental implant mimics a natural tooth and does not need support from other teeth

If your teeth shifted, you may still be a candidate for dental implants. Your dentist may recommend orthodontics first to move your teeth to the correct position.

Reasons for getting braces may include:

  • Creating space. Proper tooth alignment creates space for a dental implant.
  • Correcting your bite. Well-aligned teeth improve your bite (how your upper and lower teeth meet).
  • Preventing other dental concerns. Depending on the factors that cause your teeth to shift, inserting a dental implant in a space may stress adjacent teeth. Although your teeth may move, the dental implant will not.

What If a Space Is Too Small for an Implant?

Dental implants are available in varying diameters that resemble the size of the missing tooth. Sometimes spaces between lower teeth are too small for a standard dental implant. When that happens, a dentist may choose an implant with a smaller diameter.

Dr. Steven Brooksher, a Baton Rouge fellow of implant dentistry, sponsors this post. Request a consultation with Dr. Brooksher today.