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My All-on-4s Feel Loose?

My All-on-4s Feel Loose?

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Hello,

I used to wear a partial denture but did not like it that much. My dentist recommended the All-on-4 implant overdenture procedure, and I was excited at the prospect of the results. However, my denture is not comfortable to wear. It moves around and food gets stuck under it when I eat. Is this normal? Is there just an adjustment period I need to get used to it? I am not too happy with the results either.

Hifumi, from Waltham, MA

 

Hi there Hifumi,

It sounds like something went wrong during your procedure. The All-on-4 implant overdenture is not supposed to be loose. On the bright side, it should be easy to fix the problem.

You should go to your dentist promptly, to avoid any more problems or pain. Your dentist should be able to tighten it quickly in the office. If there is something wrong with a screw or denture itself, it could be solved in a few trips to the office. Fixing either problem will be non-invasive.

If something is wrong with the dental implants that support your All-on-4 implant, it will take more time to correct the problem. It will not be clear if the implant itself is the problem until the other possibilities are exhausted.

In any case, it is important to make an appointment to go see your dentist to fix this problem. If you dislike your dentist’s work or bedside manner, you could seek a second opinion elsewhere, but your dentist should be able to help you.

This blog post is brought to you by San Antonio All-on-4 implant overdenture provider, Dr. Gilberto Tostado, of 5 Star Dental Group.

My crown keeps falling off. Is my tooth going to fall apart?

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I had no trouble with my dental implant surgery. The surgeon was wonderful, and his follow-up care was thorough. I thanked my dentist for referring me to the surgeon. I received three implants, and my dentist restored them with beautiful crowns. I also received a new crown for a root canal tooth. But that crown is nothing but trouble. Within the past two months, the crown fell off four times. My dentist is happy to reattach it, but I am getting frustrated.

My dentist said that if it keeps happening that he will order a new crown. It seems that he doesn’t know how to stop the problem without a new crown. I am concerned that all the work on this tooth has made it even weaker. And how do I know that I won’t have the same problem with a new crown? I don’t like the idea of walking away from my dentist, but I’m not sure that he knows what to do about this crown. Is my tooth going to crumble away and fall apart? Thank you. Bryan

Bryan,

We are happy that you had a good experience with your dental implants and implant crowns. Unfortunately, the root canal tooth and crown are causing problems. When a crown repeatedly falls off, it is frustrating. But it’s relatively easy to identify the problem.

Why Does a Dental Crown Keep Falling Off?

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

Implant crowns and all types of dental crowns should not fall off

A dental crown falls off due to two factors: bonding strength and the shape of your prepared tooth. Either or both factors will cause a crown to loosen and fall off.

  • Tooth preparation: When a dentist slightly tapers your natural tooth in preparation for a crown, it increases the surface contact between the crown and tooth. Even the weakest cement will keep the crown on. But aggressive tapering—grinding the tooth down to a stump—increases the risk of a loose crown that falls off.
  • Bonding strength: Your dentist must choose cement strong enough to keep the crown attached to your tooth.

If your dentist cannot keep the new crown on your tooth, it might be best to get a second opinion. Or you can get a second opinion right away. Depending on how aggressively your dentist prepared your tooth, an advanced cosmetic dentist can build up the tooth with bonding to ensure the crown is secure.

 

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

My dentist wants to replace my dental implant with a bridge

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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.

My Teeth Fell Out All of a Sudden?

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Hi,

I will admit I have not always taken the best care of my teeth, and now that I’m in my 80s, I wish that I had. My dentist told me I have a bad case of gum disease, and warned me that my teeth could fall out. And that’s exactly what happened! Despite my mouth’s condition, I’d like to keep as many of my teeth as possible. My kids think I should get dentures, is that my only option? Do I need a full or partial denture? Are dental implants even an option at my age?

Ripley, from Dinosaur, Colorado

 

Hi Ripley,

Since your teeth are at the point where they are falling out of your gums, it sounds like your gum disease has progressed to advanced periodontal disease. In regards to answering your question, dental implants are preferable to dentures, as dental implants are anchored in your jaw and prevent decay.

However, dental implants are not the best choice for everyone, and certain risk factors increase the likelihood of implant failure. For example, a jaw that have too much decay will require a bone graft, as without one, the jaw will not be able to hold the implants. You will need a dental surgeon to properly assess you, as it would not be in your best interest to get a bone graft for dental implants only to have both the implant and graft fail.

Based on your description, a full-mouth restoration may be necessary. However, that would be the most costly option. You can also opt to remove any remaining teeth that are most likely to need it, or you can wait until they fall out on their own. Once all your teeth are out, you can proceed with a bone graft for a dental implant, or get removable full dentures. However, a removable partial dentures would be a cost-effective option and would save your remaining teeth.

Without teeth or dental implants in your jaw, your brain gets the message that you are not using your jaw anymore, and your body will begin the process of resorption. Your body slowly begins to break down the minerals in your jaw, which can lead to facial collapse over the course of ten years or so. However, given your age, dentures would improve your jaw health and preserve your teeth. With the money you save by getting dentures over dental implants, you can consult with a cosmetic dentist to make you a set of natural-looking dentures.

This blog post is brought to you by San Antonio dental implant provider, Dr. Gilberto Tostado, of 5 Star Dental Group.

How Many Years of Experience Does an Implant Dentist Need to be the Best?

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Hi there,

I am a candidate for dental implants and want to make sure I find the best cosmetic dentist. I am nervous about getting dental surgery. The more experienced the dental implant dentist, the less risk of dental implant failure, right? That’s what I read online. However, nothing I have read mentions how many years an implant dentist needs before they can call themselves “the best”? Is there a certain, specific number I should look for?

Twila, from Salem, MA

 

Hi Twila,

The more experience a dental implant dentist has, the higher their success rate when placing implants and performing surgery. Researching a dentist before starting any surgical procedures is very important, as it will help you save time and save money in the long run. For example, an inexperienced dentist may recommend a bone graft when you do not need one, or may say they cannot place implants due to lack of bone. They also may struggle to color match the porcelain crown that covers the dental implant. Choosing the wrong dentist could cause you to start over again with a different dentist, costing you even more money.

Many patients entrust their dental implant surgery to their general or family dentist, basing their choice on trust rather than the dentist’s experience. No matter how long your dentist has been in practice, if they do not have dental implant experience, they may not be the best option for your procedure.

There are no research studies done on how many years an implant dentist needs in order to be the best. However, studies show that restorations last longer when done by a dental implant specialist versus those done by a dentist. However, some dental implants just fail. Be sure to maintain your oral hygiene routines and continue with follow-up appointments post-surgery.

There is no magic number of years of practice to look for. Instead, focus on finding someone who has many years of continuing education in dental implants, and who has done a large number of cases.

To find the best implant dentist for your case, check the websites and reviews of cosmetic dentists in your area. Most will let you do a free consultation before booking an appointment. If you are really worried, you can ask your potential dentist how many of their implant cases have failed, as they will most likely remember. Bear in mind that one or two failed procedures at a practice that sees many patients is no cause for concern. Choose your potential dentist based on their experience as well as their bedside manner, someone who listens and answers your questions sincerely.

This blog post is brought to you by San Antonio dental implant provider, Dr. Gilberto Tostado, of 5 Star Dental Group. Please note that dental implant specialist is not a certified field of dentistry; however, dentists that have attended continuing education courses on dental implant procedures and have experience with palcing implants will call themselves dental implant specialists.

Should I Reschedule Getting my Porcelain Crowns?

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Hi there,

Last year, I started the process for getting dental implants. First I had a bone graft, then had the implant surgically placed. Now that I’ve healed up, I can finally get my porcelain crown placed. However, my crown placement appointment is right in the middle of a pandemic! I’m eager to get my crown, but I’m not sure if it counts as “essential”. It’s essential to me, but I can live a little longer without it if necessary. However, a lot of non-essential businesses are reopening, so I’m considering keeping my appointment. Should I keep it, or reschedule it? I’m not sure what to do.

Shayne, from Cleveland, OH

 

Hi Shayne,

This is a stressful and confusing time for everyone. CDC guidelines advise against any non-essential excursions, but stop short of actually explaining what that means. What is non-essential to some may be essential to others, so to avoid confusion, the CDC kept it vague.

If you were having a toothache or pain, you would go in to see your dentist right away for an emergency. If your jaw has fully healed and you are not in pain, you can probably reschedule your appointment with no issue. However, if you have had to change your eating habits since the surgery and cannot eat without discomfort, you may want to keep it. Dental implants are more than just aesthetic – they are replacements for your natural teeth that your mouth needs in order to function. There is no right or wrong answer here, it really is up to you and what you feel most comfortable doing.

Dental offices, like most businesses, are taking extra precautions during these unpredictable times. You will likely need to wear a mask or face covering to your appointment, and practice social distancing in the waiting room.

One thing you can do is talk to your dentist. He or she will be able to tell you whether you can safely reschedule or if you should still keep your appointment. They know you best, and can help guide you to make the best decision for you. You can also ask about any new guidelines or procedures that have recently been put in place.

This blog post is brought to you by San Antonio dental implant provider, Dr. Gilberto Tostado, of 5 Star Dental Group.

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