I’ve got an old dental implant on my left front tooth. It was first placed in the 1990s with a crown over it. It’s started feeling loose. I traveled back to the dentist who placed it. He said it is infected and needs to be removed and that we could do a bridge to fill in the area. Can’t I just take antibiotics to fix this? I don’t want to go through all this.

Rob

Dear Rob,

I’m glad you wrote. I think I can help you. First, let’s take a moment to be excited over your dental implant lasting over 30 years. That is some seriously good mileage. Great job taking care of it.

Why Antibiotics Won’t Work

While you had a good idea about antibiotics, it will not solve the issue here for your loose dental implant. Antibiotics will help with the current infection, but that infection has gone into the bone, which is why the implant is wobbly. That bone is lost and medication will not replace it. At some point, the implant will fail. In that case it is better to be proactive than spend all your time worrying if it will come out at an embarrassing moment.

What Are My Options

The implant will definitely have to come out. Either on its own unexpectedly or planned with your dentist. What you do from there is where you have some options. First, if you would rather have another implant to replace it, you can. However, that bone loss has to be addressed and you will need some bone grafting done in order to replace the needed structure to retain your new implant.

If you don’t want to do that, then the dental bridge your dentist suggested would be your next best option. It will not require any bone grafting. However, it will require the two adjacent teeth to be ground down in order to make room for dental crowns. If those teeth are healthy, you may not want to do that.

I hope this helps.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

I have a special needs brother who is 27. My parents have been taking care of him, but recently past away in a car accident. Now he’s my responsibility. I took him to the dentist for the first time and he told me my brother’s teeth are a mess. His gum disease is so advanced that he will start losing teeth. It was a little hard to get him to cooperate in the dental chair, so my dentist is suggesting we just remove all his teeth and give him dentures. I just want to do better than that for him, if possible, but my dentist says anything else will not be worth the trouble. Is this really my brother’s only option?

Kevin

Dear Kevin,

I first want to tell you how sorry I am for the loss of your parents, as well as the responsibility laid on your shoulders. You are obviously a great brother who is going to do his absolute best for your family.

I think the best thing you can do is find a different dentist for your brother. The fact that he has trouble cooperating in the dental chair is not uncommon with someone who is special needs. I don’t think your current dentist is compassionate enough to deal with him.

I want you to look for a dentist with two specific qualifications. First, I want them to be a sedation dentist. If your brother’s teeth are as bad as the dentist says, then he will need a lot of care. Having something like oral conscious sedation available will help him tremendously. In fact, he’ll likely sleep through the procedures. Getting him regular oral health care will make a tremendous difference. It’s possible that, if you get your brother’s gum disease under control, his teeth can be saved. If not, then the second qualification will become important.

The Danger of Dentures

He will need those teeth replaced. He is way too young for dentures. When people have their teeth removed for dentures, their body recognizes that and immediately begins resorbing the minerals in the jawbone to use elsewhere in the body. It does this in an effort to be as efficient as possible with your body’s resources. However, it has the unfortunate result of shrinking the jawbone. If your brother were to be in completely removable dentures, after ten years or so there won’t be enough jawbone left for him to even retain his dentures. This is known as facial collapse.

I would save as many teeth as possible and then use dental implants to replace the ones that can’t be saved. These are the closest thing to having natural teeth again and will protect him from facial collapse. You will want someone with excellent reconstructive training. Dental implants aren’t taught in dental school. You’ll want the dentist who does them to have invested in significant post-doctoral training. Take a peek at Dr. Marion’s qualifications to get an idea of what you want for your brother.

Best of luck to the both of you.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.