Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Fixing a Crooked Front Tooth

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I need some advice. I have a front tooth that is a bit crooked and goes behind the other tooth. I keep getting different advice from different dentists. One said porcelain veneers. One said braces. Another suggested I just pull the crooked tooth and replace it with something called a dental implant. I looked that up and it looks like it requires surgery. Are there other options if I pull the tooth? I feel I’m too old for braces.

Harriet

Dear Harriet,

Upper Invisalign Aligner

Who in the world are these dentists? First, I’m going to say do NOT extract a healthy tooth. Whoever that dentist is, run as fast as you can. If the tooth is unsaveable, that is something altogether. Let me know if that is the case and then my advice will be different. Dental implants are the best tooth replacement option, but there are others. I wouldn’t worry about those, though, unless there is a problem with the tooth you haven’t mentioned.

Of the choices they gave you, orthodontics and porcelain veneers are viable options. Let’s start with porcelain veneers. These won’t actually make your teeth straight, but could make them look straight. The downside to these is they are very expensive, AND you will want to go to an expert, which will be more expensive.

As for orthodontics, braces are no longer the only option. My recommendation is for you to see a dentist who offers Invisalign. These use clear aligners instead of the metal wires and brackets that are used with braces. No one will know that you are straightening your teeth, even at a conversational distance. Plus, they work in a fraction of the time that it takes traditional braces.

They also have an additional benefit. The aligners used to straighten your teeth can also double as teeth whitening trays. This allows you to straighten and whiten your teeth at the same time. If I were in your position, this is the option I would take.

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

Dental Tourism is Not Always Cheap

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I needed a dental crown and wanted to save some money so I went to a dentist in Mexico. A couple of years ago, I had three crowns placed with them a few years ago. One of them was bothering me a little anyway so I thought I’d save even more money by having them look at that while I was there. When I got there, they said all three of the crowns are failing and it’s best I replaced them. That left me getting four dental crowns that trip. However, a week after I got back the new one fell off. I went back to Mexico. This is a 600 mile trip for me. He told me that that tooth actually needs a root canal. I questioned why he didn’t tell me that at first and he said they’re not always necessary and don’t always take so he doesn’t do them unless absolutely necessary. That sounded okay and like he was trying to save me money, so I agreed to the root canal treatment. A few weeks later and that tooth is killing me and is sensitive to hot and cold. I go back, now it is officially getting not cheaper. He tells me I cracked my tooth. How did I crack it? It had a crown on it? He wants me to extract it and get a dental implant. I’m not sure what to think anymore. Do you have a recommendation?

Carlton

Dear Carlton,

An adult male grimacing in pain has he holds his cheek

I’m very glad you wrote. This is a perfect example of the difference between cheap and affordable dental care. “Cheap” usually ends up costing more money. There are two reasons that dentists will have prices well below the norm.

First, they could lack the skill to do good work and the only way to keep their practice running is by being appealing to new patients with their pricing because they don’t get a lot of repeat business. Second, is they cut corners with cheaper materials. This is so they can keep their profits up while keeping their costs down. This latter one can happen just as a result of being in another country where legal and sanitary standards are different than what we have in the United States. For instance there are Central American countries where dentists are not required to sanitize their equipment between patient use. It’s just up to the dentist whether or not they do this.

I feel like your dentist has been a combination of those two main reasons. Obviously, he lacks skill with dental crowns or they wouldn’t need to be replaced so quickly, nor would the new one have fallen off. Then, you have an obvious failed root canal. If he had done the root canal properly, then you would not have had pain. There would have been no pulp left in the tooth to have any sensitivity to hot and cold. Finally, I don’t necessarily think a cracked tooth must be extracted. It depends on a number of factors.

A dental implant is one of the most advanced procedures in dentistry. I highly recommend you do not let this dentist anywhere near your teeth any more. He has fallen well below the standard of care multiple times. You could ask for a refund, but because it is Mexico I don’t know how likely you are to get one.

Either way, I’d get a second opinion on this tooth. I recommend you use someone closer to home.

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

Cost of Snap on Veneers

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I have a couple of missing teeth and some others that just look terrible. I want to get some snap on veneers, which I have read are less expensive than the regular porcelain veneers. However, I don’t want to go to the dentist’s office to order them and find out that I can’t afford them. Can you give me an idea of the cost?

Stanford

Dear Stanford,

Illustration of Snap-on Smile

It is hard to give you actual costs because a lot of it will depend on your specific case. Dentists can sometimes give you a ballpark, but do not think it is written in stone. Things can change.

The most popular type of snap-on veneers are Snap-on Smile. Based on some lab fees by the company that produces them, I would expect the cost to be somewhere between $1000-$2000. Yes, that is a big difference. Here are some of the factors:

  • ✔️ How many do you need? A full arch? The first six teeth?
  • ✔️ How many adjustments need to be made for a good fit?
  • ✔️ Is your dentist particular about getting as perfect a fit as possible or does he or she care more about saving on the cost and will do the bare minimum?

I want to make sure that you understand the difference between snap on veneers and porcelain veneers. Snap-on veneers are NOT made of porcelain. They are generally made of a acrylic. You will need to understand that these will not look nearly as natural or beautiful as porcelain veneers will. They’ll be decent. Most people use these for a specific event, such as a reunion, job interview, or photo shoot. They’ll only last a few years either way.

As long as you understand the limitations to them and have reasonable expectations on the appearance, then you should be fine. In the meantime, while wearing the snap-ons, I highly recommend saving for a permanent solution for your missing teeth such as dental implants. They are pricey, so it may take a while, but they are definitely worth it.

If you’re looking for an affordable solution for the teeth you have that just aren’t looking all that great at the moment, then I would recommend something like teeth whitening.

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

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.

My Mother’s Teeth are Falling Out

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We recently moved my 82 year old mother across the country to live with us. We didn’t realize how bad things were, even though we skyped with her every week. We purchased a house that had an extra room for her and moved her in. The other day one of her teeth fell out. I’ve scheduled a dental appointment for her, but today another one fell out. Have you heard of this? We’ve spent all of our money on this house and my mother has even less money. Can you give me an idea of what we’re looking at? Because she is a new patient, our appointment is still a few weeks out.

Belinda

Dear Belinda,

Older woman smiling

First, I will say that I am glad your mother has you. It is wonderful that you are willing to take care of her. If your mother’s teeth are just falling out, then she is in the advanced stages of periodontal disease. It is very likely that the remainder of her teeth are not far behind these two.

Under normal circumstances, I would suggest dental implant retained dentures. However, these are very expensive. While they do prevent facial collapse, given your mother’s advanced age I don’t believe that will be something you will have to plan for or worry about.

In her circumstance, your most affordable option would be to get her completely removable dentures. This is something any dentist can do. If the advanced periodontal disease turns out to be accurate, given the financial situation, I suggest you just go to an affordable dentist to have her treatment done. As long as the denture fits well, that is all she will need.

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.

Dentures that Won’t Make Me Gag

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I haven’t been to the dentist in close to 20 years. As a result, my teeth are an absolute wreck and I need to get dentures. The problem is that I have one of the worst gag reflexes known to man and dentures require an upper plate. I even gag when trying to brush my teeth, which is why my teeth are such a mess. A friend of mine said there is a way to get dentures that don’t need a plate. Have you heard of those?

Camilla

Dear Camilla,

implant overdentures

Implant Overdentures

I am sorry about your gag reflex. That sounds a bit miserable. The good news is your friend is correct. It is possible to get dentures without needing a dental plate. You do that by getting implant supported dentures, also called implant overdentures. These use between four to six dental implants per arch and then anchor your dentures to them. In addition to being completely secure, you will also find you can eat anything you want. Even the best fitting removable dentures will reduce your chewing capacity by 50%. This is not something you will have to worry about with implant overdentures.

The downside is two-fold. Dental implants are more expensive. They also require surgery in order to place the implants firmly in your jawbone. Patients find that the pros far outweigh the cons.

If you are on a tight budget and cannot afford six dental implants, you can get snap-on dentures. These only require two implants on the bottom arch. For the top arch you will need more.

I suggest you talk to a dentist who offers dental implants and have a consultation with him or her to see what options are best for your situation and budget.

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

My Dentures Won’t Stay In

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I’m am only 58 years old and have lower dentures. They will not stay in anymore. My dentist told me that I have lost a lot of the ridge that holds them in. Is there anything I can do to keep them in? Not even adhesives work at this point?

Della

Dear Della,

Before and After Facial Collapse

Before and After Facial Collapse

This is a difficult position you are in. When you first got dentures, your body immediately recognized that you did not have teeth on your bottom arch anymore. In order to be as efficient with your body’s resources as possible, it began to resorb the minerals in your jawbone in order to use them elsewhere in your body where it feels they will be more useful. This has the unfortunate effect of shrinking the jawbone, which includes the ridge that holds in your dentures. This is known as facial collapse. By the way, it also tends to make you look older than you are as well.

implant overdentures

Implant Overdentures

The solution to this is bone grafting. It is an outpatient procedure that will build the bone back up. Once you have that bone you have a couple of choices. You can just get dentures again, but you will have the same cycle of facial collapse start again. Ideally, you would instead get implant supported dentures. These use between four to six dental implants and then anchor the denture to them.

snap on denture If you cannot afford that many dental implants, you could look into getting snap-on dentures. This uses just two implants and your denture will snap onto them. This will keep your bone in that area from shrinking, which will prevent them from falling out ever again. Obviously, the implant overdentures will be more secure because they have more implants, but even just the snap-on dentures will be a good option for you.

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

Invisalign and Missing Teeth

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If I have missing teeth, can I still get Invisalign? I’ve seen an orthodontist for a consultation and he said Invisalign only works on the most ideal cases, but my dentist thinks I can still get Invisalign if I want to. I’m not sure which is right. They both have “motive” to get my money. Hahaha. As I live in a completely different state from you and you can’t get any of my money, do you think Invisalign is possible for me?

Elinore

Dear Elinore,

Upper Invisalign Aligner

I like your style. It is always a good idea to ask for your advice from someone who cannot benefit from the answer given. While it used to be in its early days that Invisalign only worked on the easiest cases, there have been quite a few advancements in the technology and it is now on the opposite ends of the spectrum where it works on all but the most complicated cases.

Invisalign does fine working around missing teeth, so you shouldn’t have any problems with Invisalign if that is the most complicated thing about your case. So, you may be wondering why your orthodontist was saying it cannot. I don’t think it was a completely financial answer. Orthodontists were trained to work with braces. They have more confidence in working with that procedure. He’s telling you what HE can do the best job with.

If you decide to get Invisalign, you should know there is one other hidden benefit to Invisalign. The clear aligners they use can also double as teeth whitening trays. This means, if you want to, you can straighten and whiten your teeth at the same time. It is like getting a mini smile makeover for a fraction of the cost.

I would consult with the Invisalign dentist you choose about replacing the teeth. In some cases, the teeth can just be shifted, depending on the placement of the teeth, without it having a negative impact on your smile. However, in some cases, your dentist will need to open up space for you to replace those teeth. In that case, you can replace the teeth once your case is done. The best tooth replacement is a dental implant. However, one step at a time.

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

Is It Possible That I Can Smell My Husband’s Dental Implants?

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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.