gum disease Archives - Arnold Dental

Inflamed Gums After Porcelain Veneers

Posted on October 18, 2024 by writeradmin.

I had four porcelain veneers done in Columbia. I took the precaution of making sure it was done by a N.Y. dentist that lived there now. I’ve realized that I probably should have had more than four done because my other teeth are showing when I smile and they do not match up. I want to get at least four more, but can’t get any more time off to get back to Columbia. I was wondering if you knew whether or not there was a dentist who uses my Emblem Health Dental Insurance. I also wondered if you can tell me how to fix the redness and inflammation that are affecting the gums with the porcelain veneers. I probably should get the gum problem under control before adding new veneers.

Ellie

Dear Ellie,

My guess is that you went to Columbia in order to save money on your porcelain veneers and that is also why you are looking for a dentist that gives discounts through your health insurance. This is actually what lead to the problems with your gums. This N.Y. Dentist thing doesn’t mean he had any skills or that he was actually trained in New York.

I looked at the list of cosmetic dentists in the area you went. Only a handful had a connection with New York and even those were tenuous and showed no actual training in cosmetic dentistry.

Two things signal to me that your dentist in Columbia does not have the training that you need. First, knowing that you only had four porcelain veneers done, your dentist should have suggested you do teeth whitening first. Most smiles are eight to ten teeth wide. That would ensure that the teeth blended in with your porcelain veneers. This is pretty much standard operating procedure.

Second, the problem with your gums indicates that he doesn’t have the technical skill needed to do them correctly. The redness and swelling indicate that you have gum disease. This is likely due to the fact that your dentist did not place them seamlessly against your teeth. This can lead to a ledge of sorts by your gums which will trap food and other bacteria. Guess what that does? Breed gum disease.

This has to be repaired before you can move on to getting your other teeth done. That repair may be a simple one like removing excess bonding that was not properly removed, or it could mean that the veneers need to be replaced.

In your place, I would get this checked out by an expert cosmetic dentist. If you leave gum disease unchecked, you can end up losing those teeth. Go to a dentist who is AACD accredited. This is completely different from being a member and will ensure that the dentist has expert technical expertise as well as artistry.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.

Floss Catching Under My Porcelain Veneer

Posted on September 28, 2024 by writeradmin.

I need some advice. I recently had six porcelain veneers done. They do make my smile look better, but whenever I floss, the floss string gets caught under the front two veneers. My dentist says it is not a problem because you can’t see the problem when I smile. However, I’m worried that if my floss can get trapped there, so can other things. The last thing I need is decay so close to the root of my tooth. Am I worrying over nothing?

Emma

Dear Emma,

It is a shame that your dentist either does not understand the seriousness of this situation or she just doesn’t want to take responsibility for her mistakes. It doesn’t matter if you can see a problem. It is still a problem. Just because you can’t see cancer, doesn’t mean you should ignore it.

You are correct that things can get trapped there and cause decay. Even more likely, though, is your gums will get red and inflamed. Eventually, you will end up with a serious gum disease problem.

It is important that your dentist fix this. It sounds to me like you have a margin irregularity known as an overhang. This happens when the dentist had problems with the impression taken after your teeth were prepared for the porcelain veneers. Because the impression did not accurately record the upper end of the tooth preparation. This creates a bit of a bump or lip that things, such as your floss.

As I said, your dentist needs to fix this. The only way to do that is by replacing the porcelain veneers that have the problem. If your dentist has a sense of ethics, he or she will take care of this quickly and at their cost. If they don’t, it is still important you get it replaced, even if that means going to see a different dentist to do it. While you are waiting to get this replaced, make sure you continue to carefully floss the area. I know that is a bit challenging, but it is important.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold, an AACD accredited dentist.

Dentist Won’t Give Me Dental Implants Because I Smoke

Posted on January 4, 2023 by writeradmin.

Admittedly, I haven’t been to my dentist in a while. However, when I went back I expected him to give me the treatments I needed. Instead, I got a lecture and a denial. I’ve lost a couple of teeth recently and wanted to get dental implants to replace them. He told me because I am a smoker he can’t give them to me. I know other smokers and they have dental implants. I told him that and then he blamed my gums. I think this dentist just doesn’t like me. Can he deny me treatment like that? I’m sure I can find another dentist, but I’m just mad now.

Ben

Dear Ben,

I can tell you are frustrated and I’m trying to put the full picture together just based on your statement. It sounds like this is a combination of issues. You said your dentist blamed your smoking and then when you gave him a counterargument, he mentioned your gums. Granted, I was not there and didn’t hear the whole conversation, but there is a connection between smoking and your gums. I’ll go over that with you and then answer your question in case that isn’t what he meant and your first impression is right.

Smoking and Dental Implants

The nicotine in cigarettes restricts the blood flow in your gums. In some cases, smaller blood vessels will completely close off. The problem with this loss of blood flow is it reduces the oxygen to your oral tissues. When dental implants are placed in your jawbone, it is important that the bone integrates with the implant in order for it to remain secure. This process can take months. With restricted blood and oxygen flow, the healing process necessary for this to happen is slowed down dramatically and in some cases never happens at all, leading to dental implant failure.

A second issue is what that restricted blood flow does to your gums. One of the main symptoms of gum disease is inflamed and/or bleeding gums. Unfortunately, nicotine masks those symptoms, which means you can have gum disease and not even know it. Left untreated, it turns into advanced periodontal disease and you can even start losing teeth as a result.

It is possible you have reached this stage. You mentioned you had not been to the dentist in a while so you may not have known that you were dealing with gum disease. Obviously, I have not examined you and do not know if this was what your dentist was referring to, but it makes sense. Does that mean you cannot get dental implants? It depends.

Dental Implant Options as a Smoker

If the issue is just you are a smoker, but your gums are healthy, then you could go forward with the dental implants as long as you acknowledge the risks and that you have a higher likelihood of dental implant failure.
If you have gum disease you do need to address that before moving forward with dental implants. Otherwise, you will continue to lose teeth and your dental implants will fail. There are temporary replacements you can get while you get your gums healthy.
You may want to consider quitting smoking, at least temporarily, to give yourself the best chance of success. Start a few weeks before the surgery and continue until your healing is complete.
Look at alternative tooth replacements such as a dental bridge.

I hope this helps.
This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.

Clear Choice or Costa Rica for Dental Implants?

Posted on January 31, 2022 by writeradmin.

I want to get some dental implants but my dentist said I have lost too much bone due to my gum disease for that to be a viable option. I’ve done some internet scouring and learned that people in my position often get the all-on-4 dental implant procedure at a place called Clear Choice Dental Implant Centers. I looked into them and they seem to get good results. My two concerns were the price seemed pretty high and there seems to be patients who said they felt abandoned after their procedure and there wasn’t really any follow up. It looks like I could go to Costa Rica for the same procedure but much cheaper. Do you have an opinion on which is my better option?

Angie L.

All-on-4 Dental Implants

I have a few thoughts on this. First, let’s talk about the gum disease. Make certain that is under control before undergoing ANY dental implant procedure. Otherwise, you are setting yourself up for failure. You will continue to lose bone structure as long as the gum disease is present which will lead to implant failure.

After that is dealt with, you have an option other than the all-on-4 procedure. You could still get traditional implant overdentures, which have benefits over all-on-4. The biggest issue is the safety net that if one implant fails with traditional implants, you just have to replace that implant. With all-on-4, however, the entire unit would have to be replaced. In order to get implant overdentures, you would need to build back up that lost bone structure with bone grafting. This will ensure you have enough bone to safely retain your implants. Then, after a period of healing, your implants can be placed and then your overdentures.

Where Should You Go for Your Dental Implants?

You’ve mentioned two places. The first is Clear Choice. Yes, their prices can be on the high side. That is because they are pricing their procedure to be about the same as what you’d pay getting bone grafting and implant overdentures, but they don’t have to do the bone grafting, which increases their profits. Another issue is they are a corporate practice, which has a list of downsides you can read at the link. Clear Choice tends to push the all-on-4 procedure on patients without giving them other options.

As for Costa Rica, if you think Clear Choice doesn’t have great patient follow-up, how much do you think you will get there? Will you be willing to travel back and forth for follow-up appointments if they do offer them? What about if something goes wrong, will you have recourse? How will you know if the dentists are qualified? There are countless dental implant horror stories both from unqualified dentists in the states as well as from dental tourism outside of the U.S. At least here you would have recourse.

My honest recommendation is you go to a private practice and let them examine you to give you all your options. Your dentist is steering you away from implants, which tells me he doesn’t feel comfortable placing them. Don’t push him into it. Instead, find a dentist with great post-doctoral implant training and get your work done there, where you will have personalized care and great follow-up.

This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.

Could I get Dental Implants Instead of Dentures?

Posted on December 11, 2021 by Travis Wachendorf.

After thirty years wearing dentures which I got when I was in my 20s, I finally have money. I lost my teeth due to advanced periodontal disease. My parents didn’t believe in dentists. They thought it was a waste of money. I’ve never liked my smile because dentures are so ugly. Is it possible for me to finally get dental implants?

Laurie

Dear Laurie,

I am so sorry you had to lose your teeth at such a young age. Parents aren’t perfect and, obviously, yours were confused about the importance of dental care. Unfortunately, we sometimes suffer because of other people’s mistakes. You can get dental implants but may have to take some preliminary steps first.

The very first thing you will want to do is make sure your gum disease is under control. That can derail any attempt at dental implants. After that, you will need some bone grafting done. Implants need to have bone structure to help retain them. When your teeth were removed, your body began to resorb the minerals that hold your jawbone together to use elsewhere in your body. After 30 years, you won’t have much left. This is known as facial collapse and can make you look decades older than you are.

Getting bone grafting done will restore that bone. Then you can have implants placed. Don’t try to do it on a one-to-one ratio. That is too expensive. Instead, get between six to eight dental implants on each arch and your dentist can secure dentures to them. These are called implant overdentures. You will have a completely secure smile for years to come.

I know you were concerned about the appearance of your dentures. You should know that dentures can look stunning when done by an excellent cosmetic dentist. The unattractiveness of your dentures had nothing to do with the fixture themselves as much as the cosmetic skill of the dentist who made them. Choosing your dentist carefully will be extremely important.

Look for an AACD accredited dentist. These are the best cosmetic dentists in the country. Then, see which of those dentists has post-doctoral training in dental implants. When you find that magic combo, you have your dentist and will be on your way to a stunning smile you’ll be proud of for the rest of your life.

This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.

Porcelain Veneers Don’t Blend and Gums are Bleeding

Posted on June 14, 2018 by writeradmin.

I take good care of my teeth but I wasn’t born with a beautiful smile. I’d been saving up for YEARS to get porcelain veneers. I was thrilled when I could finally get them. My dentist gave me four across my front teeth. I do like them. They are much prettier than my natural teeth, but believe it or not that’s one of the two problems I’m having. I have a crazy wide smile. Now when I smile, I have these four gorgeous teeth and then the rest of my teeth which look like unloved stepchildren compared to my veneered teeth. Should he have made the veneers to blend in somehow with the other teeth? The second problem is my gums have started bleeding. I’m a fanatic about brushing and flossing. I even use a waterpick. Yet, when I went in for my last checkup, they said I’m developing gum disease. How can that happen if I’m taking care of my teeth the same way as I always have?

Carlee

Dear Carlee,

I can tell you the overarching problem here. The dentist who did your porcelain veneers isn’t very skilled. First, let’s start with the number of veneers he did. For narrow smiles, we’ll do six to eight porcelain. For wide smiles, like yours, you’d need two to four more. They’re not supposed to blend with your teeth, they’re supposed to improve them. He’s essentially given you two smiles—the pretty front teeth and the untreated rest. You’re going to feel self-conscious every time you smile with this makeover.

Additionally, he’s damaging your smile. That’s related to the second problem you mentioned. If you’re diligently brushing and flossing, including going the extra mile of using a water pick, there’s absolutely no reason you should be developing gum disease.

The more likely cause is he didn’t place the porcelain veneers flush against your teeth, the way he should. You’ve probably got what’s known as “bulky margains”, meaning your dentist left a mini shelf at the top. This allows particles of food and other bacteria causing enemies to get trapped there, leading to both decay and gum disease.

My suggestion is you ask for a refund and go to an expert cosmetic dentist to have this re-done properly.

Choosing a Cosmetic Dentist for Porcelain Veneers

There are different levels of skill and artistry in the cosmetic industry, just like there is in any artistic field. Now, you could draw up a list of cosmetic dentists in your area, review their credentials, and examine the results of cases they’ve done to determine who can give you a truly gorgeous smile, but that could take months of research.

Fortunately, knowing the dilemma patients face finding great cosmetic dentists, the American Academy of Cosmetic Dentistry (AACD) began an accreditation program. Here the candidates for accreditation will have to pass stringent oral and written exams, as well as demonstrate their artistry in a large number of varied cosmetic cases they’ve personally created. Essentially, they do all the work I mentioned above plus some. All you have to do is go to their website and search for accredited cosmetic dentists in your area.

Whoever you choose, make sure they have a beautiful smile guarantee so you’ll not end up in the same position you are in now.

This blog is brought to you by Dr. Fred Arnold. Check out his smile gallery.

Can a Serious Smoker Get Dental Implants?

Posted on October 19, 2017 by writeradmin.

I’m a life-long smoker. I started when I was eleven and haven’t stopped since. I smoke about three packs a day. My teeth are seriously stained. I’ve also lost a couple of teeth due to gum disease. I’m considering just pulling the rest of them and getting implants so I can have a decent smile. But my sister said smokers can’t get dental implants. Is that true?

Matt Q.

Dear Matt,

You’re in a tough spot. However, I’m going to try to help. The absolute first thing that has to be dealt with is your gum disease. That is the reason your teeth are falling out. It also tells me your gum disease is fairly advanced. Without healing your periodontal disease, you will lose your dental implants for the same reason you’re losing your teeth. You won’t have enough support to keep them implanted.

Let’s fast-forward and pretend you’ve worked on getting your gums beautiful and healthy. You never want to remove healthy teeth. Even with damaged or infected teeth, you’ll want to fight to keep them. Trust me when I tell you that saving as much tooth structure as possible is in your best benefit.

Now we need to deal with the missing teeth and the stains. Before you get any permanent replacement teeth, you’ll want to whiten all your remaining teeth. Once your implant crowns are made, there is no way to change the color without completely re-doing the crowns. Get your teeth whitened first, then the implants can be made to match your fresh, new white color.

Dental Implants and Smoking

You’re likely going to find many dentists who’ll refuse to place dental implants on heavy smokers. The reason for that is they have a high likelihood of failing. Smokers have much higher than normal instances of gum disease, as you’ve discovered yourself.

One of the reasons for that is it reduces that amount of blood flow in your gums. This hinders the healing process, which often leads to dental implant failure. With the requirement of surgery and such a great expense, it may not be worth it to you, especially considering the amount of smoking you do.

Dental Implant alternatives

Once your gum disease is healed, you may consider a dental bridge. Then, as you’re able to cut down on your smoking, you can get dental implants. I wouldn’t do more than a two-unit bridge though, even after you’re healed, because it puts too much pressure on your adjacent teeth.

While you will likely be able to find a dentist who’d be willing to give you the dental implants, be careful. If they do so without warning you about the high likelihood of failure, then they’re just in it for the money.

This blog is brought to you by Dr. Fred Arnold.

Can I Start Smoking Again Now That I Have My Implant Crown?

Posted on August 8, 2017 by writeradmin.

My dentist would not allow me to get dental implants until I quit smoking. I did, but I have to tell you it was distressingly hard. Going out with my friends became stressful instead of fun. They always smoke and I had to stand there and try hard not to. I’ve gone through the healing period and just got my implant crown. I’m hoping I can start smoking now that all of that is done. Is that okay? I don’t really want to ask my dentist because he keeps telling me how proud he is that I’ve stopped smoking and I’m embarrassed for him to know that I’m starting back.

Stanley H.

Dear Stanley,

It’s fantastic that you made the effort to quit smoking. It greatly increases your chances of a successful procedure. While the healing time span is the most vulnerable, smoking affects your dental implant outcome throughout their lifetime. I’ll list out the risks associated with your implants and smoking and let you make the decision. However, if you do start smoking again, your dentist will know even if you don’t ‘fess up. There are too many signs in your mouth for him not to know.

Here are the risks:

Restricted blood flow: When you smoke, it inhibits the amount of oxygen rich blood available to you. This can lead to a series of problems.
Higher occurrences of gum disease: Smokers have a much higher than normal rate of gum disease. This can be catastrophic to your implants for the following reasons:
- Inflammation: Gum disease causes your gums to swell and bleed. This often leads to infection, which is one of the leading causes of dental implant failure.
- Bone Loss: Gum disease leads to loss of healthy bone in your jaw, which is what anchors the implant. If that progresses, it won’t take long for your implants to just fall out.

You’re an adult, so obviously need to make your own choices. But, you worked so hard to get these implants. I’d hate to see you sabotage everything you’ve accomplished. Quitting smoking is one of the hardest addictions to get past, but I’m confident based on what you’ve done so far you’re someone who’s capable of getting past these rough spots and taking control of your body and health.

It’s a miserable feeling being dependent on something. Think of the freedom you’ll have (and the money you’ll save) when you get past the worst of it. Plus, you’ll get to keep your gorgeous new smile.

If you lose these implants, you’ll not only have to start over but will need expensive bone grafting in order to anchor them. Otherwise, you’ll be left with the option of dentures, which are much less pleasant to live with.

This blog is brought to you by Dr. Fred Arnold.

Are Dental Implants an Option When Your Teeth Are Falling Out?

Posted on November 1, 2016 by writeradmin.

My oral health has always been a struggle but seems to have gone into overdrive since my second round of chemo. I’ve lost two teeth. They’ve just fallen out. I know dental implants are the best tooth replacement, but will they work in my case?

Sylvia T. – Wisconsin

Sylvia,

I’m sorry for all you’re going through. Chemo is hard enough without having to stress over your smile. It sounds like you have advanced gum disease. I have some difficult news for you. Dental implants will not work yet. Chemo is hard on your oral care. Combine that with you already struggling with your dental health and it’s no wonder your gums are struggling.

Unless the gum disease is dealt with, this will only get worse. I’m disappointed your dentist, knowing your history and the fact that you were going through chemo, didn’t take extra precautions to help you and protect your teeth. The important thing now is to be proactive in dealing with it. There are other options to replace your teeth in the meantime, but your gums are the priority.

Then, the good news. After you take care of the gum issue, you may then be a candidate for dental implants. And, you’re right, they are the best tooth replacement.

This blog is brought to you by Dr. Fred Arnold.

Missing tooth causing pain

Posted on May 7, 2016 by writeradmin.

My mom had a stroke and now has cognitive issues. I take care of her. She recently complained of a toothache, which was no major surprise because she avoided the dentist before her stroke and never really took care of her teeth. I took her to a local school for dentists and was shocked to find she didn’t even have a tooth where she was complaining of tooth pain. They surmised that, because her back two teeth were missing, her top tooth had come down and was hitting on her jawbone every time she bit. We’re at the point where she pretty much needs all her teeth pulled and dentures, but she wants to know if dental implants can be put in the place where her other tooth is hitting. Are dental implants a viable option here, is there another option, or should we just plan to have the “long tooth” pulled?

Karen- Detroit

Dear Karen,

This is a difficult thing to advise you on because she really needs a full mouth evaluation. Their assesment is likely correct about her partner tooth. Teeth rely on their biting partners to stay in place. When the opposing tooth is gone, a tooth will begin to protrude because there’s no opposing biting force, but this generally takes years to occur to the degree your mother is experiencing.

This would have been simple if dental implants were place when she first lost her teeth, but now it will be much more complicated. If dental implants had been placed back when those teeth were initially lost, they would have prevented the problem. Going forward, it’s not quite so simple.

Based on what you’ve shared, your mother may not be a good candidate. First, dental implants need a healthy mouth in order to be successful. Periodontal disease, or severe gum disease, is a contraindication for treatment. There is a high risk of failure and infetion in these cases.She may need additional treatment in order for dental implants to be an option.

Secondly, with the tooth above the spot already connecting with the bone below it, there isn’t room for any type of device, be it a dental implant or appliance, to stop the two from connecting.

Your first step is a full-mouth evaluation

I’m very sorry for what you and your mother are going through.

This blog is brought to you by Dr. Fred Arnold.