Unfortunately there are times when teeth must be removed, either for infections that cannot be treated, lack of enough bone to hold the tooth, or damage so great that it cannot be fixed.
Since, tooth removal can vary greatly in how difficult it can be, we do offer an excellent alternative to experiencing this while awake. We will recommend that you be asleep for your extraction if it appears that the difficulty of the surgery is such that you will not comfortable.
While many single rooted teeth or molar teeth with very short, favorable roots can be removed very comfortably using local anesthesia only (fully awake but numb), it is not at all uncommon to have situations that will be very difficult to accomplish comfortably.
Why must we discuss whether you will be replacing your extracted tooth before we have even removed it?
What you probably don't know is that as soon as a tooth has been removed from the jaw, the bone it sat in will immediately start to slowly melt away. Again, it is a slow process where you will be losing bone width and height that are both necessary for holding a dental implant.
It has been shown that grafting donated bone (or a bone product) into the socket immediately after the tooth has been removed can slow this loss of bone, perhaps even rebuild some lost during the process of the extraction.
Not doing this additional procedure can, and has, prevented patients from getting dental implants placed later, especially when over a years time has elapsed since the extraction. The graft, however, is not permanent - it too will melt away eventually if not taken advantage of.
Bone, Bone, Bone
You need enough bone width, bone height, and bone in the right locations. While there are many other factors that make a dental implant possible, this is the most critical factor.
The key is to plan for implants soon after losing your tooth/teeth because bone will naturally melt away forever after a tooth has been removed.
The jaw will narrow and lose height where the tooth was removed. Wait too long and you may not have enough bone to place an implant into. Also, teeth can shift into the space of the missing tooth, both from above and behind it, making it much more difficult to place the implant.
Typically, you are best to do something within the first 4-12 months after an extraction.
In special circumstances, especially with a tooth that has a single small, narrow root, it might be possible to place an implant on the same day the tooth is removed, saving as much as 3-4 months in healing time. Ask Dr. Grellner whether this might be a possibility for you.
This is an acrylic guide being milled by a computer in our lab to exacting standards. The finished guide (on the right) will allow us to place a dental implant into the location in your jaw that we carefully pre-planned on your CBCT (Cone Beam Cat Scan x-ray) with precision and confidence.
This guide makes the implant placement process quicker and much more comfortable for you because there is no guesswork as to where the implant needs to go. That planning was done well before you arrived at our office.
Would you rather a surgeon place a dental implant into your jaw freehand, referring to a 2-D x-ray to estimate the best position for it or have us place it precisely using 3-D technology where your dentist needs it to go?
X-ray of a dental implant replacing a missing tooth root. A missing back tooth makes chewing of your food much more difficult because the back of the mouth is where it is easiest to do heavy chewing. Why? If you think of a pliers, you can get the strongest grip on something when you have it closest to the joint of the tool (as far back as you can go). Since the jaw joint is in front of the ear, the farther back in the mouth you chew, the easier it is. Ever wonder why molars have more than one root? Since molars have to withstand stronger chewing forces than the front teeth, they need more surface area to anchor them to bone.The dental implant, then, will replace and act as a large molar root (after it has had enough time to heal to the jaw bone). It will eventually be used to hold a crown (the part that looks like a tooth) that will be made by your dentist. The X-ray above shows...... a perfect situation for an implant (rather than a bridge) because the teeth on either side of the missing tooth had either no filling or only a small one. Why is this important? Why shave perfectly healthy teeth down for crowns to support a traditional cemented bridge that don't need to be, especially since this may shorten their lifespan? You also avoid having a food trap as under a traditional bridge.
While traditional bridges are more often covered by dental insurance plans than implants, the cost in the long run can be far less using the single implant because of the inevitable need to replace a failed bridge due to decay at the crown margins. Ask us to explain this further. This is only a small sampling of the technology we are now using to give you a dental implant (a new root) that your dentist can restore to look, feel (and chew!) as natural to a tooth as possible.
The addition of two dental implants, with a set of attachments added to the denture after the implants have healed for several months, will help to hold the denture down in the front of the mouth. This greatly improves your ability to speak and eat. No longer do you have to use your tongue or gooey denture adhesives to hold your lower denture down.Though not as stable as having additional implants in the back of the mouth to anchor to, this is a more affordable solution for managing a loose denture: X-ray of implants for a lower over-denture. An older system of anchoring a full lower denture using rubber gaskets that clipped to the posts. It required almost perfectly parallel implants or the rubber would wear too quickly: Older over-denture connection system for a lower over-denture Older over-denture system
Currently, a newer system that incorporates a rotating clip that connects more easily to the denture and reduces the need for absolutely parallel implants: Lower implants with newer Locator system connections. Lower over-denture with newer Locator attachments. Although not used as often in the upper jaw because there is usually enough suction to hold a denture, this was a case where the bone shape did not allow for suction to be created. What you are looking at are the three healed dental implants before the Locator attachments were added: Implants that will be used for an upper jaw overdenture in a situation too difficult to wear a traditional denture.In all of these cases, you will not be able to see the dental implants or any attachments after you have snapped the denture into place in your mouth. Dental implants can also be used to anchor a partial denture (not pictured). This is especially helpful in situations where there are no back teeth to anchor a partial denture to. With no back tooth to clip a partial to, the partial denture tends to come loose and flip up and down. This is especially true when back teeth are missing on both sides.
We invite you to call (813) 972-3478 to reserve a time exclusively for you and Dr. Grellner. Speaking of gooey denture adhesives... click HERE for information from Proctor & Gamble regarding the use of zinc in their denture adhesive Fixodent. It has come to light that heavy users of zinc-containing denture adhesives may be experiencing neurological problems due to zinc toxicity. Denture adhesive should never be used in excess to overcome the problems of an ill-fitting denture. A healthier approach is to anchor the denture with implants so you can minimize the need for any adhesive. The more stability you can achieve with implant anchorage, the better the chance you can eliminate the need for such an adhesive.
The key to successful use of implants is having adequate bone to place them into. Please note that bone melts away, after extraction of the teeth, to a point where over time there may be too little bone left to place an implant. Don't let your best opportunity pass you by!This is only a small sampling of the technology we are now using to give you a dental implant (a new root) that your dentist can restore to look, feel (and chew!) as natural to a tooth as possible.
Considered an authority in wisdom tooth extraction, Dr. Grellner can provide both accurate treatment and sound advice on affording the procedure. If you or your child need wisdom teeth removed, contact our practice today to set up an appointment and discuss your financing options.