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Missing a Tooth? You Have Options!

Missing a tooth?

Can I Have New Teeth on The Same Day That I Lose My Teeth?

This question may rank as one of the most sought after requests that I receive.
There are very few people to whom this point does not matter.
Going around missing a tooth is not something that most people want to do.

However, we have to qualify precisely in which situations this is relevant.
It is also true that most people do not mind walking around with a missing tooth.
Didn’t I just contradict myself?
First I said that patients do not want to be seen without a tooth, and then I followed with the opposite statement.

Let us look at these two comments and allow me to explain how they are not contradictory.

When people don’t mind missing a tooth

Let’s start and deal with the second statement.
What do I mean by “most people do not mind walking around with a missing tooth?”
With this latter statement, I am referring to our molars or chewing teeth.
In fact, I have found, not only do people not mind missing these teeth for a short period, but they don’t mind losing a tooth and not replacing it for years!

This is despite the fact that their chewing is either impaired or altered.
To chew food efficiently, they may need to favor one side. Alternatively, the person may spend a long time chewing their food before it is ready to be swallowed.

What’s the big deal? No one can tell!

The rationale for not replacing the tooth follows the thought that eating at some level can still be done. After all, there are still other teeth!
Imagine if we would apply that logic to a finger. One could say, “the loss of a finger would not be so bad as I have nine others.”
Of course, we would never say this but with teeth, since the function is not eliminated entirely and “nobody sees my space,” then what is the big deal?

When it comes to missing a tooth, many put appearance over function

I just touched upon the point which explains my first statement regarding people not wanting to walk around toothless.

Losing a tooth that is obvious to everyone around me is a big deal. In fact, this could affect chewing even less than a back tooth.

The deal breaker is the embarrassment. Walking around missing a tooth that everyone can see, bothers most people.

I remember walking into a store one time and seeing the regular employees walking around with a surgical mask on her face. I thought that she was ill and was contagious.

Being the friendly fellow that I am, I asked if she was okay. She replied that she felt well. Oh… the reason for the mask was that her front tooth broke and she was embarrassed about her appearance.

This is like the old real estate dictum.
As the saying goes, the three most important things in real estate are Location, Location, and Location.

Well, the same applies to losing a tooth in the minds of most people. Our appearance to our friends and neighbors is more important than the loss of chewing function.

With today’s modern dentistry, being toothless is a thing of the past.

I’m not going to focus on the two sides of this discussion.

I want to point out and say that with modern materials, computers and skill of the dentist, being toothless is a thing of the past.
I can either actually create a duplicate of a tooth, that is removed, at the same time that I remove it.
Today, I can also use digital impressions, photographs, and x-rays to convey information to my laboratory to allow them to create a
duplicate of our removed tooth.
This procedure applies to front teeth as well as it pertains to back teeth.
It is applicable when I am doing a permanent bridge to replace a tooth or teeth, or when I am making a removable bridge to replace a tooth or teeth.
This applies to when I remove all of your teeth and make a denture or when I may give you teeth supported on implants.

The point is, with today’s modern dental technologies and techniques, you don’t have to live with missing a tooth.

Whether your concern is appearance, functionality or both, you have options and we can help you!

My goal is to give you options and hope!

If you need to lose a tooth or teeth and are worried about the potential embarrassment, please call me and let’s talk.
My goal is to give you options, and as many people say to me, give you hope.
We can discuss various paths to follow. With your help and input, we can fine tune those options to deliver what you need and what you want.
I can be reached at 440.951.7856. Just call Megan and ask to speak to me or make an appointment for a complimentary consultation.
I look forward to hearing from you.

 

Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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Adjusting to Life With Invisalign® – Week 2

Invisalign Lower Aligner - Blue background

Continuing to chronicle my Invisalign journey from a dentist’s perspective, this week we discuss how I’m adjusting to life with Invisalign®

Week 2

Well, I just finished my second week, and it was a lot less eventful than my first.

Learning to place my aligners correctly

I learned how to set the aligners in my mouth without grabbing my lips or cheeks!

The lower set was more of an issue for me as the bottom lip always seemed to wrap forward and get caught in the aligner as I was snapping it into place.
At the same time, the back of the lower aligner would get close to my cheek on both sides. If I wasn’t careful, I would catch my lip and both cheeks at the same time creating a trifecta of sores.

Pro Tip! Using my fingers

I learned to use my fingers to hold back the lips and cheeks and still allow the aligner to seat in to place on my teeth. I needed all of my fingers to multitask.

Being a dentist, this was second nature to me. However, I see how my patients would fight and struggle to learn some of these skills. Some of them never learn those skills and tricks and come in with sores throughout their mouths.

I resolved to make an effort to teach some of these tricks and hacks when I notice sores that are present. Sharing my knowledge of holding back the lips while placing the aligners would really be a nice thing. I’m sure that my patients will appreciate it.

Inspecting the Invisalign® attachments

While I was placing an aligner, I decided to examine the attachments a little closer. One of my lower teeth, the lower right cuspid (eye tooth) had two attachments.
Remember the attachments are the little projections that are bonded to the teeth to help the aligners grip the teeth better and ultimately move the teeth properly.

The attachments are made of tooth-colored filling material and are relatively invisible. At least they are challenging to see.

Great! One of my Invisalign® attachments were missing

So when I looked a little closer, I noticed that only one of the projections was there. That tooth was missing the second attachment. I will assume that it was there and fell off.

The Importance of having two attachments

Whatever the reason the second attachment on that tooth was important. The cuspids have long roots and are difficult to move. This is probably why the Invisalign software that generated the plan placed two attachments. The better the grip, the more predictable the movement.

So I had to go back and have the second attachment replaced on the tooth. This wasn’t a big deal, except for the fact that the device that was used to holding my lips out of the way was really cutting into my upper lip.

After a reasonable amount of time grimacing and wincing, we decided that adding a cotton roll under my lip would help.
This reinforced to me that all retractors are not created equally.
I knew that from my end. Now I know it from the patients’ end as well.

Chronicling how I’m adjusting to life with Invisalign®

I just switched to the third aligner. I’ll see what develops this week.
In the meantime, I’ll just continue chronicling how I’m adjusting to life with Invisalign®.

Stay tuned for my thoughts on week 3 of this Invisalign Patient Experience – Through the Eyes of a Dentist!

 

Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

For any questions about Invisalign®  or any of the other dental procedures performed at The Healthy Smile Dental Center please call Megan at 440.951.7856

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The Invisalign Patient Experience – Through the Eyes of a Dentist

Invisalign Patient Experience

From The Doctor Chair to The Dental Chair – A Unique Perspective

As a dental practitioner administering Invisalign in my practice for nearly 20 years, I know it can be a terrific orthodontic approach to predictably straightening your teeth.
However, I never knew firsthand what an Invisalign patient experience was until now.
Now, as an Invisalign patient myself, I have the unique perspective of knowing what an Invisalign treatment entails from both sides of the equation.
I’m hoping this blog series will help give unique insight and perspective to anyone contemplating this procedure for themselves.

Welcome to The Invisalign Patient Experience – Through the Eyes of a Dentist!

Why Don’t You Practice What You Preach?

When I was in my last year of school, I listened to a physiology lecture from a practicing physician. He was morbidly obese and smoked during the address.
I kept on thinking and wondering. Why wasn’t he picking up and listening to what he was saying?
He knew that his lifestyle was heading him down the road to some serious health problems.
Why didn’t he take his own advice?

Well, some years later, I asked myself the same question.

I had developed a tooth issue which was the result of crowded teeth.
It was more than a tooth issue. It had ramifications to the gum and bone structure around my teeth.

Sure, I am a great brusher and flosser, and disease was less of an issue with me than with other non-dental people.

That being said, I was still beating up certain teeth. I knew that they would begin to chip and crack. The excessive wear was already there. I wanted to stop this.

Crowded lower front teeth

crowded teeth overhead shotI advise my patients all the time about crowded lower front teeth and what happens. I recommend fixing the issue before it becomes a severe problem. I needed to address this in my own mouth.

I finally made time for myself and began orthodontic treatment with Invisalign. As I mentioned earlier, I have used Invisalign treatment in my office for close to 20 years. Now I am on the other end of the treatment so to speak.

I now have aligners (that’s what those plastic things that move your teeth are called) on my top and bottom teeth.

I started to feel what it was like to be sitting in the dental chair, not in the doctor chair.

Sharing my Invisalign patient experience and perspective

So I thought that I would share some of those experiences, feelings, and issues that my patients have.
This time it is coming from a dentist perspective, and I hope to share what is going on and how I cope with those issues.
I hope that this may help some of you who are also going through orthodontic treatment.
For those of you contemplating this treatment, it will give you a glimpse into what lies ahead and how to successfully navigate the path.

Week 1

An appointment for Invisalign® attachments

I have just completed my first week of therapy. Let me tell you how it went for me.
It began last Monday with an appointment in which these little plastic projections were applied to my teeth.
These buttons are designed so the clear plastic aligners effect movement of the teeth.
The size and position of the attachments will control the movements and potentially their timing too.

I sat in the chair and had plastic retractors placed to hold my lips and cheeks away from my teeth.

The technician looked at my teeth and remarked as to how clean my teeth were. I rolled my eyes and thought, “what were you expecting.” Fortunately, I did not verbalize my thoughts.

Applying the Invisalign® attachments

The teeth that had the projections (officially called attachments) were cleaned. They were then dried and bonded in preparation for the attachments.
All of this was done with the cheek retractors in my mouth and cotton stuffed all over to prevent contamination of the teeth with my saliva.
The attachments were connected to the teeth, and I was given my first set of aligners. They snapped into place and really felt weird.

Two facts about wearing the Invisalign® aligners

Invisalign AlignerI knew two essential facts about wearing the aligners.

  1. First of all; wear them all the time except for eating and cleaning of the teeth.
    This should be 22-23 hours a day. They only work when you wear them. Night time wearing alone will not work.
  2. The second fact is never to put them down unless they are in some type of case. The Invisalign aligners are clear and easily lost.

Okay so far so good.

Eating with Invisalign® attachments

A few hours later, I wanted to eat something.

I needed to get these plastic things off of my teeth.

I washed my hands and put my fingers in my mouth trying to find an edge to lift them up.
It is really much easier at first when I am in the dentist role and trying to remove them.
I tried this way and that way until I finally found a spot to start pulling it off. I knew what it felt like to lift an aligner out of the mouth, so I pulled without uneasiness, and it came out.

I spent some time going through the discovery exercise on the other aligner with success.
I ran my tongue over my teeth, and the attachments felt like I found something stuck on my teeth.
I didn’t like that feeling as it was very strange to me.

I then began lunch.

Accidentally biting my lips and cheeks

As I started to chew, my lower left attachment pushed out my lip ever so slightly. This was just enough for me to catch my lip with my upper teeth and bite myself.
I did this once and then again.
I was forced to chew more slowly and deliberately.
This is probably not a bad thing in and of itself.

Of course, once you bite yourself and your lip or cheek swells just a little bit causes you to bite yourself some more.

I can’t tell you how many thousands of times that I have said that to my patients. Now it was more than words. It was a reality to me. I just needed to be more careful.

Putting the aligners back in

Okay, lunch is over.
Time to floss and brush and put the aligners back in.

Firstly I put in the upper set, and that was easy. Just line up the aligner with upper front teeth and snap into place.

The lower set was more of a challenge.
Just when I got it into position and pushed down firmly, my lip folded in and I nailed by the lip.
Ouch!
Of course, now I had a cut and was ready for a mouth sore to develop. Usually, trauma to the lips will result in a sore that takes a few days to heal.
I think that I just discovered a new diet.
Beat yourself up so that eating goes from a pleasure to a negative experience.

The crowning blow came from the inside edge of my lower aligner. I developed a canker sore (a small mouth sore) on the underside of my tongue. So now, not only was eating a pain(literally), so was the simple act of speaking. Every time my tongue moved it sent waves of pain through me.
How many more months do I have to do this?

Stay tuned for my thoughts on week 2 of this Invisalign Patient Experience – Through the Eyes of a Dentist!

 

Jeffrey Gross, DDSFAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

For any questions about Invisalign®  or any of the other dental procedures performed at The Healthy Smile Dental Center please call Megan at 440.951.7856

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Dental Anesthesia: Its Not Just Shots Anymore!

 dentist with dental anesthesia needle

I Hate Shots. I Wish That You Would Have Something Else!

Many years ago, just the opposite was stated. Dental anesthesia simply didn’t exist! There was really nothing to numb or deaden a tooth so it could be treated. The first local anesthetic used was actually cocaine. It worked but of course, it was addictive and toxic. It wasn’t until the beginning of the last century that our famous Novocaine came on the scene. In fact, it was so popular that many people today use the word to mean a local anesthetic.

Pain-free dentistry is now a reality!

We really don’t use Novocaine anymore in dentistry as it has been replaced by better anesthetics with fewer side issues. These newer products give better numbing, which we call “anesthesia” and work quicker. It would be an understatement to say that local anesthetic has revolutionized dental care. We can now perform a variety of procedures, whether simple or sophisticated with the patient being totally pain-free.

Before local anesthetic, the only treatment available was the removal of a troublesome tooth and of course was not a pleasant experience for any one. The ability to numb a tooth has led to more people keeping teeth for their entire lives, rather than being toothless in their twenties. So that’s great! We can do a dental procedure in a pain-free environment using a local anesthetic. The problem with this from the patient perspective is how we have to administer it. Of course, I am referring to the dreaded shot.

What is dental anesthetics?

Let’s talk a little about this. The method of action of a local anesthetic is to bathe the nerves that transmit sensation from the tooth to the brain in this numbing liquid. When the nerves come in contact with the solution they shut down and no longer do their job of sending a pain signal. This closed for lunch sign is effective until the anesthetic leaves the area of the nerve and sensation comes back to the tooth.

Different locations of the mouth have different requirements for giving the anesthetic. For the upper teeth, it is given one way. For the lower teeth, it is given another way. The upper jaw is much more porous than the lower jaw. Therefore, simply placing the anesthetic under the gum next to an upper tooth will cause the tooth to numb. The lower jaw is much denser and if you put anesthetic next to a tooth it will not penetrate the jaw and reach the nerves of the tooth. To numb a lower tooth, you have to find the nerve that supplies the entire side of the mouth and numb that. That is why we numb the back of the mouth when we work on lower teeth even though we may be working more towards the front of the mouth.

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Did you know? There is now a nasal spray dental anesthetic!

The human body is a marvel of complication, sophistication, and crossovers when it comes to its various parts. Because of this, we now can actually numb many upper teeth without a shot. Yes, that is not a typo! We DO NOT need a shot for a number of upper teeth. Just last year the FDA approved a product called Kovanaze for use in dentistry for upper teeth. The product is a nasal spray that is given prior to performing dental work. It can numb the upper front teeth without the side effect of numbing the lips and cheeks. It is not for all teeth, but one of the most sensitive injections is in the front of the mouth. With this nasal spray anesthetic, those days are history.

Topical dental anesthetic for pain-free cleanings

Many people are sensitive to having their teeth cleaned. Because of this, they skip their very important dental cleanings and checkups and only come when it is too late. I use another product which can be squirted around a tooth without the use of a needle to numb the area. This can make your cleaning totally pain free.

Unlike the nasal spray, I can use this any place in the mouth. It doesn’t make a difference if it is an upper tooth with its porous jaw or a lower tooth with a dense jaw. This product simply works without having to use a shot. This product is called Oraqix (pronounced Ora-Kicks) and I have used it for a number of years to make routine procedures more comfortable and easier. When you are at ease, our work goes faster and is done much better. It is a win-win for all involved.

Today, Dental Anesthesia does not have to mean shots

So although needles have not left medicine, and dentistry, in particular, there are a number of innovations that work towards my goal in interacting with my patients. That goal is providing the best care with the most comfort. Needle free anesthesia is an example of that approach and desire. If these or other dental topics are intriguing and you want to learn more about new techniques and products, please call me. I can be reached at 440.951.7856 and look forward to hearing from you.

One of the best ways to learn about the latest in dental care is to register and attend my next educational seminar which is open to the public. It will take place on Thursday, August 24, 2017. It will be at my office on Lakeshore Boulevard at 6:00 PM. Call our office to register.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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Cracked or Chipped Tooth Restoration Concerns

 

Cracked tooth restoration patient grimacing

When one’s tooth is in need of repair it’s interesting to see how as doctor & patient, we each have different concerns when faced with a cracked/chipped tooth restoration procedure.

I’m Leaving Town Next Week. What Can You Do For My Broken Front Tooth?

This was asked to me by a patient that I have been privileged to serve for 38 years. Yes, we know each other very well and I am proud to say that she has all of her teeth. This is the result of she and I working together to maintain her oral health.

Her particular dilemma last week was that she was going away for a few weeks and her front tooth had fractured. She thought that time was the biggest issue in this case. “How will you get this done in time?” I had some other concerns. Let’s talk about her anxiety and later on my thoughts and worries on the matter.

Dental treatment and Tooth Restoration repair times

At times, certain types of dental treatment can take a long time to accomplish. If I can fix something in the office, then I am usually done in one visit.
Problems of time develop when I need to collaborate with one of my dental treatment partners. Most notably, this is the dental laboratory One of the biggest things that slow us down can be laboratory time to make a dental replacement. Tooth restoration could involve crafting a crown, a denture or a variety of other dental devices that are custom made for your mouth. They could require a multitude of visits, impressions, phone calls and emails to the lab. This just slows everything down.

However, new digital technology can speed up a number of procedures and make long waits not relevant to many cases. They are not for everyone and every situation but when we can use them, they are fantastic.
This was actually the case with my patient. We were able to use a special type of metal-free material and in just a few days get our final beautiful result.

A temporary and permanent solution

In the office, I tended to her needs and immediately began to fix her broken front tooth. With new in-office materials, I was able to obtain an acceptable temporary result before she left.
The final, long lasting and highly aesthetic result needed my dental laboratory’s involvement. We chose a type of very cosmetic crown which can be made in a day.
It turns out, that time, which she thought was a major issue, was really not a concern at all. Her new front tooth came back from the lab in plenty of time for her to catch her flight.

Smiling Couple - Dental Implant Seminar

What I as a cosmetic dentist worries about when repairing a front tooth

I began this column with the comment that I had other concerns besides the time factor. My biggest worry was due to the fact that we were dealing with one of her smile teeth. Let me rephrase that. We were dealing with her very front teeth.

Matching a front tooth to its ‘twin’

One of the hardest things to do in dentistry from a cosmetic standpoint is matching a front tooth to its paired tooth. What do I mean by a “paired tooth”? Let’s draw an imaginary line right through the center of our nose in a vertical direction. Half of our teeth are on the right side of this line and half of the teeth are on the right side of this line. We call this line, the “midline”. All of our front teeth have a pair or a twin. One of these teeth is on the left side of the midline and one is on the right side of the midline. These two sides meet smack dab in the center. Our large front teeth, which we call central incisors are right next to each other.

When we need to fix one of them, the slightest difference between them in color or shape will be very noticeable. This is because this tooth’s partner or twin is right next to it. We spend a lot of time brushing our front teeth and see this pair of teeth the most. Matching them can be a real challenge. Sometimes, we are forced to treat both teeth in an effort to create a stunning result.

Both our concerns resolved to our mutual satisfaction

When I finally tried in her new front tooth, she said that I had a twinkle in my eye and a smile on my face. She knew that I had successfully dealt with my concern. I had created a natural look that both she and I were proud of.

The longer that I practice and see new innovations in the field, the happier I am for my patients. Dentistry can offer so many solutions to problems of the past.

If you have a cosmetic or tooth restoration concern, don’t hesitate to educate yourself. Call your dentist or call me, and let’s talk about your issues. I can be reached at 440.951.7856 and look forward to speaking to you.

One last thought.
I will be conducting another educational seminar which is open to the public on Thursday, August 24, 2017. Watch this column for more information, click here to register online or call us to register over the phone.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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Am I a Good Candidate for Mini-Implants?

Older couple smiling - mini dental Implants

Mini-Implants – A Magic Bullet?

There was a folk song that was popular many years ago that was entitled “If I Had A Hammer”. The lyrics began with “If I had a hammer, I’d hammer in the morning, I’d hammer in the evening, All over this land….” I thought of this song as I saw an ad in the paper for the use of mini-implants. The ad seemed to imply that instead of using conventional (whatever that may mean) implants, anyone can use mini-implants and get all the same results. The commercial said that these mini-implants were easier to place, took less time, involved faster healing, and were half the cost. It would seem anyone is a good candidate for mini-implants.

Sounds great right? Unfortunately, mini-implants are not the magic bullet some make them out to be. Let’s take a few minutes to learn together about this subject and why not just anyone is a good candidate for mini-implants.

What are Mini-Implants?

Mini-Implants are pretty self-descriptive. They are miniature versions of their big brother – traditional dental implants.

We all like small. We like items to be petite. Our phones have become miniature computers. There is even a brand of car that is becoming more popular call the Mini Cooper. In an era of super-sizing, being smaller and more compact is still a very positive attribute to have.

So it sounds like smaller, miniature implants are the new and improved implant. We have moved forward to this compact era. I can use a mini-implant wherever I previously used a conventional implant. Just like the song says: I would hammer in the morning…….” I would use my hammer everywhere and all the time.

Size – The Biggest Advantage and Disadvantage of Mini-Implants

The ad went on to say that healing is faster and the teeth can go in faster and the results are immediate. We all want this. Right? As with many things in life, if something was really true then everyone would be doing that thing. We need to talk about this.
The biggest advantage to mini-implants is their size. The biggest disadvantage to mini-implants is their size! That’s right, the best thing about them is actually the worst thing about them.

Implants serve as a foundation for teeth in the mouth

Many years ago a wise oral surgeon told me that he always over-engineered his implant cases. He used the biggest and most implants wherever he possibly could. The reason was very simple. Implants serve as a foundation for teeth in the mouth.

When we build a house, for example, do you ever hear that the contractor uses mini-supports? Where we need to use studs every sixteen inches, do we put them every three feet? Of course not. We need to construct a structure that is solid and will endure the weight and other forces that may be put on it.

So I will ask you: Why do we think that we can skimp on support for teeth? We chew meat….we chew bread…we chew nuts. These and many other foods put many heavy forces on our teeth. We need support. We have at least twenty-eight teeth. Why do we need so many? Let us develop a few big teeth on some small roots and that’s it. These mini roots would make it easier to brush and floss. Our dental cleanings would go faster as there are fewer and smaller roots to develop tartar to clean.

The answer is obvious. It wouldn’t work. From a structural standpoint, it is faulty. We need enough teeth and large enough roots to handle all the forces of chewing. People with a full compliment of teeth and a healthy supporting gums and bone can exert the greatest biting forces. These forces are needed to properly eat our food and allow us to be nutritionally fit.

Where the greater force is exerted, the greater the support needed

Where we have the greatest forces, we need the biggest implants to support these tremendous forces. Back teeth is NOT an area where we use mini-implants. The biting and chewing forces of our large molars will overload a miniature implant. You can’t put a top-heavy crown on a little tiny implant and expect the support to last. This will overload the situation and cause the implant to fail. I have written extensively on how detrimental to natural teeth excessive biting and grinding can be.  In the case of an undersized implant, even normal biting is too much!

Where mini-implants are best used

So, after all, is said and done, where would I use a mini-implant? Who is a good candidate for mini-implants?
I have used them for years, but the need to pick and choose the right candidate for mini-implants is important. I would not “use my hammer to hammer all over the land”.

Mini-Implants are best used to support a denture that already has a reduced biting force. It should bite against another denture, not against natural teeth. This will produce excessive forces for the mini-implant. Because they are smaller in diameter, one needs more of them to support a denture. Where I could use 2 normal size implants, with mini-implants, I need at least double that.

You still need to evaluate the patient and the remaining bone to place these properly. I have seen too many inexperienced dentists place mini-implants in the wrong area or missed the bone because they used shortcuts in their techniques. When I teach my students, I emphasize proper preparation before ever beginning any treatment.

So yes, mini-implants are a valuable adjunct to all the other tools and techniques that I have. Proper preparation and planning are crucial as with all things in life. If you ever wondered if you are a good candidate for mini-implants or any other type of implant, please call me at 440.951.7856. I will be more than happy to talk to you and advise you to the best of my ability. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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