6745 Sugarloaf Parkway
Suite 200
Duluth, GA 30097

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Clear Choice or Costa Rica for Dental Implants?

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I was planning on going to Clear Choice Dental Implant Center to get my dental implants, but I have some concerns. First, they want to do the all on four procedure and I was hoping for implant overdentures. Then, I read some reviews that said they don’t really have any follow up with their patients. This worries me as well. I was thinking it might be better for me to go to Costa Rica to get these implants done. I hear they do a lot of dental work for people from other countries and there is a whole dental tourism industry there. Do you think I’d be better off with Clear Choice or Costa Rica?

Kevin

Dear Kevin,

Implant overdentures

Implant Overdentures

Do you have an option C by any chance? Here is the thing. Dental tourism is very popular in some circles. When it goes okay, it goes okay. When it doesn’t, it goes very badly. If you think there is no follow-up with Clear Choice Implant Centers, what type of follow-up do you think there will be from a dentist in another country?

Dental implants are an advanced procedure. It takes significant post-doctoral training. In the United States, we have high standards and strict laws with regard to the materials dentists are allowed to use along with the standard of care dentists have to provide. In some of these popular dental tourism destinations there are not even laws about sanitation. It is up to the dentist what type of standards he adheres to. I’m not sure that is work the risk. If you get an infection in your jaw it can be very serious.

As for Clear Choice, while the all-on-four procedure is useful for those who do not have enough jawbone left or who are not a candidate for bone grafting, if you can have implant overdentures, it is better. If one dental implant of the all-on-4 procedure fails then the whole unit has to be replaced.

My suggestion to you is invest in a good dentist instead of a chain clinic or going out of the country. Your best bet is to find someone who is a fellow with the International Congress of Oral Implantologists. These are the most qualified implant dentists in the country.

This blog is brought to you by Dr. David Marion, who tries to be the best dentist he can be.

Dental Implant Horror Story

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I need some help. I had dental implants placed on a whole lot of teeth and spent a small fortune. The crowns for the dental implants kept falling off. I’m stuck with a mouth full of screws with no “teeth” on top. I can’t even eat at this point. Unfortunately, I have no recourse because the last I heard this dentist fled to another country. What do I do from here?

Morgan

Dear Morgan,

Implant overdentures

Implant Overdentures

What a horror story. I am so sorry this happened to you. In case this “dentist” returns, and I use this term loosely, make certain you leave a review of your experience so other innocents don’t experience what you did. Other than that, the best thing you can do is find the right type of dentist you want to fix your dental implants.

What To Look For When Getting Dental Implants

Don’t look for the Cheapest Dentist

People too often mistakenly think they are saving money by going to the cheapest dentist but that is never the case. Dentists who are the cheapest are usually the ones who are cutting corners on the quality of the materials they use in order to keep their profits up. You don’t have to go to the most expensive implant dentist, but I’ve never seen it work out when someone went to the cheapest implant dentist.

Look for a Dentist with Significant Implant Training

Dental implants are not taught in dental school. If a dentist wants to do dental implants well, they have to invest in that training post-doctorally. If you take a look at the training on Dr. Marion’s bio, it will give you an idea of what you want in the dentist who repairs your dental implants. This post-doctoral training is important.

Do Not Allow them to Shortcut Diagnostics

You are having multiple dental implants done. In my opinion, a CT scan will be a must. This is a three-dimensional procedure and it requires three-dimensional diagnostics. Otherwise, you risk complications such as perforation of your sinus cavity.

Check the Reviews

While some dentists can look good on paper, they have a terrible chairside manner and can be a nightmare to deal with in person. It is always helpful to look at reviews and get a feel for what patients who have actually had to deal with them have gone through.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Dentist Placed My Implant Knowing I Had Bone Issues

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I had been saving up for this dental implant for some time. My dentist knew this. I was so excited to finally have a permanent tooth there. I was horribly disappointed when I woke up from the surgery and my dentist told me he doesn’t think the implant would last. He also said he knew there wasn’t a ton of bone there to begin with but he thought he could “work around it”. Now he’s giving me the choice of taking it out and going with a dental bridge or leaving it there and seeing how long it lasts. I’ve completely lost faith in this dentist and wonder if you know what the best option is for me. Any advice will be appreciated.

Steve

Dear Steve,

illustration of a dental implant next to a tooth

What your dentist did is completely unacceptable. If I understand you correctly your dentist knew ahead of time there wasn’t enough bone and placed the implant anyway. If that is correct, it is malpractice. Especially because there is a procedure that could have been done ahead of time to ensure you would have had enough bone to secure the dental implant for many years.

The good news is, you don’t have to settle for either of the options your dentist provided you with. If you still want a dental implant, you can get it. However, like you, I do not have confidence in your dentist. What I am going to recommend is you ask for a complete refund. He placed a dental implant knowing full well it would fail.

Then, I want you to see an experienced implant dentist. For instance, Dr. Marion is an Associate of The American Society of Implant & Reconstructive Dentistry (ASIRD). Whoever you choose, make sure they have post-doctoral training in implant dentistry. It’s not something adequately taught in dental school.

The procedure I mentioned earlier is called bone grafting. Once that is done you will be ready for that dental implant you have been saving for all this time. And this time, it should work.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Implant Bridge Misaligned My Teeth

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I need some advice. I had an implant bridge placed on the bottom right side of my mouth. Before that, all of my teeth lined up, even though the teeth had some problems. Now, I have a problem with the side with the bridge lines up and touches, but the other side does not. Not only are they no longer touching, but my jaw seems to be on a slant there. I don’t think this is normal, but my dentist seems to think it is nothing to worry about. Is he right? It just doesn’t feel comfortable to me. Though, my dentist says I will adjust to it. Will I? Right now it doesn’t seem like it.

Caryn

Dear Caryn,

woman holding her jaw in pain

No, this isn’t okay. It is always frustrating to me when medical practitioners say, “You’ll adjust”. Maybe you will get used to being uncomfortable and in pain, but you shouldn’t have to. Plus, if this is left untreated, it will very likely lead to TMJ Disorder.

When dental crowns or bridges are done correctly, the bite should line up perfectly and they should not be noticeable at all. Your dentist should know this. My guess is he recognizes there is a problem, but doesn’t know how to fix it. Implant dentistry is not a recognized specialty. Dentists have to choose to invest in enough dental implant training to become skilled. Not many do, which may be why is it is one of the procedures leading the list of dental malpractice suits.

Here is my suggestion. I want you to look at Dr. Marion’s qualifications. Then, I want you to find a dentist in your area with similar qualifications to look at your case. If it is as bad as I think, they can help get it repaired. Because the implants may have to be removed, I don’t want you to just get a refund. The repair will very likely cost more than the original procedure. Because if your implants have to be removed, they will take bone with them. You will need some bone grafting done if your new dental implants are to be properly secured. This will require a bone grafting procedure. Instead of a refund, I want you to tell the dentist you want him to have it repaired by a dentist of your choosing.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Should I Keep My Last Two Upper Teeth?

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I have two upper partial dentures. The only thing left on my upper teeth are the top two front ones. I can’t decide if I should keep them or extract them and get a full upper denture or keep the last two good teeth. I don’t know anyone else in this situation that I can ask. Is there a clinical opinion on this?

Marc

Dear Marc,

I am going to have to preface this by saying my advice is given based on general principles drawn from what you’ve said. I haven’t examined you or seen x-rays so there is no way for me to give you a definitive response.

In most cases, it is better to save your natural teeth whenever possible. Whenever you extract a tooth and replace it with a removable device, there is always some shifting and movement. If you replace it with a dental implant, that is closer to having a healthy natural tooth.

The Danger of Facial Collapse

There is usually an even bigger issue with having all your teeth removed, which is known as facial collapse. When your teeth are extracted, your body recognizes there are no longer teeth there. In order to use its resources well, your body begins to resorb the minerals in your jawbone in order to use them elsewhere where it perceives they’ll be more useful. After ten to twenty years, depending on the individual body’s response, you will no longer have enough jawbone left to retain your dentures, a condition dentists call facial collapse. This doesn’t affect upper dentures nearly as much because that is held in by suction. However, if you were wearing a lower denture, it would be disastrous. These just rest on the ridge of your jawbone, which will disappear.

Your case is different. Yes, you have two teeth left, but with the eating/biting stresses put on them as your only natural teeth I don’t expect them to last long. The teeth for a complete denture will be much easier on your natural teeth on your bottom arch. In a situation such as yours, the best solution would be to remove those two upper teeth and place an implant overdenture there. This places four to six dental implants and anchors a denture to them.

Not everyone can afford that. However, even the least secure option of completely removable dentures will be better than what you have going on now. You’ll be more comfortable and it will look more natural.

This blog is brought to you by Duluth, GA Dentist Dr. David P. Marion.

Hockey Players and Dental Implants

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My son is a hockey player and recently had a tooth knocked out during a practice. I want to get him a dental implant but his teammates said it could get knocked out again and to not replace it with an implant. What do you recommend? Would a Maryland Bridge be okay?

Cathey

Dear Cathey,

Hockey player with missing tooth

I have a colleague that worked with the official team dentist for a hockey team in Minnesota. He also mentioned this problem. What happens is if the tooth gets knocked out with the implant it can rip the bone. I would listen to his teammates. Yes, a dental implant is the top of the line in tooth replacement options, but not while he is at high risk like this.

Here is my recommendation. First, you can go ahead and get the root form of the implant placed. Doing that will help preserve the bone structure for after his time with hockey is over. Just don’t place the dental crown yet. Instead, use a temporary tooth replacement.

I’m going to nix the Maryland Bridge idea as well. This attaches to two other teeth. If that gets knocked out, it has the potential to take two other teeth with it.

What he can get is a dental flipper. This will make a nice temporary replacement. It doesn’t cost that much money and won’t cause any harm to either his other teeth or any bone structure if it takes a hit with a hockey puck.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Two Vastly Different Dental Implant Plans

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I had a bridge replacing four front teeth. The bridge was anchored by the canine teeth. Now the canine teeth have come loose. I went back to the clinic where I had the dental bridge done and they suggested a partial denture to replace all those teeth (including the canines) and then another for a missing lower molar. I have found the partial to be incredibly uncomfortable. Now they’re suggesting using mini implants to replace the upper teeth. I decided to get a second opinion. This doctor had a vastly different treatment plan. He wants to do a bridge on the lower molar because he said one of the adjacent teeth needs a crown anyway. Then he wants to place three regular-sized dental implants one where each of my canine teeth were and a third directly between them. When that’s done he will attach another bridge to the implants. His plan is considerably more expensive. I’m totally confused as to which is right and am trying to not just let the price difference dictate my decision. Do you care to be the tie-breaker?

Bruce

Dear Bruce,

Right up front I am going to tell you that the second plan is by far superior, but I want you to understand why. Let’s start with the mini implants the first dentist is suggesting. These are not meant to support individual teeth, including dental crowns. They don’t have the necessary strength. Instead, they can sometimes be used to help stabilize a denture, but even then, they won’t be as strong as traditional dental implants.

At some point, likely sooner rather than later, these mini-implants will fail. Then what will you do? When dental implants fail, they take bone structure with them. In order to have new implants placed, that bone structure will have to be filled back in. Now you’re talking about needing bone grafting surgery even before you can have the surgery to replace the mini implants. All for a procedure that will likely fail again.

Your second dentist’s recommendation has solid engineering principles behind it. I want you to peek at this picture below.
cantilever bridge diagram

The way your previous bridge was designed, it put the abutment teeth (the anchors for the bridge) on your canines. There are a lot of twisting forces in this position involved when we bite or chew. It wouldn’t surprise me at all to learn that it didn’t take long for the abutment teeth to come loose, which is why you are now losing them.

Full-sized dental implants can support a single tooth, so replacing those canines with them is a fantastic solution. But, wouldn’t attaching another bridge to them have the same problem as your previous bridge? Yes, except, the second dentist is suggesting a third implant directly between them to help stabilize things. This will prevent that twisting motion, enabling the implants for your bridge to remain secure, possibly for the remainder of your lifetime.

Go with the second dentist. He has a much better understanding of dental implants, tooth structure, and biting forces.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

My Implants Fell Out the Next Day

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I had four dental implants placed. I just received the crowns and two of them have already fallen out just a day later. Dental implants aren’t cheap and I know my dentist is expecting the second half of his payment soon. I don’t feel I should have to pay for them if they fell out this quickly. He said they’d last years. Is this fixable? Should he re-do them?

Laurie

Dear Laurie,

illustration of a dental implant next to a tooth

There is something seriously wrong here. You’ve lost half your dental implants in one day. I feel fairly confident the others will not be far behind. You need to contact your dentist and let him know what is going on right away.

To answer your first question. No, you should not have to pay for these. It’s a pretty basic standard to expect your dental implants to stay in. While these can be re-done, you need to be certain your dentist can tell you why they failed before moving forward.

Reasons for Dental Implant Failure

You should know, that dental implants have 95% success rate, so what you’re experiencing is unusual. When dental implants do fail, here are some of the main reasons. Notice that most of them are a failure on the dentist’s part.

  • Infection. This often results from poorly fitting implants.
  • Subpar implants. Some dentists will cut costs by ordering cheap, overseas implant fixtures. These are rarely as well made as those that must adhere to the standards here in the states.
  • Inadequate bone. Your dentist should do enough diagnostics at the beginning to ensure you have the necessary bone structure to retain the implants.
  • Placing the dental crown prematurely. The waiting period between the surgery and crown placement isn’t just about healing. It’s also to make sure the bone has had adequate time to integrate with the implants and keep them secure. If your dentist puts the porcelain crowns on before that time, the load will be too much and will loosen the implant fixtures.
  • Incorrect surgical placement of the implant.

Once you find out why this happened, you can have it re-done (at your dentist’s expense). Unfortunately, you will need to have an additional procedure done first to get your jaw in a position where it can accept implants again. You’ll need to have some bone grafting done. Then, once you’ve healed from that, you can start over.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Type 1 Diabetes and Dental Implants

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I recently lost my first tooth. I find it quite upsetting. I’ve been told that a dental implant is the best replacement for a tooth. However, I have type 1 diabetes. Will that keep me from being a candidate?

Tammy

Dear Tammy,

dental implant diagram

I’m sorry you lost a tooth. I certainly understand why it is upsetting. You made a good choice in wanting to get a dental implant. They are the closest to have a healthy natural tooth. While having type 1 diabetes does not necessarily keep you from being a candidate for getting a dental implant, it is a significant risk factor.

You will need special diagnostics to help pinpoint any additional possible risk factors. You’ll also want to be certain you go to a dentist who has done extensive training in the dental implant procedure. It is a complicated, advanced procedure and your situation makes it even more complicated.

Look at some of Dr. Marion’s qualifications to get an idea of the type of dentist you want to do your dental implant procedure.

Cosmetic Considerations

A dental implant procedure is done in two different stages. The first is the surgical stage, where the implant is placed to mimic your tooth root. The second is the restorative stage. This is where your dentist will create a dental crown to replace the tooth itself.

If you have never had a dental restoration you should know that whatever color your dentist makes it will be permanent. A dentist with good cosmetic skills will match the crown perfectly to your tooth. You’ll want to be certain your teeth are the color you want.

If you want to upgrade the brightness of your teeth, do the teeth whitening before you have the crown made. This way you can have the crown the color you will want permanently.

This blog is brought to you by Duluth, GA Dentist Dr. David Marion.