Dear Sir/Madam, one week ago I had 2 implants placed in the lower jaw on the left side. Before that, on the same side, I had a bridge suspended between the wisdom tooth and the second premolar. The wisdom tooth was extracted. The implants were placed between the wisdom tooth area and the second premolar. The procedure was normal; 2–3 days afterward I had a slight swelling, which subsided. The sutures have also been removed. The problem began when the pain started. At first I could not determine exactly what and where it hurt. When my dentist (not the one who placed the implants) was removing the sutures, we found that the tooth on which the bridge had been supported, the second premolar, is loose and sensitive to percussion, etc. The tissue around the second premolar is very sensitive, red, painful, ... When I take ibuprofen, the pain goes away for a while. It is worst at night, when the pain is more intense. Then it hurts, I feel “throbbing”... and in short, I still do not know exactly what and where it hurts. I would like to know what to do. Should I have an X-ray? Is it possible that the procedure displaced the second premolar, its root, or perhaps something else...? Thank you for your answer! Kind regards, Ida

Dear Sir/Madam!Based on what you wrote, I believe the source of the pain is the second premolar. Whether the cause is related to the implant surgery or not is impossible to guess without an X-ray. Given that the second premolar is a non-vital, root-canal-treated tooth, the development of problems is unpredictable and not necessarily connected with any other procedure. I suggest X-ray diagnostics and, based on the findings, appropriate treatment of the second premolar (root canal treatment or extraction).Have a nice day!

Hello! My husband is 65 years old. Years ago a dentist made him dentures: a complete upper denture and a partial lower one – I think he still has 4–6 of his own front teeth and the last teeth onto which he attaches the denture?! He has never worn the upper denture. He says it makes him gag, that it "clacks" in his head as if stones were knocking together, and that food has no taste. He even removes the lower denture before eating because it is easier to eat without it!!!? I find this very unpleasant and disgusting when, in a restaurant, he secretly takes the denture out of his mouth and wraps it in a handkerchief..... I would like to know whether at his age there is a better prosthetic option that my husband could tolerate more easily, and how much it would cost. He does not know anything about this yet, but if I push him a little to go to the dentist, he says that such an investment is not worthwhile at 65...? Otherwise he is in good physical condition, only chronic stomach problems trouble him – I claim this is because of poorly chewed food (because he has no teeth) – and of course he has been a heavy smoker since the age of 14! Since dentistry has become a luxury for us ordinary citizens (of an independent, successful and relaxed country), I would like to know whether basic and supplementary health insurance covers the costs of implants for older people who cannot tolerate ordinary dentures, and what the cost would mean for us. I hear that people go to Serbia, Hungary, even Romania and India, where this is supposedly very cheap. Is this really safe? Thank you in advance for an approximate cost estimate and any answer, and I wish you a happy and successful New Year 2010!

Dear Sir/Madam!It is certainly possible to make the upper prosthetic restoration in such a way that the problems you describe are at least significantly reduced, if not completely eliminated. If we want to make an upper denture that is stable and does not cover the entire palate, it needs to be supported, usually, by four implants (in rare cases two are sufficient). Unfortunately, health insurance currently does not cover the costs of implantology, and I believe it will remain similar in the future. Price: 4 x implant (750 Eur) = 3000 Eur. A complete denture is covered by insurance. As regards having the treatment carried out in the countries you mentioned, you will have to form your own opinion.Have a nice day!

Hello, I am asking for advice. My 73-year-old wife received an upper denture six months ago. It is retained on three attachments in tooth roots. One of these attachments has failed for the second time, but that is not the biggest problem. The problem is that her tongue and lips frequently swell, which of course causes pain. Despite rinsing the teeth and denture several times a day, especially during the night-time rinse (at least once per night), the rinsing liquid becomes dark in colour. We understand that one has to get used to a denture. However, the pain is not subsiding, and the burning sensation in the mouth and on the palate is often unbearable, so she has to remove and wash the denture. During rinsing in the daytime the liquid is not dark, perhaps because of the frequent rinsing. Could this be because the body is rejecting the foreign body (the denture)? Could there be another cause? Where should we turn to check a suspicion of poor tolerance of a foreign body in the mouth? Thank you in advance for your answer. Kind regards, Janez from Maribor.

Dear Sir/Madam!Pain and swelling of the lips certainly do not belong among signs that could be regarded as normal or common in your case. The remaining teeth could cause the swelling, as well as intermittent pain. A diagnosis can be made with X-rays and a clinical examination. A burning sensation in the mouth may be the result of hypersensitivity to acrylic or other components of the denture, but it may also be due to hormonal or psychosomatic disorders. Hypersensitivity (allergy) could be diagnosed with a skin test; the other problems are quite difficult to demonstrate. Please make an appointment for an examination.Have a nice day.

Hello. I am 17 years old. I do not have upper lateral incisors (there were no tooth buds), so the other teeth adapted and the canines are where the lateral incisors should be. The problem is that there are small gaps between the teeth, which is not pleasant to look at. In addition, the canines are more pointed. I also wear braces, which have improved the situation quite a lot, as I also had an incorrect bite. My orthodontist advised me that if I want a more aesthetic appearance of my teeth (without pointed teeth and gaps), I should look into aesthetic dentistry. My lower teeth are quite nice and aligned in a straight row. In general my teeth are also quite healthy. I would like to know how this problem could be solved so that I could have a nicer smile. What is the price, and I assume the costs are not covered by insurance? Thank you very much for your answer and kind regards!

Dear Sir/Madam!Based on what you wrote, I assume that orthodontic treatment was not able to move the teeth far enough to create space for new lateral incisors, which could then be replaced with two implants. I assume that the jaw is simply too small for such a procedure. Therefore, the remaining option is to reshape the teeth in the visible upper sector. The teeth can be reshaped in a relatively simple way merely by adding composite materials, which does not require grinding healthy tooth enamel. If that is not sufficient, we use enamel preparation and make aesthetic veneers or even dental crowns. To answer what you actually need, or how many veneers or crowns should be made, I would need to examine you and probably also take a panoramic X-ray. Prices:-composite build-up: EUR 50 per tooth-aesthetic veneer: EUR 350 per tooth.-dental crown: EUR 210 (metal-ceramic), EUR 320 (E-max all-ceramic)Please make an appointment for an examination so that we can present you with an exact plan and an offer.Have a nice day!

Dear Sir/Madam, my wife and I are expecting our first child, which makes us extremely happy. Today, however, I remembered that my wife had a dental panoramic X-ray toward the end of the third or in the fourth week (when she did not yet know she was pregnant) at the health center in Kamnik. To be honest, I froze when I remembered. I know that radiation during pregnancy is extremely harmful. I kindly ask for your opinion regarding the harmful effect of radiation on the fetus. Could the amount of radiation she received be dangerous for the baby? Thank you very much for your answer.... Andrej

Dear Sir/Madam!We of course advise against X-ray imaging during pregnancy, and there are logical reasons for this. However, there is no need to panic:-the imaging took place far from the region that could be affected-the radiation dose is relatively so small that it is essentially negligible-your wife was protected from potential harm.-the body's mechanisms that deal with possible radiation damage have theoretically already repaired the disturbance long ago-the radiation you receive from the environment (earth, space, other radiation sources) is at least as great as the dose your wife could theoretically have received.-the stress caused by unjustified fear will do more harm to the fetus.Have a nice day and enjoy the most beautiful moments in life!

Dear Sir/Madam! First of all, I think I can thank you on behalf of most of us for these truly professional and clear answers. I also mean the fact that you speak specifically about prices, which in my experience is not the rule, since your professional colleagues often keep prices vague. My question is as follows: how many implants are needed to make, for example, a complete fixed upper prosthesis, and how many are needed for the lower jaw? And also, how many teeth do you recommend for normal life based on your experience or standards? Thank you again for your answers, and I wish you much success, because you certainly deserve it.

Dear Sir/Madam!To make complete dentures, we do not need any implants if the anatomical conditions provide sufficient denture stability. Resorption, or dissolution, of the bony ridges of both jaws (where the teeth once were), however, usually reduces their height to such an extent that the dentures are no longer sufficiently stable. This phenomenon is most often observed with a complete lower denture. For additional denture stability, as few as two implants in each jaw are sufficient. Particularly when treating the mandible in this way, we achieve a substantially increased stability and incomparably greater patient satisfaction. Of course, an even better result is achieved with a larger number of implants. The optimal number of implants, when they are used to additionally stabilize dentures, is therefore four per jaw. By placing four implants in the upper jaw, we achieve sufficient stability of a complete denture that does not cover the hard palate, which is very favourable for the patient.Have a nice day!

Dear Sir/Madam! I already presented my problem to you at the beginning of November. After further examinations I have now been diagnosed with dental neuralgia. The trigeminal pain appeared after treatment of the lower right first molar (replacement of the filling and repeated mandibular-block injections). The dentist at the maxillofacial clinic advised me against any dental procedures (except urgent ones) until remission. Do you have experience with cases like mine? I am worried about how my teeth will be treated in the future and what will happen with prosthetic work – whether neuralgia will be triggered every time. I still have four teeth where old fillings need to be replaced, and one tooth will need to be replaced prosthetically. Thank you very much for your answer.

Dear Sir/Madam!I completely agree with the assessment of the dentist who advised you against procedures until the condition improves. I would add that procedures on the opposite side should not affect the triggering of neuralgic pain on the affected side. Experience shows us that it is almost impossible to predict when and in what way improvement will occur and therefore when treatment could be continued. It is likewise difficult or impossible to predict what will trigger another surge of pain. I believe that the decision to perform a procedure should be made according to the relative risk that postponing the procedure could cause.Have a nice day!

Dentist - Your questions

Visitor asks:

Dear Sir/Madam, one week ago I had 2 implants placed in the lower jaw on the left side. Before that, on the same side, I had a bridge suspended between the wisdom tooth and the second premolar. The wisdom tooth was extracted. The implants were placed between the wisdom tooth area and the second premolar. The procedure

Dentist Tomaž Rotar answers:

Dear Sir/Madam! Based on what you wrote, I believe the source of the pain is the second premolar. Whether the cause is related to the implant surgery or not is impossible to guess without an X-ray. Given that the second premolar is a non-vital, root-canal-treated tooth, the devel

Visitor asks:

Dear Sir/Madam, Since you successfully advised me some time ago, I am turning to you again. My problem is as follows: in the upper jaw my dentist extracted all my teeth (except the first and second molars). He prepared these two teeth because they will serve as abutments for a partial denture. It is understandable that

Dentist Tomaž Rotar answers:

Dear Sir/Madam! Based on the events you describe, I assume that the tooth will need root canal treatment, as your dentist has already explained. I would certainly first try to treat the tooth and keep it in the mouth, since it is evidently an important abutment for the partial de

Visitor asks:

Dear Sir/Madam! I would like to know whether it is possible to make an appointment with you for a general dental examination as a private-paying patient. How much does the service cost, depending on any further treatment needed? Thank you in advance! Kind regards, Maja

Dentist Tomaž Rotar answers:

Dear Sir/Madam! You can certainly make an appointment for an examination. If we also continue your treatment, the examination is free of charge. Otherwise, the price of the examination is EUR 50. Have a nice day!

Visitor asks:

Hello! My husband is 65 years old. Years ago a dentist made him dentures: a complete upper denture and a partial lower one – I think he still has 4–6 of his own front teeth and the last teeth onto which he attaches the denture?! He has never worn the upper denture. He says it makes him gag, that it "clacks" in his head

Dentist Tomaž Rotar answers:

Dear Sir/Madam! It is certainly possible to make the upper prosthetic restoration in such a way that the problems you describe are at least significantly reduced, if not completely eliminated. If we want to make an upper denture that is stable and does not cover the entire palate

Visitor asks:

Hello, I am asking for advice. My 73-year-old wife received an upper denture six months ago. It is retained on three attachments in tooth roots. One of these attachments has failed for the second time, but that is not the biggest problem. The problem is that her tongue and lips frequently swell, which of course causes

Dentist Tomaž Rotar answers:

Dear Sir/Madam! Pain and swelling of the lips certainly do not belong among signs that could be regarded as normal or common in your case. The remaining teeth could cause the swelling, as well as intermittent pain. A diagnosis can be made with X-rays and a clinical examination. A

Visitor asks:

Hello. I am 17 years old. I do not have upper lateral incisors (there were no tooth buds), so the other teeth adapted and the canines are where the lateral incisors should be. The problem is that there are small gaps between the teeth, which is not pleasant to look at. In addition, the canines are more pointed. I also

Dentist Tomaž Rotar answers:

Dear Sir/Madam! Based on what you wrote, I assume that orthodontic treatment was not able to move the teeth far enough to create space for new lateral incisors, which could then be replaced with two implants. I assume that the jaw is simply too small for such a procedure. Therefo

Visitor asks:

Dear Sir/Madam, my wife and I are expecting our first child, which makes us extremely happy. Today, however, I remembered that my wife had a dental panoramic X-ray toward the end of the third or in the fourth week (when she did not yet know she was pregnant) at the health center in Kamnik. To be honest, I froze when I

Dentist Tomaž Rotar answers:

Dear Sir/Madam! We of course advise against X-ray imaging during pregnancy, and there are logical reasons for this. However, there is no need to panic: -the imaging took place far from the region that could be affected -the radiation dose is relatively so small that it is essenti

Visitor asks:

Dear Sir/Madam! First of all, I think I can thank you on behalf of most of us for these truly professional and clear answers. I also mean the fact that you speak specifically about prices, which in my experience is not the rule, since your professional colleagues often keep prices vague. My question is as follows: how

Dentist Tomaž Rotar answers:

Dear Sir/Madam! To make complete dentures, we do not need any implants if the anatomical conditions provide sufficient denture stability. Resorption, or dissolution, of the bony ridges of both jaws (where the teeth once were), however, usually reduces their height to such an exte

Visitor asks:

Dear Sir/Madam, the date of my last menstrual period was 25 October 2009. The pregnancy test is positive. I have a dental panoramic X-ray appointment in Kranj on 1 December 2009. Should I refuse the X-ray? Kind regards Alenka

Dentist Tomaž Rotar answers:

Dear Sir/Madam! Yes. Have a nice day!

Visitor asks:

Dear Sir/Madam! I already presented my problem to you at the beginning of November. After further examinations I have now been diagnosed with dental neuralgia. The trigeminal pain appeared after treatment of the lower right first molar (replacement of the filling and repeated mandibular-block injections). The dentist a

Dentist Tomaž Rotar answers:

Dear Sir/Madam! I completely agree with the assessment of the dentist who advised you against procedures until the condition improves. I would add that procedures on the opposite side should not affect the triggering of neuralgic pain on the affected side. Experience shows us tha

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