Archives for March 2021

Can You Have Form and Function?

Posted on March 30, 2021 by writeradmin.

I have a huge problem. I am a teeth grinder. My dentist suggested we crown all of my teeth. I went ahead and did that but now I am in a lot of pain and feel like my situation is worse than it was before. My jaw hurts and some of my teeth touch and some don’t. Now my jaw has started clicking. I haven’t even gotten to how bad the crowns look. They almost look like beige chalk. Do you have any idea what I should do to fix this? Do I have to choose between a dentist who can make them look good and a dentist who can do this right? So far, I’ve had neither.

Laura

Dear Laura,

I am sorry you are facing this. Placing crowns on every tooth is called a full-mouth reconstruction. It is one of the most advanced procedures a dentist can do. If it is not done correctly, a dentist can end up causing more problems than they are solving. This seems to be what is happening to you.

It sounds like the way your dentist shaped the bite has led to you having TMJ Disorder. I would give your dentist a couple of choices. First, he can give you a refund so that you can get this done correctly elsewhere or he can pay to have it fixed by a dentist you choose.

Look for a dentist who has strong reconstruction training, such as you can see on Dr. Thomas’ bio page. Do not be shy about asking what their post-doctoral training is. Dental school is not enough for the type of replacement work you need to be done.

As to form versus function, you do not have to choose. While looking at the type of training a dentist has, it will also be helpful for you to take a peek at their smile gallery. This will give you some idea of the type of aesthetic results they give their patients. If they do not have a smile gallery, they have no interest in how things look and you need to move on to someone else. If they do have a smile gallery and you like the results, take the additional step of calling their office to make sure the images are of work the dentist has done himself and not stock photos.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

Two Vastly Different Implant Treatment Plans

Posted on March 16, 2021 by writeradmin.

I have to choose between two options and I’m feeling a little lost. First, some background. I had to replace all my front incisors. It was done with a bridge that used my canine teeth as the anchor teeth. These eventually came loose themselves and I needed to replace everything. The dentist I had been going to suggested I get a removable partial denture for all the missing teeth. I did that but found it to be distractingly uncomfortable and asked for some new options. He is now suggesting I replace all of those teeth with dental implants and he’d use mini implants which are less expensive. I was having some doubts about this because nothing they have done so far seems to work. My dentist is at a corporate chain practice so I decided to see what a private practice would say. I was given a vastly different treatment plan. He suggested attaching a bridge to three full-sized implants– one where the canine teeth were and another directly in the middle. This is significantly more expensive. Is there a good reason to go with the more pricey plan?

Brendan

Dear Brendan,

I am glad you wrote and I think I can help you here. Let’s start with the cheaper plan. Yes, it will save you money but only in the very short term. Over time, this is going to cost you a lot more. While mini implants are cheap to place, they are too weak to support teeth. They are going to fail. When they do, it is not just a matter of replacing them with another one. You will first have to build back up the bone that was lost when your mini dental implants failed. This will require an extra bone grafting procedure and some healing time before the replacements can even start.

Now let’s look at the more expensive plan.

One of the reasons your first bridge failed was because they used your canines as anchor (abutment) teeth, as illustrated in the diagram above. This puts enormous twisting forces on those teeth. I’m not surprised they came loose and would be surprised if your bridge lasted very long at all.

By placing a third dental implant in the center, it helps to secure the teeth against those twisting forces and will give you a much more secure and long-lasting solution. Thereby, saving you money, time, and quality of life in the long run. I’d go with the second dentist’s treatment plan.

A quick word about corporate practices. These tend to attract newer dentists who are trying to get experience before going into a private practice of their own. Though we all start somewhere, for advanced procedures, such as replacing teeth, I recommend going to the more experienced dentists. This is especially true when you have the risk of dental implant failure.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas

Half My Dental Implants Have Fallen Out

Posted on March 9, 2021 by writeradmin.

I had six dental implants placed just a week ago. They are supposed to support dentures after everything has had time to heal. However, I have already had half of them fall out and have a few questions. Do you think I am entitled to a refund on those? Should I worry about the others? Can I get them replaced?

Margie

Dear Margie,

dental implant overdentures

Your first question is the easiest. Yes, you should get a refund for the ones that have fallen out. In fact, I think you should ask for a total refund, which leads me to your second question. Yes, you should be concerned about the others. I do not have much confidence they are going to last given what has already happened with the rest of them. Most dentists experienced at placing dental implants have a failure rate of less than 5%. Your dentist has a 50% failure rate in under a week. That is incomprehensible. So what happened?

There are quite a few reasons for dental implant failure. Which one has impacted your case can be determined by an expert implant dentist. While there is not a recognized implant specialty, there are some dentists who have more training than others. My suggestion is you look for a dentist who is a fellow with the International Congress of Oral Implantologists.

Reasons for Dental Implant Failure

Incorrect placement of dental implants on the part of the dentist
Premature loading of the dental crowns or dentures on the implants
Infection, often the result of poorly fitting dentures
Inadequate diagnostics to determine if you had enough bone support.

So, where do you go from here?

It will be possible for you to get the implant overdentures you want. However, it will take an additional procedure. Before going forward with implants again, you will need to have a bone grafting procedure done. This will build up the bone in your jaw enough to ensure you have enough support for the new implants.

Once that procedure is done, you will need a period of healing, then you will be ready to start again.

I’m sorry you had to go through this. Make sure your next dentist has the skills. It also would not hurt to check out their smile gallery first to make certain they can create beautiful as well as functional results.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

High Resistance to Novocain

Posted on March 5, 2021 by writeradmin.

I have the unfortunate body type that has a high resistance to Novocain. This makes every dental appointment a bit of a nightmare. For quite a few years I have avoided the dental chair with everything in me. I know I have teeth that need to come out and more than probably can be saved if I can tolerate the work. I really want a pretty smile. Is there any way to deal with this?

Ebony

Dear Ebony,

I wonder who told you that your body type was the cause of your Novocain resistance? Unless you have something that makes you resistant to all medication, I don’t think I would settle for that. There is a connection between dental anxiety and Novocain resistance. It’s a connection that has only in recent years become more well known. We are not sure why, but the higher your anxiety, the more quickly the medication will burn off.

The best solution to this is to go to a dentist who can provide you dental sedation options. This will relax you enough for the numbing medication to work. If you need a lot of work, and it sounds like you do, I would like to recommend that you use oral conscious sedation. This is administered by a pill. It will relax you enough that you will likely sleep through your appointment.

Your dentist will be able to get more work done at each setting allowing you to get caught up faster. The only real downside is you will need to have someone drive you to and from your appointment as well as stay with you for a few hours afterward, just until you are lucid and stable on your feet.

If you truly have teeth that cannot be saved, you will want to replace them as soon as possible. My suggestion would be to replace them with dental implants. These are the closest thing to having a healthy, natural smile again. The crowns can be made to match your teeth perfectly, if you go to a dentist with some cosmetic skill as well as expertise in cosmetic training.

One thing I would suggest is sometime before the implant crowns are made you get your teeth whitened. The color of the crowns is permanent, so if you whiten the teeth afterward, you will have to re-do the crowns in order to get them to match. Doing the teeth whitening ahead of time, will save you money in the long run.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.

Options for a Tooth Infection

Posted on March 2, 2021 by writeradmin.

I had a tooth which had a filling. It had been bothering me for a while so I decided to have it looked at. He told me the tooth is infected and I need to have it extracted. I wanted to know if extracting the tooth is the only option or if there are other things that can be done which will allow me to save the tooth. It a lower second molar.

Philomena

Dear Philomena,

In most cases, you have options as to what to do with an infected tooth. However, if you are on a government-funded dental care plan, they will only allow the cheapest option. In that case, removing the tooth is the only option unless you want to pay it out of pocket.

If the tooth is infected and you want to save the tooth, which is always recommended, then I would suggest a root canal treatment. Not only does this allow you to save the tooth, but because it is likely the inside tissue is dead it will be more comfortable for you than an extraction.

One thing that bothers me about this is your dentist did not give you any other options. He is under an ethical obligation to do so. I don’t understand why he didn’t unless he is just lazy and does not like putting forth effort to save teeth.

After your root canal treatment, it may be recommended that you get a dental crown. This is because a root canal can make a tooth a bit brittle and this will help protect it.

If you decide to extract the tooth, you will want to replace it. There are also many options for that as well. The best replacement is a dental implant. But, you can also get a dental bridge or a removable partial denture.

This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.