Sunday, August 2, 2009

Dental question--implants?

For those of you who know about teeth--tooth #4 (a molar) needs a root canal and crown (Approx. $700). The tooth is quickly crumbling away, but I do have an appointment for this coming Wednesday (31st) to have this taken care of. My question is--would this be the best option for me, or would it make more sense to say f*ck it, have the tooth pulled, and have an implant put in? (The type where they put the titanium screw in your jaw bone, then the impmlant tooth screws into it.) I have had horrible teeth since the birth of my first child nearly three years ago--one cavity after another, and I found out at my last trip to the dentist that I need several fillings, and a total of *4* crowns. What would be my best option? I"m a healthy 31 year old woman who wouldn't need bone grafting or anything of that nature. What would you do?

Dental question--implants?
First of all, don't f*ck it, this tooth is a premolar and most likely a part of your smileline. 2ndly, once the tooth is gone thats it. no going back. 3rdly the financial part of it. an implant runs about 3000-4000 plus the cost of extracting the tooth


(200-400). it sounds like 700 is your portion due after insurance. if you did an implant , the insurance most likely wouldn't cover a thing.


you need to ask WHY you need the crowns. is it because of decay or are the teeth fracturing? there is a big difference. sometimes as we get older, the fillings that were placed when we were kids can flex and fracture over time causing small fractures in the tooth. if the tooth breaks in a certain way it can cause the need for a root canal and a crown. another thing to think about is if you are taking any types of medication, have dry mouth, or if your diet has changed. these small things can affect how your mouth fights the virulent bacteria that cause decay/gum disease.


if you are concerned about preventing future problems, talk to your RDH. she/he can guide you towards special toothpastes/rinses, electric toothbrushes ie sonicare, and I would also ask about a nightguard. (a nightguard will help prevent against fractures, you can still get them but it will put you in a lower risk category for fractures). I would also check on more frequent cleanings. there is nothing wrong with going every 4months to have a cleaning instead of 6. you most likely will have to pay out of pocket (about 100-115$) for the extra cleaning, but you should weigh that against the amount of work that you may need in the future. also, make sure you brush at least 2 times even 3times a day. make it a priority. are you flossing? most cavities happen in between teeth and regular flossing can prevent this.


if you were my sister, I would say crown the teeth that need it and definately do what you can to prevent future crowns. if the financial burden is stressing you out, dont let it. ask the DDS which teeth are a priority and do 1-2 crowns per year until all the teeth that need them are treated.





Hope this was helpful





RDH in WA
Reply:Hope your appt went well. A lot of people go through exactly the same thing everyday. Some people are just more prone to "bad" teeth" even though they brush and floss. Don't despair, I am sure the situation will turn out well. Jonim Report It

Reply:If the tooth can be saved with a root canal and crown, then go for it. An extraction plus implant would cost twice as much, or more.
Reply:The best thing to do is to save the tooth if it can be saved. You should talk with you dr and hygeinest about options to help with your decay problem. What we all know is we need to brush 2xday and floss1xday. But what you would only find out in the dental office is there are some options for you. They have a toothpaste that has higher levels of flouride to strengthen your teeth also there is a antiseptic moth wash called Chlorahexidne Gluconate Or one trade damn is Peridex. both may help with your decay problem. Also if you're not allergic to betadine then about once a month your mix equal parts of betadine and water and rinse your mouth with that and it's a very strong antiseptic. Good Luck
Reply:#4 is a pre-molar or bicuspid... NEVER an implant is better than a root canal, if your root is healthy endo, post and cap it.... and way cheaper too
Reply:There's no guarantee that an implant would be suitable in this position. the need for bone grafting or sinus lifts cannot be guessed at without Xrays. You'd have to ask the dentist for an opinion or referral.


Having said that, RCTs and crowns on premolars can be risky as there is not much tooth structure. If you're really talking about a molar, then that RCT and crown would be advisable.


Please don't blame it on the birth of your child. It has nothing to do with it. Teeth are NOT bone, and the baby does NOT take calcium from your teeth. I hear mothers say this all the time, and in front of their children. Apart from being untrue, how do you think your child might feel?


Have a serious appraisal of your dental history - How often have you been having checkups? With Xrays? Are there some dietary factors that might cause decay? has the dentist suggested a cause? Have you always seen the same dentist over the years? What about a 2nd opinion before you embark on this path? If your current teeth are going bad, is a single implant a suitable choice - what if other teeth crumble later? Just some thoughts to consider.
Reply:Your best bet is to ask the dentist if the tooth can be saved so that they can make a prep to have a crown put on it. If so then you should do that.





Your second option is an implant. The implant would included extracting the tooth (probably more painful than a root canal), having the implant put in. Then you would have to wait about 3 months for that to heal. Then you would have to go back to the dentist and have the implant crown put in. This would take a lot more time and a lot more money. Implants are usually a substitute for dentures or if you need bridge work and there are not enough teeth that can be preped for that bridge.





To save you time and money have the crown done.
Reply:I'm a dentist.





Make no mistake about it, darlin', implants are not the equivalent of natural teeth. They are the best way to replace a missing tooth, but by no means are they the equivalent of natural teeth. They have their share of problems that natural teeth don't.





It is absolutely worth it to spend the money on restoring the premolar--even if the prognosis is questionable.



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Do missing teeth really affect the jaw's shape/health? I just had one pulled (last lower molar).?

Dentist wants to put in an implant, but the only info I found relating missing teeth to jaw issues was all from cosmetic dentists' websites. Do I really need an implant? Will my upper tooth (over the hole) realign/misalign without something on the bottom?

Do missing teeth really affect the jaw's shape/health? I just had one pulled (last lower molar).?
If the tooth on the opposing arch has nothing to bite against, over time it might start to rise out of its socket ("super-eruption"). Replacing the missing tooth in that case would be a good idea.





See your dentist for an evaluation and discuss your options.





Hope this helps!
Reply:I don't push my patients to replace their last lower or upper molars. (called 12 year molars or 2nd molars). We really do most of our chewing on the 6 year or 1st molars. But, if you do not have it replaced, you do run the chance of the upper molar over erupting. Sometimes, (rare), the lower 1st molar will drift back when the 2nd molar is missing but that hardly ever happens. Discuss the options with your dentist. If what he says makes sense to you AND won't financially break you; you may decide to follow his advice. (I always caution my patients to not spend so much of their "dental" money on one problem that they end up letting the rest of their teeth suffer. Doesn't make sense to do heroics for one tooth if you sacrifice others)
Reply:teeth are not attached to bone, rather they are embedded into ligaments that are placed into the alveolar bone. so when u chew or apply any pressure onto it, its able to move slightly. what prevents teeth from moving too much, is the adjacent teeth its next to. If there is an extraction, then either teeth next to the missing tooth has the potential to "drift" out of position. The changes might not be evident immediately, but over a few years, the drifting, will cause, an incorrect bite/occlusion, and can cause a cross bite to develop. For the most part it is cosmetic, but serious problems that can manifest would be temporal mandibular joint dysfunction, due to the improper occlusion, as well as traumatic occlusion causing loose teeth.
Reply:well it depends which tooth u took it out, if it is your front tooth upper or lower it will not look good.





How ever when any one pulls a tooth out eventually


the other tooth in your mouth will move, i mean you have empty space in your gum.


now the daintiest are so cheap they will do or say anything to charge arm and leg from their patients and they tell the patients that it is the dental laboratory who charge that much.


that is a total lie, the most that they pay to dental laboratories is $50.00 or $60.00 per unit.


and then they charge patients $500.00 or $600.00 per unit.


as i said before if your tooth is in front yes u do need the implant, but if your tooth is the molars


the back tooth i do not think is that necessary.


your jaw will not move it is your gums that expands, due to empty space not a whole lot, and not in a day or two, it will take longer.


in general any crown or bridge work it will cost the dental labarotries 50.00 or 60.00 doller and u as a patient have to pay 500.00 or 600.00 per unit,


the prise for implants is tottaly diffrent, it starts from $130.00 per unit which is the prise that dental laboratories charge the dentists and of course the dentisets will charge u way more.


good luck
Reply:hi, iam a dentist........


yes, missing tooth defentiely do affevt the shape of your jaw, you may have folds on ur cheek in due course.


and ya even the alignment of upper teeth will b disturbed with the missing lower ones.


dentals implants are costly coz they are the the only artificial replacements which have roots, all other artificials replacements are placed over the gum, while implants are inserted into the gum.



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Will my bite and/or teeth get worse ?

I lost two bottom molars 10,11 years ago, 1 one each side of my mouth (1st molars). The molars that were right next to them have both tipped forward, and now i'm concerned that my mouth is going to change alot from here. There is no pain or discomfort, but my bite is off now to where I can notice. Should I really go ahead and have braces and implants put in ? Overall, my teeth are healthy and I do take good care of them.

Will my bite and/or teeth get worse ?
you can go ahead and get braces in. but i dont think you need implants.. unless you lost your adult teeth and havent had an adult tooth grown in for a spot.





so you definetely dont need implants, since youve taken well care if your teeth, but you can consider it if an area in your mouth doesnt have a permanent tooth growing out.





so sure, go for braces.
Reply:how old are you?





in any case i do strongly suggest that you do!!


i'm sure if you look closely inside your mouth , you will realize that not only your 2nd molars tipped forward to close the space, but if you look at the tooth upstairs ( in your upper ,maxilla) you will see that the 1st molar in the upper has grown too, meaning it has shifted downward! ( this is the normal thing, when you loose a tooth, the neibor tooth in the same arch , changes its postion to come and cover the space and the one on top grow downward to fill up the space as well!!1





please do consider trying to opening that space again ( a good prosthodontist will be able to assist you the best)


and yes i suggest implant instead of bridge , since in order to get the bridge two healthy teeth have to be shaved and loose healthy enamel in order to place the pontic there in the missing space....





also, the longer you wait , the more bone you loose in that area! and your gum will follow that bone!



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Dental Implants - What does it mean when the Periodontist says that the site looks solid?

I had dental implants and bone grafting done on teeth 7/8 on Wednesday, Jan. 10. Both teeth were pulled at the same time. On March 14, I had them checked, no X-rays done by the Periodontist who did the work. He said it looked solid. What does that mean? How can they know if the implants are going ok just by looking at the site? Also, he said I could schedule my impressions for two weeks from now. Is that too soon for front teeth? I feel as if they are still healing. Will my restorative dentist know if it's too soon for impressions? How long does the front teeth normally take and what about upper back teeth? I also just had a cleaning done on Tuesday and the dental hygeniest cleaned my implants too. I didn't feel pain or discomfort when she did. If these go well, I may want to replace a few in the back too someday. What are the risks on the back top teeth as opposed to the the front top teeth? How soon for back teeth to heal if fronts only needed two months?


THANKS.

Dental Implants - What does it mean when the Periodontist says that the site looks solid?
IT MEANS THERE IS ENOUGH BONE TO PUT AN IMPLANT IN PLACE, THIS IS GOOD NEWS.
Reply:When your periodontist said they looked solid, he meant just the appearance. A radiograph (X-Ray) would have provided more information, but at this point he may be just be looking at whether the bone graft stayed in place or disintegrated. If it had disintegrated, the site would have appeared hollow and then he would definitely have wanted to X-ray the area.


Bone quality in the front teeth area is better than in the back teeth area. Actually bone quality of the posterior maxilla (back teeth area in the upper jaw) is worst of all areas one can get implants in. My guess would be a couple months longer than this time, but it would also depend on the kind of graft and how quickly the graft helps fill in bone.


The sinuses are located above the back teeth and sometimes the sinus membrane can get damaged during a bone grafting procedure, but your periodontist should be a ble to fix it pretty easily and also, such a thing happening is not very common.
Reply:Congrats on your new implants!





Only your periodontist knows for sure what he meant. What he likely meant is that the implants "felt" solid: they didn't move in the bone. This is a huge indicator. If, after 2 months,


the implants are stable, studies show us that restoring implants in the upper front jaw is safe. This is how he "knows." Often the hygienist or periodontist takes films as well.





You "feel" like it's still healing? The implants will continue to be integrated into the bone, but they are unlikely to get "more solid" at this point.





Your restorative dentist might or might not know by looking that the implants are stable. That's why she's working with the person who placed them.





Discuss your interest in additional implants with your restorative dentist, who will likely refer you back to the periodontist for additional evaluation. The bone in the upper back jaw is softer than the front (and on the bottom), so the issues are a little different.





Good luck!
Reply:after extraction, you wanna wait 6 months for the upper, esp for the 'esthetic zone' (front teeth). this makes for better healing and more bone fill in the that area. if you do it too early, your bone is still changing (as you hinted) and could change the restoration look along with it.


i'm sure 'solid' means enough bone to place the implant in that area. solid i don't think is a technical term.


if the perio guy took films or a CT prior. he probably is comparing the bone now to then. he prob should take some more films to be sure. i'd rec'd it. although in that area it's fairly predictable how the bone is shape (unlike the lower back areas; you can get some irregular bone in those areas)


yes impression can be done... but at which step... if it's for the final impression, i'd ask a couple more quiestions... if it's for the inital impression to make another 'customized' tray, it's probably cool.


restorative dentist shoudl know if it's too soon. no doubt. the perio should know too though.


uppers in general take 6 months; but you can take impressions as early as 1 -2 months. reason you want a little longer in the front is for esthetics. so it'll vary, case by case.


cleaning the implants is fine. but NEVER metal on metal. gold and plastics instruments should've been used.


implants are very predictable today. in the posterior upper, you want to be aware of your sinuses... it could come close to where the implant ends.


remember the numbers are all textbook and can change from case to case.



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How bad do implants hurt?

I have very bad teeth and will have to have implants if I want to have teeth in certain places again. I was wondering how bad they hurt. I am not as sensitive as everyone else seems to be when it comes to tooth pain because I have had so much work done and so many open parts in my teeth. Also, are there any alternatives to implants, dentures or partials?

How bad do implants hurt?
They don't hurt, but it is a procedure that takes a series of appointments over a few months. They have to imbed the screw that will hold the tooth and let that heal. Then they have to make the tooth to match your others. The last step is attaching the completed tooth to the screw. Implants are incredibly expensive.
Reply:Most dental procedures are pain free %26amp; implants are an one time investment %26amp; a permanent solution to bad teeth.



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How much do new teeth cost to be implanted?

Not sure what your dentist will tell you, but my dentist said about 1,200$ per tooth.

How much do new teeth cost to be implanted?
My mom is a dental hygenist and she told me a couple thousand for each tooth.
Reply:Between the oral surgeon's fees and our fees, the cost is usually around $2800 per tooth...probably also dependent somewhat on where you live. (We're talking about a titanium implant with a single crown attached?...)
Reply:in my area,about $2600, this is for the abutment and the crown



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How long does dental implants take?

im only 21 years young, yet i have bad gum problems. i need dental implants on two of my lower front tooth and one on the upper back. as a young social teenager, i would be horrified to be walking around with missing teeth. so does anyone know how long it will take from the time the decaying tooth is pulled out to the time of a new artificial tooth? ive heard about 1 day implants. is that possible for everyone? are there artificial dentures that can be worn over the spot of the missing tooth until the gums have healed?

How long does dental implants take?
There is a newer type of implant that has immediate placement of the crown and I have heard good things, sounds like the failure rate is about the same as traditional implants. It is not commonplace yet though, so you may have to check around and see who is doing it in your area and how many they have done, and whether this is an option for you. They are newer and I am not that knowledgeable about what criteria you need to be a candidate.


The traditional implant takes about 6 months before you will get the permanent crown. But as stated above, you can have a temporary flipper or temp partial made that is removable and will fill in the spaces until the implants are ready for the crowns.


It is great that you are going fo the implants, they are truly the best option!
Reply:months..
Reply:The first thing you need to do is find a good periodontist. Along with you regular dentist, they can work out a plan for you. First, they should take an impression for what is called a "flipper" that is temporary teeth that you can have in there while you are waiting for the implants. Then they will pull the teeth, wait for that to heal, then you will see the perio person and they will screw in the implant. That takes a few months to heal, then when the implants heal, you will have crowns put on them. You will never know you had it done. Dont sweat it, modern dentistry is awesome! Good luck sweetie.
Reply:make sure you have enough bone ..make sure you have a good oral surgeon...my implant was put too far and broke my jaw...dec 2004, i have had 5 surgerys one more to go...will be done dec 2006, i bit down first time on right implant...and felt it crack last week , think he put it too far too...this is a nightmare...get good doctor...i still have to get a right implant..in sept..this is not fun..if they are done right they are very good..
Reply:Early loading of implants has its uses AND limitiations. Critical to communicate with your implant and the prosthetic team members. The doctor placing the implant may be anything from a General Practitioner to an Oral %26amp; Maxillofacial Surgeon... including Periodontists, Endodontists and Orthodontists (for anchorage)... the placement of implants requires continuing education and are, for he most part, straight forward in their placement (technically). From a functional and cosmetic/hygienic approach it is imperative that the implant team communicate and plan properly. There are many ways to skin the cat... many way to replace teeth... check on your provider,.. ask around and go with your gut... promises are usually not a good sign... replacement of single or a few anterior teeth is VERY difficult and often requires small surgeries or grafts to accomodate the loss of soft tissues after trauma or extractions, deoending on how the tooth/teeth was/were lost... get informed... that is the name of the game... Best of Luck!




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