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Dr. Thomas

Why is Clear Choice Pricing So Arbitrary?

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I need some help and advice. Several years ago I allowed a dentist to talk me into removing all of my teeth even though I know at least twelve of them were salvageable. The worse decision of my life. He wanted to do dentures. I was worried about that in the long term but he assured me it was better to start out with dentures and then I could add the implants later if I had trouble with them.  Well, I have hated them since day one, but he doesn’t do the implants he said I could get later. So, I went to Clear Choice Dental Implant Centers. At first, they said the all-on-4 procedure would be $62,000. Then, when they learned my husband was a retired vet, they lowered it to $54,000. That seems so arbitrary to me. If they can lower it that quickly by almost $10,000 is that the right price?  It still seems expensive to me. After making the previous mistake, I don’t want to make another one. Is this the right way to go?

Margaret

Dear Margaret,

all-on-four dental implant diagram

 

So one of the things I notice right away is that Clear Choice Dental Implant Centers are pricing for someone who is getting bone grafting and then implant overdentures, but giving you the all-on-4 procedure. This increases their profit margin significantly, without giving you the quality and safety you would get with implant overdentures. With the all-on-4 procedure, which has helped many people who could not go the better route, if one implant fixture fails, the entire unit has to be replaced.

My suggestion is you call around to some exceptional implants dentists in your area and see what they would charge you for implant overdentures. if you have only been in dentures for a few years, you may not even need bone grafting. When you do the diagnostics you need for your ANY dental implant procedure, your dentist could tell you whether or not you have enough bone structure.

Who Should Do Your Dental Implants?

One of the things you need to know is that dental implants are not really taught in dental school. This means if a dentist wants to know how to do it well, they will have to invest in post-doctoral training. Because it is such an advanced procedure, you want to make sure your dentist has a LOT of training in this. There are countless stories of dental implant horror stories. Your best bet is to get a dentist who is a fellow with the International Congress of Oral Implantologists. They have proven training and skill.

Though not completely necessary, another thing to look for is whether the dentist does the implant surgery himself or farms you out to an oral surgeon. Ideally, the dentist can do the surgery himself. This cuts down risk as there will not be any miscommunication between the dentist and the surgeon on placement. What IS absolutely necessary is that it is the dentist who determines the placement, not the surgeon.

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

Half My Dental Implants Have Fallen Out

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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,

implant supported dentures

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.

Simultaneously Impressed and Hesitant about Clear Choice

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I have put off doing something about my teeth for so long that now I have no choice. The amount of pain I was in drove me to my dentist. He doesn’t do dental implants so I went to see Clear Choice.  Their recommendation is to take out both upper and lower teeth and replace them with an all-on-4 procedure. My dentist agreed that the upper teeth need to come out, but feels the lower teeth can be saved. I keep going back and forth. On the one hand, it would be nice to be done with dealing with these teeth, but I keep having this niggling feeling that makes me hesitant. I don’t know if that is a legitimate concern or just my fear of the dentist and actually going through with this. Do you have any recommendations?

Lewis

Dear Lewis,

I am glad you wrote and am sorry you have been in so much pain. There are a couple of things going on here. We’ll start with the uppers. From what you’ve said, your dentist does try to save teeth that can be saved. This is a good sign. There are some lazy dentists out there who’d rather just collect the fees from extractions than try and save teeth. If he is saying the uppers need to be extracted and replaced, I have some confidence in that. Your next choice with them is whether to go to Clear Choice or another dentist for your dental implants.

Clear Choice tends to push the all-on-4 procedure whether or not it is your best option. While there are times that the all-on-4 procedure is the right choice, it has its drawbacks. For instance. If one part of the appliance fails, the entire thing has to be re-done. Instead, I might look at getting implant overdentures for your top arch. Here is a comparison of the two:

all-on-four dental implant diagram

All-on-4 dental implant appliance

With all-on-4, the implants are angled in a way that makes it possible for those who have already lost some bone structure to receive dental implants. As its name implies, it is done with 4 implants only.

implant supported dentures

dental implant overdentures

If instead, you were to get implant overdentures, there would be more security. While you could do it with four implants, you could use more as well. It’s generally suggested you get between six and eight implants. If one part of this appliance failed, you would only have to replace that part.

My suggestion for your uppers is to get a second opinion from a qualified implant dentist. See if there is someone in your area who is a fellow with the International Congress of Oral Implantologists. These are the top implant dentists in the country. You can feel confident you are getting qualified, experienced advice.

Your lower arch is a completely separate issue. If your dentist thinks those teeth can be saved, do everything in your power to save them. First, I will tell you why. Then I will go over how you can do it without the terror you currently feel going to the dentist.

Before and after facial collapse

When your teeth are first removed, your body recognizes that and immediately begins resorbing the minerals in your jawbone in an effort to use those minerals throughout your body where it perceives they will be more useful. After all, you don’t need those minerals to keep your teeth in place any longer.

While an efficient use of your body’s resources, it has the unfortunate side effect of shrinking your jaw bone. After ten or so years, you will no longer have enough of a jawbone to even retain dentures. This is known as facial collapse. Placing dental implants helps prevent that, but they’re expensive. It is significantly cheaper and more advantageous to save your natural teeth, if at all possible.

Dealing with Dental Anxiety

I understand the prospect of continuing dental appointments is probably not appealing to you. Fortunately, I have something that may help.  See if your dentist offers dental sedation options. In your case, combining your anxiety with the amount of work you may need, I would recommend oral conscious sedation. It will allow you to sleep through your dental appointments while getting more done at each appointment. If he doesn’t offer this, you will be better served by going to another dentist. I’ve seen patients with crippling anxiety have their experience at the dentist completely changed.

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

Several Dental Implants Fell Out in Less than a Week

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I have paid half the cost of six dental implants that are supporting a lower denture. I was told this was important and therefore, emptied my savings account to get them. Within a week four of them have fallen out. Is this normal? Should I pay the other half of the bill? It seems like I should have dental implants that stay put. What is the normal procedure when something like this happens?

Mallory

Dear Mallory,

implant supported dentures

First, I will say up front that you made a good decision in getting dental implants to support your dentures, especially on your bottom arch.  When your teeth were removed, your body recognized that there were no teeth roots there any longer and interpreted that as you not needing any more support for those roots. In an effort to be as efficient as possible with your body’s resources it begins to resorb the minerals in your jawbone to use elsewhere. After about ten or so years, your jawbone will have shrunk so much, you will no longer be able to retain your dentures.

This is known as facial collapse. You didn’t mention how old you are, but my guess is you’re young enough to not want to be without teeth. Having dental implants placed there signals to your brain that you still need to retain your teeth and thereby preventing any further bone loss.

Dental Implant Failure

The dental implant success rate is usually around 98%. Your dentist has a 33% rate. There really isn’t a viable reason for that. Even if you weren’t a good candidate for dental implants, if he would have done the proper diagnostics he would have known that and could have prevented this problem to begin with.

Without having examined you, I won’t know why your implants failed, but can give you an idea of some reasons dental implant failure occurs.

  • Infection at the implant site. This is usually because of poorly fitting implants.
  • Incorrect placement of the implant.
  • Not enough bone support.
  • Premature loading on the implant. By that, we mean the dental crowns (or dentures) are placed on the implants before the bone has had sufficient time to integrate.
  • Neglecting proper diagnostics.
  • Cutting corners with cheaper, substandard implant fixtures.

I don’t think your dentist is the one to fix this. The first thing you should do is ask for a refund. Your dentist shouldn’t have an issue with that. I want you to get a full-refund. Even though you still have two of your six implants. I honestly don’t think it will be long until they fall out as well.

Next, I want you to see a dentist who has excellent dental implant training and qualifications. Look for someone who is a fellow with the International Congress of Oral Implantologists. These are the top implant dentists in the country. Not only will they be able to diagnose what went wrong, they’ll be able to help you get the implants you desire.

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

I Can’t Keep My Dentures In?

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I’ve had dentures for a bit over twenty years. It’s gotten to the point where they won’t stay in even with adhesives. I’ve recently found out I should have gotten dental implants when my teeth were still removed, but that was never even mentioned to me.  Is there a way to get them now? If not, is there at least a way to keep them in?

Mable

Dear Mable,

Illustration of facial collapse

What you are experiencing is known in dentistry as facial collapse. When your teeth were first removed your body recognized that. As a result, it thought, “Hey, you don’t have teeth there so you don’t need these minerals for the bones. They’re for teeth roots. We are going to use those elsewhere so we can use your body’s resources well.”

While remarkably efficient, it does leave those who wear dentures in a bit of a pickle. You need the ridge of that lower jawbone in order to keep your dentures in. In as little as ten years without teeth, some patients can’t wear their dentures at all. Not only is that detrimental to your health, but it also ages your appearance by at least a decade.

The Solution to Facial Collapse

The first thing you need to do is have that bone built back up. Without that, you will eventually not be able to eat. This is important. The way to build your bone back up, is a procedure known as bone grafting.

A qualified dentist or oral surgeon can graft either natural or synthetic bone into your jaw. Once that is done you have two choices. The first is you can get dentures refit.  This is fine, but you will face the same cycle of bone loss. A second option is to get dental implants.

Implant Overdentures:  The Solution to Facial Collapse

Implant Overdentures

Dental implants place prosthetic tooth roots into your jawbone. Then, after a period of healing, your dentist can place dental crowns on top of the root form. This mimics your natural teeth and preserves your jawbone.

It would be financially unfeasible to get a dental implant for each missing tooth, for all but the wealthiest of individuals. Instead, I suggest you get implant overdentures.  These use between four to six dental implants and then anchor a denture to them. It completely secures your dentures, dramatically improves your chewing capacity, and prevents facial collapse.

Ideally, you want a dentist who can do the surgery and the crowns or dentures. This eliminates the risk of miscommunication in a complicated, advanced procedure.

I hope this helps.

This blog is brought to you by Sugarland Dentist Dr. S. Thomas.