December 2020 - Dr. Rick Lane

Most people are surprised when I tell them that I was born without a tooth. Specifically, I don’t have a #7 incisor. Also, my #10 incisor is deformed and sits back further than the others. Do you have any recommendations on dental treatments for me? When I was growing up, my parents didn’t have the money to do anything. Now, that I’m older I want to stop hiding my smile. Should I be looking for a cosmetic dentist at this point? I have been doing some research and am thinking that is the best option for me.

-Kara in California

Kara,

Thank you for reaching out. Of course you are interested in getting these issues addressed. Everyone deserves to feel confident when they smile. From what you have described, I don’t believe there is any reason to believe that the teeth surrounding your missing tooth are not healthy. So, as long as that is the case, you are probably going to be happiest with a dental implant to replace that missing tooth. Dental implants look, feel and function just like natural teeth. They are a permanent solution to missing teeth.The implant post is surgically implanted into the bone and then a porcelain crown is placed over top of the implant.

Now, if for some reason the teeth that surround the missing tooth aren’t in good shape, you may be a candidate for a dental bridge. A bridge is less expensive than a dental implant. However, the two teeth that surround the missing tooth will be required to be ground down and prepared for porcelain crowns. This is because the surrounding teeth are what will support the false tooth that will fill the gap where your missing tooth currently sits. A bridge can still be an option for you, but it would be a shame to do such an invasive treatment on the surrounding healthy teeth.

Here is an illustration of how a porcelain crown fits over top of a prepared tooth.

For the tooth that is deformed, you have a couple options. A porcelain veneer may work for you. This cosmetic dentistry treatment is placed on the surface of the tooth. It will depend on the severity of the deformity as to whether or not the porcelain veneer will look right. The other option is a porcelain crown for the deformed tooth. The natural tooth is prepared by grinding it down to prepare it like a seat for the porcelain crown to fit over top of the tooth. Again, this all depends on the shape of your tooth. So it is difficult to give you specific recommendations without having seen you in person. But, the good news is that you have options.

The best case scenario for you would be to find the best cosmetic dentist in your area that also is skilled at dental implants. Both implant dentistry and cosmetic dentistry require extensive training beyond dental school. However, neither of them is considered a specialty area within dentistry. So, when you are looking for the right dentist, ask to have a consultation, learn more about their credentials and ask to see a portfolio of their work. Ask them each of them if they have treated patients in similar situations as yours to figure out the right dentist for you.

There will be some technical skill required to get the dental implant to match the porcelain veneer or crown perfectly. This is because it requires a thorough understanding of coloration and bonding techniques. Also, the veneer and crown are made much differently in the laboratory or ceramist. The bottom line is that an excellent dentist will be able to match them just right. But it is also important to realize that cosmetic dentistry is like an art. Less than 2% of dentists actually have the skill or passion for aesthetics to be considered a true cosmetic dentist. It may require you to meet with a several dentists and to get a second or even a third opinion before committing.

Thank you for reaching out with your questions. Hopefully, this information is helpful to you and will also help others who are looking to address similar dental issues.

This post is sponsored by Petaluma dentist Rick Lane, DDS.

I am seriously considering getting my dental implants done at a Clear Choice Dental Implant Center. But, after much research, I’m starting to second guess myself. My general feeling is that in the past there were some concerns from reputable implant dentists about how they provide treatment. However, my main question is do you think things have improved in the last couple years? I am not finding as many concerns recently. So, I’m hoping you will be candid and give me your honest feedback.

-Thomas in New York

Thomas,

Thank you for reaching out. It is encouraging that it sounds like you are doing your due diligence and taking the time to determine if Clear Choice is the right choice for you. Far too many people move forward without taking this important step. So for starters, kudos to you for reaching out and doing your own research.

Overall, it is relatively common that the sales philosophy of Clear Choice has remained consistent over the years. That said, each location in varying states will differ somewhat. But Clear Choice Dental Centers as a whole follow a similar philosophy when it comes to dental implants.

Most of the centers use highly-qualified surgeons and prosthodontists. Their prices tend to be higher for that reason and they have a reputation for high pressure in their sales tactics. Generally speaking, they recommend extracting all the teeth, whereas an independent implant dentist may opt to salvage as many natural teeth as possible. Then, when they get you onboard to remove the remaining teeth, they will recommend using the all-on-4 dental implants procedure.

Now, you haven’t shared what your individual treatment plan is with your local Clear Choice center. But maybe you can determine if these comments resonate with your personal experience or not.

Dentistry is not a one-size-fits-all industry. Every case is different and most implant dentists will customize their approach for the individual patient. But, it seems like the existing Clear Choice approach works well for them and they do a lot of business.

The absolute best thing you can do for yourself is to get a second opinion. As a general rule of thumb, whenever you have a major dental procedure, it is wise to get another opinion. Dentists have different opinions and perspectives. So when it comes to such an important and expensive procedure like dental implants, you will want to compare the dentists by who you can trust versus what the price tag ends up being.

If you decide to get a second opinion, try to find a dentist with credentials with the International Congress of Oral Implantologists. Or another reputable organization is the American Board of Oral Implantology. If an implant dentist is affiliated with either or both of these organizations, that is a promising sign.

Then, after you get a second opinion, if you feel confident that Clear Choice is going to provide you with the best care, then there is nothing wrong with that. You have done your due diligence and can be confident in your decision. But, I have a hunch that if you genuinely find a local surgeon or implant dentist who is affiliated with one of these prestigious organizations, you may end up happier with their fees and the overall treatment plan. You’ve asked for an upfront, honest opinion and based on my experience, there you have it.

In closing, here’s another thing to think about. They have had some negative public relations in years past. For example, I have been made aware of negative Clear Choice experiences by multiple patients that have had issues with their care. But, there aren’t as many of those out there anymore in the public and I have to wonder if patients at some of these locations are required to sign something that may deter them from sharing anything negative.

It sure makes me wonder. Anyway, hopefully this will be helpful to you as you consider next steps. There is never anything wrong with seeking a second opinion, which I cannot stress enough.

Thank you for your question.

This post is sponsored by Petaluma implant dentist Dr. Rick Lane.

I’m missing a tooth and have one deformed tooth.

Is Clear Choice a good place for dental implants?

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