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Dentistry/Bone graft in lower front jaw



In 1998 I tripped and fell resulting in my top front tooth (not sure which one) piercing my bottom lip and chipping the tooth.   In late 1999 I got a full set of braces which were removed in 2003.  This entire time I had dental insurance and went for regular 6 month visits and cleanings.  In 2004 I got married and lost that dental insurance.  While I stopped seeing the dentist I still took, what I thought was good (I was 19), care of my teeth.  Lots of life happened and in 2009 I had noticed a abnormal piece of tissue under my tongue.  By then my parents had started seeing a new dentist and found that some of the procedures the old one did was either wrong or didn't actually take place.  So they took me to their new dentist and he took X-rays to find that a bottom front tooth (I think the number was 9) and the top front tooth both were dead and had been since my fall.   He preformed root canals on both teeth and also found I had loss bone in my bottom front jaw.  He did a bone graft and placed a carbon fiber bar or wire behind my front 3 or 4 teeth to keep them stable and in place while the bone graft took.  I saw him every 3 months for almost 18 months till I was diagonsed with other health issues and had to choose where to put my cash.  (No insurance of any kind).   Last week I took a bite of something and notice my front teeth were sensitive.   I made an appointment with the same dentist.   I explained why I was absent and took X-rays.   He said I lost bone and there was some cleaning to be done.   I went in for the cleaning on Thursday of last week and he rebonded another wire or something on the back of my teeth to keep them steady.   My questions are....  Should I do another bone graft? He told me he doesn't think it is worth it and told me I am going to have to save money because the only real option is to get a bridge or something.   I feel like I want to get a second opinion but don't really know how to go about doing so without upsetting him.  I feel like I am being punished for something that another dentist over looked for so many years.   When he did the cleaning this last Thursday there has been more random twinges of pain like he hit something or something else it wrong.  Any advice?  

Very lost and confused,


Dear Elise,

As you know, I can't answer your question with any certainty.  It sounds like what is happening is that you are rapidly losing bone height from around your lower front tooth roots.  Lower front teeth roots tend to be fairly narrow.  As a result, these teeth often are the first to be lost to gum disease, bone loss or trauma.

If it is important to you to keep these teeth, I advise you to listen to your dentist.   The dentist you seem to trust.   You are certainly entitled to seek another opinion, and this should not upset your dentist.  I encourage my patients who are unsure of my recommendations to seek out other information.  I understand their concerns.

Remember, nothing in medicine or dentistry is a sure thing.  Different people respond differently to the same treatments, and different doctors may look at your condition in different ways.  But it sounds like your dentist has an interest both in keeping your teeth as long as possible, as well as giving you fair warning that you may need to replace them in the foreseeable future.  If they do need replacing, ask your dentist about implants as well as a bridge.  Implants should give your replacement teeth that are more like your natural teeth.


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Howard Finnk, D.D.S., P.A., CEO


I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.


Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center ( On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (, I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.

American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)

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Bachelor of Arts and Sciences in Psychology from Wayne State University Doctor of Dental Surgery from University of Detroit College of Dentistry Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida

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