Should I get a ceramic or metal implant?

I have read a lot about ceramic dental implants recently. Many sources have said I should go with ceramic over metal. When I brought this up to my dentist he told me that he only does metal implants. Why should I choose ceramic over metal? I like my dentist, so I’m wondering if it’s worth the trouble to find a new one who does ceramic implants? — Steven

Dear Steven,
Most dental implants are titanium or titanium alloy. Both are a top choice with dentists because they are very strong, have longevity and they integrate with the bone extremely well.

If a patient is “allergic” or sensitive to metal, a ceramic implant might be recommended. But how do you know if you’re sensitive to metal? Do you break out in a rash from jewelry or are you irritated by the snaps on your pants? If you answered yes to those questions, it’s often nickel that is the problem. You don’t need to be concerned if you haven’t had any sensitivity issues to metal; however, if have exhibited symptoms, it would be beneficial for you to get allergy tested and then follow-up with your dentist regarding the dental implant he uses and if it contains any of the metals that you tested allergic to.

A dentist might also chose ceramic purely for aesthetic reasons so that the underlying metal won’t make the porcelain crown look dark. However, even if there was some darkening, it’s rarely noticeable because most implants are placed in the back of the mouth. Also, if your dentists works with a skilled lab technician, they are experts in adjusting shade and opacity for natural-looking results.

Titanium or a titanium alloy restoration is a safe and reliable option unless you have a sensitivity metal. If you’re still concerned talk with your doctor because he knows your particular case and will be familiar with the materials he uses most and whether or not they will be a concern.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Will teeth whitening hurt my baby?

I have been planning my smile makeover for forever. I literally got the treatment plan from my dentist two years ago, but because insurance won’t cover most of it, I’ve had to save. My plan was to start with teeth whitening and then replace my metal fillings and then do some veneers. Well, I got the teeth whitening done a couple weeks ago and my appointment to start the rest of the work is next week. I just found out I’m pregnant. I don’t even know how far along I am, but I’m sure I must have been when I had my teeth whitened. Everything I can find says that you shouldn’t bleach your teeth while you’re pregnant, but nothing tells me why. Could I have hurt the baby?  — A Terrified Mama to Be

Dear Terrified Mama,
Relax and take a couple of deep breaths. There is no evidence to suggest any harm will come to your little one. In order for any kind of drug, medical material, or piece of medical equipment to be deemed safe during pregnancy, it has to get FDA clearance. The only way to get this is by having controlled trials in which healthy babies are born after the product has been used on the expectant mother. Naturally, there isn’t a whole lot of interest in the medical community, or with moms-to-be, in pursuing clinical trials. That doesn’t mean it will cause harm. It simply means it hasn’t been proven to be safe.

While this might seem like a slight nuance in language, it’s everything to the FDA and to manufacturers. This is why each one will tell you to either consult your doctor or not to use it if you’re expecting. There have been no reports whatsoever recognized by a reputable agency of babies being harmed by tooth whitening products. The warnings are simply a protective measure.

If you’re still concerned, have a chat with your OB/GYN. She’ll likely set your mind at ease. With that said, you may want to hold off on the additional cosmetic work until after you’ve delivered. Restorative treatment needed due to decay is generally ok after the first trimester and with clearance from your OB, but cosmetic work is usually on the no-no list because of the anesthetic and stress. Your OB may advise you otherwise, though, so always defer to her for treatment going forward. You can pick up where you left off with the cosmetic work after the baby is born. If need be, a few days of whitening at home should be able to boost your color back up to where it is now.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Help…my gums look uneven after porcelain veneers

I recently saved up to get porcelain veneers and was so excited when I was finally able to get the appointment scheduled and get the process going. One of the main things I was concerned about was how uneven the bottoms of my teeth were. My dentist assured me that the veneers would look great and I even tried them on before they were cemented and was very pleased with how they looked. Now that they are permanently placed and I’ve had more time to really look at them, I’m noticing that my gums look uneven. I didn’t see it before the veneers, so I’m not sure if they did something wrong? It’s frustrating because I’m still not happy with how my smile looks. Can my dentist fix this or is it something I will just have to learn to live with? — Annika

Annika,
Did your dentist mention that he would have to make any adjustments to your gums as part of your porcelain veneer prep? The technical term he would likely use would be “gingivectomy” or “gingival surgery” but some dentists will refer to it as “recontouring “ or even a “ginge.” A procedure such as this should have been discuss with you up front so that you could give your consent, but if it was done in a more casual, conversational manner maybe there was a miscommunication. However, if you don’t remember addressing the topic at all, it likely wasn’t done. The fact that you are noticing the uneven gums now is probably because your teeth are straighter. You should ask your dentist for sure, however.

Any gumline issues should be talked about during the consultation process, and if any reshaping is needed it’s done during the preparation. There is no way to correct the problem now because removing gum tissue will likely expose the margin. Not only will that look even worse asthetically, it also puts your teeth at risk of decay. Schedule a follow-up appointment so you can talk to your dentist about your concerns. Unfortunately, the only way to fix this issue would be to request a do-over.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Can I find more affordable dental implants?

I have several missing teeth and I refuse to smile anymore because I am so embarrassed about how I look. I want to get implants, but the dentist I recently visited quoted me $5000. That is so much more than I was expecting and I really don’t think I can afford it. Is it possible to find a dentist who will do implants at a more affordable cost?  — Mary

Mary,
There’s no doubt that $5000 is a lot of money, but it will certainly be very difficult to find another dentist who will make implants more affordable than the quote you were given. In fact, it almost sound too good to be true, and here’s why…

Dental implants are a two-stage process: 1) the surgical placement of the posts, and 2) placing the top of the tooth (crown) to the implant once is has fully integrated with your jawbone. While there will be some variation in cost depending on the quality of the materials, the expertise of your dentist and even where you live, you should expect to pay (at minimum) $1,000 per tooth being replaced for each stage. When you do the math for three teeth, that’s a cost of at least $6000. But consider this: some dentists can run as high as $2500 per tooth for each stage for a total of $15,000.

The first thing you need to do is verify with this dentist that the quote you were given is your total out-of-pocket expense for all procedures and materials. And make sure that he is doing three full, traditional dental implants. It could be that he is quoting you something else – like a bridge, a partial or even mini implants. Being fully prepared and informed means there will be no unpleasant surprises in the end.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about  why many consider Dr. Delaune to be the best dentist in New Orleans.