Dental Implants or Braces First?


If you have missing teeth that you want to be replaced with dental implants and you also need braces, which should come first?

Diagram of three phases of dental implants, for information on implants and diabetes from the office of Lowell, MA dentist Dr. Michael Szarek.

Dental implants fuse to the bone and won’t move with orthodontic treatment

Here are a few facts about dental implants and orthodontic treatment. They will help you understand the priority for your smile.

Dental Implants

  • Usually made of titanium
  • Surgically implanted in your jawbone
  • Require bone grafting if you don’t have enough jawbone density
  • Require a three to six month healing period so the implants fuse with your jawbone
  • Feel and function like natural teeth
  • Permanently in place and don’t contain ligaments like natural teeth to allow them to be repositioned during orthodontic treatment

Orthodontic Treatment

  • Correctly aligns your teeth
  • Often needed to move teeth that drifted into empty spaces where teeth are missing and to make room for dental implants
  • Will move your natural teeth, but the implants won’t budge

Dental Implants After Braces

Orthodontic treatment

Most often, orthodontic treatment should be completed before you receive dental implants. Otherwise, as your teeth shift, the implants can damage them because braces are unable to move dental implants along with your teeth. The rigid implants can damage your teeth as they move to the correct position.

Schedule an appointment with an orthodontist to discuss your goals for your oral health. He or she will work with your implant dentist to ensure you get quality tooth replacement and alignment.

Implant placement

Find at least two skilled implant dentists to discuss your need for tooth replacement. Before you schedule an appointment for a consultation look for the following:

  • Advanced training
  • Extensive experience
  • Implant credentials

Implant restoration/crown

An experienced cosmetic dentist can provide you with lifelike dental crowns for the implants. And if you’re considering teeth whitening, it should be completed before you receive dental crowns. This ensures the crowns will match your bright smile.

This post is sponsored by Lowell, MA cosmetic dentist Dr. Michael Szarek.

3 Reasons a Denture Might Not Fit on Dental Implants

Diagram of snap-on dentures which are secured by dental implants, for information on stabilizing your dentures from the office of Lowell, MA dentist Dr. Michael Szarek.

Snap-on dentures

When dental implants are used to support dentures, the results can greatly improve your quality of life. Many common concerns about wearing dentures can be reduced or completely eliminated, including:

  • Difficulty speaking
  • Difficulty chewing
  • Loose dentures
  • Dentures that lift or fall out
  • Bone shrinkage and facial collapse

When Dental Implants Won’t Hold Your Prostheses

If your denture doesn’t fit properly onto dental implants, won’t snap onto them, or dislodges from them, there are several possible causes. Three of them are discussed below:

  • Dentures – It is possible that your prosthesis wasn’t correctly made. Before you receive dentures, impressions of your mouth are taken. Inaccurate impressions can result in poor fit. Additionally, incorrect locations of the attachments in the denture base can cause them not to fit correctly on the implants. And, depending of the age of your dentures, the attachments might be difficult to place, or they can be worn and need to be replaced.
  • Implants – The position and angle of your dental implants are crucial for your dentures to fit correctly. Proper planning is required for accurate placement. This includes a three-dimension CT scan to identify the best location for maximum support. Sufficient bone density is needed for your implants to remain stable.
  • Communication – Close communication is required between the implant surgeon and the restoring dentist to ensure precise placement and comfort. If clear instructions are not provided, either the implants or the denture can be incorrectly placed.

What Can You Do?

If you are experiencing problems with the fit of your denture and dental implants, speak with your dentist and implant surgeon. You can also consider scheduling a second opinion with an experienced implant dentist. He or she will examine your denture and implants to determine the reason for the poor fit.  Further diagnostic studies might be required to identify the cause of the problem and resolve it.

This post is sponsored by Dr. Michael Szarek, a Lowell, MA accredited cosmetic dentist.

When I get dental implants, should I request an immediate denture?


I’m going to have my remaining teeth extracted and get 6 dental implants put in. I need dentures and I am finding that there are more types of dentures than I knew about. It’s good in a way because I am hoping for something that will look half way like natural teeth and that won’t leave me walking around toothless. It is also a little scary because I want to be sure that I make the right choice for dentures. Can you give me information on an immediate denture? What is involved? Should I ask for an immediate denture for my implants? – Robin

Robin – An immediate denture is received on the same day that your natural teeth are extracted, or on the same day you receive dental implants. In advance of the extraction, the denture is made. The denture is crafted based on an impression of your mouth. It will be secured to your dental implants as a form of temporary tooth replacement.

What to Expect with Dental Implants and Immediate Dentures

Diagram of a dental implant bar placed in the bone with a denture hovering over it and ready to be secured to the implants.

Bar-retained implant overdentures

The advantages of an immediate denture are that it will look natural because it is based on impressions of your natural teeth. Of course, you can request a different look for your final prosthesis. Also, the dentures are placed immediately, so you don’t have to go without teeth for any period. Whether it’s a temporary denture or your permanent prosthesis, it will be immediately loaded on your dental implants.

If your immediate denture will be your permanent denture, it will cost more than conventional dentures because it will need to be adjusted as your jawbone shrinks after your teeth are extracted. The denture will need to be refit and relined. It is possible that you will need a new denture altogether. It is wise to receive dental implants because they slow the progression of jawbone shrinkage.

If you need a complete set of dentures, your molar teeth may be extracted before the dentures are made. This will give the extraction site time to heal, and it will help the denture fit better. Sometimes, implant overdentures are recommended, because they can be placed over your remaining natural teeth.

We recommend that you visit a dentist who is experienced in restoring dental implants with dentures and in cosmetic dentistry. The teeth of cosmetic dentures will look natural, and a cosmetic dentist will customize the dentures to match your preferences and facial features. He or she will also thoroughly explain your options for dentures, as well as which options will be most compatible with your needs.

This post is sponsored by Dr. Michael Szarek, a Lowell, MA accredited cosmetic dentist.

Dental Implants and Diabetes


My father is thinking about getting dental implants. My concern is that he is diabetic. Are there any healing issues with the implants for diabetics? – Thanks. Danek

Danek – Diabetes has several effects on overall health that cause many patients to wonder if it’s safe to get dental implants:

  • Affects bone formation
  • Delays wound healing
  • Increases the chances of getting an infection

Dental Implants and Diabetes

Diagram of three phases of dental implants, for information on implants and diabetes from the office of Lowell, MA dentist Dr. Michael Szarek.

Healthy dental implants fuse to the bone

A 2016 study published in the International Journal for Implant Dentistry shows several factors that should be considered for diabetic patients following dental implant surgery:

  • Patients with poorly controlled diabetes have delayed osseointegration (the healing period when implant and bone fuse).
  • Sinus lifts and bone grafting are successful in patients with fairly to well-controlled diabetes.
  •  After one year, the status of the implants is equal in healthy patients and patients with controlled and uncontrolled diabetes.
  • In the long-term, there is an increased risk of periodontal disease in diabetic patients.
  • Within the first six years, the implant survival rate is the same for diabetic patients as it is for healthy patients, but in the long-term (up to 20 years) diabetic patients have a reduced implant survival rate.

Whether implants can be placed for a person with diabetes is determined on a case-by-case basis. In advance of implant surgery, your father’s dentist will review his medical history to determine if he is a candidate for the implants.

The implant dentist will give instructions about how the medication should be taken the day of the surgery.  All patients with diabetes who receive dental implants should be diligent in doing their part to keep diabetes under control. Maintaining well-controlled diabetes is an important factor for the continued success of the dental implants.

Schedule consultations with two to three implant dentists to discuss your father’s medical history and the anticipated outcome for dental implants.

After an oral surgeon places dental implants, a skilled cosmetic dentist restores the implants with lifelike porcelain crowns. No one will be able to distinguish your father’s implants from his natural teeth.

This post is sponsored by accredited cosmetic dentist Dr. Michael Szarek of Lowell, MA.

Losing weight with dentures? 4 ways dental implants help


My husband’s dentist recently recommended dental implants because has been struggling with bad dentures for the past 3 years. We have had many conversations with his dentist. I can’t count how many adjustments, readjustments, regular liners and soft liners have been tried. No matter what his dentist does, either the dentures are too loose or too tight and causing irritation and sores on his gums. Either they slip out or hurt his gums so bad they bleed. He can’t eat right with the dentures so most of the time he either skips meals or eats very lightly. Sometimes he takes the dentures out just to eat. He has lost 30 pounds since he had the dentures and he is not a big guy to start with. What does our dentist need to do to get this right? Are dental implants really the answer? – Flo

Flo – Your husband should consider securing his dentures with dental implants.

How Dental Implants Stabilize Dentures

  • The implants are surgically placed in your jawbone.
  • During the healing period, the fixtures fuse to your bone.
  • Standard implants can be used, or you can choose snap-on dentures, which use two implants and are more affordable. If it’s in your budget, choose implant overdentures with four to six fixtures will provide maximum stability and help the prosthesis feel more like natural teeth.
  • The dentures will rest on the implants, instead of on your husband’s gums, so they will no longer irritate his gums or cause sores. When dentures are stabilized with dental implants, chewing efficiency will improve, so it will be much easier for your husband to eat with dentures.
Diagram of snap-on dentures which are secured by dental implants, for information on stabilizing your dentures from the office of Lowell, MA dentist Dr. Michael Szarek.

Snap-on dentures

You can consider getting a second opinion. It can increase your comfort level in the dentist’s recommendation. Or it might help you determine that you need to switch dentists. Find an experienced implant dentist who is also skilled in cosmetic dentistry. Your husband will get cosmetic dentures that fit well and that are secured to quality implant fixtures. The change will finally give your husband a positive experience with dentures.

This post is sponsored by Lowell, MA dentist Dr. Michael Szarek.