What Happens If I Don’t Replace Missing Teeth?

Posted on by .

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.

What’s the Cheapest Fix for a Tooth Broken at the Gumline?

Posted on by .

My front left tooth broke below the gumline. I am looking for a cheap, fast way to fix it. I don’t know if there is anything like an affordable implant. Will a mini-implant work? If not, I am interested in something that is not expensive. I suppose there are not many options, but what is the least expensive? Thanks. Bart from WVA

Bart,

Cheap options do not last. You can ask a dentist to bond the tooth back with composite as an inexpensive fix, but it will not look good, nor will it last. Two treatment options can restore your tooth, but neither is cheap or fast.

Restoring a Tooth that Broke at the Gumline

Depending on the severity of the break, a dentist can restore a tooth that breaks at the gumline a dental crown or a dental implant.

Dental crown

If you do not have a strong bite or deep overbite, a dental crown might be able to restore your tooth. Treatment steps include:

  • Root canal treatment
  • Inserting two strong, flexible post in the tooth to absorb stress on the crown and prevent tooth root fracture
  • Building up the tooth and post with composite
  • Bonding the crown to your tooth

Dental implant

Dental implant components, including root form, abutment, and crown

If you need a dental implant, it will mimic a natural tooth.

If your tooth broke at the gumline, weak and you have a strong bite, a dental implant is the only solution. You will need a standard dental implant—not a mini-implant. Although mini-implants are more affordable, they are not durable enough for front teeth, molar teeth, and most teeth. A mini-implant might support a small upper or lower incisor. And some dentists use mini-implants to secure a denture.

An implant and crown cost about twice as much as a root canal, two posts, and a crown, and it takes longer to heal. But a dental implant will last longer because the implant fixture fuses with your jawbone like a natural tooth root.

You can choose to get a dental crown, but understand the risk of failure if you have a strong bite or underbite. It is usually best to get the most effective option and avoid spending more time and money in the long-term.

We recommend scheduling an appointment with a dentist who has advanced cosmetic and implant dentistry training to discuss your options.

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

My snap-on denture bone graft failed

Posted on by .

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.

 

My painful dental implant and bone graft failed

Posted on by .

My dentist has placed hundreds of dental implants in the past 15 years. I know friends and two family members who received implants from him with no problem. Before doing my implant, my dentist told me that I would need a bone graft first. After healing, he placed the bone graft. But I was in so much pain, he removed it and said the bone was not built up enough, so I could not get an implant. Now my dentist recommends a bridge. I do not want a dental bridge. Although my dentist has placed many implants, I wonder if I should switch to a specialist. Is it worth it, or am I wasting time and money? Thank you. Dylan

Dylan,

Although Dr. Brooksher would need to examine your implant site for an accurate diagnosis, we doubt that a dentist with advanced implant training would have the same problems as your dentist. It sounds like your dentist is trying to give you a solution that he can confidently complete.

How much pain should dental implants cause?

With dental implants, you will not feel pain during surgery. Afterward, most patients feel mild pain and discomfort that is temporary and mild.

  • During – Before implant surgery, your dentist will sedate you, and local anesthesia will numb the implant site. You will not feel pain during surgery.
  • After – Initial pain after dental implant surgery is normal, but it peaks in a few days and continues to improve. And you will take anti-inflammatory and pain medication to minimize the pain.

But bone grafting can be complex. Although your dentist placed hundreds of implants, bone grafting might be challenging for him—or maybe he doesn’t have much experience with grafting. Unfortunately for you as the patient, a dentist exploring new skills like bone grafting may have difficulty with a case.

On a positive note, your dentist could have left the implant in place and let it develop complications before removing it, so his choice to remove it was wise and considerate.

A dental bridge instead of an implant?

Diagram of the phases of a dental implant for a comparison to a partial denture.

Advanced implant dentists understand bone grafting and implant surgery

You have decided to get a dental implant—not a dental bridge as your dentist has offered. Although a dental bridge is an acceptable form of tooth replacement, if you want the implant, go for it. We recommend that you schedule a consultation with a dentist with advanced implantology training. You can ask your dentist to transfer copies of your x-rays and CT scans or take copies with you. The potential new dentist will explain your treatment options and how they will complete the bone graft and place the implant.

Best wishes on your next experience with dental implants. Take time to check the implant dentist’s credentials first.

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