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.

Can I Replace a Partial Denture with Dental Implants?

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My partial denture is for two missing teeth that I regret having extracted. Is it too late to get dental implants? I am only 44 years old and tired of wearing a partial denture. I have had gum disease treatment for over a year, and I think it’s best to look for alternatives that don’t wear out other teeth and my gums. Thank you. Alan from Snellville, GA

Alan,

Thank you for contacting Dr. Brooksher’s office.

Can You Replace a Partial Denture with Dental Implants?

Yes, you can replace a partial denture with dental implants. The replacement will be a healthier option for the teeth next to the missing ones and your gums. An implant dentist must complete a comprehensive exam, evaluate your gum and bone health, and determine what’s needed to give you healthy implants.

  • Gum health – Your gum tissue must snuggly form around dental implants to support them. An implant dentist will ensure your gums are healthy and do not interfere with healing.
  • Jawbone health – You need enough quality jawbone because the bone is the foundation for dental implants. An implant dentist must complete a 3-D CT scan to evaluate bone quality and volume. If you have experienced bone shrinkage, you may need bone grafting to ensure the implants have solid support.

BioMed Research International published an August 2021 article on the biomechanics of partial dentures. The article lists the possible effects of removable partial dentures on the adjacent teeth that support it, including:

  • Stress during function, insertion, and removal of the partial denture
  • Bone shrinkage
  • Loss of the teeth supporting the partial denture
  • Partial denture failure

What Are the Benefits of Replacing a Partial Denture with Dental Implants?

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

The benefits of replacing a partial denture with dental implants include the following:

  • Longevity – Dental implants can last a lifetime—outlasting a partial denture or a dental bridge.
  • Healthy for adjacent teeth – Implants do not clip onto or cover adjacent teeth for support.
  • Jawbone stimulation – Tooth roots, like dental implants, stimulate the jawbone, preventing shrinkage of jawbone.
  • Appearance – A dental implant resembles a natural tooth emerging through your gums. You will not have unsightly clasps on your teeth like a partial denture.

We recommend consulting with two credentialed implant dentists to discuss your options.

Baton Rouge dentist Dr. Steven Brooksher sponsors this post. Dr. Brooksher is a Fellow of the International Congress of Oral Implantologists. Read how he strives to give patients some of the best dental care in Baton Rouge.

Dentist Won’t Place Implants Until I Get Wisdom Teeth Removed

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My upper right first and second bicuspid teeth have been missing since I was 16 years old. Two years ago, I started saving for dental implants. I saw an implant dentist two months ago, and she did a 3D scan of my teeth and noticed my impacted wisdom teeth. She asked if I had any complications, and I told her that my wisdom teeth hurt regularly and had felt worse within the past five months.

The dentist recommended getting my wisdom teeth out before I get dental implants because if the wisdom teeth flare up during dental implant recovery, I could have a rough time. She referred me to an oral surgeon. I am 42 years old and terrified of wisdom teeth removal because of my age. All my wisdom teeth are impacted, and two are angled near a nerve. I am afraid of nerve damage from the surgery. I read about a procedure that can take off the tops of the teeth. Would I qualify for that? Do I really need to get my wisdom teeth out before getting dental implants? Thanks. Micah from Lexington, KY

Micah,

Thank you for your question. We understand your disappointment about delaying a dental implant procedure to get your wisdom teeth removed. But your dentist is correct. If your wisdom teeth flare up during your four months of recovery after dental implant surgery, you can experience much discomfort.

What Happens If Your Wisdom Tooth Is Near a Nerve?

If your wisdom tooth is near a nerve, your oral surgeon will use a 3-D CT scan to navigate around the nerve while removing the tooth. Wisdom teeth are near two nerves, the lingual nerve, and the alveolar nerve.

  • Lingual nerve – Supplies sensation to the floor of your mouth and the front two-thirds of the tongue
  • Alveolar nerve – Supplies sensation to your lower lip and skin over your chin

If a wisdom tooth has long roots entangled in nerves, some oral surgeons perform a procedure called a coronectomy.

What Is a Coronectomy?

A coronectomy is a surgical procedure that removes the crown of a wisdom tooth and leaves the roots intact. A surgeon may use this method to prevent touching nerves. The procedure is controversial because using tooth roots behind can create new risks, and your oral surgeon may not use it.

What Happens If Wisdom Teeth Removal Bruises a Nerve?

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

Dental implants need to be undistrubed in a healthy environment

If wisdom teeth removal bruises a nerve, the effects are usually temporary but can last up to 18 months. As the nerve heals, you may experience numbness or tingling in these areas:

  • Tongue
  • Lower lip
  • Skin over your chin

We encourage you to schedule a consultation with a board-certified oral surgeon to discuss your concerns and the state of your wisdom teeth. The surgeon will explain your options for sedation to relieve your anxiety during the procedure.

After dental implant surgery, avoiding disturbing the implants and preventing them from fusing with your jawbone is essential. Delaying wisdom teeth removal and needing emergency surgery could interrupt dental implant healing and recovery.

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

Can Teeth Grinding Loosen Dental Implants?

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My dentist placed three dental implants last August. One implant is loose. When I got the implants, my dentist made a custom night guard to wear because I grind my teeth. I don’t wear it because I hate the thing. It’s so hard to get used to it, and it is very difficult to sleep when I wear it. Could my not wearing the night guard be the reason why the implant is loose? Is this going to happen with the other 2 implants? I am embarrassed. I will have a hard time facing my dentist and telling him that I have not been wearing the night guard. I want to know before seeing him if this could really be my fault. Thank you for your time. TJ

TJ – Thank you for contacting Dr. Brooksher’s office. The only way to be sure about the cause of your loose implant is to have it examined.

Can Teeth Grinding Loosen Dental Implants?

Dental implant model with the fixture in the bone

Pressure from teeth grinding can weaken a dental implant

Teeth grinding (bruxism) at night puts extra pressure on dental implants and can loosen them. If you grind your teeth while you sleep, it is vital to wear a night guard to avoid damaging your implants. You should wear the night guard while implants heal and afterward.

It is best to find out now why your implant has loosened. You have two other implants that your dentist must observe. If the preventive measure is as simple as wearing a night guard, you should know that now and ensure the success of your implants.

What Happens If an Implant Is Loose?

If your dentist will examine your implant and the area around it to determine if he can stabilize it. If not, your dentist must remove the implant. Depending on the condition of the implant and the area around it, you may need bone grafting before your dentist places another implant. Although you might be embarrassed, scheduling an appointment with your dentist is important. Also, if your mouth guard is excessively uncomfortable, your dentist may need to check it for fit.

 

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

What Are My Options for Teeth Broken Near Edge of My Gums?

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I am wondering if dental implants are my only option. I have three teeth that are about two-thirds broken off. The break almost hit my gumline. I was biking on an unfamiliar trail that wasn’t in good condition. It’s a scenic trail, but I didn’t get enough information about its condition. I hit a huge hole that sent me flying off the bike. There was more damage to my lips and teeth than to the bike. I always wear a helmet and am fortunate not to have a concussion. I do not know any biker who wears a mouthguard, but I am seriously considering it now that my left front and center teeth and the two next to them broke. Amazingly, the teeth do not hurt unless I mistakenly chew on them. I have a dentist, but he is only two years out of dental school, so before I let him do anything to my mouth or refer me to a specialist, I wonder if there are options other than dental implants. – Thank you. Raymond from Tampa, FL

Raymond,

Thank you for your question.

You did not mention when you had the accident, but it is best not to delay getting treatment. Although you do not feel any pain, the trauma to your teeth and their continued exposure increases the risk of infection.

What Are Your Options for Teeth Broken Near the Gumline?

Dental implant with markers for crown, abutment, and root formIf your teeth break near the gumline, your dentist needs to examine and x-ray them to determine the extent of the damage. Tooth replacement options may include a dental implant or a dental bridge.

Dental implants

Dental implants are the best form of tooth replacement for several reasons:

  • They minimize the bone loss that occurs when teeth are missing
  • They will look and function like your natural teeth.
  • The results can last a lifetime.

The implant process takes longer than other tooth replacement options because it involves surgery and time for your jawbone to fuse with the implants before getting your final dental crowns. Still, the results outlast other tooth replacement options.

Dental bridge

A dental bridge can restore multiple missing teeth in a row. It consists of dental crowns joined at their sides. The teeth on either side of the missing ones will anchor the bridge. A dentist must reduce the size of the anchor teeth to ensure the crowns on the ends of the bridge fit over them.

If possible, look for a dentist with advanced implant and cosmetic dentistry training and accreditation. After your exam and x-rays, the dentist will explain your options and their pros and cons.

Dr. Steven Brooksher, a Baton Rouge accredited cosmetic dentist and Fellow of implantology, sponsors this post. Read about what Dr. Brooksher does to provide patients some of the best dental care in Baton Rouge.

Loose Dental implant – Is a Bridge My Only Option?

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A dental implant I’ve had on my top left incisor for 15 years is beginning to feel loose. My dentist of 8 years says he needs to remove the implant because I have an infection around it. He recommends replacing the implant with a bridge. I don’t understand why I can’t take antibiotics and get another implant instead of a bridge that requires grinding down the teeth next to the incisor. Could the bridge be my only option? Should I see another dentist? – Thank you. Patrick from Oklahoma City

 

Patrick,

Thank you for your question. Dr. Brooksher would need to examine your implant and gums and take a 3-D CT scan of the bone around it to determine why the implant is loose. Afterward, he could explain your treatment options.

Can You Replace a Loose Dental Implant?

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

An implant root form needs healthy gums and enough jawbone volume to stay in place

An implant dentist may replace a loose dental implant with or without bone grafting. After a 3-D CT scan, the dentist will explain whether you need a bone graft to support another implant or if you need a dental bridge or an alternative.

What Causes Infection Around a Dental Implant?

A buildup of bacteria around an implant can cause infection in the gums and bone supporting the implant. The infection causes bone deterioration, and the implant will loosen. Practicing diligent oral hygiene, getting regular dental checkups, and not smoking promote healthy gums and jawbone.

Will Antibiotics Get Rid of an Infection Around Dental Implants?

Antibiotics may eliminate the infection around an implant but will not resolve bone loss. The bone will not grow back over time, and only a grafting procedure can rebuild it.

Schedule a Second Opinion

If you lack confidence in your dentist’s recommendation for replacing your dental implant with a bridge, look for an oral surgeon or dentist with advanced training in implants. An accurate diagnosis requires a thorough oral exam and 3-D CT scan, so expect the dentist to recommend those procedures. After the second-opinion implant dentist explains your treatment options, you can decide whether you want a bridge from your current dentist or to switch to a new provider.

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

 

Does It Make Sense to Keep Weak Teeth and Get a Partial Denture?

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Face of a woman relaxed during dental treatment for information on sedation dentistry from Dr. Brooksher of Baton RougeMy dentist told me that I needed a five-unit bridge in early February. I asked for a partial denture, but my dentist says I have so much bone loss that a partial denture would put too much pressure on the teeth for the partial to hook onto them. The teeth are weak from gum disease. The cost estimate for the bridge is $5600. I think it’s easier to get all my teeth extracted and get a complete set of dentures. Does it make sense to keep weak teeth?  – Dwight from Kansas City, MO

Dwight,

Dr. Brooksher would need to examine your teeth, digital x-rays, and dental records to give you an accurate diagnosis. But we can say that if most of your remaining teeth are healthy, you should not ask a dentist to extract all your teeth in exchange for complete removable dentures. It will create more problems that will affect your quality of life.

Dental Bridge or Removable Partial Denture?

How do a dental bridge and a removable partial denture compare? We will explain and briefly discuss an alternative.

Dental bridge

The cost your dentist quoted you for a dental bridge is reasonable. But we are not sure why he suggests a dental bridge instead of a removable partial denture. A dental bridge requires your dentist to shave down the teeth that anchor the denture. Shaving your teeth down and using them as anchors for a bridge will further weaken them.

Removable partial denture

A removable partial denture attaches to the tooth on either side of the missing one. The clasp can be metal or gum colored.

Implant-supported bridge

If your teeth are weak and in danger of declining, an implant-supported bridge may be an option for replacing your missing teeth and anchoring a dental bridge. Dental implants would support the ends of the bridge with replacement teeth in the middle. Speak with your dentist about this option.

Treat Gum Disease Before Restoring Teeth

If you are still battling gum disease and bone loss, your dentist needs to treat your gum disease and ensure it is stable before restoring your teeth. You may also need a bone graft to build up bone and protect your oral health.

Get a Second Opinion

We recommend that you see another dentist for a second opinion. Bring your dental records with you so the dentist can use them to give you an accurate diagnosis and treatment. Also, speak with the dentist about options for relieving your anxiety during the procedure.

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

What Happens If I Don’t Replace Missing Teeth?

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I have opted for my dentist to pull teeth for the last ten years instead of doing root canals and caps. Now I am missing four upper back teeth. All my wisdom teeth are gone, so the two teeth in front of them on both sides of my upper jaw are missing. You cannot tell the teeth are missing unless I hold my head back and laugh. Now that I moved to Massachusetts, I have a new dentist suggesting that I replace my teeth with dental implants. She says I will regret it as I get older if I do not get the implants when my teeth start shifting around. She can already tell from my x-rays that my teeth are moving, and she showed me the x-ray comparison. I’ve had this dentist for three years, and I trust her. But a second opinion is always good. I am not considering dental implants yet. Why not get a dental bridge? What will happen if I don’t replace my missing teeth? Thank you. William from Springfield, MA

William,

Thank you for your question. Your dentist may be persistent, but she seems to be genuinely concerned about your long-term oral health if you do not replace your missing second and third molars.

What Happens If You Don’t Replace Missing Teeth?

If you do not replace missing teeth, it can affect your long-term oral health in these ways:

  • Tooth misalignment – Teeth are placeholders for proper alignment. Gaps in your smile cause teeth to lean against each other and crowd your smile. When teeth are missing, other teeth will begin to drift toward the spaces.
  • Jawbone shrinkage – In areas of missing teeth, the jawbone shrinks 25 percent within the first three months and up to 50 percent within six months. Multiple missing teeth can accelerate facial wrinkles and sagging.
  • Challenge with oral hygiene – It is challenging to brush and floss between teeth that lean on each other. Crowded teeth increase the risk of plaque and tartar buildup, tooth decay, and gum disease.

Why Get Dental Implants?

Dental implant model with the fixture in the bone

A complete dental implants replace a tooth’s roots and crown

A complete dental implant replaces a tooth’s root and crown. The artificial tooth roots fuse with your jawbone and look and feel natural. A dental bridge requires shaving down the tooth on either side of the missing one. But you are missing second and third molar teeth with no teeth behind them to support a bridge. Although a dentist may offer alternative bridge treatment, other teeth will need to support it. The option will be less healthy than individual implants.

We suggest that you discuss your concerns with your dentist and ask for more information on dental implants and what you can expect with or without them in the long term.

Dr. Steven Brooksher, Baton Rouge accredited cosmetic dentist and Fellow, International Congress of Oral Implantologists, sponsors this post.