Learn More about Dental Implants



I Don’t Have Enough Bone For Dental Implants

The main qualifier for having dental implants is having enough bone.  If you don’t have enough bone, the bone can be rebuilt.  If you don’t have enough gum, that can be added back too.

The following x-rays show two extremes for purposes of educating you if you are considering having dental implants or are about to lose a tooth.  The first shows my jaw and the second shows a jaw with almost complete bone loss.

Ramsey amin dds x-ray 

Dental Bone Graft need for thin jaw for implants 

All of the chin bone is gone too! Yikes!

Have you ever heard the old adage “what you don’t use, you lose?”  This applies to your jaw bone too!  Your bone stays thick and tall when your teeth are there stimulating your bone every day.  If you lose your teeth your jaw bone shrinks from disuse.   This also happens when you are only missing even one tooth! 

If you lose one tooth, the bone in the area of that tooth shrinks while the other areas stay intact.

Here is a sample of a patient where they lost a lot of bone in just one area:

Bone loss for few teeth for dental implants 

Dental implants preserve your jaw bone and prevent the natural shrinkage that WILL occur with bone loss.  A bridge or removable partial denture does not preserve or maintain your bone.

What is the best thing to do?  Prevent losing bone in the first place.  If you have to lose a tooth, replace it with an implant on the same day (immediate dental implant) or within the first 6 months after losing it.  This will drastically lower the cost of your dental implant procedure.  Besides saving you money, it will save you substantial time and greatly reduce the chance for complications which can and do occur.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California

229 thoughts on “I Don’t Have Enough Bone For Dental Implants

  1. A dental expert is not usually fun and in order to prevent this sort of experiences I strongly believe we must start taking better care of our teeth and health generally.

    1. MY THOUGHTS EXACTLY!!!!!! Prevention of medical and dental problems should be taught in school (and home) from grades K-12!

  2. Dr Amin thanks for a wealth of information you have provided.

    my face had sunken in due to missing 2nd and 1st upper molars and 2nd upper premolars on the left side of my upper jaw about 15 years ago and it really affected my appearance.
    i need a lateral sinus lift before i can have 3 implants. Will a lateral sinus lift follow by 3 implants restore my sunken in face?

    1. Maybe. You can test this by having a wax set up of teeth put into your mouth. If things look better than you know it will work. This is a cheap and reversible way of testing so that you know in advance.

  3. I have my front tooth loose and its coming dwn and i have no bone left can i still get a implant for front tooth only one tooth?????

      1. I’m only 28 and due to a genetic disorder my teeth are disintegrating by the day from the inside out… the sad part is I’m obsessed with caring for my teeth. My question is, if I get dentures with bone graphts will I be able to get implants later? How do you think it’d cost me?

        1. At your age I would not pull all teeth unless you HAD to. Bone grafts that are really WELL DONE with the right genetic gum-bone type might stabilize things for 3- 5 years but facial muscles will weaken leading to bone loss of the tooth bearing part of the jaw. Find yourself someone that can help you remineralize your teeth if possible and avoid implants at your age.
          You need a really good dentist that cares about you.

          1. Hi I just had my upper teeth pulled do to periodontal disease and some bone loss got upper Dentures and I hate them I was interested in dentures implants the 4in one well I did and X-ray and they said my back molars will take an implant one on each side but they need to put 2up front like close to my eye teeth well there saying the front won’t take implant cuz they flare not understanding that he said I would have to see a surgeon is this safe to even consider need advice

          2. Every case is unique. It sounds like you may have a difficult situation. The upper jaw is far more challenging than the lower jaw for a fixed replacement such as a Prettau dental implant bridge and sometimes they require sinus lifts or zygomatic implants if you do not have a regular amount of bone. All on 4 on the upper jaw is a little bit under engineered for the long-term unless there are zygomatic implants. I would recommend minimum 6 standard implants and of course fixed teeth made on the same day if at all possible. This way you do not have to use the denture anymore and all the implants can be biomechanically connected to one another which aid in the healing process.

            Ramsey A. Amin, D.D.S.
            Diplomate of the American Board of Oral Implantology /Implant Dentistry
            Fellow-American Academy of Implant Dentistry

  4. I have recently had a CBCT scan done which has shown my upper jaw to be very thin. 3 mm width.
    Is it possible to place implants with it being so thin? Apparently the height is not a problem, but the width is concerning.
    If implants are possible would I require bone grafting?

    I have access to the scan if you’d care to take a look?

      1. I am missing all of the upper teeth and all but 6 on the bottom.
        I’ve been an upper denture wearer for 25 years and a lower partial for near to a year.
        The idea of the All on Four for both upper and lower has been discussed but now I’m unsure with the results of the scan.
        Super scary moving forward.

  5. I am so thankful that I came across this article! I have had an upper denture since I was 22. At the time my teeth were fixable, but I was unable to afford to fix them properly and extraction and a denture was the only thing I could afford. I have regretted that decision every day for the past 13 years. Up until I read this article I believed that there was nothing I could do about it due to bone loss. I knew you could have bone graft done on a single tooth but was not aware this was an option to replace a denture. However, it seems that I can’t find a good dentist in my area, all the good ones are in CA :). How do I go about finding a good dentist in my own area? Thank you!

    1. I’m 38 years and is suffering from severe periodontist disease, my incisors are mobile can they be replaced by dental implant.

      1. Vedita — there are only very few situations or a dental implant is not recommended. Usually it is because the bone continues to get narrow the deeper you go. Often times multiple incisors have to be replaced rather than just one when the gum disease is severe and a bone leveling alveoloplasty can be done to make an FP 3 style bridge. This may very well be a good option but of course I have never seen you or your x-rays..

  6. I am that person who is completely toothless and I have lost all bone and gums have severely receded even chin bone

    I look like that yikes picture and it makes me chronicallt suicidal as I no longer go outside of the house .. I look like I am 100 years old and I feel like there is just no hope anymore

    I lost all of my teeth almost nine years ago from combination of years of bulimia and years of heavy psych med use .. causing dry mouth and I just plain did not take care of myself ..
    Is there hope for someone as bad as me ..

  7. I m 21 yrs old boy from Kathmandu,Nepal..My name is Avishek Pokhrel..As i saw your website regarding dental implants i would like to know something about that..So i hope you will answer me as fast as possible sir..In 2010 i was diagonoses with Non metastic ewing sarcoma mandible and my treatment was done in Rajiv gandhi cance hospital delhi..It went for 1 and half year and 17 cycles of chemotherapy along with radiotherapy was done..at that time only titanium plate was attached because i was only 14 yrs old and dr said that bone will not be better idea at that time as my height will grow up ..And in 2015 the plate suddenly broke and free fibula flap surgery was done..My mandible was reconstructed with fibula bone..Now it has been nearly one yrs of my surgery and when i asked for dental implants to dentist of that hospital then he said that in fibula bone dental implants may not be possible..after ct scan we can tell all about implants..So sir i want to know really implants are nt possIble

    1. Implants are very possible even though you lost part of your lower jaw. I have treated patients before they have lost part of their jaws and have reconstructed bones with part of the legs and ribs. I even had one patient reconstructed with part of their skull.
      Maybe you can seek treatment elsewhere or perhaps leave the country? I’m not certain where are you should go but it is definitely possible. Do not lose hope. You have been through so much already. I will pray for you.

  8. I have had dentures for about 40 years. I know my bond and gum are both very small now. Anything that could be done to have full implants. ? Tim.

  9. I have lost alot of jaw bone in my lower and in some upper areas of my jaw I have my most of my teeth except my lower bottom back teeth and on the top left side of my mouth I am really worried as it is affecting the shape of my face and affecting my confidence… can this be fixed I am saving up to get it sorted

  10. i had cancer and radiation to my mouth i had to have my teeth pulled dentist says not enough bone or gums for implants to hold bottom dentures in Is there anything else that can be done? Please help me i am desperate as i cant swollow well at all anymore due to radiation and dont know how I will ever be able to eat solid foods again

    1. I have treated many radiation and cancer patients. If the Dose and area that was radiated is high and in the spot where you need the implants it can cause a big problem. If it was many years ago it may be improving.
      If you don’t grow hair (fuzz) on your face that is a clue that your Dose was very high.

  11. I lost a lost most of my back teeth 20 years before having implants. My process started May 2013 when teeth 7,8,9, 10, and the roots of 12 & 13 were removed. Since the dentist had problems getting me sedated he waited until August 2013 to install implants. I have had pain since my overdenture was installed and the dentist has remade this overdenture several times. He removed so much of the overdenture that did not fit against my gums and every time I eat food it gets into the implant. Because the dentist could not relieve my paint, I went to a Prothodontist who told me the dentist did not understand vertical dimension required for the prosthesis and the implants are too shallow, not to mention off angle, plus I could not get to them to clean them which was probably the cause of my pain. He also stated almost all of my bone was gone around the implants and I needed to have them removed, get extensive bone grafts, and wear a regular denture for at least a year or more. He stated after this time, if I got new implants I would have to go to a snap-in denture and I could never wear an permanent overdenture.

    If implants improve the chances of bone loss, how could i have lost so much bone around my implants and is there no solution for me, as I have so little ridge and don’t see how I can wear a denture. I have 3D bone scans if you want to see them.


    1. It sounds like this is your upper jaw. You can treat extreme bone loss easily with zygomatic dental implants. I have never had an upper jaw that I was not able to treat this way. Using this technique you can avoid bone grafts altogether.

      Same thing with the lower jaw, extreme bone loss can be treated and fixed, nonremovable Bridges can be made even in the thinnest of situations. You typically need five implants and in the most extreme of cases a nerve repositioning if the main nerve is in the way.
      These are more advanced procedures but they are intended for patients with extreme bone loss. When done correctly these can last many many years! I have many patients I treated 18 years ago that still have 0 bone loss around there implants.

      1. Should I have lost so much bone after the implants, as I thought they preserved or reduced the chance of bone loss. Is it possible they were not put in enough bone to start with? Or could I have lost 70% of my bone after an implant?

          1. So getting implants does not guarantee someone from bone loss? I just want to know because I don’t want to go through this again, only to find out I have lost so much bone they will not stay in.

            Thank You

          2. Bone loss is a big term. There is jaw bone loss and then there is bone loss around teeth and implants. There is no guarantee in medicine or dentistry but most people do not get bone loss after implants.

          3. But everything I read stated getting implants will prevent bone loss. Is this true or not, or are we just being told they will prevent bone loss. What is the odds of someone having significant bone loss from every dental implant?

  12. Hello dr
    Im 20 years old girl,recently i had appointment with my dentist cos i want to get braces for my protrusion kind of teeth. But my dentist advice me to not get braces due to risks. She said i have a thin bone and my gum already recede(mostly front part). So if i get my braces ,my gum will recede more and my teeth will look like the long one. And also, my teeth will fall early than when it should (like maybe 5-10 years) .when i ask if there is any solution to improve mine, she said no cos its hereditary one. I was very disappointed. Now i was trying to find an answer or opinion from dentist outside, cos i thought maybe i have a chance.and here i am stumbled upon this, i’ll be thankful if you can help me 🙂

    1. Sounds like you have a dentist that really cares about you and that does not want to hurt you in the long-term. Maybe have a second consult by a board certified orthodontist and see what they say. Make sure you tell him everything the first person said!

  13. Can you please help me? I’m 18, and a few years ago I lost my back molar. I got it extracted after the dentist did a bad root canal and failed to tell me that if I don’t get something in there then i’ll lose bone. Well now there’s a HUGE dip where my tooth was, I mean it’s gotten so deep that I’m now extremely worried(only where I lost that tooth) What do you suggest I do? please tell me if my bone loss can be fixed or at least prevent it from getting worse.

    1. Please search my site for the type of bone graft I call a block bone graft. This can fix most areas of severe bone loss

  14. Can i put a question here? I have 4 implants in the front teeth however they took out a failing implant from another dentist from 4 years ago and niw they say there is no room for a front tooth implant. I know without an implant my bone will shrink there. Can a smaller implant surfice? Thankyou for your time

    1. Yes but going smaller is not always the answer because it may look terrible if this is not a denture or complete implant
      replacement. You can search my blog for a block bone graft if you want to have it replaced.

      Worse yet, if an implant is put into very thin bone it will dissolve. It is important to have adequate thickness of bone around the implant at all times especially on the outer wall.

  15. Hello Dr, Currently I am undergoing orthodontic treatment in order to place an implant ( tooth 28). I’m 36 and 13 years ago I had removed my 3 bicuspid upper 13, lower 20, 28, as my 3 wisdom teeth erupted and the spaces were almost closed with braces. The space between 27,29 was almost closed leaving 1.5 mm space and my gum receded on the tooth 29 about 1mm or bit more. It resulted with overbite and overjet about 2mm. My current orthodontist suggest to open the one space with invisalign and place an implant and move my teeth only forward and to the left to correct my bite. When I saw my dentist for my routine cleaning he had some concerns whether it is possible… The clincheck proves that is possible to create a space 7.4mm…though I know the results may vary. I saw after totally 3 specialist and got different opinions. A periodontist said it’s gonna be very complicated… other said as long as the space is created probably I won’t even need bone graft… and also one dentist said I probably won’t have enough bone to move my teeth forward to support my teeth…I ‘m really confused. The orthodontist I see has pretty good reputation… I told my ortho what I was told… and the orhto said she doesn’t see a reason I can’t have the implant. …Please advise…

    1. Wow. Those are pretty different opinions!!
      Without seeing you I don’t think I can chime in accurately. I would just continue on with the braces because there is no way to really predict the future. Whatever happens you will have to deal with unfortunately. tooth 29 is right above a special nerve ending.

  16. hello doctor… i have a case of severe jaw bone loss, specially in the upper jaw..now my dentist has suggested me to go for full upper jaw implants. Please suggest should i go for the dental implants, are they safe and long lasting . since i m having little bone left. i m 34 years old.

    1. If you truly have severe bone loss of the upper jaw then using a fixed bridge is far more predictable than an over dentures snap on. I suggest you see somebody who is very experienced. Remember there are techniques to either rebuild the bone and then there are other techniques where bone grafting can be omitted and your base jawbone can be used avoiding sinus lifts etc. In the most severe of cases I often use zygomatic implants.

  17. Hi, I’ve been reading a lot about bone regeneration. I have had gum recession and bone loss in my two lower incisors. They now feel slightly loose. I would say they move a millimetre horizontally but not vertically. I’m wondering would it be an option for me to have bone and gum regeneration rather than extraction as I’m a bit nervous to have metal in my mouth.

    1. you can try splinting or connecting them together to avoid losing them. Also your bite must be adjusted very well to make sure you are not biting prematurely on these teeth.

      1. Thank you for your swift reply. The first dentist I visited said I would loose them within two years which I was surprised because the teeth are healthy. I visited another dentist yesterday and he said the the teeth only has grade one mobility and this can be corrected with allogram gum graft. He said I have very thin gums and the frenum is pull my gum down. I have been scheduled to have it removed and the allogram graft. I would really appreciate if you could give your opinion on this. Should I have the allogram gum graft or use my own tissue from the the top of my mouth? Thank you very much for your time.

  18. I’m in my middle 60s, I haven’t had any teeth since I was in my 20s. I haven’t always worn dentures on the bottom because of how they fit. I have recently been wearing both top and bottom. As a result of not wearing the bottom plate for a log time, I have very shallow jaws and no gum in the bottom. I read that new bone grafts can be made transfered from other areas, from animal, or from a donour. Would it be possible to get one or more than one of these procedures done; and complete teeth implants put in. If all goes well, it sounds very expensive.

    1. And 17 years I have never found a lower jaw that could not be treated with a fixed dental implant bridge… No matter how long the teeth have been missing. There is almost always bone near the chin to be able to anchor a bilateral cantilever fixed Prettau dental implant bridge and eliminate dentures altogether. Some of the most severe cases require a nerve repositioning but that is very rare.

      Generally speaking the lower jaw does not need a bone graft if you have no lower teeth. This will also help save cost, very predictable and is much less risky!

  19. Hello Dr I am 77, with a lower jawbone about 1/3rd inch thick. mostly gone. Dangerous ?? ;Lost lower teeth in 1956. got dentures in 1961, wore bridge in top from ’73 to ’85. now have dentures with bone loss. I adjust dentures myself from time to time.
    Have no gum or bone for denture to straddle on lower jaw. . Remnants of gum, jawbone is lower than big part of bone. Denture sets on gum, bone remnants, rolls about , none, gum and bone, causing much soreness and pain. Gummed, unchewed food not helping my stomach. I don’t want implants. just dentures and no pain. I am afraid, with 1/3rd inch left, bone may break Is this a danger, a general med problem or dental only. Can i get VA or medicare to do preventive bone breakage treatment to stop bone breakage? I am healthy. What do you think Sir/ jim

    1. If you can’t wear regular dentures there is not great options for your lower jaw besides dental implants. Even patients that have super thin lower jaws can be safely treated by a skilled and experienced dental implant provider. I have treated patients that have jawbones that are about 8 mm tall. Fortunately the base of the lower jaw is very strong and it takes quite a blow to the lower jaw to break it.

  20. Hello,
    I have had all of my teeth extracted for about 17 years now. As a result, I have significant lower jaw loss. I am not sure what my options are for restoration. It seems as if my lower jaw and chin are dissolving. I would like to know if there are any options for full restoration. I am being seen at a dental school, but it is a very slow process. I want to be sure there is something that can be done and that there is hope, but feeling very discouraged and waiting for a CT scan.

    . My implant specialist said that the bone could be rebuilt. However the specialist she referred me to said the same, but that I had less bone than he was comfortable working with and simply dismissed me. I have had regular X rays and was told there is enough bone for 2 mini implants as is. I am down to the base of the bone on my lower jaw and was referred by the implant specialist for a sinus lift and ridge reconstruction. Can these procedures help regrow the bone and restore fullness in my lower jaw ? I am not sure what can be done for that. I am only 44 and need my teeth and jaw to eat and speak properly. I also work in the public and would like the results to be aesthetically pleasing. I would appreciate any information you can provide as my questions have gone unanswered to this point



    1. I have treated the most extreme thinnest of lower jaws you can imagine without any bone grafting whatsoever. I do this by engaging the bone around the chin or by sometimes moving the nerve out of the way. These are very easy procedures when you have no lower teeth. When your jaw is very thin the last thing you want to do is only use 2 miniature dental implants. You typically want to use for 5 regular diameter dental implants!

      For the upper jaw, the most extreme cases require zygomatic dental implants which have been around for 25 years. You really need to be seen by somebody who is an expert in this and you can have fully fixed implant teeth for sure!

  21. I have no teeth, dentures, the bottoms are very loose, not much gum left and not much bone either…im on a fixed income…how much could inplants coast me???

  22. Hello Dr. I’m 35 type 1 diabetic my gums and bone are deteriorating my front bottom teeth are gone and most of my other teeth loose what can I do ..

  23. Where are you located? I want a caring and knowledge dentist just like you!! My dentist removed 2 back molars on my upper jaw, did 2 bone grafts in preparation for an implant and now 7 months later after a cat scan saids, “not enough bone for the implant. Now what can I do? Any suggestions?

  24. I am 60 years old healthy with no bottom teeth on either side of my jaw
    The remaining eight center teeth are healthy
    I would like to be able to chew again
    Cat scan showed extensive bone loss on either side what should I do
    Thank you Doctor

  25. Hi Dr,
    I am 20 years old and I’m having a treatment for a dental implant as I lost a tooth, however I had an option to move my teeth with braces to fill in that gap. But I chose to have a dental implant instead. However the dental implant did not fit in properly so Is it possible now if my teeth can be moved with braces?

    1. That is the beauty of braces. He should be able to move the space closed again. Sometimes teeth just do not budge and do not cooperate with what we want them to do orthodontically!

  26. This is the dentist that turned me away while in tears I asked for help because my jaw was dissolving and there is so little left. He said, oh so politely, “I’m sorry, but you can’t afford me!” As I am on government insurance since I lost everything in my divorce. I asked him what was causing my bones to dissolve like this and who could help me? But, I left in tears with my questions unanswered. He may be good at his trade but is he fair? And once a model I am now one everyone turns their eyes from.

  27. Hi Dr. I recently got all my teeth pulled out and that dentist said that he had left a little bit of bone in there. so my dentures will secure it, is that true?

    1. Sounds like some sort of miscommunication. The goal is always to leave as much bone behind if you are having traditional dentures.

  28. Hello Dr! Amazing you actually respond to people! So I am 35 years old & unfortunately have a mouth full of decaying broken teeth & they’ve been like this for about 10 years. I’m a single mom of 6 & can not afford dental procedures, what are my options??

  29. Hello Dr Amin.
    I am 41 years old and have no upper teeth and 6 lower teeth.
    My entire face has started to collapse and the 6 teeth I have are becoming more exposed.
    I only just learned about the jaw bone receding and facial collapse as a result of having no teeth.
    Shockingly my Family dentist who has been treating me my entire life never informed me of this.
    Is there any procedure available that can stimulate bone growth and restore my sunken face, or at least stop it from further collapse?
    Many Thanks..Gary Cameron.

    1. Yes… but it likely won’t benefit you that much.
      Why not have a prettau style fixed bridge? Search my site in the search bar. That is a really good options for many in your situation. When done properly it can restore facial skin and lip support

  30. I don’t have enough bone to do a mini implant on my lower jaw they told me they possibly could do 4 of them with a denture how much would that cost and is there a synthetic bone that would work for me as well I am 53 years old I am in the word for still and I need my teeth done 53 and looking goodm

    1. Bone grafting is rarely needed for just an over denture with four implants if regular size. It has probably been a decade since I had to graft one of those cases.

  31. I’m 15 years old, and I had my decayed molar extracted 3 years ago. And I notice that my lower left jaw feels slightly weird from my right jaw (which feels a lot stronger, i preferrably chew on this side) and it’s making me worry. I couldnt really describe it but i fear my bone is thin for an implant to placed. And my last molar (i still dont have wisdom teeth) looks kinda bent, moving into the space where once my teeth was. I dont know whether I need my teeth to be straightened first and undergo grafting. I can still feel it from my tongue. Im really worried because the bone feels really thinner right after the canine, and maybe it would cause facial asymmetry as I grow. I am currently taking Vitamin C tablets in, if they would help
    And I would like this to be fixed as soon as possible but currently my parents dont have any souce of income.

    1. I dont know the age for surgery, but is there anything else I can do that might help as I grow? Maybe some other vitamins like vitamin D might help? I also have other dental problems like an overjet. Im really depressed and I dont really know what my options are.

  32. I’m only 16 and I have a missing tooth and my gums in that area are too thin for an implant but my dentist suggested a procedure (I forgot what it’s called) it’s where they basically just make your gums big enough for the implant … Any idea what it’s called . Another thing is he said I probably would have to wait to get an implant because he doesn’t know anyone who would do that kind of surgery on someone this young.

    1. good advice for now. wait until you are about 20 years old or even a bit more. Until then there are other temporary options.

  33. I have periodontitis and I am missing three teeth. I have been told I do not have enough bone for dental implants. I am afraid to get dentures because it would rearrange the alignment of my mouth and would force me to look older. I am very depressed over this. Please help me.

    1. Hmm. See someone else. There are some exceptions but bone grafting can be done to restore lost bone. It will cost more but it usually can be done. Look for someone who is well known in your area these types of procedures.

  34. Dentures are the worse hard hurt make tmj worse In future when not enough one I hope they come up with something more comfortable when you have bone loss and or no money to get implants. I hear conflicting info on subjects too

    Missing teeth can cause one loss. BS not always true. My dad is 90 and has had false teeth since 22 or so. Total contradiction he just got lower implants the kind you can remove

    I’m way younger missing teeth. And do not have enough one for even the cheapest way to go. Spent thousands all gone.I hate dentures and have to live with them sickening. Better than nothing

    1. You are right Lou. There are VERY FEW PEOPLE That don’t get bone loss after extractions. Most of us do. About 95% do. Consider yourself lucky!!

  35. I am 46 years old with both an upper and lower molar that need crowns. The lower is cracked, the upper has just had so many fillings my dentist feels it will crack at any time. An actual implant is not monetarily feasible for me. I have osteoporosis for years (SEVERE due to anorexia). Will (just) crowns on either of these teeth be successful? Can you give me a percentage of bone loss on both the upper and lower jawbones that would tell me “yes” or “no” to the crowns?

    1. Don’t pull your teeth if a crown will fix it!! If it has lost more than 30-40% of bone or has mobility it should go.

  36. I dont have enough bone in my mouth and i want to have implants i dont have enough gum either im only 35 a very young 35 except for my teeth i blame my parents anyway ive heard they can fix this? Pls help my face is sunken because of the bone loss and im very conscience of it…

  37. I lost all my upper teeth because of messing with them since I was 15.
    Now I’m on antidepressives and have already lost 4 implants.
    I’m depressed already 1 year.
    When will this depression end?

      1. Hello, I lost my upper molar tooth last February and have been thinking about getting a implant replacement. I am an 18 year old male. Is it impossible to get an implant if my bones haven’t yet stopped growing?

        1. Better to wait even longer if possible. You are still young and growing. Can it wait until you are 20?

  38. Hi I am 39 years old .my front upper 6 teeths r missing due to periodontitis disease . Now I have rpd denture instead from last 7 years. One dental college asked me to have implants later. And pulled my teeth because all r mobile. But later they said there is no enough bone. I have many times dental scan and consult doctors some says it’s possible where others not. I am so confused to what to do. Please suggest me the right way because my other teeth r also going day by day what to do. I am too much depressed. I can pay for the best treatment. My gums are also so much shrinked due to space in teeths. And have too much sensitivity. Please help me out

    1. It is unlikely that you don’t have enough bone. The skill and experience of your implant dentist is going to determine the reality for different options. In my own practice probably only less than 1% of the time are implants not possible. Many times there are options that many doctors are unfamiliar with.

      1. I am 35 and have been told I don’t have enough bone for bone grafts to fix it so I could get implant supported dentures on the top. Can you recommend any of the options that might help so I can see if I can find anyone here that could maybe help me?

        1. I doubt you are one of the very few people that I don’t have enough bone for full mouth don’t implants. You need to see a very advanced implant dentist to handle a case like yours. Please search my site for an article on how to choose an implant dentist. I would send you a link but I am unable to do that from my iPhone.

          If not, come see me in California. 🙂

      2. I forgot to say that I was also told I need more bone “in every way possible, in all directions” and he did say also that it would be either in 3 (or 4) demintions, the number is all I am unsure of.

        1. There are wonderful options still available for people like you. Please read my previous reply. Sometimes there are ways to do this without any type of grafting even in the most severe of bone loss cases.

          1. Thank you for reading and replying – I appreciate it increadibly! I wish I could afford to come see you, it has been a dream since I found your site after I started to lose my teeth and my septum from a vomiting condition! I flat cant afford it, not even the travel there let alone treatment! I have a disabled dad I have cared for since I was 14 and that’s when I started working, but now 28th my spine and stomach i cant work. I still do all I can to get my dad to eat right, meds, doctors, physical therapy, and my own set of meds, doctors and physical therapy. It has been just he and I most of my life, I saw mom on alternating weekends until she was diagnosed with stage 4 colon cancer and for those 7 weeks I took care of her in one city and my dad in another. Basically caring for dad has been my priority since I can remember – he was disabled when I was 5, but I couldn’t work then and he still could until another accident later and at 5 I still had my grandma’s help before she fought cancer for only 3 days when n I was almost 13. Do to my health and financial situation I have done everything to get involved with a program where dentists and oral surgeons and even the labs donate to people with disabilities and chronic illness. I have read, watched videos and every bit of info I could get my hands on from your site and others – you being the only doc that takes the time to write back! I have dentures, since December (and I asked my dad to get me his dentures fixed for my b-day and Christmas gifts for the last 5 years and next 5 – so now he has wearable dentures!). I have been told that I don’t even have bone for 6 on top 4 on bottom to give me smaller dentures and what I would really like – to be able to sleep in them sometimes so when I would start to date, the date wouldn’t wake to me having no lips and no teeth! Obviously after a relationship is not new then I wouldn’t want to hide this, but right now I won’t even go out to meet someone new! I have worked with this oral and maxiofacial surgeon before and checked his reviews and ratings and professional references, but I don’t feel like I have a choice since my life I have put physically taking care of my family and when I could work, I did it financially too 4 years before I became an adult – many say it’s amazing but it isn’t at all. My dad and grandma did all they could to care for me, so I have always done the same – even at 4 when grandma was sick, I was 6 and could only make canned soup, but she had it on a tray in her bed with juice and a flower because I knew that would fix a fever and a cough (I was wrong, but she loved it). I wish I had the finacal ability to have real individual teeth, but I would even feel better with implant supported dentures witch he said he could do with a sinus lift procedure before I needed to go to the dental program. I am hoping that even if I have to be a case for the doctor to learn new techniques or something that I can do anything to lose the top denture plate! My mouth is dry from medicine so they have me on spray, mouth wash, and lozenges to fix that, but it doesn’t work much and if I use enough glue to stick the dentures i cant get them out when my stomach is mad and when I get sick with my dentures in – I asperate the fluid everytime! It’s scary for me. I am hoping you could possibly point me to some procedures, or products (like I learned all about a playdouh like putty grafting material) or anything I could ask about. One thing that he did say that broke my heart was the bottom is quick, it takes about 90 minutes and the top is much longer and harder so it would be about another 3 hours and a harder surgery recovery and he already knows I am willing to eat baby food for 9 months or whatever! I know he makes a bunch of money an hour, but he is equating 3 hours of his time to the next 3+ decades of mine! Why get involved helping sick disabled people if that’s how you feel – and those thoughts make me feel ungrateful, and I am sooo greatful- I just don’t want to go through surgery and the pain of recovery to end up as unhappy with my mouth as I am now.

          2. Hi Jenn,
            You may want to consider treatment at a local dental school. You also need to consider maintenance cost in whatever treatment you choose. This type of treatment typically takes 1-2 years in severe cases like yours. There is an average of 20 clinical hours plus another 20 in lab time….there is way more to it.

            I think you are a wonderful human being and I will pray that your situation improves.

  39. Hello, i have bone loss and some of my teeth have fallen because of perio. disease. i went to see a dentist and the only think he did was push on my teeth to see which ones were loose and which ones werent thats it no xrays nothing. he told me i would have to have dentures on the bottom because of bone loss. Is this correct? anyone that has bone loss has to have dentures???? i just cried and walked out of his office. With all the technology now a days.

    1. Oftentimes, the bone loss is so advanced there is no other options but to pull all the teeth. I removed all teeth on two patients in the last two days for this very same reason.

  40. sir I had my premolar canine teeth extractedin sep2013 without replacing it with fix teeth since then the bone mass has severely receded &its adjacent teeth have shifted in it’s place it has caused me tmj problem s & my face has change d into a female like face I want to know that can I get an implant In its place pls rspond

    1. Unfortunately the external profile of your face can change because of the lack of muscle function if you’re missing multiple teeth. You will likely need substantial grafting like a block bone graft if it is a large area of deficiency..

      1. sir I have been missing 1uper right molar & 1uper left molar &3rd lower jaw premolar canine & it has caused severe jawbone loss that adjacent teeth have come in its place implant dentists r saying to have braces but I m about my facial structure as it is looks like a female facial structure I wntd to have implant but dentists r saying there’s no space to place implant hence I wntd ur e-mail adrss to send u my xray photos pls rspond

        1. Unfortunately you would have to be seen in person to determine your unique situation and provide definitive treatment. Everything else would be speculation.

  41. i had premolar canine got extracted 2& half yr ago in lower jaw since then bone mass has severely deteriorated as I hadn’t replaced it &adjacent teeth have shifted in its place causing a drift in middle of jaw I m having tmj problem s also &collapse of facial structure creating a female like face structure pls respond

  42. Hi periodontal disease and have been told mine is worse then most 31 year olds that come in. I went to a oral surgeon and he told me I need to go see a periodontist and get the disease under control and I can possibly do the bone grafting and implants for my two missing teeth but he also said I have a lot of bone lose and suggested I can pull all my teeth and get implant dentures.. I broke down and started crying and really confused what I should do. When I went to see my dentist he said not to have my teeth pulled and to come in every 3 months and to fight the good fight. Only thing I worry is by me waiting to do the implant dentures and trying to keep my teeth am I making the chance of getting implant dentures not an option anymore if I lose more bone? I want that as an option over regular dentures but I rather get bone graft with dentures but the oral surgeon wanted me to see the periodontist as well because I have some gum loss as well.. This whole thing is stressing me out and I don’t wanna have my chin reduced because of bone loss. When I asked the oral surgeon would that have my chin shrink he said no but when I said that to my dentist he said he’s seen people that lose 50% after having dentures.. Please any help to steer me in the rite direction would be greatly appreciated.

    1. I meant to say I’d rather get bone graft with implants not dentures, but would do implant with dentures if that’s my only option.

    2. At your young age I would try to keep your teeth if possible. Dental implants do last a long time but they are not “permanent.”

      Your better off removing some of the bad teeth and keeping the good teeth. Don’t just pull them all because a few are bad. Maintain strict 3 month recall cleanings with your dentist and hopefully your not a smoker.

      1. If they are not permanent, what do you do? Pay to get them replaced again? I am 30 years old and stopped leaving my house due to facial collapse and bone loss and am trying to start a fundraiser so that I can get the surgery but after reading this comment I feel hopeless.

        1. Unfortunately a huge part of marketing has made the general public including some dentists feel that this is a 100% permanent procedure. It may in fact be permanent in your case but each situation is different and to be honest it depends on how long you will live!!

          those of us that are heavily experienced know that not all dental implants will survive. This does not mean that they will all fail but everything has a lifespan.

          A straightforward single molar replacement May last 45 years. A fully bone reconstructed upper jaw with low density and other medical issues may begin to lose bone after 10 years.

          Don’t lose hope. Dental implants are the best replacement for teeth

          The vast majority of patients do not have problems with them

    1. it sounds like you are ready for dental implants. I don’t understand the details of your question but just go ahead and find a really good and experienced implant dentist and start the process.

      Good luck!

  43. hi dr. amin, I am 31 years old and have periodontal disease that is treated and under control, haves some gum lost and have 2 baby teeth 20 and 29. tooth 20 was lost eating cold chocolate when I was 15 years old and 29 is still there but smaller then the other teeth I was told this is genetics, my dentist said that I have to replace both teeth with either an implant or a bridge I want to get an implant I think in the long run I will benefit from it, what do you think is think I should do ? I have an appointment may 3 for a 3d imaging and consultation with an oral surgent to see what he says. my fear is if I get an implant that my bone will continue to get lost and i may lose the implant later on. let me know what you think.

  44. I was at the hospital today and was told by the dentist that I couldn’t get implants as not enough bone I am absolutely devastated as I had cancer of my submandicular gland did had it removed I had all my hopes on implants as cannot war dentures am only 48 n feel like an old woman bone reconstruction wasn’t even mentioned do u think I still could get implants done thanks

    1. Did you have radiation to your jaws? That can make dental implant treatment very difficult. There is a rate risk of bone that won’t heal if that is the case. There is treatment called hyperbaric oxygen that can help the bone prepare better for Implants in some patients that have had radiation to the jaws. Try going to a dental University for treatment

  45. Hi, i have periodontitis disease and 2 loose tooth at the front upper teeth. I wish to know if i wish to add extract the loose tooth and do a dental implant for the tooth, is it still possible?
    I am afraid that the periodontitis disease need to be treated first before i can put the implant, i am also unsure how long the treatment would take, including enduring the pain and i am very scared and worried.
    Can you let me know if i only wear a partial denture for the 2 loose tooth, will the bone still be lost and cause change in my appearance?

    1. If you extract the teeth and do nothing the bone will definitely shrink.

      Actors gum disease should be treated and controlled prior to starting any dental implant treatment.

  46. I am 37 years old. I went to the dentist and they did xrays and the dentist came in and told me that my front lower 4 teeth has very little bone and the rest of my teeth is losing bone so there is nothing they can do so they were going to stop treating me and just pull out all of my teeth and give me dentures. Is this true, is there absolutely nothing that can be done. Would I qualify for the bone grafting procedure so I can get implants. I don’t care of the cost, i would pay anything.

  47. I have gone to a dental school for the all on four upper and lower. The lower is complete and seem fine the upper jaw had to much bone loss. The dental School is looking to use a zygoma implant and four smaller implants should I get a second opinion and should I use a more skilled dentist the school has dental professors observing the procedure as it is being done

  48. I have had a back molar extracted about a month ago and the wisdom tooth is trying to push its way through. I have noticed in the past week or two that my bone under mt gum seems to be leaning in towards my tongue and if it brushes against it it is very painful sharp pains. I am considering a partial in the next week to replace 9 upper teeth and 4 lower am i at risk of bone loss?

    1. you probably have exposed bone from a dental extraction. Go see your dentist ASAP. This often occurs in people that smoke were bone becomes exposed on the inner aspect of the lower jaw near the wisdom tooth. This is called the mylohyoid ridge.

  49. Hello. I am 21 and haven’t lost one tooth but have many that are failing or the exposed part is broken off. What I’d my best bet to do? I want to have my mouth fixed. But just not sure where to start.

    1. you need to see a really good DDS….not one that will just patch holes and the problem comes back. Research heavily!

  50. Hi, So 5 years ago I lost one of my permanent upper tooth.Is it likely or how likely is it that I’ll need a bone grafting.Also I am 18 years old and will be turning 19 years come June.Thanks.Reply soon.

    1. very likely…. The bone on the upper jaw especially for the incisors tends to shrink rapidly. In order to get a beautiful, natural result a bone graft is going to be likely. Some bone grafts are more complex than others. One of the most complex grafts is called an onlay block bone graft. Hopefully you haven’t lost that much bone requiring this procedure as it is more costly than other more simple grafts.

      Good luck.

      1. Thanks for your reply.The tooth I am missing is the tooth next to my right canine. So IF I don’t require much of that bone grafting how long will the procedure take forr an implant and bone grafting?

        1. This is variable based on technique, bone density, aesthetic demands, the type of gum tissue that you have and hundreds of other things. Don’t rush it. On average a front tooth may be completed as soon as three months but could take as long as 18 months

  51. I have not had bottom teeth for almost 10 years (due to my insurance deciding to stop paying for dental work. I can now get dental work.) My gums have receded and my jaw bone is starting to recede also. My question is can I get my gums/bone back so I can get dental implants or dentures?

    1. Yes but you usually don’t have to rebuild the gums and bone on the lower jaw if you are missing all teeth. Usually it can be done without.

      Use the search feature on my site and type in overdenture and bone leveling. This will help you a lot.


  52. Dear dr ramsey,
    I had a bone graft in june and it was a failure. i had a second one in October and the surgeon told me to wait 6 months till the bone is formed. but it seems like after 2 months the bone graft is still soft.
    i have a missing lateral and canine in the lower jaw.
    please tell me what to do i really want the implant procedure to work i really hope that i don’t end up getting a dental bridge.

    1. I need more information to answer your question. Dental bone grafting with a skilled implant dentist should be a very predictable procedure. Failure is uncommon. You may want to seek out someone with more experience as long as you don’t have any medical problems that are causing this. I assume you are nonsmoker also.


      Ramsey Amin DDS

  53. I got a crown bridge covering from tooth 10 to tooth 15. My tooth 10 is showing the root and look like I’m losing bone. My problem I want to fix it but how? I don’t want to remove the whole bridge I just want to fix the tooth 10, is there a way to cut the crown on tooth 10 and then fix ? Or is there any other way?

    1. Hello Lily
      That is the inherent problem with the bridge. When one anchor fails, all of the teeth on the bridge become affected. Without seeing you, I could not give you an exact guidance but that is a very long span bridge if you are using the American dental numbering system.

      The longer the bridge, the earlier failure will occur. Nothing is permanent, not even a dental implant. You should consider doing something that is more stable over the long-term. You likely will require dental implants and bone reconstruction.
      Take care,
      Ramsey Amin DDS

  54. I really would like to know about these “Complications” referenced above, that could and “DO” occur when replacing a tooth or teeth?!? I have 5, maybe even 6 to be fixed or replaced actually! Thank you for your response!

    1. Here are some basic consent items that you should be aware of:

      A. Postoperative discomfort and swelling that may require several days of recuperation.
      B. Prolonged or heavy bleeding that may require additional treatment.
      C. Possible damage to adjacent teeth, especially those with large fillings or caps.
      D. Postoperative infection that may require additional treatment, or in rare instances, hospitalization.
      E. Stretching of the corners of the mouth that may cause cracking and bruising and may heal slowly.
      F. Restricted mouth opening during healing; sometimes related to swelling and muscle soreness and sometimes related to stress on the jaw joints (TMJ), especially when TMJ problems already exist.
      G. Fracture of the jaw in rare cases.
      H. Numbness or altered sensation of the teeth, gums, lips, tongue, and chin, due to the closeness of the implants to the nerves, which may be bruised or damaged. Almost always sensation returns to normal, but in rare cases, the loss may be permanent.
      I. Opening of the sinus possibly requiring additional surgery or treatment.
      J. Allergic reactions to any of the medications or materials used in the procedure.

      2. No guarantee can be or has been given that the implant(s) will last for a specific time period. It has also been explained to me that once an implant has been inserted, the entire treatment plan must be followed and completed on a schedule. If this schedule is not carried out, the implant may fail.
      3. I understand that if nothing is done any of the following could occur: bite problems, loss of bone, gum inflammation, infection, sensitivity, looseness or loss of other teeth. Also possible are TMJ (jaw) problems, headaches, and referred pain. I am aware that if nothing is done an inability to place implants at a later date due to changes in oral or medical conditions.
      4. It was explained that there is no method to predict accurately the gum and the bone healing following the placement of the implant.
      5. It has been explained that in some instances implants fail or lose bone and gum and must be removed. I have been informed and understand that the practice of dentistry is not an exact science; no guarantees or assurances as to the outcome of the results of treatment or surgery can be made. I am aware that there is a risk that the implant surgery may fail, which might require further corrective surgery or the removal of the implant with possible corrective surgery associated with the removal.
      6. I understand that choosing to have an implant placed at the same time of extraction and/or a temporary placed soon after implant carries more risk than waiting. I will follow all the instructions given to me such as a soft diet and not chewing on the implant during the immediate healing time.
      7. I understand that smoking, alcohol, or blood sugar may effect healing and may limit the success of the implant. I agree to follow my doctor’s home care instructions. I agree to report for regular exams.
      8. I have given an accurate report of my physical and mental health history. I have also reported any prior allergic or unusual reactions to drugs, food, anesthetics, blood or body diseases, gum or skin reactions, abnormal bleeding or any other conditions related to my health.

  55. Hello,

    I had all my teeth removed over eight years ago and when I take my dentures out my face is sucked in and I look older than what I really am. Is there anyway this can be corrected?

  56. I have my front left tooth loose due to bone density loss. Can you help me please. How much will this cost, and can I make payments. You can contact me at 580-483-5272. Greg

    1. Hi Gregory.
      Happy Thanksgiving. Sorry about your tooth. The best thing would be to call my office when we get back in on Monday. My staff can help you with all your questions about finances. I am looking forward to meeting you.
      Dr. Amin

  57. Hi Dr. Amin,

    I have lost a front tooth more than 20 years. I have a bridge. Now I would like to have an implant for that missing tooth. Do you think is it possible? and usually how much it cost for bone graft of a long time missing tooth? please advise.

    thanks in advance,

    1. Yes it is very possible. I do this every day. Bone grafting will likely be needed because the tooth is been gone for so long. This is highly variable in cost depending on how much bone you need and what technique needs to be used to place it.

      This could vary from $200-$8000 just for the bone graft. I know that is a huge range but without seeing you there’s no way to tell you an exact figure.

      1. I dont have any wisdom tooth left in the right side. I’m 16 years old. After how many years, I noticed that my face is starting to sag. What should I do? 🙁 Can I still have a fake tooth? 🙁

        1. you are going to have to be seen by a dentist and have a clinical exam, x-ray and possible 3-D scan. If you’re considering a dental implant, I advised almost all beyond patients to wait until they are 18-20 years of age so that you don’t potentially outgrow the implant

  58. My front tooth had really bad crack due to accident and had to be extracted.. i wear dentures for about two years until now bacause i had no money for implant.. i dont think the bone loss is that bad cause its only a tooth.. will i still need bone grafting? And how much does implant cost in us? Please answer and thanks in advance

    1. Don’t necessarily look for the cheapest implant. Dental implants are not permanent but can be performed to last a very long time. Do your research carefully. Cost is going to vary tremendously by experience.

      The critical outer wall of bone on upper front teeth is really skinny and thin. It has likely thinned out more than you think. Most front teeth require a bone graft because the anatomy of human’s is so thin in this area. Even know it might look good to you, it is likely to thin. Some people require advanced grafting such as a bone block graft in order to regenerate all the lost bone.

      Ramsey Amin DDS

  59. HELP. 2006 bone graft and sinus lift. 2007 8 maxilla implants. Fast forward to today. Only 3 implants are being used for an open pallet OD.

    I’ve lost most of the bone around 3 implants that are not being used! Surgeon wants all splinted after BMP tried etc. Dentist says it doesn’t matter. Splinting will not help.
    Originally they were splinted but bar didn’t work. I listened to dentist, removed bar about 2 years ago. Your opinion on splinting, please?????

    1. connecting, or splinting implants in the upper jaw is highly recommended. This is because the bone is soft in comparison to the lower jaw. I’m so sorry to hear about your situation. Typically a full arch of implants in my practice is a stable and long term successful procedure. Let me know if I can help at all.

      Attached is an article about connected dental implants.

      1. Thank you! I have a meeting with restoration dentist and oral surgeon mid- September. Can you direct me to any sites that show splinted implants and an open palette OD? I’ve been tole I’m looking at $10k. I’ve already spent over $50k. Yes, I did. Hip graft, sinus lift etc etc etc. am tired of the “money pit”

          1. I really need help now! I’m losing bone all over the maxilla. The graft in September helped but not enough. Now I have 7 implants. Surgeon won’t see me any more until the 7 are splinted. Restoration dentist doesn’t believe in splinting so he wants me to go somewhere else. Back in 2009i had a bar that was supposed to work with Hader clips. The OD didn’t stay in! Can the bar be re-attached and just have a regular denture? I really need to speak to someone. I’m in Oregon. I’ve probably spent $60,000 so far and cannot keep this money pit going. Can I please speak to you?

          2. Ugh…wow….Something is really wrong here. Splinting (connecting dental implants together) is good to prevent bone loss…especially in the upper jaw. It will not grow the bone back though.
            I suspect you have have VERY thin bone and the implants just BARELY fit in your jaw or they are oversized. Bone loss has multiple causes. Splinting is the way to go on the upper jaw. It is especially needed if you’re missing all the upper teeth. Bone loss and tissue loss around dental implant is called peri-implantitis.

            I suggest you get a 3-D scan taken and evaluate the current implants before you do anything with putting teeth on top of them. The last thing you want to do is build teeth on a poor implant foundation.

            I am sorry you’re having trouble with the process. This is usually a very streamlined procedure with high predictability in my practice.


            Ramsey Amin DDS

  60. Hello.

    I’m a senior with severe bone loss in the bottom of my mouth. My dental
    insurance is Medicare. What can be done to build artificial bone or what
    can be done so that I have a lower denture? Will Medicare cover the expense?
    For years now I’ve been eating without a lower denture.

    1. unfortunately Medicare does not cover these types of procedures. Most often the lower jaw does not have to be rebuilt to have something as simple as a lower over denture. Please see this post that will help you understand a bit about bone leveling alveoloplasty.

      this will help you avoid a bone graft for the lower jaw in most cases

      Good luck,
      Ramsey Amin DDS

      1. Peace be to you!
        Thank you for your quick response and concern.
        I will look at the information you suggested on bone leveling alveoloplasty.

        Renee Sanders
        (Sahiba Begum)

  61. I have a problem with complete mouth tooth loss and my jaw bone has really shrunk making my face look more aged than normal. please suggest how can I fix this problem so that I can have better facial structure.

    1. Your question is very broad. Without seeing you, there is no way that I can help you. My guess is you have had undiagnosed gum disease for years which has lead to loss of your teeth. Please make an appointment with a very experienced dentist can help you achieve your goals.

      Good luck,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  62. Hi Dr. Amin,

    Thank you so much for your site and explanation of bone loss that can come with missing teeth. This is the first time I understand what happens since you explained how the teeth stimulate the bone. Could you please give my your opinion on the following issue?

    My 14 year old daughter has a missing permanent bottom molar under her baby tooth. She’s had braces for about a year now. The orthodontist wants to pull the baby tooth because it’s starting to sink. The thing I worry about is the bone loss that will occur in those few years. I’m guessing she’ll require a bone graft, which I’m not that excited about. Also, they explained that a baby molar is bigger than the permanent one so they want to pull her other molars forward to get the teeth lined up correctly.

    Would you agree with this plan even though bone loss is likely to occur? Will a lot of problems result if the tooth keeps sinking? Thank you so much for your time and for educating us!


    1. Hello Stephanie,

      It is too early to know what is going to happen. Your daughter is way too young for an implant. I would suggest you wait until she is 18 years old to reevaluate things. In the meantime just make sure that the space is maintained where the tooth used to be. Bone grafting can be done very easily in order to have a stable, thick bed of bone for a dental implant

      Good luck,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  63. Hi I just had two extractions I’m on fear that my teeth will shift I have no bone due to peridonall disease what are my options please help

    1. need more information. You need to be seen by a dentist and have a complete exam, x-rays and likely a 3-D x-ray too

      Careful treatment plan and diagnosis going to be key for long-term dental health

  64. I went to my dendist couple of week ago and removed my front tooth and put a processed bone graft .after a week my doctor says she might put a bridge cuz she says there might be enough bone to grow.I told her that im willing to wait even if it takes a few more months for the bone to grow.I was disappointed with my dentist since she was the one who told me that bone graft is an optioned so i can proceed to my implant.Please advice.

    1. Wait for the bone graft to mature for 4-6 months. At that point, take a 3-dimensional scan of your jaw to be assessed for implants. After 2 weeks only, the bone is not mature enough to make any final decisions unless you’re lacking a tremendous amount of bone which would require secondary bone grafting.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  65. My 7 year old son, lost both of his front, top (adult) teeth in a playground accident. He is scheduled to get a partial in a few weeks. What landed me on your site is my concern that he can’t get implants until he is over 18. 11 years of no teeth is sure to result in serious bone loss in the front of his mouth. In casual discussion with a friend who also happens to be a dentist, she wondered if putting the posts in just to give the bone something to “hold on to” would be helpful. Wondering your thoughts? Is there any way to preserve bone for the next 11 years until he can get implants?

    1. Hello Lisa,

      The same thing does happen to my niece. It is awful and just breaks my heart to hear this.

      Placing implants, posts or any type of bone grafting at his tender age would be contraindicated. Unfortunately he will have a lifelong commitment to different types of dental appliances eventually being dental implants. He will likely require significant bone grafting when he is about 18-22 years of age. At that point the bone to be rebuilt with likely onlay block bone grafts and restored with 2 dental implants.

      For now consider a removable partial denture or a metal based Maryland bridge. Also consider orthodontics to make sure that space does not close down. This would be a good time to see orthodontist in case any growth patterns can be corrected early on.

      Good luck,


      Ramsey Amin DDS

  66. hi Dr, m 23 old, facing a problem that the space between my lower front missing teeth is 6 mm as my dentest say it is very lass bone to implant a teeth. tell me the solution ,+9108699962477

    1. I would need to see you personally in order to help you. You have not shared enough information for me to give you general guidelines.


      Ramsey Amin DDS

  67. Hi
    Am age of 52 and just completed 2 implant at my lower left. Perfectly done. Due to the fact that I have been wearing denture since young age; upper since early 30s and lower since early 40s, thus I have bone lose situation and to continue my next implant for lower right, it needs to have bone transfer from my jaw bone. After this , the next plan is to fix my upper which is even worst as no bone left at all. Need your kind advise for my case. Thanks.


  68. Hi, I have lost all my bone, maxilla, jaw bone, cheeks and have very little bone from my eyes down. I know it sounds crazy, but i need help. :(((( My head has shrank from top to bottom and side to side. I’ve lost about 75% or more of my face. I”m so upset. :((( please tell me what i should do. i think gum disease is in my family, my brother has it my dad had it before he died, my mom apparently has some and me. 🙁 I’m so embarrased and get headaches and I need help… ty.

    1. Hi CW,

      It sounds like you’re bone loss is substantial. Some patients lose all of their “alveolar process” leaving only the basal bone at the base.

      You will likely need considerable bone grafting using bone blocks if your bone loss is the substantial. This means that I would take blocks of bone from a cadaver and screw them into your jaw in order to rebuild enough volume to have dental implants. Oftentimes the bone can also be built with titanium mesh in combination with cadaver and cow bone.

      Regardless you will need substantial rebuilding of bone to achieve a stable base for dental implants. I would strongly suggest a fixed dental implant bridge such as Prettau full zirconia bridge.

      Follow these links to learn more information>:
      Block Bone Graft for Dental Implants 2015 Update-Ramsey Amin DDS Reviews
      Burbank Implant Dentist Explains Titanium Mesh Bone Grafting for Dental Implants

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  69. Hi,
    At the age of 12 I had oral surgery to remove my front baby tooth. The oral surgeon hoped to be able to pull the permanent tooth forward but lucky me it was deformed. At the time, dental implants weren’t an option since I didn’t have enough bone to support the implant. So, I had a retainer denture until about 16 when I had a Marilyn Bridge performed. About 4 years later, I had to have a traditional bridge crowning the two teeth next to the missing tooth. 15 years later and the bridge is starting to feel loose. My question… if the implant wasn’t an option because of not enough bone, is grafting something newer? It wasn’t even a consideration when I originally had oral surgery. Can a loose bridge /crown be fixed instead of replaced?

    1. Hi Pati,

      You did not mention your current age so I cannot give you a history. I am assuming you are 30-40 years of age.

      In the hands of a very skilled dental implant surgeon, bone grafting is extremely predictable. What was not possible 15 years ago, has changed tremendously.

      Oftentimes, a loose bridge/crown can be replaced. This all depends on the quality of the teeth underneath the bridge. Oftentimes they are badly decayed and have minimal tooth structure remaining to anchor a new bridge or crown.

      You may end up needing a block graft if this is in the front of your mouth. This particular post will likely help you understand the process.

      Block Bone Graft for Dental Implants 2015 Update-Ramsey Amin DDS Reviews

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  70. Hi Dr. Amin,

    I got my 4 wisdom teeth taken out about 4 years ago and am now wondering if I should have gotten implants and/or can still get them? I keep finding conflicting medical opinions over whether wisdom removal can alter jaw/face structure. Could you clear this up for me? Thanks so much for your time.


    1. Hi Victoria,

      If you have a full complement of teeth, removing wisdom teeth would not cause any issue at all. Many people including myself, did not have room for wisdom teeth and they cause a lot of problems. I would not ever consider reimplanting your wisdom teeth.

      Wisdom Teeth Extractions

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  71. Dear Dr. Amin,
    I’m 40 year old female. I had an upper molar (2nd from the back excluding the wisdom tooth) removed last year. The dentist added some material add the time of extraction to help my bone grow (don’t know the exact name). I went back after almost a year and he performed a CBCT scan and said I have 9.8-9.9 mm of bone and everything looks good. He might have to do a bit of sinus lift but a 10 mm implant will work just fine.
    On a separate note, I have always needed to do a light braces for my front teeth that are a bit crooked. I learned that after doing the implant I cannot do braces.

    My dilemma: I want to spend a year working on my braces and do my implant next year but I’m worried that I will loose too much jaw bone by then which would make my implant complicated. I asked my dentist and he said it will be fine next year too but I just want to get a second opinion.
    I don’t know if its worth it doing the braces (for cosmetic reasons) or just go for the implant now and forget about the braces. I certainly don’t want to go thru complicated procedures of bone loss. How much bone could I potential loose within a year? is there any studies done on that?

    With many thanks for your time.

    1. Hello Ana,

      I would see an orthodontist first for a consult. Just because you have a dental implant does not mean you cannot have braces afterwards but dental implants do not move with braces so they can cause complications depending on their location. Oftentimes adults just want cosmetic alignment of their front teeth and do not want to go through complete functional braces. If that is the case the dental implant will likely not cause any problems.

      Doing the orthodontic consult before the dental implant will help you make your own informed decision. That is what I would do.

      The bone in the upper back teeth is notorious for shrinkage and lack of bone density. The sinus is very close to that area. It sounds like your dentist knows what he is doing.

      This is a great post that will help you understand your implant process:
      Upper Molar/Internal Sinus Lift 3-D Scan Real Time Dental Implant Before and After Planning Video –Narrated by Ramsey Amin DDS

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  72. Hi. Im 28 years old, just graduated college and have severe bone loss. I had all my uppers pulled in 2012, they did a sinus lift, ridge contouring, added cadaver bone and autogenous bone from both sides of my jaw line. An expected 2 hr surgery lasted 6.5hrs bc I was awake. I was on methadone at the time, so the iv meds had little effect. A few weeks after the surgery I noticed the head of the screw through my gum. I texted my Dr, she said it was just the head of the screw from the bone they took from my jaw. A few weeks later, the whole screw is sticking out. They remove it and assure me that the bone reabsorbs fast at first but will plateau out, and that they have to wait for the bone to stop reabsorbing to place implants anyway. So it was several months before they got me back in. I forgot to mention I had been accepted into the grad pros program at Baylor, a blessing at 1/3 the price I thought. Anyway my Dr got married, it was spring break, the OR was under construction etc. By the time they go to do implants, they discovered I had far less bone than I’d had before the surgery. They said I’m just an anomaly that reabsorbed bone at an incredibly fast rate and they dont know why. Fast forward 3+years later to 20`5; I’m on graduate student #4, she really wants to help me not be in a denture because I don’t take it out at night. It’s just too humiliating, I cant talk or close my jaw…Anyway last week she tells me my last chance is to have autogenous bone harvested from , my iliac crest and basically do sinus lift bone grafting all over again, but I’d be on a cane for 6wks and I cant have anything in my mouth for 4 months. No teeth for 4mo. Another $30,000, all just for a chance. But this time itd be real blood filled bone from my body. Even though they dont know why the first bone grafting failed, maybe my own bone would be better…Later that night it occurs to me that they already did all that, got autogenous bone…. What if I hadn’t known that? Ugh…. I just dont have very much confidence in them anymore. I want a second opinion before I settle for another 60 years with a denture and lower partial, at 28. Is there anything I could do to increase my chances for bone graft succes? Take calcium? Or something? I know the answer is no, but I just wanted to make sure…..
    So sorry for the ungodly length of this. Thanks for your time!

    Ashley out of state.

    1. Hello Ashley,

      I feel so bad for you. You have gone through allot at such a young age. Unfortunately a dental school works very slowly and there is a lack of continuity of care. I think at this point you should seek out more of a veteran dental implant dentist to can take your entire case from start to finish. In the long run this will likely cost you last money and you have spent already.
      A high level practitioner may be able to treat your mouth using immediate dental implants and computer guided surgery. This would alleviate the need for a full denture to be worn at all.

      This may help:
      How to Choose an Implant Dentist

      Computer Guided Dental Implant Surgery, Things You Need To Know


      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  73. I have a bridge on my lower back teeth. My gum is swollen around the tooth, and my dentist said the tooth under the bridge may be cracked, and I do not have enought bone for an implant. But, bone can be added (somehow). I have to decide whether to just have the bridge and tooth removed, or consider an implant. My question is: If I decide to just have the tooth removed, would it be advantageous to have some bone added anyway, in the space where there won’t be any teeth? I’m thinking that could prevent further bone loss. I am a senior and I don’t think I’m too interested in spending thousands of dollars on the implant. Thank You!

    1. Hi Dianne,

      When one tooth is lost, it starts the cycle for other teeth to be lost. Teeth need each other to distribute force pressure. Consider having the dental implant if you’re going to have the bone graft. If you are going to have the bone graft, be sure to speak your dentist about what type of bone to use. The reason this is important to you is some bone replacement products do not last as long as others. In many situations it is advantageous for the bone graft material not to last that long and for it to begin replacing itself quickly. This is intended for patients that are going to have implants right away. Your dentist should be well-versed in types of bone graft materials and techniques that I will allow a slow dissolving/turnover rate which will by you more time.

      I have attached a link on why you should bother replacing teeth in the first place. Of course it really depends on your unique situation that needs to be evaluated with dental x-rays, 3-D scan, study models, photography and of course a thorough examination by a dental implant expert.

      Why Even Have Missing Teeth Replaced? – Dental Implants, Etc…
      Bone Grafting For Dental Implants…Where Do You Get the Bone?

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  74. Hi,
    I am 37 years old and have bone loss with upper dentures and a bottom partial denture that is no longer fitting properly in my mouth because my the teeth that was holding them in place is slowly crumbling. I am absolutely terrified of having my teeth worked on because of my experiences as a child. I know my gums are in bad shape. I was told I couldn’t get implants because of my boneless. Then I ran into your website. I am a Mother of of 3 with 2 grandchildren. I have isolated myself because I am embaressed and just do not feel pretty anymore. The cost for the bone recovery is so expensive. My question is ” Are there any payment plans for this process?” My gums are swollen and bleeding on the bottom and feel mushy “soggy” I’m sure it is causing health problems… To be honest I just do not have 20,000.00 and am sure there are not very many that can. I just want my smile back but can not find anyone that provides payment plans. Do you have any recommendations on what I should do?
    Thank you so much..

    1. Hello Amy,

      I treat people with extreme fear of dentistry every single day for the last 15 years. Consider finding a dentist that is skilled in IV sedation anesthesia. You can have all your dental work done while you sleep!!

      If finances are an issue, you may want to consider treatment at a dental school. Their prices are a little bit lower than private practice but not tremendously lower. Of course it will take much much longer to do it there that will any private dental office.

      Most dentists outsource payment plans to third party finances companies which are very good. We use on called Springstone and another one called CareCredit. Look them up in Google and see what you may qualify for based on your credit.

      Your absolute best replacement at your age would be an upper and lower full dental implant bridge called a Prettau.

      Prettau Dental Implant Full Mouth Bridge

      Good luck.

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

          1. Got the money together! Thank you again. Wish your office was close to me… Thank you again I was truly lost until you told me about Prettau!!

  75. Great site…super useful…thanks for giving us real information. Most of what I see does not go into the detail that you do

      1. Dr Amin, I am so grateful for the information you provide. I find it very hard to get information on dental options. I am 60 and just got my upper teeth pulled for a denture because of gum advanced gum disease. The appearance is satisfactory with my denture. I am still having mild problems with the fit but It has only been a month. I wish I had known what I have learned from you about bone loss. I am in Northern California near Sacramento. If I find the finances to see you in the future, I will do so for an evaluation. None of this information was discussed with me by the dentists I saw. Thank you for what you are doing.

  76. Hi Dr. Amin,

    My grandmother just got her full dentures. However, the bottom dentures hurt her when she puts it on. The dentist told her this is because she does not have enough bone to hold the bottom dentures, since she has never used bottom dentures (only implants, which she only had 2 left and were extracted to put the dentures). She was disappointed that the bottom dentures did not work out and was considering getting implants for her lower mouth. However, since she does not have enough bone I was wondering how this would affect her. Would she need to get bone reconstruction in addition to implants? If so, about how much do you think that would cost? Thank you.

    1. Hi Erica,

      It is extremely rare for somebody that has no teeth on the bottom to not be able to have dental implants. I would suggest you take your grandmother to a dentist who is highly skilled and dental implant treatment. Every single week I meet patients who say they were told they don’t have enough bone and I routinely place implants on them that last for very long time.

      If your mom has no teeth on the bottom jaw, I would suggest she has for implants placed near the front of her mouth with locator type of abutments. This will help her tremendously. Cost is variable depending on bone structure but can cost between $5000-$20,000.

      Dental Implant Overdenture Locator Attachments…Patient Information

      Lifting, Moving Over-Denture…Leading Burbank Dental Implant Dentist Reviews Reasons Why. (3 min Video)


      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  77. I had an implant placed in the front bottom teeth. During the implant process I lost a lot of bone on both teeth around the implant. Now the doctor wants to make a bridge and rip out the implant. Do you know of any way I can regrow that bone. The periodontist told me there is a lasor LANAP that will regrow some of the bone. They are telling me a bone graft wont work because of the tight space.
    Thank you in advance.

    1. Hi Lisa,

      Ugh… The lower front teeth are very tiny so the space between them makes bone grafting an ailing dental implant very difficult. This condition is called peri-implantitis.

      What is Peri-implantitis and What Do I Do About It? – Bone Loss Around Dental Implants ~Burbank Dentist, Ramsey Amin Reviews

      Your other option is to remove the implant and bone graft the area, then start all over with a second dental implant. If the teeth on either side are in excellent condition then the second dental implant may work out better than the first. If you have bone loss on the lower front natural teeth, oftentimes the for small incisors are removed as a group and replaced with 2 dental implants in a for tooth bridge. Because of the wimpy roots in this area, when bone loss starts on one tooth it generally spreads to the others. It is not likely that the laser procedure will work, but you may want to seek second opinion.

      Socket Bone Grafting….Do I Need It for My Dental Implant? Ramsey Amin DDS Reviews

      Sorry for the bad news ;-(

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  78. Hi. Oh my, after reading everything, I feel stuck. I am very appreciative of the information offered on your websitI dealt with an oYeh first place I went after I moved out of Burbankce, as well as all the comments and questions that we are able to view, but now I’m even more frightened then before, I started researching implants. See I’m a single mom from Burbank. A couple years back, I had to move to Santa Clarita (not by choice). Long story short the Western Dental in Newhall ended up removing my 3 remaining wisdom teeth, which I didn’t want removed and they did two root canals, which one I had no pain in one of the tooths I was told needed a root canal. I went into them and it was because one of my teeth waI don’t even know why I am going to do. I want the two implants, but I am sure I got gum disease during my antibiotc stage frustrating me with the painfull feeling it would feel everytime I drank something cold, but I was informed that because they advise me to do all the above, they can’t work on my tooth that hurts, unless they do it all. So not knowing what a root canal was, I agreed, because I couldn’t handle my other tooth; I also am thinking its like a filling just more worse. So I had the 3 wisdom teeth removed. Worst experience. I can feel him hammerng away and everytime I cringed he was mad saying I am only cringing cause of the noise Of course! letting me know so I could’ve had earphones on, would’ve been nice, because I have only been chewing on my right aide too just thought of the wisdom tooth I had removed because my surgeon had said medical covers just one, and he even put me to sleep, I was not expecting to be awake when all 3 came out at once.

    I realized what.aafoot canal was when i went back in and they were trying to have me fit for a cap. The thing is Western Dental is the first dentist I went to after I left Burbank. Ever since I can remember there were two sisters with an office on Glenoaks and the one who would do my teeth, sometimes would beg, because she had told me, she would not ever I don’t want to look ut caps on my teeth because my cars are too small and if she can guess it wouldn’t hold. Well I ended up doing what they wanted and ever since then my life changed. So finally i went back to my old office, because i feel as if my bottom mouth has shfted completely too. i dont know if its in my head, but i know its not because of my teeth. i i look at myself everyday. Well the two sisters must’ve rellocated so the dentist thats there now referred me to a surgeon in Glendale, so i called that instant and told him that teeth #4 and #19 nd to go a.s.ap. i was living of antibiotics for like two years. well now here i am. on a saturday making sure i am alone. i hate my smile now, the flossing is hard, but was hard because it yanks now beause of the shifting. so for peace of mind…first i really hope that someone is reading this and 2). before talking about the two gone i was curious as to the ones next to the one that was removed. it seems lonely and i just dont like how it feels. I was told to check in 6 months later for anything else. it he didn’t sound too positive. he just said he willl check for non. I have a strong messed up feeling that my bone isnt there. I’m real terrified of looking any more different. I eat when I must now…or its not worth ibecause of the pain I still feel. so I never even thought of my bones leaving and looking more different. I feel like everybody has stolen my joy of mothering already. I don’t understand why this was done. I am on depression medication and really I don’t know what to do. Isnt there a way I can find out besides going crazy, before the 6 months? i dont know what to do with myself anymore. 🙁 I am so sorry…I have ADHD/Anxiety too, so that’s why I am all over the place. =/

    1. Hi Vee,

      Wow, sorry to hear about the negative experiences you have had. What you need is a full mouth diagnosis and treatment plan for your teeth and future dental implants. Without a complete plan that is sequenced and executed properly, your mouth is likely to worsen.

      Treating one tooth at a time may not be the answer and may cause further deterioration.

      It is important to really understand your mouth and all recommended procedures. You should understands all risks, benefits and alternatives before any tooth is treated.

      I am local to you, so you know where to find me. Good luck!!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  79. Hi..i would like to ask if i am qualified to do bone graft on my upper anteriors even i still have my braces on? I have a receeded gum on my anteriors since college. Thank u so much..

    1. Yes oftentimes a bone graft is done during braces. I do this quite commonly when somebody is missing an upper front tooth from birth and the orthodontist is correcting the spacing for the implant.

      The gum can be corrected at the time of implant placement.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  80. Hello there, I got over to your web-site via Digg. Not something I typically read, however I enjoy your views nonetheless. A big heads up for developing something worthy of reading!

  81. I’m 26 years old and I was born with permanent missing teeth! Most of My teeth never came out nor I think the bone. I have been wearing partials since I was 6 years old. Most people can notice it. And it’s very embarrassing. I’m trying to find a option because I have been struggling with my ugly smile and it’s affecting my life in every possible way.

    1. Hi Sully,

      I am sorry to hear about your situation. Dental implants and probable bone grafting is going to be your best option. Let me know how I can help.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  82. I am 43, and have been missing teeth #9 and 10 for my entire life. I took a bad fall on my mouth as an infant and damaged both the deciduous and adult teeth—both sets of which had to be removed surgically. I had a Marilyn bridge put into place when I was 14 and this lasted until a cracked molar filling changed my bite at age 40 and I started tapping on it with occlusion. Then some minor facial fractures in the L maxilla moved teeth 11 and 12 lingually and the trusty Marilyn bridge had to be removed.

    There was a plan to move 11 and 12 outward, get a bone graft for a sizable window defect in the superior ridge, and put in two implants for 9 and 10. After a CT of the anterior ridge, this plan of a graft with two implants was deemed not a viable option due to the amount of missing bone (a full-on A→P hole) and proximity of the bone gap to the central nerve foramen (~1mm). Canine tooth #11 is still out of place presently causing significant malocclusion after both Invisalign and Bioliner-Plus (with pegs and bands) failed to move it appreciably. And so, I have stalled out at a crossroads on my restoration work for my missing #9 and #10 teeth, and would appreciate some your perspective.

    Presently, I’m still trying to decide about whether to proceed with or without a bone graft. Even with a graft, I would need to decide whether to go with: a single implant with cantilevered pontics, another Marilyn bridge, or a conventional 4 tooth bridge. Putting it all together, I’ve really got 5 sets of options.
    1. Orthodontics, No graft, Marilyn bridge: Less expensive, saves teeth #7, 11 but less permanent and leaves misaligned #11 in place that may require prior orthodontics or major adjustments.
    2. No graft, conventional 4-tooth bridge: Better outcome with matching #8 & 9, able to essentially “move” the misaligned #11 as it’s new shape and position can be part of the bridge.
    3. Orthodontics, Bone Graft, Marilyn bridge: Better alveolar ridge shape, less likely to show soft tissue gap with high smile, possible to do a single or pair of implants later(??), #11 requires othodontics or a major adjustment.
    4. Bone Graft, conventional 4-tooth bridge: Matching #8 & 9, Better alveolar ridge shape, less likely to show gap with high smile, but later implants are not a good option, since teeth #7, 11 are reduced to pegs and would require crowns.
    5. Orthodontics, Bone graft, single implant w/ 2-cantilvered pontics: Most expensive, teeth 8 & 9 do not match, leaves #7 in place that may require orthodontics.

    I’m not made of money, and I’m not a fan of dental surgery. My feeling is to go with option #1, 2, or 3. I am concerned about whether the A-P hole in the maxilla above teeth #9, 10 is a problem in itself, so I’d put #3 on the table too. Anything’s possible.

    • Does leaving the boney gap there, pose more or different risks than filling it in with a graft? (e.g. Is it possible that it is a cyst harboring an infection?)
    • Does letting the graft heal for a longer time make a two separate implants more likely to be possible later on?

    May we all be well!
    Dr. T.R. Morris, ND

    1. Hi TR,

      You may want to consider a single “in between” implant to replace 9 and 10.

      It is a unique replacement modality for this specific situation. The implant can be placed more deeply and trying to rebuild vertical bone in your situation will be very challenging with the bone hole you describe. You will need some very well done pink colored gum ceramics.

      Very few dentists are well versed in this, so do your research carefully! Good luck!

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

  83. Hi Dr Amin,

    I have the following dilemma. Currently I’ve had braces for one yr now, they are coming off in about a year. I have had two teeth extracted about 20 yrs ago(i’m 38 yrs old now), on top, the same tooth each side.(2nd from last..) My orthodontist recommended me to go to an oral surgeon to replace the missing teeth. However, after consultation(+X-ray), I found out I don’t have enough bone in my upper jaw (sinus bridge is too thinned out). My question is how complicated/lenghty is it to thicken the bone..? I also thought about the bridge option, but Aetna won’t cover the bridges, since the teeth have been already extracted, before my coverage w. Aetna. So the cheaper option would be the implants, but I don’t know how complicated and tortureous the process is. Thank you very much.

    1. Hi Erika,

      Don’t do the bridge! It is an irreversible procedure that will destroy your adjacent teeth.

      Upper molars and sinus graft lifting is really great. Just connect yourself with someone very skilled in implant dentistry and this should be a breeze.

      You may only need internal sinus lifts rather than lateral window grafting.

      Check out this video on YouTube:


      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Blog ~ http://www.burbankdentalimplants.com/blog
      Sent from my iPhone

  84. Hi, Dr. Amin
    I want to see if you could help me out Im 22 years old I lost all by the age 15 due to gum infeaction. I started losing all my teeth when I was really young. I got my dentures when I was almost 15yrs old. Before I got my dentures I had to get home schooled. I got made fun of just because I had missing teeth. I was embarress of my teeth. Then I got my dentures at age 15 I felt embaress young and already having both top and bottom dentures. I felt better being able smile and have teeth. But now my problem after so many years I feel more embaress im 22 and my jaw bone shrunk I been having a lot of pain. I want to see if you could help me. Im a single mother of a 2yr old baby boy. Struggling, myy face has changed I dont want my son growing up and him telling me I look like his grama. Im only 22 young mother I been through a lot in life. I deserve a least a great smile on my face not a old lady face. So please Dr. Amin help me out…. 🙂

    1. Wow Sandra,

      I feel for you and your desire to look and feel your age. Being a mom is going to be the most important job you ever do.

      If finances are a big concern, you may elect to seek treatment in a local dental school which is a little bit less costly.

      If you are local, please give me a call to schedule an exam.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

  85. i am 35 and have awful pains have been told i dont have any dental bone left and need to have facial reconstructive surgery from my sinus cavity down.what can be done if i dont have any bone left to do bone grafting.I am desperate i weigh 95 lbs. because it hurts so bad to eat and also have bad TMD,and TMJ. HELP PLEASE ???

    1. Hi Salena,

      Have you considered seeking dental treatment in a dental school? They may be able to help you. Almost all bone in the mouth can be regenerated or alternatives done to get your smile healthy again.

      Dr. Amin

  86. Hi Louis,
    It sounds like you are describing a cantilever. That will work with 8 implants as long as they are all connected.
    A bar underneath works when the space from top to bottom is very large. Otherwise, I would avoid it and have a fully fixed bridge.
    You won’t lose any major jawbone in the area of the implants.
    Ramsey A. Amin, D.D.S., D.A.B.O.I.
    Diplomate of the American Board of Oral Implantology /Implant Dentistry
    Fellow-American Academy of Implant Dentistry
    Website ~ http://www.burbankdentalimplants.com
    Visit My Blog ~ http://www.dentalimplantdentistryblog.com

  87. hi dr Ramsey,could you please help me with your advise ,i need to do 8 implants and fixed porcelan bridge with 10 teeth on it ,sinus area and one on the close to mollar is going to be attached without implant due to bone loss.
    abutments are going to be semiprecious alloy.i currently wear denture and intend to use it after one week after my first surgery ,my surgeon is very experienced and also lecturer on faculty .i investigated in detail for couple of months about implants,bone loss ,grafting ,sinus lift etc. i need to ask you will i have further bone loss in areas where i have connected tooth with no implant and would that bone loss spread to my implants and cause loosing it ,that would means loosing my bridge all in one piece screwed into implants ps my oral surgeon want to create bridge supported with bar inside,what is your opinion about this prosedure

    1. My lower teethes never came out nor the bone I have been wearing partials since I was 6 years old. But I will really like something more permanent and better looking. I’m 26 years old now

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About Ramsey A. Amin, DDS

Dr. Ramsey Amin has extensive experience in surgical and restorative implant dentistry. As one of only less than 400 Diplomates of the American Board of Oral Implantology/ Implant Dentistry (ABOI/ID) he is considered an expert, and board-certified in dental implants. He is a former instructor at the UCLA School of Dentistry.