Dental Implants Archives - Dr. Duane Delaune's Blog

Need some advice for a badly decayed first molar tooth

September 27, 2021 by AllSmiles

My bottom right first molar is decayed and does not have a second molar behind it. My dentist wants to try to save it with a root canal, and if that does not work, she recommends a dental implant. The tooth is far enough back that I wonder if removing it and doing something like a half snap-on smile would work. I work from home, so I would only need to wear artificial teeth when I socialize. My dentist says that if I want an extraction, I need to find another dentist. She hates removing teeth. Do you mind offering your opinion? Thank you. Tytus from GA

Tytus,

Thank you for your question.

If you have already lost your second molar, removing the first molar would leave you without any lower right molars. We want to help you understand the effects of removing your first molar.

Effect of Lacking Molar Teeth on One Side

If you have no molar teeth on one side of your mouth, it will affect you in these ways:

Chewing – You will not be able to chew on that side of your mouth. And you will add stress to the teeth on the other side of your mouth. As molar teeth on the left side of your mouth wear, you will eventually need to eat soft foods that do not require a lot of chewing unless you get some form of long-lasting tooth replacement.
Temporary replacement teeth – A Snap-on Smile and similar products do not replace the function of molar teeth. Even if you wear it for socializing, it is not durable. You will need to replace it repeatedly.
Tooth misalignment – When one tooth is missing, nearby and opposing teeth begin to drift into the space. Without molars on the lower right side of your mouth, your teeth will start to move, detract from your smile, and create orthodontic issues.

Treatment Options for a Decayed First Molar Tooth

If your molar tooth is damaged, your treatment options likely include:

Root canal treatment – Your dentist can try to save your tooth with root canal treatment and a dental crown. Saving the tooth will prevent surrounding and opposing teeth from shifting. Root canal treatment is less expensive than extraction and a dental implant or dentures.
Dental implant – If root canal treatment fails and your dentist cannot save the tooth, a dental implant can replace it without damaging your oral health. An implant has an artificial root and a crown. It will function as a healthy natural tooth.
Partial denture – Although a partial denture can replace a missing tooth, it must attach to other teeth to stay in place. Over time, the pressure from the clasps of a partial denture weakens healthy teeth.

We recommend talking to your dentist about your concerns with root canal treatment. If your tooth is healthy enough, root canal treatment is the best way to save it and avoid a series of temporary solutions that require replacement.

Best wishes.

Duane Delaune, DDS, an accredited cosmetic dentist of Metairie, New Orleans, sponsors this post.

I Paid for a Crown But Now the Dentist Says I Need a Root Canal

September 15, 2021 by AllSmiles

The filling in my lower left second molar cracked, and the tooth cracked. My dentist removed the filling and put a crown on the tooth in June. I felt pain most of the appointment. When my dentist checked my bite, it hurt. Within three days, I returned to the office because it hurt to chew with the tooth and floss between it. The dentist asked me to return early last month for a new crown. When I went in for the crown, the dentist said I needed a root canal after all because the tooth had a periapical abscess. I was upset because the dentist never told me that I might need a root canal eventually. I do not want a root canal, but the dentist says my other option is extraction. Should I have to pay for the extraction, and should I request a refund for a crown that I will lose along with the tooth? – Marco from GA

Marco,

Thank you for contacting us about your case. Yes, your dentist’s work was sloppy. A cracked molar and filling mean that the tooth is already weak. Putting a crown on the tooth without checking its condition is careless. And your dentist should have mentioned root canal treatment. Then you returned to the office for an attempted second time, but you had a periapical abscess. We understand your frustration and not wanting any more treatment from this dentist. But why not consider root canal treatment?

Reasons to Consider Root Canal Treatment

A periapical abscess is a sack of pus from an infection that settles at the tooth roots. And it means the living tissue inside your tooth is dead. A dentist can drill into your tooth, remove the dead pulp, and refill the tooth—and it will be painless. So, root canal treatment would not hurt, but extraction can be traumatic.

Effects of tooth extraction

Root canal treatment is more manageable than extraction for other reasons. Consider the effect of tooth extraction:

Surrounding teeth will drift toward the space of the missing tooth
Your tooth alignment and bite will change
You will need a dental bridge or an implant to replace the tooth and prevent other teeth from moving
Without tooth replacement, you can also develop TMJ (temporomandibular joint) disorder, including jaw pain, earaches, neck pain, headaches, and more

Ask for a Refund

You agreed to a dental crown to restore your tooth, but it didn’t work. And now, instead of a second tooth, you need root canal treatment. It is appropriate to ask your dentist for a refund. If your dentist does not admit his mistakes, explain that you received faulty work—not a solution.

You can see a cosmetic dentist for a second opinion. Afterward, you can use the results of the visit to ask your dentist for a refund. Best wishes for a fair resolution.

Duane Delaune, DDS, an accredited cosmetic dentist of Metairie, New Orleans, sponsors this post.

Boxing and Dental Implants

July 17, 2021 by writeradmin

I’m a boxer and recently lost a tooth. Before you ask, yes, I was wearing a mouth guard. Sometimes those hits are just too hard for the guard. I keep hearing that dental implants are the way to go for tooth replacements. I’m just wondering if that is true for boxers. If so, are there any precautions I need to take?

Leroy

Dear Leroy,

woman hitting man with a boxing glove

That is a great question. Under normal circumstances, I would say get that dental implant. It is the BEST tooth replacement. It is. However, you are in significant risk of having that same implant ripped out again. If that happens, it will take the bone with it and can do some serious bone damage. Because of your unique situation, here is what I am going to recommend.

First, get the dental implant root form but do not have the crown placed yet. This will preserve the bone. Be certain that you get a dentist who has post-doctoral training in dental implants. This is an advanced procedure and it is not taught in dental school. That training will be necessary.

Second, get a temporary tooth replacement for the crown (the visible part of your tooth) to use while you are still boxing. This way if you have another hard hit to the mouth, your jaw will not be affected. Two good options are a dental flipper or a removable partial denture.

Third, once you are done boxing, that will be the time to get the permanent crown secured to your dental implant.

This plan gives you the best of both worlds. You get the best replacement with the implant form, but the safety of the temporary tooth in case of injury.

I would go ahead and get started on this. It won’t take long for your other teeth to begin drifting or tipping into the empty space you have now.

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

Why Did Three of My Dental Implants Fall Out?

June 13, 2021 by writeradmin

I had six dental implants placed a few weeks ago and I’ve already had three fall out. I’ve paid 3/4 of the fee already. Should I get a partial refund? Is it possible for me to get them again because they were supposed to secure a denture to them.

Leigh

Dear Leigh,

dental implant side by side twith a natural tooth

You absolutely should have a refund, and not just on the ones that have already fallen out. I think you need a complete refund. I don’t know what your dentist did without examining you, but you need to get to a different dentist as soon as possible for an evaluation. Most experienced implant dentists will have around a 95% success rate. Those that do fail, won’t often do so until much later down the line. Your dentist has a 50% success rate and the failure was in just a few weeks.

There are a few reasons that dental implants can fail and we need to nail down what was the cause of your implant failure. This will give you an idea of how to proceed. If you are in good general health, you can most likely still get dental implants. Though, because of the failed implants, you will need a bone grafting procedure.

Here are some reasons that dental implants can fail:

Infection. I don’t think this is your issue. It is often accompanied by pain and/or fever.
Diagnostic shortcuts. This means the dentist did not take adequate diagnostic x-rays to determine whether or not you had sufficient bone support to retain your dental implants.
Cheap implant fixtures. Some dentists, in an effort to increase profits, will purchase their implant fixtures from outside the United States, where standards might not be as high.
Incorrect placement of the implant. This can occur because the dentist is unskilled or careless, but it can also occur if the dentist did not get the right x-rays done.
Premature Crown Placement. A dental implant has to integrate with the surrounding bone tissue in order to securely retain the implant.

As I mentioned before you need to find out what went wrong. Dental implants are not adequately taught in dental school. In order to really develop the skills necessary, a dentist must invest in post-doctoral training specifically in the implant procedure. Before going to get your second opinion, make sure the dentist you see has that training.

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

Help! My Dental Implants are Falling Out.

May 31, 2021 by writeradmin

I had a full mouth reconstruction done a year ago and the dental implant crowns have been falling off leaving me with nothing but the screws. Now one of the implants themselves have fallen out. I’ve been trying to reach my dentist for months, but they keep blowing me off. Now I learn he’s actually fled the country. Is there any way I can get some teeth now?

Liz

Dear Liz,

An image of a dental implant next to a tooth

I am sorry for what you are being put through. It seems your dentist was a crook. I think he or she knows they are in trouble as they fled. I wonder how many other victims there are. It will be hard to recoup your money unless he comes back to the country. I can, however, tell you how to get the smile you want.

You made a good choice in getting dental implants. They are the best tooth replacement. I hope you actually needed a full-mouth reconstruction and that wasn’t just another part of his unethical behavior. Either way, you need one now. To be frank, this is one of the most advanced procedures. Unfortunately, this procedure is not taught in dental school. In order for a dentist to get the training to do this properly, it will require a dentist who invested in a significant amount of post-doctoral treatment, specifically in three areas:

Cosmetics – to ensure your smile looks beautiful
Dental Implants – for obvious reasons
TMJ and occlusion – to make certain they know you your teeth should meet with proper occlusion.

I know that is a tall order. Start with the the cosmetic training. I would not look for the cheapest dentist. That usually means they cut corners in order to keep profits up. That is the last thing you need. Look for someone listed on the mynewsmile.com website. Any dentist listed there has had their technical training as well as their artistry evaluated. They cannot just pay to be listed. Next look at their implant training. Dentists with implant training often have TMJ training as well because proper occlusion is necessary for a good outcome with dental implants. For instance, Dr. Delaune did implantology training with the Zimmer Institute, but he also invested in advanced TMJ training with the renowned Dawson Academy.

Please don’t be surprised if they mention you need a bone grafting procedure to get these implants done correctly. Your implants will probably have to be removed, if more of them haven’t failed by then. When that happens, you lose some bone structure. In order for your dental implants to remain secure, you will need that bone support. In fact, it is imperative that bone integrates with the implants for a successful case.

Following these guidelines, you should receive an amazing smile you will be proud to share that will serve you well for many years to come.

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

16 Year Old with a Baby Tooth

April 30, 2021 by writeradmin

I have a baby lateral incisor still, even though I am sixteen years old. I would like to replace it so I can have a “grown-up” tooth. Can I replace it with a dental implant? I am planning on having my senior pictures taken in the fall. I’d like to have something that looks nice.

Candace

Dear Candace,

dental implant side by side twith a natural tooth

A dental implant is a great tooth replacement option. However, before you do that, two things need to be in place. First, you will want to make sure that you do not have an adult tooth under your gums that is impacted. If you do, a dental implant will not work because there will be no place to put it. The tooth root will be in the way. Instead, you will need to work with your dentist to open the gum and direct the tooth into its proper position. This may require some orthodontics, but if you get on it quickly, you shouldn’t have any trouble getting some beautiful senior pictures.

If, however, you are dealing with a congenitally missing tooth, then it will definitely need to be replaced. While a dental implant is the best tooth-replacement option, you will need to wait until your jaw is completely developed. This will be in your early twenties. Until then, you will not need to go without a tooth there. After you have the baby tooth extracted, I would suggest a temporary tooth replacement, such as a dental flipper.

Finding the Right Implant Dentist

Once it is time to get that dental implant, you want to be careful about who does it. This is the leading area for dental malpractice suits. This is because too many inexperienced (or worse, untrained) dentists do this procedure with horrible consequences for the patient. There are a couple of things you will want to look for in the dentist you choose.

First, their dental implant training. Dental school is not enough. Ask them what type of post-doctoral training they have in the dental implant procedure. If they are offended by that question, it means they don’t have the training and you need to seek a dentist elsewhere. Secondly, you will want to ask them their success rate. It needs to be no lower than 95%. While there will always be some cases that fail, due to no fault of either the dentist or patient, when done by an experienced and skilled dentist most will succeed.

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

Dentist Place a Dental Implant Knowing it Would Fail

December 3, 2020 by writeradmin

I need some advice. I went to see a dentist who said he’s placed a lot of dental implants. I trusted him and now feel like I’ve been taken advantage of. When he “finished” my implant surgery, he told me that he realized I didn’t have enough bone structure and now he wants to know if I would like him to take out the dental implant and give me a dental bridge. Why would he place the implant knowing I didn’t have enough bone for it to work? Can he do this?

Andrew

Dear Andrew,

dental implant side by side twith a natural tooth

I’m not sure how your dentist thinks he can get away with this. It is negligence at best. Let’s say that he didn’t know you didn’t have enough bone support before he started the surgery. Why didn’t he? Did he not do the appropriate diagnostics? Did you have a CT scan? If he did, does he not know how to interpret the diagnostics? Or worse, he knew and did the surgery anyway.

You can easily get a refund for this. He knew the procedure would fail and didn’t inform you. Instead, he placed a doomed dental implant. However, now you still have a missing tooth that needs to be replaced.

If you still want a dental implant for your tooth replacement that is possible. However, you will have to deal with the bone issue. There is a bone grafting procedure you can have done that will build back up the missing bone. Once you have healed from that you can move forward with the implant procedure.

Obviously, you will want a better implant dentist. I want you to look at Dr. Delaune’s bio to get an idea of the type of training you want your dentist to have. I’m not talking about his dental school. Instead, look at all his post-doctoral training. This is important. Dental implants are an advanced procedure that isn’t adequately taught in dental school. It requires significant post-doctoral training to really know what you’re doing.

Then, there is the cosmetic factor. You didn’t mention where the tooth was located that you are replacing. Is it a front tooth? If so, you will want an expert cosmetic dentist as well. This way it will perfectly match the adjacent teeth. With a back tooth that will not matter as much, so you could focus on the implant training alone.

For a front tooth, you’ll want implant and cosmetic training. For the latter, I’d look for an AACD accredited dentist. These are the top cosmetic dentists in the country.

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

Getting an Implant Crown to Match

November 28, 2020 by writeradmin

I had to have a dental implant on a front tooth. The dental implant itself is fine. The crown, however, is an entirely different story. We’ve done three different crowns and none of them have matched the teeth next to it. My dentist said I don’t have teeth that go with the dental colors. Apparently, my teeth are between an A1 and A2. I really don’t like how different my two front teeth look. My dentist is frustrated with me and said I should be grateful I have a tooth that is close. She feels I am being unreasonable. Am I? I thought it was possible to match front teeth. When I asked if we could try just one more time, she said I could damage the dental implant if I keep trying. I”m not sure what to do at this point.

Kristin

Dear Kristin,

I do not like that your dentist is pushing her lack of ability onto you as being unreasonable. Of course, you would want your two front teeth to match. While it is very likely your teeth are between two shades, that doesn’t mean you cannot have an exact match of your teeth. Those shade guides she is using will give a very close match. That is good enough if you are doing dental crowns on just about any tooth except the front teeth.

Front teeth are especially tricky. This is because they are completely exposed to the light when you smile. This shows them in much more detail. An exact match is necessary or your front teeth will look strange, which you have, unfortunately, discovered for yourself.

A color map If you look at the image directly left, this is what true cosmetic dentists use to help the lab get an exact match to your teeth. First, they’ll use the basic shade guide, such as the A1 or A2. From there, your dentist will have to map out where to put various tints to create the perfect shade on your porcelain crown. When done with expertise and artistry, no one will be able to tell the implant crown from your natural tooth.

I don’t think you are going to get the result you need from this dentist. Because the implant seems fine, I suggest asking for a refund on the dental crown only. She hasn’t been able to give you a crown that matches your teeth. Then, I want you to go to an expert cosmetic dentist. One way you can find an expert cosmetic dentist in your area is to use the mynewsmile.com website. They have a “Find a Cosmetic Dentist” link. You input your zip code and how far you are willing to travel and they will give you a list of dentists who are true artists. Any one of them will give you a crown that matches your adjacent tooth exactly.

As far as your dental implant being at risk, if your dentist did that correctly, you shouldn’t have any problem. Though, here again, she is showing her lack of knowledge of cosmetic dentistry. The best cosmetic dentists know that the patient needs to see the work and approve it before it is permanently bonded onto the tooth. They do this using a temporary try-in paste. You’d get to see the crown in various lightings in order to be certain you are pleased with the result. Only then will it be bonded on permanently.

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

Titanium or Zirconia Dental Implants

July 31, 2020 by writeradmin

I have a titanium dental implant but recently read that there is evidence metal, including mercury, in dental work can cause neurological problems. I’m about to get a new dental implant and I am trying to find a dentist willing to give me zirconia type. It’s proving to be a tad difficult to find one. My question though is when I do find one should I also replace the old implant?

Olivia

Dear Olivia,

dental implant side by side twith a natural tooth

I’m not sure where you read that metal in your body can cause neurological ill effects. Do you happen to have the link to the article? I would be surprised if it was from a medical journal. If you think about it your body naturally has metals in it that are necessary for your survival. One example is the iron in your blood. When someone is low on iron it has massive repercussions and they have to take supplements to stay healthy.

That being said, if you really want metal-free implants you will be able to find a dentist willing to provide them. The main reason why most dentists still prefer standard titanium implants is simply a matter of data. We have been using dental implants for decades now and have a lot of research and results on the safety and longevity of the procedure.

The zirconia implants haven’t been around as long. As a result, we don’t have any long term studies on them to show how they hold up over the years. It may turn out they are just as stable with an equally long or maybe even longer lifespan. We just have to wait until they’ve been around long enough to know.

Should You Exchange Your Dental Implants?

While there isn’t a problem with getting your new implant from a different material. I can’t recommend switching out your current dental implant. It is too much of a risk. First, when you remove your dental implant, it will take bone structure with it. That bone is necessary to keep the implant secure. Without it, you will experience dental implant failure.

In order to replace your current dental implant, you will now have to build back up the bone in your jaw. In order to do that, you will need an additional surgical procedure known as bone grafting. If that is successful, then you will again have dental implant surgery. Both the bone grafting and the implant could fail. If you have a successful dental implant now, I can’t think of a good reason to risk it.

It is your choice, of course. I just wanted to make sure you understood the risks.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune. We are a mercury-free dental office.

Bone Grafting for Dental Implant Didn’t Work

June 30, 2020 by writeradmin

I have a dentist who has done many dental implants over the years, so I felt fairly confident he could do mine. When he went in the first time, he decided I needed to have some bone grafting done for the dental implant to have the best chance. So, we decided to go ahead with that. After I had time to heal, we went ahead to do the dental implant procedure a second time. Again, there wasn’t enough bone. He’s suggesting I get a dental bridge. I really had my heart set on getting a dental implant. Is a bridge my only option at this point? Should I go to a specialist?

Dan

Dear Dan,

dental implant diagram

The good news here is you have a dentist who is trying to expand their skills. Most dentists don’t even bother learning bone grafting and just tell their patients they have to get a different procedure. Your dentist, in contrast, is trying to keep up with all the advancements in his field. The bad news is your dentist is currently new at the procedure, so it didn’t work as expected.

Before I move on, I’d like to praise your dentist for another aspect of his practice. He’s honest. Some dentists would have had too much pride to admit their procedure didn’t work. They’d put the implant in there. A year later, or even sooner, you’d experience dental implant failure without having any idea it was because your dentist placed an implant where there wasn’t enough bone.

Unfortunately, implantology isn’t a recognized specialty. That means you won’t really be able to look up dental implant specialists and have any realistic expectation they have the necessary training. What I’d like you to do is take a look at Dr. Delaune’s training and qualifications. This is what you want from a dentist who is going to work on your dental implants.

At this point, you have two choices: You can start over with another dentist who has the right qualifications and experience. It will mean another round of bone grafting, time for healing, and then a dental implant procedure. I’m sure your dentist will be willing to give you at least a partial refund. It sounded like a dental implant was important enough to you that you’ll be willing to go through it one more time. If you’re weary of surgery, then getting a dental bridge is your next best option.

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