bridge or implant, lets talk teeth

[Arcadian]

So sadly, its time. This is a discussion I haven't wanted to have for a very long time. My teeth are, unfortunately, dismal all thanks to several courses of chemo many years ago. I've done a very good job taking care of them, but it is what it is, and they are for lack of a better word; crumbling. they can't fill them anymore and I'm having a pretty nasty situation where they will likely have to remove several.... So tomorrow there's going to be a come to jesus talk about the next steps.

I do not want typical dentures! but I'm looking for some thoughts about implants, bridges, or even both and the pros and cons and what I should be aware of when talking to the dentist about this.

If anyone has had these procedures done (even if its not whole mouth) and you don't mind sharing, I'd love to hear about your experiences.

right now all I know right now is that its gonna cost a lot...

 

[CHRISTY-DANIELLE]

I am in the implant process now. It is not cheap, 4k or so, ( & seriously digging in to my bling fund). But, my dentist said implant or bridge? "Keep in mind, you'll have to take out the bridge to eat". That's all I needed to hear. An implant, once it's done, is just like any other tooth.

 

[SandyinAnaheim]

I am in the implant process now. It is not cheap, 4k or so, ( & seriously digging in to my bling fund). But, my dentist said implant or bridge? "Keep in mind, you'll have to take out the bridge to eat". That's all I needed to hear. An implant, once it's done, is just like any other tooth.

I agree with the above. I have a couple of molars that I just put crowns on, and my dentist told me next time it will be a bridge, for the same reasons you have problems, except my jaw bone is weakened as well. My aunt has an implant and she says it feels just like a tooth. If you can afford it, I would go with implants.

 

[Austina]

Bridges are cemented in, so I don’t know why the dentist would tell you that they need to be taken out to eat. Even well fitting dentures aren’t taken out to eat.

You need really good bone for implants to be successful @Arcadian

I’m tagging @Tekate as she’s had numerous problems with implants so if she’s happy to share, I think it’s well worth hearing her experience.

Once fixed, assuming the teeth either side are strong enough, bridges rarely cause problems, and don’t involve major work involving jaw bones, unlike implants. That’s not to say that implants aren’t successful, just that if you get problems, they can be serious.

 

[Arcadian]

Bridges are cemented in, so I don’t know why the dentist would tell you that they need to be taken out to eat. Even well fitting dentures aren’t taken out to eat.

You need really good bone for implants to be successful @Arcadian

I’m tagging @Tekate as she’s had numerous problems with implants so if she’s happy to share, I think it’s well worth hearing her experience.

Once fixed, assuming the teeth either side are strong enough, bridges rarely cause problems, and don’t involve major work involving jaw bones, unlike implants. That’s not to say that implants aren’t successful, just that if you get problems, they can be serious.

@Austina I do worry if my teeth in general are strong enough/and if I do have enough jaw material. This is where chemo sucks so bad...the aftermath.

I do hope @Tekate pops in with some words of wisdom.

The side where I'm having the biggest amount of issue, well...not much left there. I've got 2 molars one of which is not all the way in (yeah I know!!).

I will get more info at this appt as to the situation and how many teeth are involved (hoping for as few as possible, and let you guys know this afternoon if I'm not drugged up...lol

 

[Austina]

Good luck @Arcadian

 

[Taylorbug!]

I tried and tried to get an implant, but it failed. I had 2 bone grafts and then got the mounting screw for it. That stayed in 4 days before my body started rejecting it. Swollen jaw, pain, etc and it came out! Unfortunately for me, it is a back tooth so I am unable to get a bridge.

 

[Arcadian]

So I'm back and thinking.

The good news is this: I might be able to just do a bridge. three teeth are involved. One tooth is just gone, the others can be capped and they both seem secure enough. If I can't do a bridge then its caps and an implant. They won't really know until they go in and clean things out.


Based on xrays, my jawbone is very sound and implants should not be an issue. @Taylorbug! do you remember what you had? (titanium?) I'm trying to dig up as much info as I can. I'm very sorry you had a rejection, I would be majorly freaked out/ upset. thats a ton of money down the drain!

The appointment is for next Thursday, so I have plenty of freakout time between now and then. I will have to be on antibiotics between now and then too (600MG/Day!!!!) The travel I've been doing has exposed all of this, so at the moment its not the worst it could have been!

Xrays show my jaws bones are in excellent shape So if I HAVE to get an implant, I should have enough to dig into.

Onto the money. Money wise its cheaper for a bridge (but of course!) based on the entire procedure the way they'd do it would be about 4k (with insurance) but if I had to go the implant route, roughly 6K. Does this sound about right?

 

[Austina]

I can only gauge prices based on my knowledge in the UK @Arcadian, and I know dentistry is more expensive in the US.

The dentist I worked for really didn’t charge enough for his work, so 2 crowns and a bridge would probably be about £1000, 2 crowns and an implant, probably about £3000. Other local dentists would charge £1000 or more for crowns.

That’s really great news that your bone density is good.

 

[Taylorbug!]

@Arcadian , yes, it was titanium. The last Dentist I went to said I could have another bone graft (width and height) and they would also need to move the nerve in my jaw to place a new implant. $10,000.00 and no guarantee that it wouldn't reject again. I just decided I would have to do without a tooth there.
FWIW, if I had the option, I would go the bridge route. I know implants do work for many, but there are just too many variables involved. No guarantee it will work and you still have to pay the money. (I paid for 2 bone grafts, and the titanium implant. My dentist did refund 1/2 of my money for the implant)

 

[Luce]

Hi @Arcadian,

I had one successful implant about 5 years ago and am in the middle of a second one. I will get the abutment in August. Implants are expensive but worth it to me. My insurance covered part of it this time around. Good luck to you!!!

 

[asscherisme]

I am sorry you are going through this. I had a tooth that had a second root canal and the endodontist prepared me for the fact that it only had a 50% success rate. Thankfully it took. But I researched options in case I lost that tooth. I would have definitely gone for an implant if I lost it. If that would not have worked, then bridge that is cemented in. There is no reason you should need to take out your "tooth" when you eat. I would make sure that whatever you choose, that is not something you need to do.

 

[Arcadian]

Hi @Arcadian,

I had one successful implant about 5 years ago and am in the middle of a second one. I will get the abutment in August. Implants are expensive but worth it to me. My insurance covered part of it this time around. Good luck to you!!!

You sound like you were an excellent candidate! Where are yours located?

 

[Arcadian]

I am sorry you are going through this. I had a tooth that had a second root canal and the endodontist prepared me for the fact that it only had a 50% success rate. Thankfully it took. But I researched options in case I lost that tooth. I would have definitely gone for an implant if I lost it. If that would not have worked, then bridge that is cemented in. There is no reason you should need to take out your "tooth" when you eat. I would make sure that whatever you choose, that is not something you need to do.

The dentist did say it would be a permanent bridge I've been looking that up over the afternoon and I'm a little scared! Maybe I shouldn't be but looks like they whittle the natural teeth to nothing, then fit the caps over? and they can't be removed from what I can tell.

BTW I didn't know it was even POSSIBLE to have more than one root canal per tooth!

 

[asscherisme]

Yes, my ex husband (married to at the time) talked me into having a dentist do the root canal instead of endodontist to save money. I was stupid and listened. I was a stay at home mom at the time and he was very controlling with money, so I really had no choice. The tooth kept causing me pain for years after even though exrays looked clean. I finally switched dentists who had a good eye and detected what looked like an infection on xray and sent me to an endodontist. Turns out I am one of those rare people that have a hidden canal and the dentist missed it. So the root canal was not complete and he missed an entire canal which left nerves that became infected. The endodontist, as well as my new dentist told me that a dentist has no business doing a root canal.

I ended up spending an additional $2,500 to save the tooth between the second root canal (revisions always more expensive than the first because it is more work) and then the crown could not be saved so I had to redo it. It was years ago, and it happened to be in the middle of my hellish divorce. So bad timing! But all is good now.

It sounds like the process of a bridge prep is similar to prepping a tooth for a crown. So, an implant would be less invasive to the surrounding teeth.

 

[Tekate]

@Austina
@Arcadian
Hello Arcadian, I have much experience as Austina graciously said. My opinion on what you should do is that you should have them all pulled if they need to be, then have implants put in a certain spots and have bridges made. That is what I would do.

My experience with implants has been mixed. I've had 2 with no problem, one that didn't take at all, and one that has caused me pain, sorrow and money.

I have been involved in an infection in my jaw called osteomyelitis. This was not caused by the implants per se. 2.5 years ago I had an abscessed tooth, I had root canal done poorly and my OS pulled the tooth a year later this is where the problem arose from. My oral surgeon put in 4 implants that became infected that fell out. The last implant he placed into where I had the bad root canaled/pulled tooth, this was where the osteomyelitis started, he put the implant in and in 2 days I was in such extreme, horrible pain that I took oxycotin (which makes me sick) to try and pass out.. it was horrible, finally my OS pulled out the implant, went for my 3rd biopsy and it came back with a rare and very very very hard to treat bacteria, so for 2 years I've been on antibiotics, one caused me to have hepatitis drug induced, it has been one hell of a mess.

My case is somewhat unique as it was the domino effect really, everything getting worse each time they tried to fix it.. Going back next week for the big CT scan, I've been going to an infectious disease specialist for over 18mos now, I don't know if the infection is cleared, we shall see.

My case is extreme of course, talk to your Oral Surgeon, I would highly highly recommend that you don't have just a DDS/DMD do your implants because if there is the extreme off chance you have a problem you have a medical doctor doing your implants. You are a cancer survivor and you may have unique situations. Be wise, and do what they tell you to do.

I wish you luck and please know my case is unusual, BUT implants get infected more than dentists say, our mouths are full of bacteria.

Hope this helps.

kind regards, Kate

 

[Tekate]

Money wise, that sounds about right. Bridges are great Arcadian but they do not last, under the crowns your teeth can decay (I KNOW )

So I'm back and thinking.

The good news is this: I might be able to just do a bridge. three teeth are involved. One tooth is just gone, the others can be capped and they both seem secure enough. If I can't do a bridge then its caps and an implant. They won't really know until they go in and clean things out.


Based on xrays, my jawbone is very sound and implants should not be an issue. @Taylorbug! do you remember what you had? (titanium?) I'm trying to dig up as much info as I can. I'm very sorry you had a rejection, I would be majorly freaked out/ upset. thats a ton of money down the drain!

The appointment is for next Thursday, so I have plenty of freakout time between now and then. I will have to be on antibiotics between now and then too (600MG/Day!!!!) The travel I've been doing has exposed all of this, so at the moment its not the worst it could have been!

Xrays show my jaws bones are in excellent shape So if I HAVE to get an implant, I should have enough to dig into.

Onto the money. Money wise its cheaper for a bridge (but of course!) based on the entire procedure the way they'd do it would be about 4k (with insurance) but if I had to go the implant route, roughly 6K. Does this sound about right?

 

[luv2sparkle]

I have two crowns that have to be replaced in the next month. I am so dreading it. I am hoping they can just be replace but the dentist has mentioned hooking them together. I am such a dental baby. About a year ago, I had to have the endontist drill through my jaw to fix a root canal that had a problem. It was a miserable experience.

 

[whitewave]

My body rejected an implant twice so I had to get a bridge. I do not have to take it out to eat. It’s like my teeth— I don’t have to do anything to it.

 

[Luce]

You sound like you were an excellent candidate! Where are yours located?

Hi @Arcadian, they are the Second bicuspid (top left) and second molar (bottom right).

 

[Arcadian]

Thank you to everyone for sharing your procedures. my goodness, anything that has to deal with the mouth is a pain in the ass.

I'm on antibiotic (made me pretty sick last night), and this morning woke up and one of the three teeth they mentioned is loose. not the one they were going to take out My mouth is falling apart.... I'm hoping it tightens up again. This also means no real food for a little bit because the pain is super unreal. I'm going to be the protein shake queen for a while it seems.

@Tekate Thank you for sharing the good and the bad of all of it. I do indeed worry about additional crowns because I have a few, but so far, knock on wood, no problems with any of them (that day will come though, always does!)

 

[ame]

I am in the process of an Implant now, but the other side in the same place I have a Bridge. This one unfortunately won't work for a bridge bec one of the supporting crowns/teeth won't survive recrowning it. I had the extraction in I think November? but I haven't been able to get in for the base of the implant yet bec I had a back surgery and am playing catchup now.

I have financed like 5 range rovers in the last few years for specialist dentists. It's been rad.

 

[tyty333]

Hi @Arcadian
Going through the process as we speak. Actually, it has been a very long process. I had a root break and cause an infection. My oral surgeon removed
the tooth and had inserted graft material. Went back 3 months later and had the implant inserted. Went back 3 months later to have the abutment
put on it and the implant had not taken. Had to have it removed. Added more bone graft material and went back 3 months later. Bone did not fill in.
So now they have added more bone graft material and I will go back in August to see if my bone has filled in and repeat the whole implant process if
it has. I'm doubting its going to work though. Just seems like too my body does not want to cooperate. They have taken several full jaw x-rays. I
would have assumed that they could tell if my jaw bone was good enough or not (but maybe they couldnt).

On the other hand, my Mom has had a bridge (not removable) that she has had for 20 years. No problems. I think thats what I'll probably end up
with in the end. So, I get to pay for an implant procedure and a bridge (oh yeah).

Cost wise with insurance the implant has been $1500. This does not include the cap to go on it since I cant seem to get to that point. :roll Good thing
about my oral surgeon is he doesnt charge more for second chances.

I wish you luck Arcadian. I hope your body takes the implant without a problem.

Personally, I wish I had gone the non-removal bridge route. Its been about 10 months I've been dealing with this and will be several months beyond
a year by the time I end up with whatever I end up with.

Dont forget to take your pain pills. My doc also gave me valium for the night before and that morning. I was very thankful to have it because I am
a wimp when it comes to dentist and pain.

 

[Arcadian]

Hi @Arcadian
Going through the process as we speak. Actually, it has been a very long process. I had a root break and cause an infection. My oral surgeon removed
the tooth and had inserted graft material. Went back 3 months later and had the implant inserted. Went back 3 months later to have the abutment
put on it and the implant had not taken. Had to have it removed. Added more bone graft material and went back 3 months later. Bone did not fill in.
So now they have added more bone graft material and I will go back in August to see if my bone has filled in and repeat the whole implant process if
it has. I'm doubting its going to work though. Just seems like too my body does not want to cooperate. They have taken several full jaw x-rays. I
would have assumed that they could tell if my jaw bone was good enough or not (but maybe they couldnt).

On the other hand, my Mom has had a bridge (not removable) that she has had for 20 years. No problems. I think thats what I'll probably end up
with in the end. So, I get to pay for an implant procedure and a bridge (oh yeah).

Cost wise with insurance the implant has been $1500. This does not include the cap to go on it since I cant seem to get to that point. :roll Good thing
about my oral surgeon is he doesnt charge more for second chances.

I wish you luck Arcadian. I hope your body takes the implant without a problem.

Personally, I wish I had gone the non-removal bridge route. Its been about 10 months I've been dealing with this and will be several months beyond
a year by the time I end up with whatever I end up with.

Dont forget to take your pain pills. My doc also gave me valium for the night before and that morning. I was very thankful to have it because I am
a wimp when it comes to dentist and pain.

@tyty333 I wish I could get something for the pain, but I'm in Florida and lots of docs down here are super paranoid about losing their license. FWIW I can't take Vicodin or codeine anyway but they def. will not prescribe valium!

thankfully I have MM card, so I do a combination of THC/CBD + small amount of baclofen to take the edge off and allow me to sleep this combo doesn't work during the day, so I just sort of deal with it (and starve...so hungry right now.... Man I had better lose some weight from all this craziness!)

So some have made mention of bone grafts needed.... where the heck are they getting the material from? (do I want to know? maybe I don't wanna know....)

 

[rocks]

@tyty333 I wish I could get something for the pain, but I'm in Florida and lots of docs down here are super paranoid about losing their license. FWIW I can't take Vicodin or codeine anyway but they def. will not prescribe valium!

thankfully I have MM card, so I do a combination of THC/CBD + small amount of baclofen to take the edge off and allow me to sleep this combo doesn't work during the day, so I just sort of deal with it (and starve...so hungry right now.... Man I had better lose some weight from all this craziness!)

So some have made mention of bone grafts needed.... where the heck are they getting the material from? (do I want to know? maybe I don't wanna know....)

It depends....can be cow, pig, human cadaver, lab created....just ask. Hubby uses human cadaver.

 

[tyty333]

@tyty333 I wish I could get something for the pain, but I'm in Florida and lots of docs down here are super paranoid about losing their license. FWIW I can't take Vicodin or codeine anyway but they def. will not prescribe valium!

thankfully I have MM card, so I do a combination of THC/CBD + small amount of baclofen to take the edge off and allow me to sleep this combo doesn't work during the day, so I just sort of deal with it (and starve...so hungry right now.... Man I had better lose some weight from all this craziness!)

So some have made mention of bone grafts needed.... where the heck are they getting the material from? (do I want to know? maybe I don't wanna know....)

Hi @Arcadian...I am in Florida. My doc didnt seem to have a problem with giving me valium. He only gives me a script for 3 pills. You take 1 at night
(to help sleep if needed) and 2 before the surgery.

I hope whatever you can use (THC/CBD/MM) is enough to handle the pain. I have a feeling I have a very low pain threshold . The valium was nice
because it really help to take the edge off. I know I would have been a nervous wreck going in there without it. You're probably much better at
handling pain than I am though.

No, you dont want to know where they get the bone grafts from...ok, cadavers. There, I said it. I was not happy to learn this either.

 

[tyty333]

It depends....can be cow, pig, human cadaver, lab created....just ask. Hubby uses human cadaver.

Hey @rocks ,
So is your DH an Oral Surgeon? Can you ask him about what percent of attempts to do implants fail? I'm talking about not getting the implant to actually implant.
My doctor told me about 10 percent but after having one fail and talking to various people it seems like the real numbers may be higher.

After implants are inserted, about what precent of implants fail in the first 3 years or so? I didnt ask my Doc this because I assumed once it was
in there it was good but now I'm hearing otherwise.

@Arcadian ...spoke with my Mom. She says she has 3 bridges (all permanent). The oldest she thinks is about 20 years. The youngest maybe 5.
No problems with them. The reason the docs suggested an implant for me is that the 2 teeth on either side of my missing tooth are nice(in good shape),
natural teeth that they would have to file down.

 

[rocks]

Hey @rocks ,
So is your DH an Oral Surgeon? Can you ask him about what percent of attempts to do implants fail? I'm talking about not getting the implant to actually implant.
My doctor told me about 10 percent but after having one fail and talking to various people it seems like the real numbers may be higher.

After implants are inserted, about what precent of implants fail in the first 3 years or so? I didnt ask my Doc this because I assumed once it was
in there it was good but now I'm hearing otherwise.

@Arcadian ...spoke with my Mom. She says she has 3 bridges (all permanent). The oldest she thinks is about 20 years. The youngest maybe 5.
No problems with them. The reason the docs suggested an implant for me is that the 2 teeth on either side of my missing tooth are nice(in good shape),
natural teeth that they would have to file down.

He is a general dentist with significant surgical post doc training. His focus is restorative/prosthetics....a lot of cosmetics. The failure rate is very low for his patients, and for those he refers out to the specialist (a periodontist). They take no shortcuts. Bone grafts, CT scans, and surgical guides. He isn't cheap, and neither is the specialist her refers to. The one failure I remember him talking about was my former assistant. She had other medical complications...it took the second time.

 

[Arcadian]

@tyty333 I want your dentist Seriously, Mine is fine and they're a pretty small office that does some very good work. He knows with me to be on the lookout for additional roots bridges are his specialty. Equally, he's referring me to the proper surgeon if it does require the implant (I'm really hoping no) I thought I mentioned that in the OP but I guess not.

But no, they don't "give out meds". I had always heard the closer to Miami, the more careful some tend to be. Case in point; I whacked my hand (thought I had broken something) and it swelled up like a balloon and couldn't get my ring off, They got the ring off (cut the band AND me!) and and I got a few little stitches...but I got zero for pain meds at urgent care. I got the "you should take Ibuprofen" talk. In their favor they were willing t give me the 400MG prescription tabs which I cannot take

Pain med paranoia is the other reason why I'm so glad I have a MM card.

Hope all goes well with you, I'm still not eating because anything I put in my mouth hurts like hell an makes me nauseous (including coffee) I do try to take in protein drinks when I can.

 

[canuk-gal]

I am in the process of an Implant now, but the other side in the same place I have a Bridge. This one unfortunately won't work for a bridge bec one of the supporting crowns/teeth won't survive recrowning it. I had the extraction in I think November? but I haven't been able to get in for the base of the implant yet bec I had a back surgery and am playing catchup now.

I have financed like 5 range rovers in the last few years for specialist dentists. It's been rad.

So have we. Painful process in every regard. Just gotta hang in there.