Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

August 4, 2016

A couple of teeth just fell out!


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Dr. Hall,
My mother is 85 years old. Just last week she had two teeth filled. She recently lost a tooth and has a partial for that area. Then a few days ago, another tooth fell out. Both missing teeth are from the lower jaw. Fortunately they are in different areas of the mouth. She is very self-consious. At her age, her remaining teeth and gums are probably not in the best of health. We are considering a bridge(s) but are not sure as we don’t know how healthy the rest of her teeth are. Do you have any affordable recommendations on what we can do for the area that is missing teeth?
– Diane from Colorado

Diane,
If I am understanding you correctly, these two teeth just fell out. If that is the case, your mother has advanced periodontal disease (gum disease). It doesn’t get more advanced than that, for teeth to be so loose that they just fall out.

Continuing on with that assumption, it is likely that she has no really solid teeth left, so bridges would be out of the question. A bridge anchors replacement teeth to the remaining teeth, but in doing so it puts additional stress on those remaining teeth. In your mother’s case, that would hasten their demise.

The ideal replacement for missing teeth is dental implants. However, you asked for something affordable. Your mother would likely need full-mouth restoration, and the price for doing that with dental implants could easily get to be $20,000 to $40,000.

Given the condition of advanced periodontitis, all of her teeth are likely loose and would be candidates for extraction. I would seriously look at complete removable dentures. The main disadvantage of removable dentures is that it begins a long-term process of bone resorption. But at the age of 85, that would not be likely to be a significant problem for her.

Cu-Sil partial denture

A Cu-Sil partial
(image courtesy of Dental Arts Laboratory, Peoria, IL)

Another solution would be a type of partial denture called a Cu-Sil partial that is built like a complete denture, but has holes in it to allow the existing teeth to poke through, and there is a silicone ring in each hole that snugly holds each tooth. This is a little more stable than a complete denture, and as additional teeth are lost, it is a simple matter to then close each hole and put in a new artificial tooth.

A conventional removable partial denture also puts extra stress on the remaining teeth. It’s not as much stress as a bridge, but it’s still enough to weaken the teeth, so I wouldn’t recommend that either.

Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

February 18, 2016

Finding a dentist who can make a gingival mask for me

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Dr. Hall,
I am suffering from periodontal disease. I have searched for a cosmetic dentist that does gingival masks in my area and haven’t found one. Would you have any idea what I should search for?

My gums have receded a lot, so I have large black triangles between my front teeth. And then I and am scheduled for gum surgery in the near future which is going to make them look worse. It’s a very unsightly thing and seems to be getting worse, and I think a gingival mask would help a lot.

Also, have you seen gums come back to fill these triangles in after gum surgery, seems the future of my once nice smile is in jeopardy. I just want to be able to smile confidently again, any help would be greatly appreciated.
Thank you,
Mike from Michigan

Mike,
Here’s the thing on gingival masks. Even cosmetic dentists who do a lot of appearance-related dentistry don’t get calls for them very often, so they’re very unlikely to mention them on their websites. And if you call the office, the receptionist is likely to not know what you are talking about. But any dentist who is seriously into aesthetic dentistry is going to be able to do this for you and do a nice job.

The concept of a gingival mask is fairly simple. It’s simply a piece of silicone shaped to fit over these black triangles between your front teeth and colored to look like gum tissue. It has little tags that slip through those black triangles and help anchor it into place.

gingival mask prosthesis

Gingival mask photo courtesy of Chromeworks Lab, Chico, CA

Silicone is used in dentistry for several purposes—soft denture liners for one. So any dental lab that does dentures can make them. And all the dentist has to do is send a good plaster model to the dental lab. So any dentist who is really into cosmetic dentistry should be able to make this.

So my suggestion would be to simply make an appointment with any cosmetic dentist that I recommend on this website, and I’m confident they could do this for you.

And no, your gum is not going to grow back. Even trying to correct this surgically isn’t really going to work. The gingival mask prosthesis is the only real way to address the aesthetics of your situation, if you have a high lip line that shows your gums.

Do you have a comment? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

September 25, 2012

This new tooth gap is really serious – her teeth may fall out

Filed under: Gum disease — Tags: , , , — mesasmiles @ 6:09 pm

What would you recommend for my smile? I had a huge overbite as a child from sucking my thumb, had braces and was very happy with the results. My problem is that I’ve been told I have periodontal disease and now have a HUGE gap between my lateral incisor and canine tooth and makes my smile look crooked.
– Karen from Washington

Karen,
Your periodontal disease sounds serious. Once your teeth start moving, they are already getting loose and may have lost half or more of their bone support. So your treatment plan is going to have to focus on that first. Exactly what options are available to you, that is going to depend on the severity of your periodontal disease. And your first step is going to be getting your periodontal disease under control, if that is even possible. Your dentist has hopefully made that clear to you.

And from there, you need to proceed cautiously. If saving your front teeth is a hopeless proposition, for example, you probably won’t want to invest thousands of dollars in porcelain veneers. Instead, you may want to be looking at getting dental implants, or a removable appliance to replace the hopeless teeth. On the other hand, if the periodontal disease can be brought under control and the destructive processes stabilized, the teeth may be able to be moved back into an esthetic position with braces and stabilized there with some type of splint that will prevent them from moving again.

You do want to be sure that your dentist is one of the small minority of dentists who is truly sensitive to appearance-related issues. 98% of dentists have a strong engineering mentality, focused on fixing things. While they are generally honest and skilled practitioners, they are not artistic and would not fully appreciate your concerns about your appearance or be able to give you back your beautiful smile. I would urge you to check our list of screened cosmetic dentists and choose one of those. That is why I operate this website.

Dr. Hall

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

October 7, 2010

Snap-On Smile vs Flipper Partial

Filed under: Snap-On Smile — Tags: , , — mesasmiles @ 12:50 pm

Hello Dr Hall,
I have been contemplating about “Snap On Smile” temporary teeth. I’m not sure if I would be eligible though. You see I am missing 2 front uppers with one other that might have to come out as well. I can’t afford dentures or implants, so I don’t have many options. I realize that a visit to the Dentist is the only true way of being sure, but before I spend the money I would like to have some idea if I am eligible. I’m 54 years old and in good health. Please let me know what you think.

Thank you very much,
Douglas from Texas

Douglas,
I don’t understand the condition of your mouth well enough to give you a recommendation, but I’ll try to be helpful.

You are missing two front teeth, and have another that might need to come out as well. It kind of sounds like you have periodontal disease, and that is why these teeth have to come out. That would mean that other teeth are loose and are in danger of needing to come out when they get too loose. The problem with doing a Snap-On-Smile in a situation like that is that it snaps on to your existing teeth, which means that it will put additional stress on the remaining teeth and accelerate the periodontal disease. Additionally, it may be very difficult to get a good fit if the teeth the dentist is fitting it to are mobile.

There is another option that would be even less expensive, and that would be a flipper partial. That provides a relatively inexpensive plastic tooth for each missing tooth. It doesn’t do anything to cover up other teeth, but if your other teeth look okay, the flipper partial would be much less expensive and easier to make and fit.

Dr. Hall.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

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