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My dentist gave me an implant despite knowing there wasn’t enough bone in my jaw.

I had to have a tooth pulled recently, and I felt self-conscious about the gap in my smile. So when my dentist recommended an implant, I agreed. My dentist said that the bone in my jaw was ready for an implant, so we scheduled the procedure. But after the surgery was done, my dentist told me that the bone wasn’t that good after all. He said the implant will be weak, so he now recommends removing the implant and placing a dental bridge to fill in the gap.

Now I’m wondering why my dentist put the implant in if he knew that the bone wasn’t strong enough. I originally wanted an implant instead of a bridge, but I feel like my dentist should have told me it wouldn’t work out. Otherwise, I wouldn’t have wasted $4,000 like this.

Could I get a refund for this?

— Theresa from Seattle

Hi Theresa,

You went through the trauma of losing a tooth and then sacrificed all that time and expense to replace the tooth with an implant, so it’s only natural to be very disappointed when you’re told the implant won’t succeed.

The good news here, however, is that you are probably entitled to a full refund and then some.

We can only say “probably” because we don’t know the full details of your situation. But based upon what you’ve shared with us, it looks like your dentist is responsible for this disappointing outcome.

Here’s why:

1. You have every right to expect a dental implant to support a replacement tooth when your dentist says you are a candidate for an implant. Dental implants have a very high success rate and modern dental technology allows dentists and oral surgeons to precisely plan the outcome of dental implant surgery. But since your dentist placed an implant and realized later that it couldn’t do that for which it was intended (support a replacement tooth), the implant is totally useless and you deserve a refund for it.

2. It seems your dentist demonstrated some clinical negligence by not properly assessing your jawbone before starting the dental implant surgery. Experienced professionals will thoroughly evaluate the quality of the bone tissue before recommending a dental implant procedure. Your dentist either did not use the right diagnostic equipment, did not take enough time to thoroughly examine the bone in your jaw, or lacked the expertise needed to interpret the diagnostic images and determine whether there was enough bone tissue to support an implant.

3. Finally, assuming your dentist did his due diligence while examining your jawbone and was still surprised when he opened up the gums on the day of the surgery, he should not have gone ahead and placed the implant. According to your account, your dentist realized there was not enough bone to support the implant, but he placed it anyway.

So in summary, yes, it looks like you are fully entitled to a full refund for your unsuccessful dental implant.

The good thing is that your dentist sounds like he was being honest with you. Some dentists unethically try to hide a poor implant job by placing a dental crown and then not informing the patient that the implant could fail within a year or two. So there’s a good chance your dentist made a genuine mistake and will work with you to make your situation right again.

Ask your dentist directly for a refund for the failed treatment. If he puts up any resistance or tries to talk you into letting him do a bridge instead, perhaps for a reduced rate or as compensation for the implant, then it’s probably time to start looking for a new dentist.

Also, keep in mind that there’s no need to settle for a bridge. You can always seek a second opinion from a dentist with a more solid reputation for placing dental implants. You might be a candidate for bone grafting to build up the weak spot in your jawbone so that you can get a successful dental implant some day.

This post has been published on behalf of Dr. Heng Lim, an Owasso dentist who places dental implants.

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Braces ruined my bite, so my dentist says that I need crowns on all of my teeth.

I had braces when I was younger. I thought orthodontic treatment was supposed to fix my bite, but my current dentist told me that my bite was “off” and he says that I now need full-mouth reconstruction. There’s nothing about my bite that bothers me, though. And I can’t afford to get the number of crowns my dentist suggests I need.

Could I be missing something? Do I really need all those crowns to fix my bite, or is there an alternative?

— Grant from Sanford, ME

Hi Grant,

While it’s not unheard of for some people to have bite alignment issues after wearing braces, it doesn’t sound like that’s what you’re experiencing.

Most people who really need full-mouth construction are in pain or discomfort and need to have their teeth physically altered to take the stress off their TMJ. These people have bites that are so off they cannot chew, speak, yawn, or smile comfortably. And it isn’t as simple as placing a crown on each tooth. Full-mouth reconstruction requires both technical and artistic expertise to design crowns that are the perfect size, height, shape, and color for each tooth. When done well (and when it’s truly necessary) full-mouth reconstruction can be life changing.

What this means is that there should be a really compelling reason for you to get full-mouth reconstruction. We have no idea what your dentist saw in your mouth that made him feel obligated to recommend crowning all of your teeth. But, again, full-mouth reconstruction is an extensive and complex process which isn’t usually needed for people who don’t have any issues with the way their teeth fit together.

If you don’t feel like your dentist is giving you enough diagnostic evidence to justify the investment of a full-mouth reconstruction, then you should seek a second opinion.

In your particular case, you should consider seeking out a dentist with special training in TMJ treatment and full-mouth reconstruction. Such a dentist will carefully evaluate your bite, will let you know if there are signs of trouble, and can recommend more conservative measures to try correcting your bite before going the route of full-mouth reconstruction.

This post has been published on behalf of Dr. Heng Lim, an Owasso dentist who has received training in creating balanced bites at The Las Vegas Institute for Advanced Dental Studies.

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Why does my mouth look like it’s caving in?

I have no idea what exactly is causing it, but my mouth seems to be collapsing over time and I hate the way it looks.

For one thing, it’s hard to show my upper teeth with a natural-looking smile. I also have a hard time speaking and I experience jaw pain quite often now. My symptoms get worse when it’s cold. It feels like my jaw tightens up, and I feel very embarrassed about the way my mouth looks when I have to force a natural-looking smile. I’ve noticed that my jaw feels better, and it’s easier to move my mouth when I wear a night guard, however.

One dentist suggested veneers to make my teeth look longer and more visible in my smile.

Are there any other options?

— Stefan

Hello Stefan,

Porcelain veneers would certainly be an excellent option if your concern was strictly a cosmetic one.

But as you have clearly stated, what you’re dealing with is a problem that causes you physical discomfort, as well. Dental veneers can’t provide the structural support your jaw needs to move with comfort. If anything, addressing just the cosmetic element of your concern could potentially lead to even more discomfort.

So far, it sounds like you might be suffering from an over-closed bite due to excessive tooth wear. As your teeth wear down, your smile will look more “open” and you will have to lift your lips even farther for your teeth to show. And as your teeth get shorter, your jaw will be strained as it has to close at an unnatural angle for your upper and lower teeth to meet together. This can result in TMJ disorder.

The symptoms you’ve described make it sound like you could already be experiencing some TMJ issues, but you should visit a TMJ dentist who has special training to get a definitive diagnosis.

Once you find out what has caused your bite to feel so off, your new dentist will likely recommend full-mouth reconstruction (something much more extensive and effective than just veneers) to help all of your teeth fit comfortably in your bite.

This post has been published on behalf of Dr. Heng Lim, an Owasso TMJ dentist who was trained in TMJ treatment at The Las Vegas Institute for Advanced Dental Studies.

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