Category Archives: Dental Implants

Dental Implants after Dentures

I’ve had dentures for about 12 years and can finally afford dental implants. Have I waited too long or is it still possible?


Dear Beatrice,

Side-by-side profile photos of a middle-aged woman that show the effects of facial sagging and how dental implants can help; from Dr. Duane Delaune of New Orleans.

The answer to your question is yes. However, there is a “but”. When your teeth were first removed, your body, in an effort to use its resources as efficiently as possible, resorbs the minerals in your jawbone. It does this because, without teeth, it doesn’t think you need the bone any longer.

This has the unfortunate effect of shrinking your jawbone. In dental terms, it is called facial collapse. The amount of time you’ve worn dentures is enough to allow facial collapse to set in.

Dental implants require you have enough bone structure to retain the root form. There are two ways around this:

The first thing you could do is have the bone grafting done in order to build the bone back up. This is an outpatient procedure .

A second option is with All-on-Four Dental Implants. This is for patients who have only lost some bone and are looking for a way around bone grafting.

illustration of the position for all-on-4 dental implants
All-on-4 Dental implants

Using shorter implants and angling them, can help your dental implants to stay on. This has helped quite a few patients get dental implants that wouldn’t otherwise. However, not as many dentists know how to do the procedure.

Your best bet is to meet with a skilled implant dentist. Look at Dr. Delaune’s qualifications to see what type of dentist you will need to do this well for you, regardless of which procedure you choose.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Are dental implants possible for me?

I haven’t been able to afford dental care for years. Now, I finally have dental insurance. Because of advanced periodontal disease, I’ve lost several teeth. Is it possible for me to get dental implants instead of dentures?


Dear Cathy,

Abutment and crown being placed on dental implants

Dental implants are the best tooth-replacement option you can get, while dentures have many problems that come with them. For instance, even the best fitting dentures will reduce your chewing capacity by 50%. However, that’s not the worst part.

Your body recognizes when your teeth are gone. In an effort to be as efficient as possible with its resources, it begins to resorb the minerals in your jawbone to use elsewhere. This begins to shrink your jawbone. After about ten years, it becomes difficult to even keep your dentures in. This is known as facial collapse.

Getting dental implants prevents that because the implants serve as prosthetic teeth roots. Your body recognizes their presence and leaves the jawbone intact.

Gum Disease and Dental Implants

You will need to deal with your gum disease to be a good candidate for dental implants. Periodontal disease leads to bone loss, which may have been a contributing factor in your losing teeth.

Your dentist can help you get that under control. Once that is, you want to find a well-trained implant dentist. They need post-doctoral training in the procedure. You can look at Dr. Delaune’s credentials to get an idea of the type of dentist you want to find in your area.

He should run diagnostic tests, including a CT scan to make sure you have adequate bone and to plan the ideal positioning of the dental implants. Don’t be discouraged if you’ve lost too much bone. There is a procedure to repair that. You can have bone grafting done to restore the missing bone. Then you’ll be good to go on your implants.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

type 1 diabetes & dental implants

If I have type 1 diabetes, is it still possible for me to get dental implants or am I not a candidate?


Dear Ben,

dental implant diagram

With diabetes, you can still get dental implants as long as your diabetes is under control. While it is not a contraindicator, it is a risk factor. A significant one, in fact.

One thing I highly suggest is you research your implant dentist very carefully. You need someone who has had significant post-doctoral training in dental implants. For instance, Dr. Delaune received the following training in dental implants.

  • Implantology training from the Zimmer Institute and Russo Seminars
  • Advanced dental implant training at the Medical University of South Carolina

You’ll want them to do all the diagnostic work possible and keep a close eye on everything throughout the process. Diabetics often have trouble healing so make sure they do extra checks on you during the healing process.

While some dentists will do the implant surgery themselves, others refer you out to an oral surgeon. Don’t make the mistake of seeing an oral surgeon before the dentist. You’ll want the dentist to have close communication with and surgeon to make sure they only place the implants where the dentist wants them.

If you’re going to have a mixture of your own teeth and dental implants, you’ll be more happy with your smile if you whiten your teeth beforehand.

Your dentist will place porcelain crowns on top of the implants. When he or she does that, the crowns can be matched to your natural teeth. However, once that color is made, it is permanent. You’ll want to make sure your teeth are the color you’ll want your implant crowns for a long time.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

maryland bridge before a dental implant

I’m trying to figure out what to do. My daughter has a congenitally missing lateral incisor. We did orthodontics to open the space. Now we’re working on the temporary tooth replacement. Our dentist decided on a Maryland Bridge. We did non-metal wings because I wanted them to be as natural-looking as possible. The problem we’ve had is the bridge has fallen off twice in just a couple of weeks. After the first time, she (our dentist) tried a different bonding cement, but that didn’t make it any stronger. Now she wants to try doing it with metal wings. Here’s the thing. My daughter is 14. She’s going to have to wear these for a few years. I don’t want her to feel self-conscious. I have two questions:
1. Will these stay on better? 2. Will the metal be a better choice?


Dear Karyn,

I’m a little concerned about some things I’m hearing here. First, I would not consider a Maryland Bridge a temporary replacement. This requires tooth preparation, which means you’re reducing tooth structure. If you’re doing that, you might as well stick with a dental bridge and not get a dental implant.

Another thing is the bonding issue. It doesn’t sound like your dentist understands bonding principles. She placed the bridge with a cement and it fell off. Then, she gets (I’m assuming) a stronger cement and it still falls off. Her next thought is to switch to metal wings.

Maryland Bridge Preparation

That’s not likely to work out any better for her. The non-metal (zirconia) wings are usually easier to bond than the metal ones. My guess is the problem is with her tooth preparation. If you look at this image on the left. You can see that a groove should be cut into the tooth to support the wings. Without this, she’s likely to have trouble no matter what type of bonding she uses.

While she could go back and make the correct grooves, I am going to recommend a completely different direction. While you can go ahead with the bridge, once she gets her dental implant, you’re going to need another procedure to have these grooves filled in. Why do that when you can instead get a temporary tooth which will not require any modification to her adjacent teeth?

I’m not trying to discourage you from your future plans of getting her a dental implant. It is the best tooth replacement around. It will be a great solution for her when her jaw is fully developed.

I am trying to discourage you from the dental bridge. Instead, I’m going to recommend something else.

Removable Partial Flipper

A removable partial flipper will be perfect for her situation. When well cared for it can last long enough for her to get her dental implant. Even if something happens, it is significantly less expensive than any other tooth-replacement option. You could replace several of them for the cost of a single Maryland Bridge.

They can be made to look beautiful too, so your daughter won’t look self-conscious.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

can I get a beautiful smile after 3o years of Dentures?

I’ve had dentures for about thirty years. Back then, I don’t think dental implants were available. If they were, my dentist should have told me about them. I have a friend who has them and her smile looks so much better than mine. I’d love to get a beautiful smile now if that is possible.

dentures and dental implants

I’m going to give you the great news first and then tell you how to make it come to pass. You can absolutely get a beautiful smile again. I’m going to tell you something which may sadden you, but I want you to understand it for the smile you’re going to get with dental implants.

You could have had a beautiful smile with dentures as well. The beauty of the smile doesn’t depend on whether you have crowns for dental implants or dentures. What makes the biggest difference is the artistic skill of the dentist.

Implants After Dentures

When your teeth are removed, your body recognizes that and begins to resorb the minerals in your jawbone in order to be as efficient as possible with your body’s resources.

This has the unfortunate effect of slowly shrinking your jawbone. This is known as facial collapse. Eventually, there won’t be enough jawbone left for you to retain your dentures at all, leaving you a denture cripple.

This creates a problem for dental implants too. As you can see from the image above, when an implant is placed, it requires the bone in your jawbone to integrate with it in order to retain the implant securely.

After 30 years, you will probably require a bone grafting procedure in order to have enough bone to secure them. This is an outpatient procedure. Then, when you’ve had time to heal, it will be time to get your implants then.

Getting a Beautiful Smile

As I mentioned above, getting a beautiful smile requires a skilled, artistic dentist. My suggestion is for you to look on the website. This is run by an accredited cosmetic dentist. He screens each dentist who wants to be listed on their site for both technical knowledge and training, as well as an artistic eye and hand. Any one of them can give you a gorgeous smile.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.

dental implant perforated my sinus cavity

I’m a little concerned about some things. I was several months into my “healing period” from my dental implant being placed when the dentist removed it. He said it wasn’t integrating with the bone and the implant perforated my sinus by a few millimeters. He gave me flonase and instructions not to blow my nose, etc. Then we’ll try again after a while. Is this okay or will the same thing happen again?


Dear Miranda,

dental implant diagram

I’m a little concerned by some things I’m hearing. While it may seem a matter of semantics, the dental implant didn’t perforate your sinus cavity, your dentist did. Plus, he did it by several millimeters which by dental standards is quite a bit.

When your dentist was doing the diagnostics for this procedure, did he take any three-dimentional x-rays, such as a CT scan? This is a necessary step to prevent sinus perforation.

Additionally, the implant didn’t integrate with the bone. This is a nother cause of concern. Yes, it should have been removed, but before you go forward, I’d like to know what your current dentist will do to prevent this from happening again before moving forward.

When a Dental Implant Fails

In order to move forward, you are going to need to make sure the sinus cavity is properly healed. After that, you’ll need some bone grafting done. Without that, there is not enough bone there to inegrate with your implant.

I’d like you to get a second opinion on this situation to see what another implant dentist says.

From there, you can either go with the other dentist to replace this or you can get assurances from the second dentist with specifics as to how he’ll take steps to prevent another perforation.

If he was planning on replacing the implant without any bone grafting, I suggest you find another dentist completely. Make sure the new dentist has specific training in dental implants. Dental school isn’t enough. It needs to be post-doctoral work.

Cosmetic Consideration with Dental Implants

Whatever color the implant crown is made will be permanent. If you are happy with the color of your smile, then you are good to go. However, if you have contemplated whitening your teeth, you’ll want to get the teeth whitening done before having the porcelain crown made.

This will save you money while allowing your smile to match from the beginning. The other option is to whiten your teeth later, but then you will have to redo the crown to match the newer, white color of your teeth.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

help avoiding dental implant failure

I’m looking at dental implants. One dentist is insisting on a CT scan but he uses a brand of implants I’ve heard a lot of good things about called Straumann. The other dentist says the CT scan isn’t necessary, but he uses a brand I can’t find much about called Southern Venturi. I like the idea of saving money on the CT scan, but want to make sure the brand is okay first. Do you have an opinion on that brand?


Dear Keith,

dental implant diagram

CT Scans and Dental Implants

I’m glad you are asking these questions. Both have important implications for a successful dental implant case. Let’s start with the CT scan. I would spend the money on that. The big reason is getting dental implants is a 3-Dimentional procedure. In order to get the right placement, it helps to have 3-Dimentional scans.

A lot of dentists are willing to place the dental implants without the scan but here’s what concerns me about that. If you’re talking about a an implant for a front tooth, without the scan the dentist risks it perforating your sinuses. Some dentists try to circumvent that issue by using a small implant, but they aren’t always able to retain the tooth in the long-term.

Another important piece of information is the depth and thickness of the bone. You only get that with the CT. This one additional step can prevent a host of problems.

The Brand of Dental Implants

The first brand you mentioned, Straumann, is one of the brands the top implant dentists prefer. Other good ones are Nobel Biocare, BioHorizons, Zimmer, and Astrotech.

The second brand you mentioned has me a tad concerned. I don’t know any of the top dentists who use this brand. It may be a cheaper brand which saves the dentist money, but you have to be very careful with “cheap” implant fixtures.

Often, it goes fine at the procedure but fails later and the patient has no idea it’s because the dentist used a cheap implant fixture. You also have no real recourse if that happens. It’s much better to pay a little more and get a proven fixture.

The Importance of a Skilled Implant Dentist

Another huge factor in the prevention of dental implant failure is the skill of the dentist. You want a dentist with extensive dental implant training. You can look at some of Dr. Delaune’s credentials to get an idea of what you are looking for in a dentist.

Don’t hesitate to ask where they received their dental implant training. Dental school isn’t enough. They must have post-graduate training.

You also want to make sure they do a significant amount of cases and have a lot of experience. Additionally, ask about their success rate. I’d want someone with a 98% success rate.

I hope this helps you. This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Is It Too Late For Dental Implants To Help My Sagging Face?

Is it too late for dental implants if I’m 64 years old and have already experienced facial sagging? I’ve been wearing dentures since I was 50 and have had continuous problems with them. This situation is difficult for me because my face looks uneven. I want to try to avoid cosmetic surgery if possible. It’s easier for me to get implants rather than have my face cut. Besides that I want the results to look natural. I’m not trying to look 44 again like cosmetic surgery might do. I just want to give my face a natural-looking lift. Thanks. Leilani T.

Leilani – As you may know, when your teeth are missing for years, your jawbone will progressively shrink. This is because tooth roots stimulate the bone, so when teeth are missing, it’s a signal to your body that the bone isn’t needed. Your body will resorb the bone and use the minerals from it elsewhere.

When dentures are resting on your jawbone, the pressure from them accelerates bone shrinkage. Although cosmetic surgery may eliminate excess facial skin, jawbone shrinkage can continue. And if it does, so will facial sagging. The good news is that it’s not too late to receive dental implants.

It’s Not Too Late for Dental Implants to Help with Facial Sagging

If you’re already experiencing facial sagging, your jawbone has begun to shrink. But dental implants need to be placed deep enough in the bone to be stable. It’s likely that you’ll need bone grafting first.

Side-by-side profile photos of a middle-aged woman that show the effects of facial sagging and how dental implants can help; from Dr. Duane Delaune of New Orleans.
Dental implants can prevent or improve facial sagging
  • Bone grafting – Even after jawbone shrinkage occurs it’s not too late for dental implants. Bone grafting can be used to replace the missing bone. In a few months, the grafts will heal and dental implants can be placed. The implants will stimulate bone and prevent further shrinkage. Four to six implants will stimulate a wider area of the bone.
  • Support for your dentures and facial muscles – The built-up jawbone will support your facial muscles. Dentures will be attached to the dental implants. Implant-supported dentures don’t rest on your jawbone and put pressure on it.

What’s Next?

Before you receive any treatment, 3-D x-rays will be taken to determine the extent of bone shrinkage and the best way to treat it. Both bone grafting and dental implant surgery have a healing period of three to four months, so be patient. Your oral health and your facial appearance will improve.

We suggest that you schedule consultations with
at least two experienced implant dentists to discuss your options for implants and natural-looking dentures.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Dr. Delaune is a sustaining member of the American Academy of Cosmetic Dentistry.

considering dental implants

I need to replace three teeth. I’ve been considering dental implants but wanted to know what things I should consider ahead of time about them. Any input?


Dear Laurie,

Abutment and crown being placed on dental implants
Dental implant parts and placements

While dental implants are the top of the line replacement there are some things to consider. First, are you committed to the long haul?

The journey starts with the surgery to place the dental implants. From there, is a healing period. This is to allow the bone to integrate with your implants, keeping them secure. Once that’s completed, your dentist can place the dental crowns. That process takes a while.

You also want to be committed to a lifetime of good oral health. You don’t want to invest all that time and money on something if you’re not willing to take care of it. It would be like buying your dream house, but never bothering to clean or care for it until it sits there, nothing but a shambled ruin.

A third consideration is your long term smile goals. If you want a white smile, it’s important you have any teeth whitening done before you get the dental implants. While a skilled cosmetic dentist can match your implant crowns to the color of your teeth, the color is permanent. If you want them white, you’ll need to make sure you do that before the crowns are created.

All that being said, the most important consideration is the dentist.

Finding an Implant Dentist

Dental implants are an advanced procedure. Too much can go wrong if you have an inexperienced dentist. It’s something which requires extensive post-doctoral training.

Never hesitate to ask a dentist about their implant training. if they name their dental school, that’s not enough. If they seem offended, they don’t have enough. No dentist with skill minds those type of questions.

Instead, they want patients to feel confident and secure going into any procedure. You can take a look at just some of Dr. Delaune’s credentials to get an idea of the type of dentist you’ll want to do your implants.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Premedicating with Dental Implants

I’ve got two conflicting opinions and I’m not sure which direction is the right one. I had a hip replacement about ten years ago. Now I need to get some dental implants. One dentist says I’ll have to pre-medicate with antibiotics; the other says that’s nonsense. Who’s right?


Dear Beth,

dental implant diagram

Oh…the medical community. Don’t you love them? They all claim to be experts and none of them agree with one another. That’s a lot of experts who see things differently. Here’s what is going on in your situation.

It used to be that the standard recommendation was any time someone with a hip replacement had anything invasive done, including a dental cleaning, they were to have antibiotics so there was no risk of any bacteria being introduced which could make its way to the replacement site.

However, that changed in 2012 when both the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) released a new study which said recent studies showed there was no direct evidence to continue to make that recommendation.

That simply means it’s up to the dentist. It sounds like the dentist recommending the pre-medication likes to take every precaution possible. Which you do is up to you. There’s not a right or wrong answer. I would say if you’re a healthy person who doesn’t easily get sick it won’t matter. If you tend to catch things more easily, I’d pre-medicate.

Cosmetic Care and Dental Implants

I want to give you a heads up on a cosmetic issue that recently came up with a patient I know. She’d planned on getting dental implants and teeth whitening. Even though her dentist knew she wanted both procedures, he didn’t warn her that the teeth whitening needed to be done first.

The reason for that is the gel used to whiten teeth only works on natural tooth structure. While her natural teeth were getting whiter, her dental implants stayed the same color they were the day they were placed.

Only then did her dentist tell her to get her smile to match she’d have to replace her implant crowns. If he’d have advised her to get her whitening done first, she wouldn’t be in this situation having to spend unnecessary money. Her crown could have been made to match her new, white color from the beginning.

I don’t know if you were ever going to want teeth whitening, but as this just happened to someone I know, I thought I’d warn you just in case.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.