March 2021 - Dr. Noah's Dentistry Blog

My husband is in the process of receiving “all on 4’s” dental implants on the top front, where he has temporary teeth until the permanent can be implanted. I suffer from chemical sensitivity, and whenever I am close to my husband, his mouth smells like rubber. The smell is so strong.

The posts are made from titanium, and the teeth that he has in now are acrylic. My husband isn’t thrilled about having the screws in his jaw removed, but I can’t live with this chemical exposure long-term. His oral surgeon said the titanium posts were the best option for him.

Is there a less toxic material that the titanium could be replaced with?

-Rose

Rose,

I don’t believe that the titanium posts have any smell, especially when embedded in the bone. However, you can certainly ask your dentist to let you smell one of the implant fixtures to see if that is indeed what you are smelling.

Is it possible that you are smelling the acrylic in his temporary teeth because acrylic does give off a very slight smell. Another possibility is that he has food debris stuck somewhere that you are smelling. If that is the cause using a Waterpik is helpful, or rinsing with hydrogen peroxide can clean out the food debris. However, make sure only to use the peroxide for a couple of weeks because it could cause an oral yeast infection.

It would involve several surgical procedures to replace the titanium posts. It would involve removing some of the attached bone, which would mean bone grafting would have to be placed to grow some bone back. They would have to make new holes in the bone for zirconia posts, but there could be a reaction to the zirconia as well.

Are you having an actual sensitivity reaction, or is it that the smell is bothersome?

I wouldn’t recommend replacing the titanium posts as it could be risky, and I really don’t believe it is the smell’s source. Instead, I would recommend talking to your dentist and maybe see if it’s food debris caught in his mouth.

Take Care

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

I am wondering if the all-on-4 implant dentures should be placed 2 to 3mm from the gumline, or should they follow the gum line? Is this how it’s typically done or different for each dentist? Because of where the dentures were placed, I now have bulky lips.

Steve from Idaho

Luis,

First, let’s discuss the terminology because the word gumline means the edge of the gum that meets the tooth. If your teeth are extracted, then you no longer have a gumline there. When the teeth are replaced with dentures, the gumline then refers to the edge of the pink acrylic on the denture where it meets the false tooth. In other words, the gumline is determined by where the teeth are placed, so the teeth are always placed right at the gumline.

I believe what you mean is the placement of the teeth in relation to the ridge of the jawbone under the denture. When you have removable dentures, they need to be placed directly over the bony ridge because if they are placed too far forward, the denture will tip up in the back of your mouth whenever you bite anything with your front teeth.

All-on-4 dentures are implant-retained and they won’t tip when you bite. So it’s not as important that they be placed right over the ridge. The teeth being 2 to 3mm from the ridge is within normal range, so it sounds like their placement is fine from a functional viewpoint. However, they should also consider the appearance of your lips, and there should be a wax try-in of the dentures before they are finished. For quality dentures, the dentist should have had the teeth set up in pink wax on a plastic plate and then it can be tried in before it is processed in acrylic. Then you and the dentist should evaluate their appearance, speech, fullness of the lips, vertical dimension, and the bite to ensure everything looks good before the dentures are completed.

Your dentures are already finished, but there may still be an easy fix by having the dentures unscrewed from the implants and the teeth re-set. It can be done fairly easily to have the front teeth cut off and re-processed, and if your dentist doesn’t want to do this for free, it shouldn’t be expensive. But I should add that there may be other reasons the teeth have to be where they are placed. Nevertheless, you shouldn’t have bulky lips. If you feel like your dentist isn’t listening to your concerns about the appearance of your face, get a second opinion.

This blog is brought to you by Tulsa dentist Dr. Ryan Noah.

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