| Author | Message | ||
     Ourdee |
Now my friends, On a serious note, I've had an infected jaw and gum for over a week. My dentist opened her office just for me this morning. She took some x-rays of the suspect tooth and it isn't pretty. The tooth had a root canal and gold crown years ago. The root is fractured and there is infection in the jaw and a lot of swelling in the gum to the outside. I was taking Amoxicilin all last week and she has switched me over to Clindamycin and a little narcotic. Her practice does not pull teeth. I have to get that done this week coming up. Later after the infection is gone and my mouth is stable I have a choice to make. A bridge or a titanium screw with a fake tooth on top. The bridge would mean cutting the healthy tooth on each side for caps with a cap soldered in between and I have to learn how to clean under it. The other option involves a screw into the jaw bone below the gum line, wait for it to heal, then a base is mounted on the screw, then a cap is put on the base. I'm looking for first hand experience with the two choices I have. Any advice? | ||
| Hex |
Kathleen here. I have worked in the administration side of dentistry for close to ten years. Currently, I manage an oral surgery practice. It is good that you are putting a lot of thought into your decision. There are many things for you to consider. 1. Are you able to have an implant placed? Not everyone can. Have your dentist refer you to a good oral surgeon (not a periodontist). He or she will be able to let you know if you are a candidate. 2. In the long run an implant is a better choice. Over the long term, many people develop problems with bridges. Bridges also don't last that long. If you are lucky, you will get ten years out of a bridge (most don't last that long). So depending on how old you are, if you have to replace that bridge three or four times in your lifetime at $3000.00 a pop, what will that cost? 3. Placing an implant is expensive and most insurance plans (if you have insurance) don't cover any cost associated with it. In the Sacramento, CA area the average cost of implant placement and the crown (or tooth) to go on top it is about $4000.00, perhaps more. Hope this helps. If you have any additional questions, I would be happy to try and answer them for you. Just write to Hex. | ||
| Steeleagle |
I have a bridge on one side, an implant on the other. The bridge is the second iteration, so I can verify Kathleen's comment re; lifespan, although my first edition lasted a LITTLE longer than 10 years. I have to screw around with making sure I clean UNDER the bridge, and I use a Waterpic to flush under. Not a big deal, but I'm sure the current model will be up for replacement at some time as the support teeth on either side age. The implant was a bit more complicated (and expensive) and again, Kathleen is correct: When I had mine done, my medical plan only covered the surgery to remove the old tooth (which had been a root canal gone bad). I had to pay myself for the implant since I guess the insurance looks at it as more of a cosmetic option(??). I've had no issues with the implant since (knock on wood!). If finances weren't a factor, the implant (screw in the jawbone...sounds like pain but it really isn't) would be the option I'd pursue. | ||
| Mr_grumpy |
I have both, no probs with either & the bridge is now over 25 years old & still solid as a rock. | ||
| Ourdee |
Thanks, The way the pain and swelling is going, I'm ready to pull it myself. It's just that last hour before the next pill. Seams like the pain med. always wears off an hour early. I'm hoping at this point that I'll be able to get the screw put in my head. | ||
| Bjbauer |
I have a dental laboratory and fabricate the restorations for the restoring dentists. I have fabricated literally 1,000s of bridge units over the years and 100's of implant cases. Bridges have served people well for a long time but if it were my mouth I would opt for the implant unless there is some contra-indication. You may be able to save some money by finding a general dentist who places implants themselves. Unless there is a lot of bone grafting or a sinus lift involved they do just as well as an oral surgeon in my experience. | ||
| Sycho |
I had a situation where I had a bridge put in and ended up fracturing one of the roots on the tooth it was based on. So I ended up with 2 implants. In the long run the Implant will be your better option if you like to chew on hard crunchy things. And I feel your dilemma on the cost, but the dentist did give me break since I did 2 implants at once, and that the bridge failed within a year. Now I have another tooth with a "Catastrophic Fracture" of a root as the Dentist put it, that was having a root canal done to it. So I'll be right there with ya on having that one pulled and replaced with another Implant. It just sucks that there really is no Insurance coverage on them. | ||
| Jumpinjewels |
I had a bridge put in probably 30yrs ago. It contained one false tooth in between the two good teeth. I too, got an infection in the gum around the tooth, not the tooth itself. It became a necessity to pull one of the teeth that the bridge was on. I was given the choice also of doing another bridge with two false teeth in between or the implants. I, however, clench my teeth at night when sleeping and was told I could break the implants (I would have needed two of them). As much as I hate going to the DDS, I chose another bridge. I've had no problems and it's not a pain to clean under it. I was concerned about having to drill down another good tooth but I just couldn't see going thru the implant process. Either way, it's a drag and I can feel your pain. | ||
| Theironmaiden22 |
Couple things, working in a dental lab. That titanium screw you're talking about is an implant. You're probably looking at around a 6000$ dentist bill if you go that route. They feel better than a crown since the abutment is actually hammered/drilled into your jaw bone. Thus, the crown that goes on it will feel somewhat natural where as a crown doesn't. Knowing that the root is fractured could make pulling the tooth a thousand times more difficult than it normally would be since there is a chance that when they go to extract the tooth that some of the root will stay in your gum. If that happens they'll have to cut your gums open to get that last bit of root. Also, ask your dentist if you could get a bridge where the pontic rests on the tissue. Then you woulnd't need a special brush to get underneath it. Or, ask her if you could get a 2 unit bridge. That way one of the teeth they would've sacrificed for the bridge can be saved. Basically what they would do for a 2 unit is prep the tooth infront of the infected one (where the pontic would go). The other tooth would then just have a little bit relieved from it's occlusions where a tongue (a rest) would sit. That way you woulnd't need to sacrifice the other tooth. In my opinion, if you can afford it, or if your dental insurance will pay for it, go the implant route, for a couple reasons. First, there wouldn't be any tooth where the crown would go on so there wouldn't be a possibility of decay happenening under the crown due to an open margin. And, if that crown breaks all they have to do is fabricate another and they'll screw it onto the abutment just like before where as if a tooth does decay under a crown, the dentist will have to completely reprep the tooth and have a whole nother crown to fab. However, implants do have their problems. Alot of the time when people get theirs is about half a year to a year down the road the abutment will actually start to sink and will push the crown in lingually. (buccal is towards your cheek, lingual is towards your tongue.) For that they can either take the whole shebang out, including the abutment that's in your jaw, and re-set it. We did a 6 unit bridge that were all anterior teeth, 4 incisors and 2 cuspids (also known as canines). And it actually started sinking into the gals mouth back and under her tongue. What we did for that was make a partial frame that she would have to wear so it wouldn't sink any farther then it went. But remember, implants take up to a year to be finished. That means when they set your anchor they stitch up the gums so it can heal and grow into your jaw. After about 6 months, they cut it back open, screw on the abutment, take an impression for the lab, and give you a temporary crown. Depending on what lab your dentist uses, making a crown for an implant can take around a month or two. Whereas getting a bridge would take all but a month. If a month. Discuss with your dentist what YOU want to do/can afford. Our lab would be more than happy to fab your crown/implant. Infact, I could probably get you a discount since you're a fellow BadWeB-er, AND, we may even be able to rush it for you. Rushing means we'll get the case in the mail and we'll have the crown/bridge/implant out within a week we get the case. Again, discuss with your dentist your options, alot of insurance companies will pay for crowns and bridges but won't pay for implants, or won't pay all of the implant. | ||
| Reindog |
This is my experience to use as a data point. I had a three unit bridge installed on my upper right ?/first/second molar in 1995 and have had zero problems with it. I thread dental floss underneath daily for cleaning. It takes an extra minute and is no big deal. | ||
| Theironmaiden22 |
That's another thing I forgot to mention. Crowns, bridges, implants, etc... last a thousand times longer if they're upkept. Brushing daily, flossing daily, mouthwash, etc.. A good bridge or crown can last a lifetime so as long as it's taken care of, that is if the porcelain doesn't fracture and the lab got the tooths margins right. If they didn't get the margins right then it can decay under the crown and will eventually break off with the tooth or pop off all together. | ||
| Reindog |
 Pop out freak out! I'm running upstairs to get my floss threader right now! Couldn't we just talk about motorcycles?  | ||
| Ourdee |
Sorry, Reindog. I wish I could just think motorcycles right now. I appreciate all the info. couple more hours and I have to go in to work the graveyard shift. I hope to get in early tomorrow to get this rrrrr pulled. Nitrous will be the first break I've gotten. Seams like all I do is lay around looking at the clock trying not to spit up the meds. Thanks, everybody for the outlet. | ||
| Ourdee |
At least I didn't post pics.  | ||
| Ourdee |
Tooth pulled. Came out in pieces. Not too bad. Wife won't let me ride my bike. I sat on blue for a while, things seamed better. | ||
| Theironmaiden22 |
I wouldn't ride if I was on N2O or narcotics, that's just asking for an accident, though I have. Another thing I forgot to mention. Don't be afraid to get estimates from different dentists, it could save you quite a bit, and discuss the different options that are available. | ||
| Fast1075 |
With that fresh extraction and being up north, be careful with the cold and dry until it heals...the last ting you want is to develop a dry socket. | ||
| Ourdee |
My dentist was talking about having the screw put in at another dentist for about 1200 out of my pocket and she would just accept the insurance payment for the next 2 parts. Of course I could have been hearing wrong at that point. I know I have a little while before making a decision. | ||
| Theironmaiden22 |
1200 isn't too bad for an implant, out of your own pocket anyways. At least your insurance covers implants otherwise you'd probably be paying 2 other 1200$ payments out of your own pocket. Did that dentist figure in the periodontist costs and the anaesthesia too? | ||
| Ourdee |
I don't know. The pain was pretty intense at that point. | ||
| Husky |
My wife has 3 of the titanium implants, at an average of 3K each and is very happy with them. On one of them they had to first build up the jaw bone using either ceramic or cadaver bone chips before installing the implant. This took 4 months for the jaw to regrow the necessary amount. Joe | ||
| Paralegalpete |
Can't really help you out as I am facing the same decision. I just had (today) my second rear lower molar removed as it was too badly cracked to have a root canal on it. In December its opposite number was removed for the same reason. So like you I've been living on pain meds for almost 3 months. I also found out today that the adjoining molars now have hairline cracks and of course they will be carrying the load. I need to get caps on them and then implants for the teeth that are gone Total bill = 8 grand. Hope things work out for you. | ||
| Ourdee |
I feel your pain. I hate the narcotics, keep me on the edge of spitting up. I do like the instant banana cream pudding. I always think I'm blessed. This week I don't live in Haiti. And I have had friends call to check on me. Hang in there Pete. | ||
| Just_ziptab |
My Dad sez...take care of your teeth!He's 91 and got dentures about 4 years ago and still just hates it all. He had all his teeth jerked out in one sitting and ....surprise,there was an implant he had completely forgot about from WAY younger years. | ||
| Fltwistygirl |
Seems there's an epidemic of dental problems going round, even beyond Badweb. My friend just went thru 10 days of hell with a cracked bridge. I just spent 4 hours this afternoon looking for a new dentist, finding the one in the area taking appointments sooner than one week out, getting x-rayed, numbed, poked, prodded, drilled, suctioned and generally grossed out. The cause: taking a big bite out of a slice of seemingly harmless cheese pizza, hearing "kuuurrrunch", looking at the plate and seeing half a tooth staring back at me. Insurance changed at the new year, old dentist no longer covered. Panic, started calling around. Snowbirds are here, don't dare get sick now. Somehow got lucky, found an opening and hauled AZZ. Old filling had deteriorated and cracked. Need a new crown. Jaw is numb, son is laughing at my strange speaking patterns and telling me to french kiss the cat (yuk!) if I can't pucker up to give her a smooch on the head, pocketbook has $611 less in it, but thank goodness for insurance coverage and dentists offices who are willing to work a total stranger in. Any of you in the dental care biz, you may feel like you have thankless jobs, but know you make a difference and are appreciated.  Teaching this weekend in total discomfort would have been a drag. Now I'll be able to focus on the student. B. | ||
| Ourdee |
The dentist that pulled mine called me at 9 that night to check on me. I was impressed. |
