Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Worried About Maryland Bridge Before Dental Implant

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I have a 13 year old daughter who needed orthodontics and has a congenitally missing tooth. We’re finished with her braces and our long term plan is to get a dental implant for her missing tooth. We just need to keep that space open until she is old enough for the procedure, in the meantime.

Our dentist has suggested that we use a Maryland Bridge. He’s been doing one with a ceramic back, but it keeps falling off. He is talking about doing a metal one, but I’m not crazy about that. I worry it will stain her teeth. What do you think? Would a different cement on the ceramic one work better?

Abigail

Dear Abigail,

Two illustrations of a Maryland Bridge

I’m glad you wrote. The good news is that your choice of a dental implant is perfect. It is the best tooth replacement you can give her once she is older. I don’t think this dentist is serving your daughter (or your bank account) well. I am sure he has the best of intentions, but I don’t like his choice of a temporary tooth replacement. A Maryland Bridge isn’t really a temporary tooth replacement. That is because in order for it to really stay in place, the dentist has to cut a notch into the tooth, such as in the image above. Anything that changes the structure of your teeth is not a temporary tooth replacement. Once she is ready for her dental implant, she will need dental bonding in order to fill in the notch needed for the bridge.

The fact that your dentist cannot keep the Maryland Bridge on makes me wonder if he did that notch. If he didn’t, don’t have him do it. Instead, I want you to get a real temporary tooth replacement— a dental flipper. In fact, get one either way and get a refund on the Maryland Bridge. As an additional benefit, not only will the dental flipper not change any of her tooth structure, but it is significantly cheaper than the Maryland Bridge your dentist suggested.

I hope this helps.
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Ordering Dental Parts Online

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Is there a way for me to order dental implant parts online that does not require me to be a dentist? What I need is the male retention parts. My dentist charges me for one what I can get for six of them online. I’m retired and thought I’d have enough to get through, but the economic problems really hit me hard. I need to pinch every penny I can or I will outlast my money. Not that I’m hoping for the opposite problem either. Any advice you have will be greatly appreciated.

Michael

Dear Michael,

snap on denture

While it is true that dentists have a great deal of overhead, this would not be a huge earner for him and should not make much difference in his bottom line. I would start by talking to your dentist about your situation. My guess is that he would be willing to work with you. If he is not, you will still have options.

My next step would be to look for a dentist who works with dental implants, who also advertises themselves as an affordable dentist. I have found that most dentists went into their profession in order to help people. Affordable dentists are especially sensitive to the financial straits that people sometimes find themselves in. You could call around to a few dental offices and tell them what you told me. It’s often the staff who orders the parts instead of the dentist anyway.

A final option would be to order from eBay. There are overseas companies who are willing to sell these to non-dentists. I’m making that a final option because you would have to know some information such as the strength of the cap you need as well as how to place them into your denture.

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

My Dental Implants Fell Out

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I got eight dental implants in order to not have removable dentures. I’ve paid for about 1/2 of the procedure and am supposed to pay the remaining 1/2 soon. After just a few days, three of the dental implants fell out and another one feels loose. I have two questions. First, should I have to pay for the ones that fell out? Second, should I be worried about the other implants, especially the loose one.

Susan

Dear Susan,

Dental Implant Diagram

Your choice of getting implant supported dentures was a good one which, when done properly, will prevent facial collapse. Obviously, your dentist did not do it properly and I am sorry to hear this happened to you. You have very legitimate questions and concerns. First, you should not expect to have to pay for the dental implants that fell out. A basic tenant of dental work is that it actually stays in your mouth. Most dentists with dental implant training have a 95% success rate. Your dentist is looking at a an abysmal 50% success rate, with that fourth one already loose. Not only that, most cases of dental implant failure that do happen would take at least a year. Your dentist’s work didn’t even last a few days! As to the other implants, I would not hold out too much hope that they are going to stay in.

Reasons for Dental Implant Failure

  • Infection at the implant site. This is often because of poorly fitting fixtures.
  • Poor bone support. This can be completely avoided by your dentist doing adequate diagnostics.
  • Cheap dental implant fixtures.
  • Incorrect placement of the implant fixture.
  • Premature loading of the denture or dental crown. This happens where there was not given enough time for the bone to integrate with the implant before putting stress on it.

Do not pay any more money to this man. You need to get these looked at by another dentist who can tell you what has gone wrong. Don’t let your dentist choose who gives you the second opinion. You want someone with dental implant experience. However, you might want to choose a dentist from a different city. That way there will be less of a chance that they are friends. The dental world is a small one.

If the second opinion dentist wants the diagnostics and notes from your current dentist, he or she is under an ethical obligation to provide them.

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.

Why is My Face Shrinking?

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I’ve heard you can get smaller as you age, but lately, it seems like the lower half of my face is shrinking as well. I don’t know what’s going on. My dentures barely fit anymore. I’m afraid to go out in public because there’s no room for them and they slip out. Is this typical?

Avery

Dear Avery,

An illustration of the damage done by facial collapse using two pictures of a woman, one before and one after

Wearing Dentures for Too Long Causes Facial Collapse

What you’re suffering from is known as facial collapse. This occurs when you’ve been wearing dentures for a number of years. When you remove your teeth, your body realizes that you no longer have teeth roots in your jaw. Because our bodies are incredibly efficient (I mean what other pieces of equipment holds up for 80 years living mostly off burgers and fries?), it resorbs the minerals in your jawbone to use elsewhere, perceiving they’re no longer needed.

This is why your jaw is slowly shrinking. It’s also why your dentures no longer fit properly. Eventually, you will be unable to keep them in your mouth at all, leaving you a dental cripple stuck on a liquid diet. I’m concerned your dentist neither warned you about this nor recognized what was happening to you.

A Solution for Facial Collapse

There are two solutions for you. Both will include getting bone grafting done. This is where a surgeon builds back up the bone you’ve lost. After that, you can choose to have your dentures remade to fit the new structure. Just bear in mind, you’ll face the same issue of disintegration that your original dentures caused.

Another option is for you to replace your teeth with dental implants. This uses prosthetic tooth roots, usually made out of titanium, to help your body to know the bone is still necessary to hold in the new roots of your teeth. They have other benefits as well.

Advantages of Dental Implants

  • They are permanently secure. Once they’re placed, it’s like having healthy, natural teeth back. There’s no slipping. No sliding.
  • Your chewing capacity will increase dramatically.
  • They protect you from developing facial collapse.

The key is to communicate with your dentist and let him look and advise.

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