Dental Woes...

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I feel your pain, I REALLY, REALLY do. As do my gums..
Im currently in the process of major dental reconstruction myself as a result of a low bite, causing me to gnaw through the enamel of the front teeth. End point being I have to replace the crowns of 6 upper front teeth and increase the height of the molars.
It sucks and it is expensive, but it beats the pain you describe by a long shot.

One of my front teeth already got a hole into the the nerve, which got infected and died and I didnt have any pain untill the nerve had rotted all the way through the tooth and into the bone, which was a pain that seem similar to the one youre having.

I had to drill through the tooth and into the bone to let all the puss out, then go on antibiotics for I think it was a week before they could do the final root canal.

In my case the tooth was not broken other than the hole in both ends though so they could do a root canal and leave the tooth intact, fortunately.
 
runnerchic,

They sound like great credentials. You appear to be going to a Periodontist. They do not typically restore the implants they place. If your regular GP cannot do it, ask the periodontist who he would recommend.

Good luck.

Thank you :)
 
I'm not a dentist but from personal experience I'd go with implant. I also had a failed root canal and the tooth had to be extracted. After a period of time to give the gum and bone to heal fully had a tooth implant, and it's working great. The implant tooth does leave a small gap that has to be flossed carefully but other than that it was a good choice thus far, knock on wood.
 
Spaces, especially between molar teeth can occur. Molars are roughly square to trapezoidal just under the gum before the roots separate. Implants, on the other hand, are cylindrical and rarely are as wide as the molar they are replacing. The net result is that the smaller width at the neck of the implant crown (the restoration) requires that the restoration "flare" from a more central position and creating a taper that is more likely to trap food.

The shape of the gums around the implant changes following the initial extraction. This is one of the reasons the extraction site is frequently bone grafted at the time of extraction... in order to reduce the amount of shrinkage of both bone volume and bone width.

Wider implant are now available but are not perfect. Another way is improving the restored width of the implant restoration by the use of a custom milled anatomic abutment or Patient Specific Abutment. Using computer software, the connection between the implant and the crown is custom milled on a cad/cam machine in a way to mimic the shape of the tooth that was lost. In this way, it is possible to reduce or eliminate these food traps.

Following front tooth removal, we often try to maintain the shape of that part of the socket through the gum by the use of an "ovate pontic" in the temporary restoration, which is inserted immediately after extraction—we try to maintain the height and shape of the soft tissue like it was around the tooth before it was lost. The width of the available implants more closely resembles the width of the roots of front teeth. Even then, it may be necessary to fabricate a custom abutment to maintain the original tissue contours so there can be less space issues.

It is through such tissue sculpting that a front tooth can be made to look like the one that was lost.

DSC04483.jpg

Which tooth is an implant? Answer: BOTH front teeth.

This was one week after insertion. The shape of the gum around the neck of the right front tooth was to be modified (you can see the anesthetic injection site toward the upper left) to look like the left and the space between the front teeth filled in over the space of one month. There are traditional ceramic caps on the lateral incisors... on either side of the two front teeth. When all was done, there were no spaces and both teeth were symmetrical.


This takes a bit if experience, skill, patience and good implant selection and placement. This takes extra time and extra appointments. All that = $$. This is why you don't let just anyone "plug in" any old implant and have Acme dental lab down the street make the crown. What can I say.

Just to give you an idea...Surgical extraction $250 plus bone grafting procedure, $500 plus the cost of bone grafting material (@$160 per bottle). Cost of the top tier, FDA approved implant used by the surgeon can be more than $300. Healing abutments, $75. Temporary abutments, $50-$75. permanent abutment screws, $75. Final abutments, $160—$380... depending on whether they are made of titanium, gold or hi-tech ceramic (zirconia). Milled custom abutments, $300. Impression copings and implant analogs, $60—$75 each. Final crown, $250-$350. Each implant site requires at least one of each.

Services of a specialist x 3 hours and a minimum of 3 visits. Services of the restorative dentist x 5 hours and a minimum of 4 visits. Practice overhead, staffing, insurance, etc. ??$ and then you have to make a profit!

Oh, I forgot to add the costs of continuing education to provide these services and continue to improve those services....

...and you also want it to look and feel good.

Tell me exactly how would this come out "cheap" or how could all this be done for $1200, all inclusive as some cut rate practices might advertise?

I can tell you that in a large city in the US, an extraction + bone graft + provisional + single implant + restoration will cost somewhere in the neighborhood of $5—$6000.

I'm not trying to discourage anyone away from these procedures... just put them and their associated costs in perspective... and why you can't expect a good outcome by scrimping.

By the way, the alternative to a single tooth implant is the 3 unit fixed bridge. You must prepare one tooth either side of the missing tooth for a cap to hold the bridge in the mouth. The cost for such a bridge, is about $3500-$4500 + the extraction. That's not a whole lot different than the implant solution (OK, I admit that $1000-$1500 is not a little bit of money) but you must sacrifice two additional teeth. This was the preferred method prior to implants just a few years ago.

Hopefully, you get an idea of what is involved and what current technology allows us to do.

Regards, everyone.
 
One reason I want to go implant with my #17 molar instead of a bridge. At those amounts, most people (myself included) will finance into a monthly payment.
So over 5 years the extra 1500 is not that much more per month, for an implant that will last a lifetime.

I doubt a bridge will.

That said - what should we "aim for" - as "rich" men - eventually changing ALL our teeth for implants, or dentures? Can we really keep all our original teeth past the age of 80 or 90 with proper maintenance?

Versus yanking everything out for dentures - a choice my parents & grandparents did - because going the "denture road" was cheaper.
Plus - easier maintenance.
 
6214_1140407922070_1583599415_346197_3412284_n.jpgI had an implant done here (see photo for the "before" pic, avatar pic is "after") in Belize for US$1,250. Root canals for $175.
My daughter is considering coming here for two implants because flying here twice from Hawaii over a 3 month period and getting the implants is about 60% of the cost of having it done in Hawaii.
One of the dentists is also my diving/spearing buddy. He's done two root canals for me. His nephew did the implant.
One thing I learned is how to keep the root canaled tooth clean afterwards. The crown leaves a bit of a gap between it and the gumline and food gets jammed in there. It's painful at times. Dental floss or a softened toothpick work for me.
But one thing is for sure....nothing is as good as the original. I try to keep all my teeth. The one I had an implant for was broken in half when I was 17....39 years ago. It finally gave out.
 
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Hank,

Why would anyone have to "learn" how to clean around the crown on a root canal tooth? First, the root canal has nothing to do with hygiene of a tooth with or without a crown. Next, a well done crown should not have a place where food gets jammed and then becomes painful. A crowned tooth should function just like the original.

It sounds like you have an open contact. If it is associated with the crown, then it also sounds like you need to replace the crown. That shouldn't be a problem because is only cost 60% of what you would have paid in the US.

Since I haven't had the opportunity to examine your problem in person I guess I shouldn't draw any conclusions.
 
I'm not in any position to argue with a dentist. All I'm doing is relaying what my dentist here told me.

And how did you post on my post? That's a first. You should win some kind of prize.
 
Hey All,

I suffered an injury to my upper large middle tooth (quite obvious by now I am not a dentist, nor do I work in the field...). Long story short it turned black within two weeks and became quite painful. I was started on a course of antibiotics and scheduled for a root canal.

Following the root canal, things got A LOT worse. I can tolerate pain, but this was unbearable. I was started on a new course of anitibotics, and given pain medication. Within a couple of days it settled down, but was still not 100% painfree. I finished my course of anitibiotics on Sunday morning, and since then the pain has started to amp back up and return.

I spoke to the dentist today - and they do not think that the infection is back...but it really feels like it is. They are wanting me to see the primary dentist in there office, and potentially a specialist to determine if there is a root fracture, and to see if the tooth can be saved. (Won't be able to see the primary dentist for 2 weeks!!) My feeling from the way they were talking to me today is that the root canal was a waste of $ and I am going to need to pull this tooth and do something with the resultant hole in my mouth. I work with the public, and a huge gap in my smile is probably not going to be good for my business.

My question is - dental implant? Or bridge? The teeth beside it are in there original condition, no fillings... I also have a trip scheduled to Bonaire (and paid for) leaving December 22nd. I am concerned about being able to dive on the trip we have been looking forward to. Any thoughts at all would be appreciated.... thank you so much,

I would like to suggest you for dental implant because my friend has already taken this treatment and he has no any issue. He was taken dental implant treatment by empowered doctor clinic and he is really satisfied with this treatment. It is costly treatment but very effective.
 
Here's a cool idea - Laurence becomes a course director, opens up a scuba resort, catered for divers & dental care, located in easy-to-reach Caribbean location for US & Canada. (Belize, Roatan or Cayman Islands...)

He gets to keep nearly 100% of the fees, since the local gov't won't tax him nowhere near as much as Florida, plus his "guests" are in his "guest house".

I also imagine that it would be cheaper for dental work than most of Europe...

2 for 1
 

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