Dental Implant Issues: What to Do When Your Crown Falls Off

Q: Dental Implant Issues: What to Do When Your Crown Falls Off

Hello： <br>1. <br>1.8 years is actually quite a long time. <br>Generally, a dental prosthesis is considered successful if it lasts over 3 years, and after 5 years, there is typically no warranty in the industry. <br>"The situation with the lower bridge from 8 years ago has not ch

Dental implant prosthesis dislodgement?

1.
First, let me explain about the lost dental implant.
It has been in place for 8 years and is the last tooth on the upper right side.
The corresponding lower teeth are a continuous three-unit dental bridge.
Due to the limited space available for the prosthesis, the final restoration appeared relatively short after it was completed.

2.
Recently, the prosthesis fell out while eating, so I visited a nearby hospital (not the original implant clinic) to see if it could be reattached.
I was informed that the implant brand was different, making it difficult to secure, and I was advised to return to the original clinic.
After a long journey back to the original clinic, the doctor stated that the prosthesis had developed a hole due to wear, allowing saliva to seep in, which made it impossible to reattach.
The doctor recommended remaking the prosthesis and suggested reducing the size of the lower dental bridge to create some space for the upper prosthesis.
However, I am concerned that grinding down the lower bridge, which has been in place for a long time, might lead to fracture.
The doctor acknowledged this possibility and requested that I sign a waiver if I decided to proceed.
Ultimately, the doctor advised me to consult several other clinics before making a decision.
3.
My questions are: First, the condition of the lower dental bridge has not changed in the past 8 years, and it was not necessary to grind down the lower teeth at that time.
Why is it required now? Is it impossible to remake the prosthesis without leveling the lower bridge? What kind of force would be needed to create a hole in the prosthesis? Second, if the lower dental bridge (which has been in place for thirty years) really needs to be reduced, is there a high risk of tooth fracture? Third, if issues arise after the dental implant procedure, and I have to return to the original clinic for resolution, what happens if I move? Most clinics are reluctant to handle cases that have been treated elsewhere, which raises concerns about patient rights and protections.
Fourth, I strongly disagree with the hospital's practice of heavily promoting dental implants during patient consultations, even when the resulting prosthesis is so short and ineffective.
When problems occur, the blame is placed on the user for improper use, and the conditions for remaking the prosthesis are often unacceptable.

Wúzhù de rén, 40~49 year old female. Ask Date: 2024/02/14

Dr. Lin Jiayong reply Dentistry

Hello:
1.
1.8 years is actually quite a long time.
Generally, a dental prosthesis is considered successful if it lasts over 3 years, and after 5 years, there is typically no warranty in the industry.
"The situation with the lower bridge from 8 years ago has not changed to this day." This requires objective evidence for before-and-after comparisons (such as occlusal height, lower facial height, bilateral symmetry, etc.), rather than relying on personal perception of no change.
2.
No physician would dare to make such predictions or guarantees.
If something has lasted over 30 years, it should be cherished; if it unfortunately fails, that is also normal, and one should adjust their mindset to accept imperfection.
3.
Caution and careful consideration are essential from the very beginning.
There were undoubtedly many factors to consider at the time of selection, such as economics, convenience, and trust between both parties, especially for fully self-paid medical items, which are not covered by national health insurance regulations.
The subsequent hospital or physician taking over is often walking on thin ice, especially when patients have high demands without reasonable compensation, making it difficult for other physicians to take over.
If there are disputes, one can still file a complaint with local dental associations or health bureaus for assistance.
4.
If there are disputes, one can still file a complaint with local dental associations or health bureaus for assistance.

Reply Date: 2024/02/14

More Info

When dealing with dental implant issues, particularly when a crown falls off, it can be a stressful experience, especially if you have been living with the implant for several years. In your case, you mentioned that the crown on your upper right last tooth has been in place for eight years and has recently fallen off. The situation is compounded by the fact that the corresponding lower teeth are part of a bridge, which complicates the matter further.

Firstly, it is essential to understand that dental implants and their crowns can sometimes fail due to various reasons, including wear and tear, improper fit, or issues with the underlying implant. In your case, the dentist indicated that the crown had developed a hole, which allowed saliva to seep in, making it impossible to reattach the crown securely. This is a common issue, particularly if the crown has been in place for an extended period and has experienced significant wear.

Regarding your concerns about the lower bridge, it is understandable to be apprehensive about modifying a structure that has been stable for thirty years. However, the recommendation to adjust the lower bridge is likely based on the need to create adequate space for the new crown. If the upper crown is too short and does not have enough support from the lower teeth, it may not function properly, leading to further complications down the line. The dentist's suggestion to grind down the lower bridge is a common practice to ensure that the new crown fits well and functions correctly.

To address your specific questions:
1. Why is there a need to adjust the lower bridge now when it wasn't necessary before? Over time, dental structures can shift due to wear, bone loss, or changes in bite. What may have been a suitable fit eight years ago may no longer be the case. The forces exerted on the dental structures during chewing can lead to changes that necessitate adjustments.

2. What is the risk of the lower bridge fracturing if it is ground down? While there is always a risk when modifying existing dental work, a skilled dentist will take precautions to minimize this risk. They will assess the integrity of the bridge and determine how much can be safely adjusted. It is crucial to have a thorough discussion with your dentist about your concerns and the potential risks involved.

3. What if you move and need to find a new dentist? This is a valid concern. While it is true that some dental practices may be hesitant to work on cases initiated elsewhere, many dentists are willing to take on new patients with existing dental work. It is advisable to keep detailed records of your dental history, including any treatments, materials used, and the names of the dental professionals involved. This information will help new dentists understand your situation better.

4. Concerns about the encouragement of implants and the quality of care: It is essential to have open communication with your dental provider. If you feel that the recommendations made are not in your best interest, seeking a second opinion is always a good idea. Dental care should be patient-centered, and your concerns should be addressed thoroughly. If you feel pressured into decisions that do not align with your needs, it may be time to find a provider who prioritizes patient care and satisfaction.

In conclusion, while the situation with your dental implant and crown is concerning, it is essential to approach it methodically. Consult with your original dentist and consider seeking additional opinions from other dental professionals. Ensure that you are comfortable with the proposed treatment plan and that all your concerns are addressed before proceeding. Your oral health is paramount, and you deserve a treatment plan that reflects your needs and circumstances.

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