"I'll just replace the tooth when I get insurance."

I hear this quite often, and it sometimes leads to a more expensive tooth replacement. Even if you have a bone graft at the time of a tooth removal, bone will tend to be lost over time. Often this necessitates another bone graft prior to implant placement. The best time to get an implant is at the time of the tooth removal if possible. The second best time is a few months after the tooth was removed and a bone graft placed. Too often when people put off tooth replacement, months turn into years, and the replacement becomes more complex than it had to be. An implant is an investment in yourself, why not enjoy the benefits of it for the maximum amount of time and possibly save money in the long run?

"My gums have receded, and my dentist wants to cover my exposed roots with white fillings."

If there is decay on a root surface, it will need a filling to stop and prevent further decay. Placing white fillings over root surfaces for aesthetic reasons though is sometimes a bad idea. If the objection is gum recession, why not cover the exposed root with gum tissue? This is generally the best option, as it prevents further recession, reduces sensitivity, and looks more natural. Once a filling has been placed on a root surface, it is more difficult to get a gum graft to adhere. Before you get a root filling, see a periodontist for a consultation. He can tell you if there is a better alternative. 

"But my cousin had a lot of pain after her implant was placed and it ultimately failed."

I hear this from a patient occasionally, and it is very disheartening, because implant placement generally is not accompanied by severe pain. As a matter of fact, when a patient tells me that they experienced significant pain following implant placement, I suspect that something isn't right, and the implant may be infected. This is really a very rare occurrence. Implant success rates are in the 95-98% range. You would be hard pressed to find another procedure in medicine or dentistry that has that kind of predictability. Keep in mind that you likely have many friends and relatives who have implants that are doing well, and who had a good experience with their implant procedure. People are much more likely to voice their dissatisfaction when something doesn't go well than to brag about a procedure that they underwent in which everything went perfectly. That's just human nature. I tell my patients to expect some soreness following implant placement that may last 2-3 days. Anything worse than that, and I want to hear from them, because something isn't right. Fortunately, I rarely do have patients call to complain of unusual discomfort following implant procedures, and that's because implant placement really is a predictable and comfortable procedure in the vast majority of cases. 

Don't lose your benefits!

Most insurance plans start on January 1st and end on December 31st. If you've been delaying treatment, it's now or never to use your remaining benefits for this year. Even if you don't do all of your treatment this year, do what you can to lessen your out of pocket expenses next year. The Holidays are also a good time to recover from surgical treatment without having to use vacation or sick days. Time is growing short. 

What should gums look like?

Well, that really depends. In general, red is bad, but it's not that simple. There are many kinds of gum disease, and they all manifest themselves differently. You really can't tell how healthy gums are just by looking. Periodontists take many different measurements to determine gum health. They also note swelling, bleeding, puss, ulceration, and other factors to come up with a diagnosis. In some instances, a biopsy of the gum tissue is necessary to obtain an accurate diagnosis so that the prescribed treatment will be successful. A regular examination is the best way to know how healthy your gums are, and, like most other things, prevention is the best treatment. 

How long can I wait after losing a tooth to get a dental implant?

I get asked this question quite a bit, and the truth is that every situation is different. The one certainty is that sooner is better once the tooth socket has healed. In fact, often the best time to get an implant is the day that the tooth is removed. Implants and bone grafts tend to preserve the bone contours of your jaw. When you lose a tooth and the area is allowed to heal naturally, some of the bone is generally lost, and that can compromise the ability to replace the tooth with an implant or to place the implant in the best position possible to allow for a more natural look to the implant crown.  I generally recommend a bone graft at the time of the tooth extraction if the implant can't be immediately placed, and if there is no severe infection in the area. Research shows that these grafts cause more symmetrical healing, and prevent loss of bone height. In some cases, this is the difference between being able to eventually place an implant and having to do more bone grafting or give up on an implant altogether. Now, just because you lost a tooth 20+ years ago, it doesn't mean that an implant isn't possible. What it does mean is that some bone grafting may be necessary prior to implant placement, and you may have to wait 6-12 months to have the implant placed. Like I said earlier, every situation is different, so you won't know about your options unless you see a periodontist to allow him or her to evaluate you as an individual to determine the viability of implant placement in your mouth. 

Receding gums are not necessarily a part of the aging process

Many people assume that receding gums are a sign of aging. While older individuals do tend to have more root exposure, gum recession is often tied to other very specific issues unrelated to age. Things like grinding or clenching your teeth, brushing improperly, plaque, and thin gum tissue are the primary causes of recession. By addressing these issues, you can prevent and even correct receding gums. Some of these problems can even be identified in childhood, when intervention can prevent recession from even happening. If you notice that your gums are receding in yourself or a child, evaluation by a periodontist as soon as possible is the best way to prevent or correct this problem before it becomes a major issue that ruins your smile or leads to tooth loss.