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Advanced cosmetic and general dentistry

Why Do My Dental Implants Hurt When I Chew?

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In August 2020, my dentist finished my full-mouth reconstruction, including five implants, seven crowns, and veneers. Two of the crowns on my natural teeth fell off last week, and I have an infection around three of the five implants. My gums are swollen around the implants, and chewing hurts. My dentist relocated last December, and I cannot find a listing for his new dental office. I am anxious about finding a new dentist to reattach the crowns and worried that I would need to repeat the full-mouth reconstruction. Where do I begin? Thank you. Baldwin from CT

Baldwin,

Thank you for contacting Dr. Szarek’s office.

We are sorry to hear about your stressful experience. You can benefit from an exam and a 3-D CT scan to identify the cause of your discomfort. Also, a skilled restorative dentist can determine why your crowns have fallen off.

What Causes Dental Implants to Hurt When You Chew?

Model of a dental implant, including the crown, abutment, and artificial rootDental implants can hurt when you chew if you have an infection around the implants. Usually, the condition is a form of gum disease that can lead to dental implant failure. Signs and symptoms of infection include:

  • Bad breath or a bad taste in your mouth
  • Bleeding around the implants
  • Difficulty chewing
  • Loose implants
  • Pain, aches, or discomfort around the implant
  • Pus around the implants
  • Red or swollen gums
  • Visible implant threads

Treatment for Infection Around Dental Implants

Depending on the cause and extent of infection around dental implants and the quality of your dental implants, treatment options may include:

  • Antibiotics
  • Antimicrobial therapy
  • Laser therapy for your gums
  • Surgery
  • Implant removal, bone grafting, and implant replacement

Find a Skilled Implant Dentist

Look for dentists with advanced implant and cosmetic dentistry training. Dentists who restore implants but do not perform surgery partner with an oral surgeon or periodontist for implant surgery. Dentists with post-graduate cosmetic dentistry training are skilled at identifying the cause of faulty crowns and restoring dental implants.

We recommend scheduling consultations with two advanced cosmetic dentists to discuss your options.

Lowell, Massachusetts, accredited cosmetic dentist, Dr. Michael Szarek, sponsors this post.

My Tooth Broke at the Gumline and the Repair Is Unresolved

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Five months ago, my left front tooth broke at the gumline. Although my dentist said he would do an extraction and bridge, he did a root canal on the tooth instead of the extraction. My insurance company will not pay for the bridge because I have other missing teeth and one that requires extraction, so really, a bridge will not work. My dentist said he would give me a refund if I signed a waiver to agree that he is not responsible if I have problems with the tooth that broke at the gumline. I am wearing a poor-fitting partial flipper and waiting for a solution for the damaged tooth. My dentist wants me to pay for the flipper without telling me about the final solution. I do not think it is fair to ask me to sign a waiver. Should I accept the loss and go into debt for a dental implant? – Thank you. Tyrone  from Kansas City

Tyrone,

Your dentist is responsible for starting work that he cannot complete and switching treatment options on you without proper notice. We recommend that you not make any decisions before switching to another dentist. Do not sign a release.

Getting a Refund from Your Dentist

Picture of dental iimplant parts separate and put together

A dental implant can replace a tooth broken at the gumline

You can get a refund from your dentist by contacting these professionals or organizations for help:

  • A lawyer – Consult with a lawyer to understand your options for getting a refund and compensation for your discomfort. Get copies of your dental records before the consultation.
  • A cosmetic dentist – Look for a dentist with advanced cosmetic dentistry training—preferably accredited—to conduct a thorough exam and take x-rays to determine how to restore your teeth. The new dentist will likely be willing to confirm that your dentist’s work on your teeth was faulty. A dental implant is a reliable way to replace your missing teeth. Talk with your new dentist about payment plans or financing to make treatment affordable.
  • Your dental insurance company – Report the issue to your insurance company if it is involved. Your dentist should not receive payment for the care you did not receive.
  • The state dental board – Report the issue. Although your dentist may not receive a reprimand, reporting the problem can help prevent other patients from having a nightmare experience with your dentist.

 

Best wishes for a progressive and thorough resolution.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post

Why Are My New Implant Crowns Beige?

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Last summer, I got three dental implants. In November of 2020, my dentist placed the final implant crowns. I gradually saw the crowns darkening and mentioned it to my dentist. He told me the crowns are white but not stark white and can look different depending on the lighting. The crowns are beige in sunlight, fluorescent light, bright light, and candlelight. The lighting does not matter. And I am trying not to be furious because I mentioned this to my dentist months ago. I am a suspicious person by nature, but when my dentist told me that crown color depends on the lighting, I felt he knew he was at fault. What kind of battle can I expect with a dentist who probably won’t admit he is at fault? – Thanks for your help. Angela T. from MD

Angela,

We understand your disappointment in receiving implant crowns that detract from the time, effort, and money you spent to improve your smile.

Why Are Your New Implant Crowns Discolored?

If your new implant crowns are discolored, it could be due to surface damage, faulty construction, or the composition of the crowns.

  • Faulty construction – If the glazed surface were damaged when the lab tech made your crowns, they would progressively darken.
  • Damage by your dentist – Sometimes, a dentist can grind away the glaze when adjusting the front surfaces to fit your mouth well.
  • Damage during a hygiene appointment – If a dental hygienist uses power cleaning instruments or acidulated fluoride treatment on your teeth, it will damage the glaze. Your crowns will attract stains and darken.
  • Crown composition – Some patients who complain of yellowing crowns or porcelain veneers discover that they have composite—not porcelain restorations. Although most dentists do not misrepresent your treatment, it happens.

Determining Why Your Implant Crowns are Beige

Look for an accredited cosmetic dentist and schedule an appointment for a second opinion. If you cannot find an accredited dentist, look for a dentist with post-graduate cosmetic dentistry training. The dentist will examine your implant crowns to determine why they darkened.

You have good reason to request a refund from your current dentist. But before you ask for a refund, get a second opinion and documentation of the issues with your crowns.

Dr. Michael Szarek, an accredited cosmetic dentist in Lowell, Massachusetts, sponsors this post.

Before and after dental implant photos from Lowell, MA dentist Dr. Szarek

Dr. Szarek beautifully replaced a dark tooth with an implant and crown

Can I Trust My Dentist for a New Implant Crown and Dental Bonding?

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I agreed to extraction and a dental implant after three failed root canals on my top left first molar tooth. But I also have brown fluoride stains on my teeth. Although, I have never done anything about the stains. I do not want a blotchy brown implant crown to match my stained teeth. In 2018, my dentist bleached my stained teeth and applied dental bonding, but both look bad. Now that I need an implant, I am afraid of how my smile might look. My dentist asked me what I wanted to do about the fluoride stains, but I don’t think I want him doing anything. Neither do I want to see two dentists – my current one for an implant and another to lighten the stains. How can I handle this situation? Thank you. Daniel from Ithaca, NY

 

Thank you for your question, Daniel

Bleaching or Dental Bonding for Brown Fluoride Stains?

Bleaching your teeth does not help with fluoride stains. But neither does direct dental bonding if your dentist doesn’t have advanced training. Dentists apply dental bonding by hand, so you will not get good results unless a dentist has cosmetic dentistry training and an artistic eye to make the bonding look natural.

However, you can find a cosmetic dentist to replace your old dental bonding and hide your stains without making your teeth look pasty or opaque.

Dental Implant Crown to Match Bonding

Dental implant diagram of component, implant fixture in bone, and crown placement

A cosmetic dentist can match dental bonding and implant crowns

If you want your dental implant crown to match your new bonding, it is best to let one skilled cosmetic dentist do all the work. Crown matching requires specific instructions from the dentist to a ceramist. Together, they can ensure your bonding and implant crown match.

Unfortunately, your current dentist has not proven his ability with dental bonding. So, it is unlikely that you would get results if you allowed him to place your implant crown.

Look for accredited or advanced cosmetic dentists in your area. Schedule consultations with two skilled cosmetic dentists to discuss your options. The consultations will increase your comfort in switching dentists for a natural-looking smile that you can feel confident about.

 

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.

Why is my dentist recommending a crown for a healthy tooth?

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Asian woman smiling - for info on dental crowns on healthy teeth from Lowell, MA dentist Dr. SzarekI wonder if my dentist’s business is in a slump, and he is looking for ways to generate income. I’ve had this dentist for four years. He did a root canal on my canine tooth three years ago, and now he says I should consider a crown to prevent the tooth from breaking. I have no symptoms in the tooth, and the x-rays show it is sound. Why would I get a crown? Thank you. Wei from MA

 

Wei,

Thank you for your question.

Does a Front Root Canal Tooth Need a Crown?

A front tooth with a root canal does not need a crown unless it is weak or is already missing most of its structure. Sometimes, a dentist will place a crown for aesthetic reasons, but an advanced cosmetic dentist might use another option to improve the tooth’s appearance.

How Does Root Canal Affect a Front Tooth?

Root canal treatment removes tooth infection, but it also makes any tooth more brittle. Although it is easy to crown the tooth, more care is needed with a front tooth.

Canine Teeth and Root Canal Treatment

Preparing a canine tooth for a crown requires a dentist to remove about one millimeter of structure all around the tooth. About 50% of the tooth’s fracture resistance will be left. If the tooth weakens over time, it can break and create the need for a dental implant.

Canine teeth have long roots to absorb intense horizontal stress to protect back teeth. So, grinding down a canine tooth for a crown is not advisable when the tooth is in reasonably good condition.

Your dentist’s exam and x-rays show that your canine tooth is sound. So, we recommend not accepting a dental crown. You can ask your dentist for more information on why he recommends a crown if the tooth is in good condition. But based on the information you provided, we would not disturb the tooth and weaken it without good reason.

You may choose to get a second opinion from a nearby accredited cosmetic dentist.

 

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.