Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Dentist Said My Face Will Collapse with Dentures

by

I don’t know if my dentist is saying this just to scare me into dental implants, but thought I’d check just in case. I’m losing my teeth due to a lifetime of both problems that could and couldn’t be controlled. My dentist wanted me to get dental implants, but they cost a fortune. I was considering dentures, but he says they make your face collapse. Is he just trying to scare me into the more important procedure?

Troy M.

Dear Troy,

A dentist and patient

Has your dentist given you a reason to think he’s manipulated you in the past? If so, that would be an egregious breach of trust between a patient and caregiver. Whatever his character, in this case, he’s right. Though, when he talks about your face collapsing he doesn’t mean your whole face. He’s referring to your jawbone shrinking.

Once you remove all your teeth, your body reabsorbs the minerals in your jawbone to use elsewhere throughout your body. This causes your jawbone to shrink little by little. As that progresses, you’ll no longer be able to wear your dentures because they won’t fit.

Why Your Dentist Suggested Dental Implants

Implants, as their name implies, places a titanium implant into your jawbone. Then after your bone has reabsorbed around the implant and is stable, your dentist can place a porcelain crown on top. Now you’re talking about all your teeth, so you don’t want to pay for a one-to-one ratio dental implants to teeth, unless of course you are independently wealthy.

Generally, you would get implant supported dentures, which is a mixture of the two treatments. It anchors your dentures to your jaw. This prevents you from losing mass in your jawbone and keeps your dentures from slipping and sliding around. Obviously, the more dental implants the better.

Talk to your dentist about what would work best in your particular situation. However, if you don’t trust your dentist, you’d be better served looking for another dentist which you can. Be sure to check their reviews so you get some idea what you’re getting into.

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

Can Emergency Dentist Save Tooth Hit by Baseball?

by

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.

Dentist Refusing to Give Me Dentures

by

I’m very worried. I’ve been in an accident that is causing me to lose most of my teeth. In preparation for that, I went to my dentist to make plans for dentures. He told me it’s imperative I get dental implants. It’s not that I don’t want them, it’s just I can’t afford them. He is absolutely refusing the give me dentures saying that at my age (I’m 23) it would be irresponsible. What should I do? It’s not like it’s any more responsible for me to be without teeth. Can you advise?

Daniel M.

Dear Daniel,

Cu-Sil denture Affordable dental treatment

First, let me express sorrow that your accident has caused you such devastating trouble. I’m sure this has been an extremely distressing situation for you. I also understand that it would be extraordinarily difficult for a 23-year-old just starting out in life to afford a procedure like dental implants. I’ll be honest with you. I don’t think you’re going to get anywhere with him, so you’ll be better served going to a different dentist. However, I am going to explain his concerns and what your options are.

While he’s handled the situation poorly, his concern is valid. At your age, if you were to get dentures and stick with that procedure, you’ll be afflicted with facial collapse before you even hit 40 years of age. While I know you can’t afford full dental implants there are ways to get as much protection for your jawbone as possible.

Affording Care You Can’t Afford

The first thing I’d do is see if there are ANY teeth which can be saved. Even one or two is better than nothing and will preserve some bone. There are dentures which can be made to have holes in them where you still have natural teeth to fit through.

Next, if there are even just a couple of implants you can afford that will help. Your dentist can strategically place them to give you maximum protection. Ask about implant overdentures.

Then, as finances allow, you can add implants your treatment plan.

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

I Need Affordable Help For My Mom, Fast!

by

I went to visit my mother who lives in a different state. We’re trying to talk her into moving in with us. She’s 85 and her health is declining. While we were having dinner one of her teeth fell out, right there on the plate. She said she lost two others as well. I don’t know how much money she has. What is an affordable way to take care of this? I’m worried sick about her. I’ve heard both dental implants and bridges are good. What’s your opinion?

Elizabeth E.

Dear Elizabeth,

Tulsa Affordable Dentist

It’s lovely that you’re there to care for your mother. When we’re children we rely on them. As they age, it is sometimes hard for them to allow us to look after them. I hope she allows you to help.

If your mother has teeth just falling out, that means she has incredibly advanced gum disease. That needs to be treated right away. She’s going to continue losing teeth until it is under control. Because of the gum disease, neither dental implants or a bridge will work. She doesn’t have anything strong enough to maintain them.

Affordable Tooth Replacement Options

However, once her gum disease if dealt with, dental implants are the top of the line treatment. But, you asked for affordable and I would not call them that.

The most affordable dental treatment for her will be complete dentures. Generally, it wouldn’t be something I’d recommend because of the facial collapse which results from bone resorption, but your mother’s 85. I don’t think it will be an issue for her.

Cu-Sil denture Affordable dental treatmentIf there are teeth which can be saved, don’t switch her treatment to removable partial dentures. Her teeth have been through a lot and that particular treatment (along with a dental bridge) puts too much stress on the remaining teeth for her situation. Instead, you could get her a denture which makes room for her remaining teeth without putting stress on them. It’s called a Cu-Sil Denture. I’ve put a picture of it to the left.

Best of luck with your mother.
This blog is brought to you by Dr. Ryan Noah.

Did I Crumble a Tooth?

by

My husband and I are in a disagreement as to whether or not I need an emergency dentist. I think I can wait until my appointment on Tuesday, but he thinks I need to be seen right away. I had a root canal treatment almost two weeks ago. I had a business trip so put off getting the crown. My dentist gave me a temporary filling to hold things over. Everything was okay until dinner last night. I was eating Chinese food and started feeling something grainy. I discreetly reached in and some whitish crumbly material was the culprit. My husband thinks my tooth crumbled. I think it’s actually just the temporary filling. If I’m correct, I can wait to see the dentist, right?

Melinda F.

Dear Melinda,

First, let’s see if we can’t figure out who’s got the right end of the stick. If there’s a way for you to peek at the tooth, do so. If the tooth looks intact, but there’s a hole in the center, then you’re talking about the temporary filling falling out. If there’s any disintegration to the tooth, then you’ve got a crumbling tooth.

If it’s just the filling, you can likely wait until your appointment. You may want to take the precaution of getting some temporary dental filling material. You can find it at many pharmacies. Bear in mind, it’s only meant to be used for a few days. So, keep the appointment you have with your dentist to get your dental crown.

If you wait too long after a root canal, the tooth will become brittle and could end up crumbling as your husband suggested. If that happens, they’ll be nothing to crown and you’ll be looking for tooth replacement options.

On the other hand, if the tooth has started crumbling, the sooner you get in to see a dentist the better. In fact, I’d call your dentist right away and let him not what happened. He’ll want to crown the tooth right away if it’s still possible.

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

Smile Club or Professional Orthodontics

by

I’ve been trying to do save up for orthodontics for a long time. I’m getting close, but just read something about Smile Care Club. It’s a lot less expensive than the orthodontics. Is it okay for me to use that and then save the rest of the money for something else?

Lisa A.

Dear Lisa,

The best thing about the Smile Club is the cost savings. I just want you to think about it ahead of time. They have you send x-rays, but there are some things, such as gum disease, which is very hard to discern by x-rays alone. It usually takes a physical exam as well.

Gum disease is serious and can creep up on you silently. If you get this type of orthodontics while having gum disease, it will make the situation significantly worse. That puts you at risk of losing your teeth. In that case, instead of spending a little extra money up front, you’ll end up spending thousands to replace lost teeth.

The other thing to bear in mind is things which can go wrong during the treatment. Sometimes, as teeth are brought together, there needs to be some mild shaving to ensure they come together well. In that case you’d need to see a dentist. You’d want it to be a dentist invested in your case, but you won’t have one of those.

Smile Club keeps up with you by photos and phone. I feel one on one monitoring in person is the safest way to go, especially for the patient. This is designed to be a mail order substitute for Invisalign. You’d be better served getting actual Invisalign and the personal attention you both need and deserve during your treatment.

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

I’m Being Bullied By My Dentist

by

I’ve lost several teeth. I don’t have much money, so I thought I’d get a removable partial denture. My dentist insists I get dental implants. He keeps telling me I’ll ruin my life with dentures, but I don’t want to go into debt for a procedure I can’t afford. He won’t shut up about it. Is it really that horrible a decision?

Brooke – Texas

Brooke,

This type of behavior from a dentist really galls me. While dental implants may be the top of the line treatment, it also comes with a top of the line price tag. Not everyone can afford that. And dentists need to understand that.

There is something called phased treatment that affordable dentists are very willing to suggest and provide. You can start off with a removable partial denture. Possibly you could even afford to have it anchored with a mini implant. Then as you have the money you can switch to a full implant. Depending on how many teeth you’ve lost, you may only need one or two.

While his methods are a bit bullish, he likely only has your well-being in mind. Dentures can be uncomfortable and reduce your chewing capacity no matter how well made they are. Then, there is the loss of jaw bone minerals that come from not having a tooth root anymore. With dental implants, the body is tricked into thinking that root is still there and you retain all your minerals.

In your place, I would just tell him this is what you can afford and that’s that. If you’re interested in working toward another treatment, you can tell him that. It may shut him up. But, either way, it’s your mouth, your budget, and your choice.

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

Can an Orthodontic Disaster Be Fixed?

by

My mom had me see an orthodontist while I was younger and the orthodontist had two of my teeth pulled because I didn’t have much space. I’m not quite sure why, but he went with the two nearest my two front teeth, which means that my pointier teeth are closer to the front than they should be, if that makes any sense. I’m 26 now and my teeth have shifted some, so now there’s a big gap between those teeth and my front teeth too. It looks so bad. I’ve been considering going in and seeing if an orthodontist will give me braces again to close the gap, but that’s not really what I want. If possible, I’d like the pointier teeth shaved down or moved or something instead. After all these years, is it still possible to correct what the first orthodontist did?

Thank you,

Tammy

Dear Tammy,

It sounds like you had your lateral incisors removed, which isn’t very common because people wind up with the problem you currently have- it never looks quite right. Plus, the canines play a crucial role in the side to side motion of chewing, protecting the back teeth from undue stress, so those are not usually moved much. With that said, what’s done is done and now you want to see about fixing it.

You’re probably right about not just having the gap closed again. Even if you see a really good cosmetic dentist, it would be difficult for him to make your canines look like lateral incisors. The teeth are built so differently. If there isn’t enough space to replace the lateral incisors that were taken, you may have to go that route anyway, though. If you do have a considerable amount of space, you may be able to go through another round of orthodontics to straighten things up and shift the gap, so you could have something like dental implants, a bridge, or partial denture made.

The bottom line with this one is you’ll want to see an orthodontist and a dentist who specializes in cosmetic dentistry to do an exam and x-rays. Every case is a little different and it’s difficult to know how much space you have to work with. With something this extensive, you’ll probably want to get a couple of opinions, so you can get a good feeling for what’s best and you’ll want to see someone who has preferably handled a case similar to yours before. You can fix it and make it look better than it did before, but it’ll never be quite the same as it would have if those teeth weren’t extracted.

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

Do I Need to See an Emergency Dentist for Implant Pain?

by

I’m about halfway through the healing phase of my dental implants. I’ve been so excited about this and hadn’t had any problems until recently. Yesterday, it felt tingly and spongy. Today, I woke up with the area swollen and painful. I haven’t eaten.  Can I wait until I can get in to see the implant dentist or do I need to see an emergency dentist?

Sylvia P. – South Dakota

Sylvia,

This requires you get seen immediately. I’d let your implant dentist know what it going on. If he or she can’t see you right away, then go to an emergency dentist.

It sounds like you’ve developed an infection at your implant site. You don’t want it to settle in or you’ll lose your implant. If they have to remove the implant, you’ll have to get bone grafting done in order to re-start the procedure.

Even without the worry about the implant, you don’t want a tooth infection to spread. It’s close to your heart and brain. People still die from tooth infections.

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

Is There a Special Dentist For Implants?

by

I’m in need of a new tooth. I’ve done some research on my options and think a dental implant is my best choice. Is there a special dentist for that or just a regular dentist?

Andrew P. – Utah

Andrew,

I applaud your choice of tooth replacement. It will be the most like having your natural tooth back. If you’re asking if there is a recognized specialty in implant dentistry, there isn’t. However, while any general dentist can place dental implants, it is an advanced procedure so I wouldn’t allow just anyone to do it.

You’ll want to be sure they’ve had significant implant training. For instance, Dr. Noah has had enough training and experience with dental implants to be named a fellow with the American Academy of Implant Dentistry (AAID). Less than one-half of one percent of dentists reach this level.

Don’t hesitate to ask them where they received training for dental implants and how many procedures they’ve completed successfully. If they’re qualified, they won’t be the least bit offended. In fact, they would expect an educated patient to inquire.

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