Archives for September 2020

Should I save my last three teeth?

Posted on September 23, 2020 by AllSmiles.

Although I all but 3 of my bottom teeth, I will soon only have three upper teeth left. My dentist recommends extracting the other few remaining teeth because they are worn out from gum disease and stress from a partial denture. I got a second opinion from another dentist who gave me the option of keeping the three teeth upper teeth because they are mostly healthy and in the front of my mouth. He says that a partial denture will work. Now I need a third opinion, so I am writing to you. Won’t a full denture look and feel better than a partial denture. I have a budget, though, of about $6000, and that concerns me. I’m in my early 50s and would like a smile that looks natural. Max from Denver, CO

Max,

Dr. Tostado would need to examine your teeth and take x-rays for an accurate diagnosis. However, we will share some information that might help you determine your next steps.

Saving natural teeth

Whenever possible, it is usually better to save your natural teeth. Removable appliances, including a partial denture, are not anchored, will have some movement, and put stress on the anchor teeth. And with few remaining teeth, your jawbone will shrink everywhere that teeth are missing.

When few teeth are left

Eating and chewing put a lot of stress on your remaining teeth. Although your remaining teeth may look healthy, the force of your lower teeth against them is harmful.

What about a full denture?

Suction holds a full upper denture in place and makes it more comfortable and more stable than a lower denture, which rests on your gums. A complete denture is also more comfortable than a partial denture.

Protecting your long-term oral health

Whether you choose a partial denture or a removable complete denture, your jawbone will shrink if most or all your teeth are missing. After 10 or 20 years, so little jawbone is left that your facial muscles will sag, and you will experience facial collapse. Only the areas where teeth are left will be unaffected.

A thin lower jawbone makes it almost impossible to keep a denture in place. Some suction may remain for an upper denture, but bone shrinkage can still make you look older prematurely.

Implant-supported dentures

A snap-on denture is a removable implant overdenture

The healthiest long-term solution for a situation like yours is usually to replace teeth with an implant-supported partial denture or a full implant-supported denture. But either option would be beyond your budget. Although a dentist would need to take a 3-D CT scan to determine your options, two implants might be enough to add some stability to a denture. A CT scan reveals your bone structure and oral anatomy to reveal bone density and where to place implants.

If you have a strict budget, an upper removable complete denture is an acceptable solution. Unlike a partial denture, it won’t stress a few remaining teeth, and it will improve your comfort when eating.

We recommend getting a third in-person consultation and exam with a skilled implant dentist to discuss your options.

Gilberto Tostado, DDS of San Antonio, TX, sponsors this post.

I think I’m allergic to zirconia crowns

Posted on September 17, 2020 by AllSmiles.

I think that I am allergic to zirconia crowns. My daughter discouraged me from going to a holistic dentist and getting allergy testing. I regret it. I don’t have any known allergies, but sometimes I am sensitive to certain foods. I am skeptical about any artificial dental work in my mouth. Since I received the crowns in February, my tongue is dry and sticky, and my throat burns. I read online about other people who had a similar experience.

I took a clue from some of them and visited my doctor and an ENT. Neither doctor saw any pathology or signs that it’s something serious. My primary care doctor says it is probably burning mouth syndrome. Although my dentist says that it’s impossible to be allergic to zirconia, I am sure that I didn’t have a problem until I received the crowns. The whole experience with her was terrible. I thought she was going to drown me with all the water she used in the process. Somehow, I panicked, and water went up into my nose, and I started choking. My dentist let me take a 30-minute break before she finished. Did I mention that I keep clearing my throat, too? Doesn’t this sound like an allergy?

My dental work is not complete. I need two more crowns. And I would like someone to look at my new zirconia crowns because my bite seems off. But the allergy and discomfort concern me more. Thanks for your help. Lenny from AZ

Lenny,

Although allergic reactions to zirconia are rare, it’s not impossible to be allergic to any dental material. Any patient concerned about how they might react to dental materials is free to choose the dentist of their choice—including a holistic dentist—who can explain how you can receive testing.

Are You Allergic to Zirconia Crowns?

The only way to know if you are allergic to zirconia crowns is to get tested for it. The trauma you experienced while getting zirconia crowns might be causing burning mouth syndrome. Although many articles say that the cause of burning mouth syndrome is unknown, it is often linked to traumatic experiences. And you had a traumatic dental experience.

What Is Burning Mouth Syndrome?

Burning mouth syndrome is a condition that makes you feel burning, tingling, or scalding sensations in your mouth—primarily the tongue. It can also cause dry mouth and altered taste. Some experts believe that a medical condition or nerve damage can contribute to burning mouth syndrome.

Read more about burning mouth syndrome on the website of the National Institute and Dental and Craniofacial Research.

What’s Next?

Zirconia crowns on upper front teeth - an option for holistic dentistry

A holistic dentist with advanced training in aesthetics will respect your healthcare wishes and enhance your smile

Your dental work is incomplete. Sedation dentistry will help you continue on the road to oral health. If you don’t trust your dentist, you can schedule consultations with two holistic dentists with advanced cosmetic dentistry training. And take your dental records with you. Each dentist will explain what sedation levels they offer and how they will help correct your bite and complete your treatment.

Afterward, you can make an informed decision about who you want to complete your dental care.

We wish you the best.

San Antonio dentist Gilbert Tostado, DDS, sponsors this post.

My dentist wants to replace my dental implant with a bridge

Posted on September 3, 2020 by AllSmiles.

This past spring, my dentist placed an implant in an upper right molar. I lost the tooth in a 2015 accident but didn’t have it replaced. Before surgery, my dentist told me that I didn’t need a graft, and he could place the tooth with no problem. After my recovery, my dentist changed the story and said that he placed the implant, although I had little bone left. I’ve had nothing but problems with the implant, and now my dentist said he recommends a bridge, but he will have to grind down my teeth. I don’t want a bridge. I want a $2675 refund for the implant that he wants to remove. I am incredibly frustrated because now, during a pandemic, I will have to find another dentist. I don’t know what I should ask you. I am looking for advice. Thank you. Fallon from Augusta, GA

Fallon,

Legally and professionally, your dentist owes you a refund. We’ll discuss both aspects.

Legal responsibility

An implied warranty is a legal principle that says you should receive what you paid for, and it should be suitable for its purpose. Your dentist failed to meet the agreement for these reasons:

A dental implant needs enough bone volume to support it.
Before surgery, your dentist explained that you could receive an implant without bone grafting.
During surgery, your dentist saw that you don’t have enough bone to support an implant, but he placed it anyway.
Your dentist now recommends removing the implant and replacing it with a dental bridge.

Your dentist can’t give you what you paid for, so you are entitled to a refund.

Professional responsibility

Three phases of dental implant - three components, root form in bone, crown on abutment.

Dental implants need enough bone to support them

Before you receive a dental implant, your dentist or oral surgeon must take x-rays—preferably a 3-D CT scan—to reveal your facial and jaw structure and your teeth. Information from the scan helps determine if you need bone grafting. Your description seems to indicate that x-rays were skipped because it was not until during surgery that your low bone volume was noticed.

If that is what happened, you probably have a malpractice case because your dentist violated the standard of care. A malpractice attorney can tell you if your compensation can include inconvenience, trauma, and risk fees.

What about a dental bridge?

If you are a candidate for dental implants, you don’t have to settle for a bridge.

Key points:

A dentist must cut down the healthy tooth on either side of the missing one must to accommodate a crown for the bridge.
A dental implant does not affect adjacent teeth.
Implants are anchored in the bone and outlast and outperform a bridge.

We advise that you look for a skilled implant specialist.

Schedule a consultation to get information on how the dentist plans for a successful outcome.
Ensure that your new provider will take a CT scan and explain your options for building up your bone if needed.
Ask your new dentist if he or she is willing to contact your current dentist to help you get a refund.

Best wishes on a smooth resolution with your current dentist and getting an implant that lasts.

Gilberto Tostato, DDS of Five Star Dental Group in San Antonio, sponsors this post.