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Is a CT Scan Truly Necessary for All-on-4 Dental Implants

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I am considering getting dental implants, specifically the all-on-4 dental implants. I’ve done a ton of x-rays and such and now the dentist wants me to get a CT scan. Is this really necessary or is this more of a way for him to line his pockets? I don’t want to spend unnecessary money and I certainly don’t want more radiation than is necessary.

Billy

Dear Billy,

all-on-4 dental implants

I’m glad you wrote. It is great that you chose dental implants as your tooth replacements. They are top of the line and the closest thing to having healthy, natural teeth in your mouth. Generally, all-on-4 is used for people who are already dealing with some bone loss. If that ends up not being you, it may be in your best interest to get implant overdentures. With all-on-4, if one implant fails, the entire thing has to be redone. However, that is not the case with an implant overdenture. Now to your question.

Importance of a CT Scan

Diagnostics on Your Bone Capacity

In order for dental implants to stay in place, the surrounding bone needs to integrate with the implant in a process known as osseointegration. However, if you don’t have enough bone then, you need to look at your options.

Finding the Best Procedure

In some cases, there isn’t too much bone loss and you can still get the all-on-4 procedure. However, in some cases, there is enough bone gone that you would need to do a procedure to replace it known as bone grafting. This will enable you to get overdentures if you are interested or you could stick with the all-on-4.

Getting the Correct Landscape

Getting dental implants of any type is a 3dimensional procedure. X-rays alone will not give the dentist enough information. They need 3D images of your mouth and jaws, including close to the nasal cavity. This will give them adequate measurements for safe placement of your implants. Dentists who take short cuts will often end up misplacing the implants or puncturing the nasal cavity.

So, in your place, I would definitely get the CT scan.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

Why Do Dentist Want Me to Have Dentures?

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I have a disaster of a smile. I always need a ton of work on my teeth. I am willing to invest in them and fix them, but it seems like all my dentist ever recommends is the most aggressive treatment possible. I have two teeth he just wants to pull and put in partial dentures. I’m only 32 and I feel like my life is over if I’m already getting dentures. Is there another option for me?

Patty

Dear Patty,

woman smiling with dentist behind her

The Best Dentists Try to Save Your Teeth

I’m going to tell you right off the bat that this is not going to be the best dentist for you. Some smiles are high maintenance. You can do everything right with your oral hygiene but they still end up needing a lot of work. Just as teeth vary, so do dentists. You have some that will just not want to put in the effort to deal with your smile. Others will make every effort to save as many teeth as possible.

My first recommendation for you is to get a second opinion on whether or not these two teeth can be saved. It may be you will not even need to worry about a tooth replacement. For argument’s sake, though, let’s say the teeth cannot be saved. Your dentist was under an ethical obligation to give you all the options available to you — not just the easiest for him.

There Are Other Tooth Replacement Options

Removable partial dentures are probably the worst option for you. If we want to go to the other end of the spectrum and tell you the best option, I would recommend dental implants. These are like having a healthy natural tooth in your mouth again. Though, they are pricey and surgery is required because they place a prosthetic root in your jaw to mimic your natural tooth. You’ll also want to find a dentist with post-doctoral training in dental implants because it is quite an advanced procedure.

If you decide that is out of range for you, the next best option is a dental bridge. This will suspend a false tooth between two dental crowns. Of course, that means the two adjacent teeth will have to be crowned, but if they happen to need work anyway, they may be a great option for you.

Find a dentist willing to put in the work and give you all your options.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.

16 year old Still Has Baby Canine Teeth

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I am 16 and still have my top two baby canine teeth. They look really stupid next to my big teeth. Is it possible to take the baby teeth out and replace them with dental implant teeth that are the right size?

Allie

Dear Allie,

metal and zirconia dental

My first question is to know whether or not you’ve been under the care of a dentist as you were growing up? If so, he or she was quite negligent in not taking care of this for you. Do you know whether or not you have adult canine teeth beneath the baby teeth? That would determine what solution is best. If you’re not sure, the first thing you will need is a good set of x-rays.

If you do have your adult teeth but they just haven’t erupted yet, then the most common reason for that is that they are impacted. You’ll need to have the baby teeth extracted and then have an orthodontist help you get them in the right position to erupt properly. Dental Implants will not work in that situation because you have teeth that are already there.

There are occasions where you’ll have congenitally missing teeth. In that case, dental implants will be a great permanent solution after your jaw has fully developed. What you can do in the meantime is have the baby teeth extracted and get your other teeth back into alignment in order to make room for the adult teeth. Then, when there is enough space for the adult teeth, you can get a temporary tooth replacement. Don’t spend a lot of money on that because you won’t need it for too long. I would get something like a dental flipper.

Once your jaw is fully developed, it will be time to get that permanent replacement. Make sure the dentist has significant post doctoral training in dental implants. Dental school is not enough for such an advanced procedure. Three great post-doctoral institutes for this will be the Dawson Academy, The Pankey Institute, or The Las Vegas Institute for Advanced Dental Studies.

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

Titanium Versus Zirconia Dental Implants

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I have concerns about metal being used in a body. I already have two metal implants and now found out that I will need another one. My understanding is there are now non-metal implants. But my dentist doesn’t feel these have been around enough yet to warrant using them yet. Is there a reason why I shouldn’t? Should I switch out my older implants for these newer ones?

Carol

Dear Carol,

metal and zirconia dental

I am going to start with your last question first. Unless there is something wrong with the dental implants, I would not switch them out. Here is why. When your dental implants are removed they take some of the jawbone with it. That bone is essential for you to have a successful implant procedure, so before you can put the new implants in, you will have to have a bone grafting procedure in order to build back up that bone. Once that is healed, you can then have another surgery to place them. That is three additional procedures to replace successful dental implants. Each of those three procedures carry the risk of complications and failure. I would leave the succesful implants in place for as long as possible.

It is likely that your dentist’s concerns over the zirconia implants has to do with the lack of data we currently have on their longevity. The reason for that lack of data is they haven’t been around as long. We have tons of data on the titanium implants because they have been in use for decades. The zirconia are likely just as enduring, they just haven’t been around long enough to say that. Zirconia, nicknamed ceramic steel is certainly strong enough.

So, which should you get? Honestly, whichever one you want. However, I don’t want you thinking that the ones you have are dangerous to you. You mentioned concern over having metal in your body. Not only is titanium, the metal your current implants are made of, extraordinarily biocompatible, but our bodies need and use metals every day. One major example is our blood. If it doesn’t have enough iron, you become anemic, which can cause serious health problems.

If you do decide that you want the zirconia implants, my suggestion is that you do it with another dentist. Your current dentist does not seem comfortable wtih them and it is never a good idea to push a medical provider outside of their comfort level. You are better off finding a metal-free dentist who will have done this procedure quite a bit.

This blog is brought to you by Dr. David Marion, who tries to be the best dentist in Duluth, GA.

Losing Teeth Like Crazy

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I have pretty advanced gum disease and have already lost seven teeth. Is it possible for me to get dental implants to replace my teeth or will I be stuck with dentures?

Joe

Dear Joe,

Implant overdentures

Implant Overdentures

Dental implants are a great solution when you’ve lost your teeth. Anyone in good general health can usually get them. However, your gum disease will be an issue that will have to be addressed in order for this to be a successful option for you. In order to retain your dental implants, you need to have enough bone to integrate with the implants. Gum disease eats away at your bone structure, which is why you’ve been losing your teeth.

Here is my suggestion to give you the best outcome possible. Get serious about your gum disease treatment. Once that is handled, you will need to build back up the bone structure. There is an outpatient procedure known as bone grafting which can do that. Once you’ve healed from that, it will be time for your implants.

I know you’re probably thinking that is a lot of trouble to go through to get those implants. Maybe it would be easier to just get dentures? While it may seem easier at first, you will not feel that way with your quality of life. Even the best fitting dentures reduce your chewing capacity by 50%. Then, because there are no roots of your teeth any longer, your body will begin to resorb the minerals in your jawbone. This shrinks your jawbone to the point where you will no longer be able to keep your dentures in. The implants are worth it. They are like having healthy, natural teeth once again.

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

Implants after Dentures

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I have been in complete dentures for twelve years. I have never really liked them. Is it still possible for me to get dental implants or is it too late?

Mariella

Dear Mariella,

Implant overdentures

Implant Overdentures

Technically, it is never too late to get dental implants no matter how long you have been wearing dentures. The only issue may be how much bone structure you have lost in your jawbone. There is a nasty side effect with removable dentures that I hope your dentist warned you about. Once your teeth were removed, your body recognizes that you no longer have any teeth roots. In an effort to be as useful with your body’s resources as possible, it begins to resorb the minerals in your jawbone in order to use them elsewhere in your body. After ten to twenty years, you will have lost so much jawbone that you are no longer able to retain your dentures. This is known as facial collapse.

When you see a qualified implant dentist, he should do a round of diagnostics in order to determine how much bone structure you have. If you have lost too much, hope is not lost. There is a bone grafting procedure that will help to build up the bone in your jaw and allow you to get the dental implants you want.

It is important that you find a dentist who has the qualifications necessary to do this right. There are way too many dental implant horror stories. This is likely because dental implants are not really taught in dental school. It is such an advanced procedure that dentists really need to invest in significant post-doctoral training. Without that, you are at a much greater risk of serious complications.

I would look at some of Dr. Marion’s qualifications to get an idea of what type of implant dentist you need.

What your dentist will provide you with is between four and six dental implants. Then, once your bone has had time to integrate with the bone your dentist can anchor a denture to them. These are known as implant overdentures (pictured above). You will find that your quality of life goes up significantly once you have your implant overdentures. Not only will your teeth be more secure, but you will find your ability to eat skyrockets. Even the best fitting dentures will reduce your chewing capacity by 50%, but once you add those implants, you can eat steak if you want to.

This blog is brought to you by Duluth, GA 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.

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.

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.