Why Does My Face Look Different After All-on-4 Dental Implants?

Since having All-on-4 dental implant surgery at a large implant chain, I’ve noticed changes in my face. My cheeks are more sunken, my skin seems to sag, and my upper lip turns downward. The area below my eyes looks hollow, the distance between my nose and upper lip seems longer, and one nostril has partially collapsed. The changes were not gradual. I noticed them after the surgery. The doctors haven’t explained what may have happened. Could the implant surgery have caused these changes, and if so, how? – Thanks. Himari from NY

Himari,

While we can’t reach conclusions without an examination, the concerns you described with your All-on-4 implant-supported denture deserve careful attention.

Dental treatment affects far more than teeth alone. Restoring missing teeth also restores support for the lips, cheeks, and lower face. When that support is recreated properly, many patients notice a healthier, fuller, and even more youthful appearance.

Are You Experiencing Facial Collapse?

Implant-supported dentures are generally intended to prevent or correct the facial collapse that often develops after teeth have been missing for many years. They normally restore facial height and provide support that helps fill out the cheeks.

If the denture does not provide enough width or vertical support, facial tissues may appear less supported than expected. That can change facial contours even when the implants themselves are successful.

Could Surgery Have Changed the Nose or Upper Lip?

Preparing the jaw for implant-supported dentures often requires reshaping portions of the bone. In the upper jaw, that bone lies directly beneath the nose.

Although every patient’s anatomy is different, extensive bone reduction in this area could influence the appearance of your upper lip or nose.

How Should You Proceed?

Patients who notice major changes in their appearance should not feel they have to accept the result. An open discussion with the treating practice can help determine whether improvements are possible.

The conversation should include questions such as:

• Can the dentures be redesigned for better cheek support?
• Is the vertical height of the bite appropriate?
• Would a wider smile improve facial fullness?
• Are additional treatment options available to improve facial appearance?

While restoring bone after surgical reduction may not always be straightforward, modifying or remaking the prosthesis may improve your facial support. If you still have questions after a meeting with the treating dentist, get a second opinion from a dentist experienced in implant-supported dentures.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post. Read why many of his patients say he is one of the best dentists in town.

Should I Get a Dental Implant or Try to Save My Tooth with Repeat Root Canal?

Is it worth it to save an upper molar tooth with a repeat root canal, or should I get it removed? – Thanks. Colston from NJ

Colston,

Losing upper molars without replacing them can create long-term problems, even later in life. If upper molars are extracted and left unreplaced, the lower molars can gradually drift upward into the empty space. This can change the way the teeth fit together and affect the bite. Even if that doesn’t happen, chewing may become limited to one side of the mouth, placing extra stress on those teeth and muscles.

For that reason, any discussion about extracting these teeth should also include a plan for replacing them.

How Do Dental Implants Compare with Root Canal Treatment?

If a tooth is savable, then comparing implants with root canal treatment becomes worthwhile. Whenever a healthy tooth can reasonably be preserved, many dentists believe saving the natural tooth is the better choice.

Both treatments have excellent long-term success rates. Modern root canal treatment, particularly when performed by an endodontist using current technology, is very reliable. Dental implants are also highly successful and may have a slightly lower risk of failure. However, if an implant does fail, correcting the problem is usually much more involved, often requiring additional surgery and bone grafting.

Cost is another important consideration. In many cases, a root canal and crown cost about two-thirds as much as an implant and crown.

What Are the Pros and Cons of a Dental Implant vs. a Root Canal?

Choosing between these treatments involves more than looking at success rates alone. Recovery time, cost, and future treatment needs all deserve consideration.

Dental Implant and Crown

• Typically costs about 50% more than a root canal and crown
• Requires at least three months for the implant to fuse with the jawbone before the final crown is placed
• May be slightly more reliable over the long term
• Can be much more complicated and expensive to repair if it fails

Root Canal and Crown

• Generally costs less
• Can often be completed in two or three weeks over several appointments
• Has a small risk of future failure, which could require replacing the tooth with an implant later
• Preserves the natural tooth without placing an artificial fixture into the jawbone

Are Your Teeth Likely to Need Root Canals?

You haven’t mentioned unusual sensitivity or other symptoms that would suggest the your tooth is close to needing root canal treatment. While there is always a small possibility that a tooth receiving a crown could eventually require a root canal, the risk appears low.

Removing healthy teeth simply because they might need root canal treatment in the future is difficult to justify. A more conservative approach would be to place the crowns and monitor the teeth. Even if one or both eventually require root canal treatment—which would be an uncommon outcome—preserving the natural teeth would still offer important advantages over extracting and replacing them with implants.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post. Read why many of his patients say he is the best dentist in town.

Can I Get Low-Cost Dental Implants by Signing for a TV Ad?

I’m a 41-year-old single parent who needs dental implants but can’t afford them. Every consultation I’ve had quoted a price for implants that is completely out of reach financially. Dentures may be my only option, but I’m struggling with the thought of wearing them.

My teeth are affecting my self-esteem. I hide my smile and avoid situations that might draw attention to my teeth. I’ve spent a lot of time searching for grants, assistance programs, or other resources but haven’t had much luck.

I’ve also watched a lot of YouTube videos featuring implant patients and wondered whether some of them received discounted or free treatment in exchange for allowing their cases to be used for advertising. Are programs like that available, or is there another way to get help paying for implants? – Thanks. Felix

Felix,

In most cases, dentists do not provide implant treatment in exchange for promotional or advertising opportunities. Established implant dentists generally receive referrals, reviews, and testimonials from satisfied patients who have paid for treatment. As a result, there is usually little incentive to offer free implant treatment for publicity.

Although the cost of implants can feel overwhelming, there may be ways to reduce the financial burden.

What Are Some More Affordable Options for Dental Implants?

There are several approaches that may help make treatment fit more comfortably within your budget. Not every option is right for every patient, but they are worth discussing with a dentist who can evaluate your specific needs.

Before deciding, it helps to understand that implant treatment can often be customized. Depending on your oral health, goals, and budget, there may be more than one solution available.

• Ask whether a snap-on denture supported by two implants could work for you. This option is often less expensive than replacement teeth attached to four or more implants.
• Find out if mini dental implants are appropriate for your situation. Because they are smaller and easier to place, they can sometimes lower treatment costs.
• Start with a removable denture and plan for implants later. Getting treatment in phases may make it easier to manage financially.

Can Charity Clinics Provide Dental Implants?

In most cases, charity dental programs focus on providing essential dental care rather than implant treatment. If you have lost all your teeth, these programs will often recommend a traditional removable denture.

Removable dentures were considered the standard treatment for many years and still provide a functional solution for many patients. While they may not offer the same stability as implants, they can restore appearance and basic chewing ability at a much lower cost.

 

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post. Read why many of his patients say he is one of the best dentists in town.

Can I Trust a General Dentist to Complete Bone Grafting?

Can I trust a general dentist to complete bone grafting before getting dental implants or do I need a specialist? I’ve had two consultations. The first dentist said he would refer me to a periodontist for bone grafting. The second dentist stated that she has received training in bone grafting and has completed nearly 100 bone grafting cases. I’m unsure whether I need a surgeon for bone grafting. Taylor from SC

Taylor

Yes, many general dentists perform advanced surgical procedures with skill. A dentist who has been placing bone grafts for several years is likely to do quality work. Some general dentists also perform complex treatments, such as sinus lifts or the removal of impacted teeth. Dentists without advanced implant training refer their patients to an oral surgeon or periodontist for bone grafting and dental implant placement.

How Can You Confirm a Dentist’s Implant Training?

When considering dental implant treatment, focus on your dentist’s credentials and continuing education. Reputable programs equip dentists with the knowledge and hands-on experience necessary to handle complex cases safely and effectively. Some respected organizations include:

• American Academy of Implant Dentistry
• Engel Institute
• International Congress of Oral Implantologists
• Misch Implant Institute

A dentist does not have to be an oral surgeon to provide excellent implant care. What counts most is advanced training, ongoing education, and experience with implant procedures.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post. Read why many of his patients say he is one of the best dentists in town.

Why Is My Dental Implant Crown Color Still Off?

Although my dentist replaced the first mismatched implant crown he gave me, the second crown is no better. Twice, I went to the lab my dentist uses for color assessment. However, my dentist attached the crown without assessing the color. He did not even ask my opinion. I thought he was putting the crown on for me to check—not cementing it. It felt as if my jawbone would break because my dentist had trouble attaching the crown to the implant. Well, now the crown is the wrong color, and it hurts. I took my time to choose this dentist, but it doesn’t seem like he is good with crowns. Should I ask for a refund and find a better dentist? Am I wrong to think this is ridiculous? Thank you. Jane from Oregon

Jane,

Your frustration is understandable. Unfortunately, your case shows the difference between dentists who understand aesthetics—creating beautiful dental work—and those who want to fix and get it done.

From your description, it seems your dentist lacks aesthetics training or is not interested in your satisfaction with the work.

What Can You Do If Your Dental Implant Crowns Do Not Match?

If your dentist cannot correct your implant crown color, find a dentist trained in aesthetics and artistic inclination. A skilled cosmetic dentist is your best option for getting predictable results.

A cosmetic dentist would ensure the crown color is correct before cementing it. If the color is off, they will return your crown to the lab to correct it.

When a dentist sends you to the lab for a color check, it is a clue that the dentist is not skilled in matching restorations (e.g., a crown) to your tooth color. Your dentist should be more qualified than the technician and instruct the technician, including notes on color-matching the implant crown to your natural teeth. A cosmetic dentist also sends a shade guide and pictures of your smile to help the lab tech craft an accurate match.

How to Find a Reliable Cosmetic Dentist

We recommend looking for a cosmetic dentist with advanced cosmetic dentistry training. How can you find a trustworthy cosmetic dentist?

• Look for a dentist with extensive post-graduate training in cosmetic dentistry.
• Look at a few cosmetic dentists’ websites to see the quality of their work.
• Then, schedule consultations with two of them, discuss your concerns and decide who you can trust to finish the work.

Rocky Hill, Connecticut, dentist Dr. Thaddeus Michalski sponsors this post. Read how he provides some of the best dental care in Rocky Hill.

 

 

My Implant Crown Doesn’t Match My Teeth

My dentist did my implant crown the wrong color three times. The shade doesn’t match my surrounding teeth. My dentist said the crown was a close match and suggested that I am fortunate that my dental implant is stable after requesting that she redo the crowns. I am dissatisfied with her work and want to switch dentists. Am I at risk of dental implant failure by having the existing crown removed? – Thanks. Nelson from CT

Nelson,

Removing a dental crown by grinding it will not damage the underlying dental implant. However, achieving a perfect color match for a front tooth crown requires meticulous attention to detail and skilled craftsmanship.

Standard shade guides, such as the Vita shade guide, often fail to provide an exact match for front teeth. Shades like A1 and A2, while suitable for back teeth, are inappropriate for the aesthetic demands of a front tooth. Dentists must customize the standard shade to achieve a more precise match by incorporating additional tints and shades.

A common cosmetic dentistry approach involves the following:

• Draw a detailed color map – The dentist will outline areas where additional tints (e.g., pink, yellow, blue) are needed. This map serves as a blueprint for the dental ceramist, who will meticulously apply these tints to the crown to blend seamlessly with the surrounding natural teeth.
• Conduct a try-in – After the initial crown fabrication, the dentist conducts a try-in to assess the color match. Any discrepancies are noted and communicated to the ceramist, who may further adjust the crown.
• Take a picture of the try-in – Digital allows precise visual comparisons and more accurate color corrections.

Only once a perfect color match is achieved is the implant crown permanently cemented.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologists, sponsors this post. Read why his patients think he is the best dentist in Rocky Hill.

Do I Need a CT Scan to Get a Dental Implant?

Do I need a CT scan to replace a front left missing tooth with a dental implant? I’m trying to avoid unnecessary xrays. Also, I had three consultations, and one dentist uses Southern Venturi dental implants, which I have not found on the list of best dental implants. I’m inclined to remove the dentist from my list of providers. Are Southern Venturi implants safe? – Thank you. Kasen

Kasen,

We understand your desire to minimize radiation exposure.

Do You Need a CT Scan to Get a Dental Implant?

A CT scan provides invaluable three-dimensional information about bone density and structure, essential for accurate implant positioning. Many dentists skip CT scans for implant placement and use traditional X-rays. However, placing an implant without a CT scan, especially in the front tooth area where the nasal sinus is close, can lead to complications such as implant penetration or the need for shorter, less stable implants.

Which Dental Implant Brands Should You Choose?

When selecting an implant brand, the focus should be on quality control and manufacturing precision. While finding replacement parts or adjusting is a concern, the primary goal is to prevent implant failure.

We recommend avoiding lesser-known brands like Southern Venturi. Leading implant manufacturers known for their high-quality products include Straumann, Nobel Biocare, 3i, BioHorizons, Zimmer, and Astrotech. Some experts have reservations about Bicon implants.

It is crucial to choose an implant dentist who prioritizes implant quality and is knowledgeable about the options. A cheaper implant brand can compromise the long-term success of the procedure.

Look for an implant dentist with credentials (fellowship, diplomate status, or accreditation) from the International Congress of Oral Implantologists or the American Board of Oral Implantology.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologists, sponsors this post. Find out what Dr. Michalski does to provide some of the best dental care in Rocky Hill.

 

Is It Too Late for Dental Implants If I’ve Worn Dentures for 17 Years?

Is it too late for dental implants if I’ve worn dentures for 17 years? What can I expect from the procedure? Thanks. Lucas

 

Lucas,

Wearing dentures for years will not prevent you from getting implant dentures.

Can You Get Dentures After Wearing Dental Implants for Years?

You can get dental implants after wearing dentures for decades. However, the longer you wear dentures, the more complex your dental implant procedure will become. When all your teeth are missing, they can no longer stimulate and preserve your jawbone. As the jawbone shrinks, your facial muscles will begin to sag.

Getting dental implants often requires bone grafting procedures to ensure they have enough support. Your dentist or oral surgeon may use bone harvested from your body, such as the hip, or the dentist may recommend donor, bovine, or artificial bone.

The All-on-4 or All-on-6 procedure is an alternative to bone grafting. The procedure angles the rear implants in the jawbone to help prevent displacement.

We recommend consulting a skilled implant dentist with post-graduate training in implantology. Otherwise, a dentist with implant denture experience can refer you to an oral surgeon. Ensure that you visit the dentist before the oral surgeon. They can coordinate your care so the dentist provides dentures that fit your mouth and bite. The surgeon will use a surgical guide to place the implants based on the dentist’s plans for your denture placement. After an exam and CT scan, the surgeon will explain your implants and bone grafting options.

Your implant dentures will be stable and look and feel more like natural teeth.

Rocky Hill, CT, dentist Dr. Thaddeus Michalski sponsors this post.

 

My New Partial Denture Burns My Tongue

My tongue has been burning since I got a new partial denture last November. It burns beneath my tongue and on my lips. I also have bad taste. My dentist suspects a metal allergy and recommends a $4,500 bridge instead. He also gave me liquid lidocaine to numb my mouth. I know that’s not a solution, but I wanted to describe what’s happening completely. Is a dental bridge my only alternative? – Thank you. Sona from IL

 

Sona

You’re right. Liquid lidocaine is not a solution to the burning sensation on your tongue and lips. We are concerned with your dentist’s diagnosis and treatment options.

A skilled dentist knows the alternatives to a metal-based partial dentist. One option is the Valplast partial.

What Is a Valplast Partial Denture?

A Valplast partial denture is a denture with a thermoplastic resin framework. Thermoplastic resin is stronger and more flexible than acrylic. It may be a tooth replacement solution if you are allergic to metal-based dental restorations. Although we are unaware of allergic reactions to Valplast, it is not impossible to be allergic to it.

Ask your dentist whether you can benefit from a Valplast partial denture or another thermoplastic resin denture.

What If You’re Allergic to Your Partial Denture?

If you suspect a reaction to your partial denture, we recommend testing from an allergist. Ask your dentist about the metal content of your existing denture and the contents of alternative partial dentures, including acrylic. Nickel in dental materials is the most common allergen. Test results from the allergist can help you find a biocompatible solution.

If your dentist cannot recommend a non-metal partial denture, schedule a second opinion with an advanced cosmetic dentist to discuss your options. A dental bridge should not be necessary. Also, a bridge requires work on teeth adjacent to the missing one. Although it costs more, a dental implant is a healthier, long-lasting solution for a missing tooth. Nevertheless, a cosmetic dentist can explain your tooth replacement options after allergy testing.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologists, sponsors this post.

Why Do My New Dental Crowns Still Hurt?

In September, I had two upper left crowns replaced. I wore temporary crowns for almost four weeks while waiting for the final one. As I wore the temporary crowns, they started to smell, leave a bitter taste in my mouth, and become painful. My dentist said that the new crowns would resolve the issues. The pain increased after I received my final crowns. When I returned to the dentist, he said my bite was probably off. He drilled to correct my bite, but now that pain comes and goes. It hurts to chew and bite down on the left side of my mouth. I am afraid that I have tooth infections and will need dental implants if I continue to let my dentist experiment on my teeth. What can I do? Thanks. Oakley

 

Oakley,

Almost four weeks is a long time to wear temporary crowns. We understand that your experience is frustrating. Although you need an exam and X-ray to determine the cause of your discomfort, we will discuss some causes of problems with temporary and permanent crowns.

Pain and Odor with Temporary Crowns

If your temporary crowns begin to smell and hurt, microscopic particles are trapped between the crowns and your teeth and breed bacteria. The bacteria affect the dentin (the layer beneath tooth enamel) and irritate it. The tooth beneath a crown can begin to decay.

Why Do Your New Dental Crowns Hurt?

Dental cement that bonds a new crown can irritate your tooth. If a tooth is already sensitive, the sensitivity may temporarily increase but gradually decrease and go away. When sensitivity does not improve, the tooth may be infected. Your dentist might need to perform root canal treatment on the tooth.

Pain When Biting with a New Crown

If you feel pain when biting or chewing with a new crown, your dentist should adjust your bite until you are comfortable. Even tooth ligaments are sometimes irritated, and your dentist would need to x-ray the roots to see their condition.

If your dentist cannot resolve sensitivity with your new crowns, we recommend that you get a second opinion to prevent the need for dental implants.

 

Rocky Hill, Connecticut, cosmetic dentist Dr. Thaddeus Michalski sponsors this post.