Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Dentist Placed Implant Knowing It Would Fail

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I had a dental implant placed. Before the surgery, my dentist assured me that we were good to go. However, when the surgery ended, the dentist told me that after he went in there he discovered that there was not enough bone support for the dental implant. He went ahead and placed it, but said my best option is to remove it and get a dental bridge. Why in the world would he place the implant knowing he would just tell me to take it out? Should I have to pay for this? Am I able to still get a dental implant or am I stuck with a bridge? I could have saved myself a lot of time and money if I would have gotten a dental bridge in the beginning, but my dentist assured me that I was a good candidate for implants.

Corrie

Dear Corrie,

Dental Implant Diagram

I am beyond puzzled how your dentist thinks this is acceptable. I want you to imagine ordering a stove that you have been told by the store that it is a fantastic stove that will be perfect for your house and will cook delicious food. Then, it charges you for the stove, delivery, and installation. But, after it is installed in your home, they turn right around and tell you, “Oh, by the way. This one doesn’t work. Why don’t you pay me to take it out and then I’ll get you a grill or something.” This is beyond the pale. Your dentist not only needs to give you a refund, but he should remove the implant without a fee.

In reality, if your dentist would have done the proper diagnostics to begin with, he would have noticed the condition of your bone and whether or not you had adequate support for the dental implant. Then, preparation could have been made to build up the bone, which would have enabled you to get the dental implant.

All you can do at this point is remove the implant. The good news is that, as long as you are in good general health, you can still get a dental implant. You will need some bone grafting done. Then, after a period of healing, you can start over with the dental implant. It goes without saying that I am going to suggest you see a different dentist to place the second implant.

I’m sorry this happened to you.
This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.
Click here to learn about facial collapse.

Affordable Solution for a Missing Front Tooth

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I lost a front tooth and look absolutely ridiculous. My dentist wanted me to get a dental implant but I didn’t have enough money for that. So, he suggested a snap-on smile. I got that because it was in my budget. I’m really disappointed in it. My smile looks WAY bulkier. I almost feel like I have horse teeth. Are there other options or am I stuck choosing between being a horse or a hillbilly?

Pamela

Dear Pamela,

Illustration of Snap-on Smile

I’m actually really surprised that your dentist suggested snap-on smile for your situation. It has its uses, but this isn’t a use I’d think was a natural fit. The bulkiness issue is because snap-on smile fits over your teeth. There is no way to avoid that.

Instead of covering your entire upper arch, for a missing tooth you just want to replace that tooth. Yes, dental implants are the best option, but not everyone can afford that. I don’t understand why he didn’t tell you about the more affordable tooth replacement options. Ethically speaking, a dentist is supposed to give you all of your treatment options.

For a missing tooth there are quite a few options, such as:

I put those in order of cost so if you are looking for the least expensive option, then I would just get a dental flipper to put in the place of the missing tooth.

What you don’t want to do is leave the space open too long because you have the snap-on smile. If you do, the adjacent teeth will begin to shift into the open spot. This will throw off your bite and can lead to jaw pain, headaches, and even TMJ problems.

If I understand what you were wanting, which is an affordable means of replacing a tooth, not just hiding the hole, then your dentist is giving you bad advice. Even if you just asked for a way to cover the space, he should have warned you about shifting and given you the options I mentioned above.

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

Dentist Said I Need Implants that I Cannot Afford

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I don’t know what to do. I lost two teeth a year ago and need to fill the space. My dentist wants me to fill it with dental implants but I just can’t afford to do that, especially because he wants full payment up front. Do I have any other options that are more affordable? I hate looking like a hillbilly.

Kevin

Dear Kevin,

Hockey player with missing tooth

The good news is that you do have options. Before going into them, I want to make sure you understand how important it is that you do get these teeth replaced. When you have open spaces in your bite, the adjacent teeth will begin to shift or tip into that space, which will throw off your bite. Aside from an unsightly smile, that can also lead to painful TMJ disorder.

While dental implants are your best option because they protect you from bone loss in your jaw, they are not your only option. Sometimes, you need to get an affordable option while you save up for the ideal procedure.

Tooth replacements, other than a dental implant, range from a dental bridge, which is also permanent, all the way down to a dental flipper, which is removable and meant to be temporary. If you plan on saving up to get dental implants, then I would get the dental flipper. It is your least expensive option and will keep your teeth in place while you work toward your goal.

If you have no intention of getting dental implants, then I would lean toward the dental bridge. It is permanent and will give you a greater sense of security. You’ll also have a much higher chewing capacity than if you were to get something like a removable partial denture.

Finally, bear in mind that dentists differ in their willingness to work with patients financially. If you look for a dentist who advertises him or herself as an affordable dentist, they may be willing to let you pay your treatment out slowly. This could give you a more realistic chance of getting the better procedure.

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

What’s causing the pimple on my husband’s gums?

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My husband recently said that he has a little pimple on him gum on the upper left, above his molar. Is this something that needs an emergency dental appointment? Karen

Dear Karen,

Tulsa emergency dentist

There are a couple of possibilities for a pimple on the gums. If it is near the root tip of your husband’s molar, it is most likely from a tooth abscess. When a tooth gets infected, the pulp eventually dies and the infection festers inside the tooth, spilling out bacteria into the bone. The infection in the bone then looks for a place to escape, and it will often try to drain through the gums.

While this wouldn’t be considered a dental emergency, it would need attention. If untreated, the infection can spread into the surrounding bone. It can also begin to dissolve away the roots of that tooth. It is unlikely that the tooth will be hurting, for two reasons. First, the tissue inside the tooth is dead, so it has no feeling. Second, while an abscess around the end of a tooth can cause the tooth to be painful to biting, since this infection has found a pathway to drain, pressure isn’t building up. Though my guess is that your husband has some mild discomfort to biting on this tooth, assuming that it truly is an infection and not just some little growth on the gum.

It’s Important He Doesn’t Put This Off

The tendency for men is to “tough it out” and hope it goes away. This won’t go away. And while the tooth will need a root canal treatment, I would tell him not to worry about that. Since the tissue inside the tooth is dead, the dentist could probably do a root canal without any novocain, since there is no feeling in it. I expect it will be a completely painless procedure. The dentist may still want to make the tooth numb, and may put your husband on some antibiotics to get the infection completely under control before starting treatment and to help insure that there is no post-operative flare-up.

It’s always better to take care of these things sooner rather than later. Better a root canal treatment and dental crown than to need a tooth extraction and replacement.

If the Tooth Can’t be Saved

There’s always a chance, depending on how long this has gone that the tooth can’t be saved. In that case, you’ll need to look at tooth replacement options.

Two of the best are to get a dental implant or a dental bridge. A dental implant is the better treatment, but it is more costly than the bridge.

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

Dental Implant Perforated My Sinus

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I’m not sure what to do. I had implant surgery, but the oral surgeon seems to have perforated the sinus. He noticed this six months later, when the implant still hadn’t integrated. He removed the implant, started me on Flonase and told me not to blow my nose until he gives me the all clear. He said this was normal and happens all the time. He also said it only perforated a few millimeters and we can try again when I’m ready. My questions are as to whether I should try again if this is normal. Would I be better off with a dental bridge?

Sara

Dear Sara,

A side by side comparison of a dental bridge and a dental implant

While some oral surgeons may consider it normal, it is preventable. I’m also quite concerned he said “only a few millimeters.” Really? In dentistry, that is a significant amount. When a dental implant is removed, it leaves a deficit of the bone necessary to support a dental implant. In order to have an implant successful, you’ll have to have bone grafting done.

Dental Implants versus Dental Bridge

You asked if you should try again or get a dental bridge. It would help to know the differences between the two so you can know what each requires.

With a dental bridge, both adjacent teeth have to be ground down to fit dental crowns. Then, a false tooth is suspended between the two crowns. If one (or both) of those teeth need crowns, then it makes sense to get a dental bridge. However, if those teeth are healthy, you may not want to grind them done unnecessarily.

With dental implants, as you know, you can replace a single tooth or multiple teeth. It does require surgery, but it is most like having your own natural tooth again.

Getting this Dental Implant Done Right

It’s up to you which procedure you decide on. If you decide to go with a dental implant again, I wouldn’t go anywhere near the oral surgeon you used last time. My suggestion is you find a good implant dentist and ask them for a different surgeon. It is always better to see the implant dentist before the surgeon anyway. This way you can make sure they communicate with one another clearly so you know the oral surgeon will properly place the implant where the dentist needs it. They should also do adequate x-rays, including three-dimensional ones. This will help prevent sinus perforation.

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

Emergency Dentist for Gum Injury

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We don’t yet have a dentist in this area. We’ve been busy relocating and haven’t had the time. My husband recently complained about an injury to his gums that is swollen. He can’t remember when he did it or what happened, but it looks to me like it resembles a giant swollen pimple. Of course, I know we don’t get pimples on our gums so it must be inflamed from an injury. Will this go away on its own or does he need an emergency dental appointment?

Karen

Dear Karen,

Tulsa emergency dentist

Relocation is stressful, so I completely understand you not getting to finding a new dentist. However, what you described on your husban’s gums doesn’t sound like a gum injury. Instead, I think he has an abscessed tooth. This manifests in what looks like a pimple on the gums.

This is considered a dental emergency, so he will need to see a dentist right away. It means his tooth is infected. These infections can blow up quickly and become life-threatening.

I know you don’t have a dentist right now, but there are dentists who will treat non-established patients in cases of emergencies like yours. You can do an internet search using the term “emergency dentist“.

It’s Important He Doesn’t Put This Off

The tendency for men is to “tough it out” and hope it goes away. This won’t go away. Eventually, the tooth may stop hurting, but that is because the pulp of the tooth will die, That won’t stop the infection from spreading though.

It’s always better to take care of these things sooner rather than later. Better a root canal treatment and dental crown than to need a tooth extraction and replacement.

If the Tooth Can’t be Saved

There’s always a chance, depending on how long this has gone that the tooth can’t be saved. In that case, you’ll need to look at tooth replacement options.

Two of the best are to get a dental implant or a dental bridge. A dental implant is the better treatment, but it is more costly than the bridge.

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



Are Dental Implants Really Superior?

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I’ve got three teeth that need replacing thanks to a baseball bat that hit me instead of a pinata. The neighbor kid has a swing like you would not believe. Seriously, the Yankees should already be on the phone with his parents. I wanted to get a removable partial denture because it seemed the most in line with our budget. But, my dentist keeps pushing me toward dental implants. He says it’s because the teeth are at the front of my bottom jaw. I looked into it and, yeah, they’re stronger, but I get the feeling he’s saying to get them because he’ll make LOADS more money.

LeeAnne

Dear LeeAnne,

Dental Implant Diagram

If you call the Yankees and it pans out, maybe you’ll get a recruiter fee. Before we get into your treatment options, I wanted to ask whether your dentist had given you a reason in the past to doubt his integrity and think he’s just trying to get you to do the most expensive treatment? It’s important you’re able to trust your dentist. If you have a reason not to feel he can be trusted, you’d be better served to find a different dentist. You want a dentist you can trust.

Now, onto your question. I think your dentist is concerned about the effects of facial collapse on your lower jaw. If you’re missing three teeth in that same area, your jaw will begin to shrink. Dental implants protect you from that. The implanted prosthetic root tells your body teeth are still there and your jawbone is still needed. So, yes, they’re stronger. But, they also protect your jawbone from slowly disappearing.

What Your Dentist Should Provide

Ethically, your dentist should tell you all of your options whether he thinks they’re good options or not. However, he should also recommend which options he thinks are better, along with why. He’ll know the pros and cons of each option and should take the time to share them with you.

The second thing he should provide is answers. You should be able to ask as many questions as you need and he patiently provides answers. It sounds like you were totally unsure about his recommendation. I don’t know if you asked questions and he refused to answer or if you weren’t comfortable asking.

Know when you’re talking about your health and finances, you have every right to ask questions. I know some dentists tend to get offended when you ask questions as if because they’re the dentist they should not be questioned. But that is unfair to patients.

Options for Missing Teeth

  • Removable Partial Denture

These have the obvious downside of not being permanent. Plus, we already discussed facial collapse. As far as quality of life goes, some patients complain of food getting under their denture. Their big benefit is their price.

  • Dental Bridge

These are permanent, but you still have to deal with the facial collapse. Additionally, the more teeth you need to replace on the same bridge unit, the less stable. If one part of the bridge breaks, the whole unit has to be replaced. Where your bridge would have to be placed is especially tricky.

  • Dental Implants

These are permanent, strong, and will protect you from facial collapse. Their biggest drawback is their cost and the fact it requires surgery.

Those options are up to you, though. A dentist can strongly recommend one solution over another, but it is up to you which one you pick.

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

Can Emergency Dentist Save Tooth Hit by Baseball?

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I was playing a game of baseball with some neighborhood kids when one of the balls went flying and hit me in the mouth. I originally thought I was fine because it didn’t bleed or bruise. But this morning the tooth is wiggly and loose. Is there a way to save it or is it toast?

Payson

Dear Payson,

Woman Smiling Text: A smile is the best makeup any girl can wear

It’s very possible your dentist or an emergency dentist if you don’t have one can save your tooth. But two things need to happen for you to have the best shot.

Stop wiggling it.

Your tooth has ligaments that are a bit stretchy, like rubber bands. But, just like rubber bands, if you stretch them too far or too often and they’ll snap or lose their elasticity. This puts your tooth at greater risk.

Get to the Emergency Dentist

You’ll want to get in as quickly as possible. The longer this is left that way the less chance you have to save it. The dentist can stabilize the tooth by using a splint or bonding the tooth to a stable adjacent tooth. That may be all that’s needed. It gives the ligaments time to heal. However, if the pulp of the tooth was damaged, you’ll need a root canal treatment and dental crown.

What if the tooth can’t be saved?

If it’s not possible to save the tooth you have several replacement options. The top of the line replacement is a dental implant. However, if either of the adjacent teeth is in need of a dental crown, then a dental bridge may make more sense.

If both of those options are out of your current budget, you can either find an affordable dentist who’s willing to work with you on payments or get a removable partial denture until you can afford a more stable replacement.

Either way, you need to be seen right away. This blog is brought to you by Dr. Ryan Noah.

What if I Can’t Afford My Dental Procedure?

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I’m in need of replacing several teeth and my dentist is insisting I get dental implants. What do I do if I can’t afford the procedure? Are there options? Do I just leave the spaces blank?

Kevin

Dear Kevin,

Image of a traditional implant and the more affodable mini implant

A traditional dental implant compared to a mini implant

It actually makes me angry when I hear about situations like yours. Yes, dental implants are the ideal procedure when you’re talking about replacing several teeth, especially because of the possibility of facial collapse. But, they’re not the only procedure. His job, as your dentist, is to provide you an explanation of all the options available to you, give his recommendations and why, then let you decide. Not everyone is working under the same budget.

Finding Affordable Dental Options

In your situation you have several choices.

  1. Affordable dental implants. Things like implant overdentures are a great option when you can’t afford the ideal. You’re certainly not the only one facing this, so don’t feel badly about it.
  2. A Dental Bridge. Depending on how many teeth you’re talking about, this could be a great secondary option, especially if any of the adjacent teeth are in need of a crown anyway.
  3. A removable partial denture. This would be my least favorite option because your quality of living won’t be as high, but it is still an option. It can often be used as a temporary solution while you work out financing for the ideal.
  4. Payment Plans. Many dentists work to be affordable, do that by offering payment plans so you can get the care you need, then slowly pay it off. Some do in-house payment plans. Other dentists use Care Credit—a medical credit card that offers low and no interest payment plans.

This is the minimum amount of information your dentist should have provided you. If you’re not getting the whole picture, you might be better served getting your oral healthcare elsewhere.

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

Can I Trust My Dentist About Dental Implants?

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I’ve lost two teeth. My dentist said I need to look at tooth replacement options. But, he said the only thing he’d recommend is dental implants. Of course, it’s the most expensive treatment. Is it really my only serious option?

Mark

Dear Mark,

Dental Implant Diagram

Dental implants are the top of the line tooth replacement option. So, would I recommend them? Yes. However, there are times when a dental bridge makes more sense. For instance, if the teeth adjacent to the one you lost are in need of a dental crown, then get a bridge. Other than that, if you’re a good candidate for dental implants, then I’d recommend those over other lesser options, such as a removable partial denture.

Reasons to get a dental implant

  • It’s the most like having a healthy, natural tooth back.
  • It preserves your bone structure
  • You can eat and brush normally
  • No food will get underneath

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