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Dentist Place a Dental Implant Knowing it Would Fail

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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

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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

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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

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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.

Dental Implants after Dentures

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

Beatrice

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?

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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?

Cathy

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

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

Ben

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

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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?

Karyn

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?

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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 mynewsmile.com 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

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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?

Miranda

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.