Replacing front tooth

[eks6426]

When I was 3 I fell off a chair and hit my front tooth. When I was 11, I had a root canal on that tooth. Last year, I had a redo on the root canal because there was an infection. I just had my 1 year check up and the infection has not gone away and the bone loss around the tooth has not grown back. So, now the endodontist and my regular dentist are recommending I get an implant.

They say that likely I will need a bone graft after the extraction that will need to heal for 6 months before the implant can be placed. Then the implant will be inserted. Wait another 3 months or so before the dentist can do the final crown work to replace the tooth.

I just got braces off about a year ago so I''''m really tired of dealing with my teeth.

I''''ve been told they will make a "flipper" which is basically a retainer with a fake tooth on it. That can''''t look too pretty on a front tooth. They also said I can''''t eat with the flipper in so I will be missing my front tooth whenever I eat which I know will make me extremely self conscious. I''''ll probably hid for 9 months and not eat around anyone...I guess it will be good on the budget since I won''''t be doing restaurants or dinner parties.

I have was given a choice of going to a peridontist or an oral surgeon for the extract & implant. Which would be better?

What questions should I ask? Anyone been through this. I''''m just totally freaked out about the idea of missing a front tooth for really 9 months or more.

 

[Kaleigh]

I''d get a second opinion. I''ve been through h***l with my teeth too, not this exactly. But always best to seek out the best in your area, get recs from friends, even your family dentist. That seems like a long road to me, and hopefully a shorter one can be found for you. I get the healing part, but sheesh. Good luck!!

 

[Ellen]

Date: 11/8/2007 2:26:18 PM
Author:IslandDreams
I have was given a choice of going to a peridontist or an oral surgeon for the extract & implant. Which would be better?

What questions should I ask? Anyone been through this. I''m just totally freaked out about the idea of missing a front tooth for really 9 months or more.

An oral surgeon. A good one.


I haven''t been through it personally, but had a friend who did. Hers was in front, but on the bottom. Yes, it''s a pain the youknowwhat, but it doesn''t last forever, and once the implant is done, you''re done.

 

[somethingshiny]

I had an injury to one of my front teeth when I was a kid. We never had insurance or money, so we just kind of shoved it back where it belonged. It did take hold again and was "fine" until a few years ago. The dentist said it was severed at the root and was basically being held in by skin. Needless to say, that tooth had to go. Root canal and all that, too. BUT, my dentist put a filling type material to sculpt a new tooth. It lasted several months. Ask your doctor if he can do something like that for you.

 

[widget]

Hi, ID....I''m no expert, but I''m learning some, since I too have been disciussing the implants lately with my dentists. Sob..

Anyhoo, the long time you''ve described sounds pretty typical to me...and everyone I''ve talked to says implants are worth the trouble and $$...

It seems to me that there must be some sort of prosthertic device that could be used that DOESN''T need to be removed every time you eat...I''d sure push for that if I were you...

Good luck!

widget

PS: To all you kiddies out there: floss and see your dentist regularly. If you do, you probably won''t have to be talking "implants" to your dentist when you''re my age!!!

 

[erica k]

I''m really sorry for your dental problems. It sounds a bit more complicated than what I had to go through:

When I was 10, I knocked my front tooth out while roller skating. We rushed to the dentist where they were able to stick the tooth back in. 2 years later the tooth turned a bad color and my dentist did a root canal. When I was 17, my dentist decided to put a crown over the tooth. 10 years later, I go to a different dentist who tells me my tooth is completely dying and I should get an implant (it feels fine to me...). He also thought that the other front tooth was weakening from the 17-yr old impact because it appeared to be dropping on one side. I had assumed that my recently crooked teeth were a result of my wisdom teeth finally coming in. I go back to my old dentist (in California), and he tells me there''s nothing wrong with the tooth, except that it''s never going to be 100%, but I could get a new crown since the old one no longer looked right. It appears that my teeth had become larger since the first juvenile crown was made. My parents had been making fun of my mismatched front teeth for about a year, but my husband thought my smile was endearing. Since my parents agreed to pay for it, I thought, why not?

The ''flipper'' sounds like bad news bears! When I had my first crown made, I had to wear a plastic veneer for a week. It split down the front and there were quite a few people who teased me at school about it. The second time around, the veneer cracked again. This time I was at home doing research for my dissertation. I had to do interviews with planners and speak with archivists. Needless to say, I was mortified. But after a certain point I stopped caring about how I looked. My research was more important than a really icky-looking front tooth.

I strongly recommend that you get a second opinion and sort out your options. Do you really need a bone graft? That sounds like serious business...

 

[TravelingGal]

ID, I know EXACTLY what you are going through. I have an implant in my front tooth. It was TOTALLY worth it.

I struggled with it a lot. I did not like the idea of losing a tooth. I was 32 at the time and thought I was too young to be losing teeth! But I was a tomboy growing up and the tooth was definitely dead from all sorts of knocks. They could never get a crown to look right and I hated my smile.

On top of recommending I get the implant, my dentist also recommended that I get a porcelain veneer over the other front tooth. She said it would be the best look, as it''s hard to match anything EXACTLY to another tooth (even two crowns, for that matter). That was even tougher for me to figure out, since once I shaved down the tooth (which was perrfectly good), it was gone forever and I would have to get veneers to upkeep it forever.

I knew from hearing it from a lot of dentists that the color and gradation of my teeth were hard to match. After a ton of research AND a second opinion, I decided to go for it.

Of course, the WORST thing you hear about is that damn flipper! I had always been sensitive of my teeth, and then to think that now I would have a GAP TOOTHED smile! Ugh! No way! While I was living alone at the time, I had already planned a visit to TGuy within the 6 month time frame needed for the implant to take, and the thought of him seeing me like that was SO deflating.

But honestly, it''s a NECESSARILY evil in my opinoin. My dentist was really good, and I was shocked when they put to the flipper in that it looked better than some crowns I have had before. I don''t know if it''s because the crowns were so bad it set the bar low, but I was pretty happy with the flipper in.

I think it''s also necessary because you REALLY need to keep that area clean to get ready for the crown. I took meticulous care of my teeth during that period. Also, I learned to eat with the thing on quite easily...it''s like eating with a retainer on. Kind of gross, but really, better than eating in public with it out! One thing I had to be very conscious of not doing (that I did with my retainer) is flip it in and out...wouldn''t want my tooth moving around and scaring people, hehehe. I did keep my passionate kissing of TGuy to a minimum though.

BTW, I spent a week with TGuy 24/7 and he never saw me without the flipper out. He did ask though, and I told him to piss off!

I can''t remember what kind of dentist I went to for the implant (it was a team effort...my primary dentist was the cosmetic lady, and a gentleman did the implant), but he was very well known and a leader in his field. I googled him, and things seemed to come up A-OK. I really liked his staff and was AMAZED at how painless the procedure was, but I guess I may have a high tolerance for pain? It didn''t take long at all...tooth extraction then put the implant in. I don''t believe I needed a bone graft, but I can''t remember. Recovery process for me was pretty much nil. I remember no pain at all after the surgery. I have had cleanings that left my teeth more sore.

It is VERY important to find a great cosmetic dentist. Mine sent me to the actual lab to have the technician look at my teeth in all sorts of lighting. He made a diagram of my teeth and color coded each region so it would look natural. When I left the lab, I actually remember tearing up a bit. All those years of frustration and an icky front tooth and there was a different way all along. I didn''t have to have a uniform colored crown! I remembering calling TGuy in Australia and telling him how elated I felt!

It''s been wonderful to have them in. And I have to say, I am glad I did both teeth, because it looks pretty darn good. I WILL say that it''s harder to keep clean. Right now, I am having bleeding issues since I am pregnant, but it''s hard to know if it''s not problems with the implant. However since I can''t take xrays, I will have to wait to see what is going on. It helps that I don''t have a gummy smile, because I will admit, it''s looking a bit battered up there the gumline right now. The rest of my teeth are fine. Either way, even though it''s still not perfect (meaning the bleeding gums), I am so pleased with them.

So add me to the list of those who think it was all worth it. It''s definitely hard in a lot of ways, but there are worse things one could go through. Don''t skimp on your teeth and ask lots of questions! I paid a LOT of money (living in LA, plus having an expensive dentist) and sometimes I''m amazed that my two front teeth cost me way more than the diamond on my finger.

 

[robbie3982]

I don''t have implants, but I''m missing the 2 teeth on either side of my front teeth. When I was growing up, they thought I was only missing one, so after the first time I had braces (I had them twice between the ages of 9 and 15) they gave me a retainer with a fake tooth to hold the place that they''d created (never knew it was called a flipper!). They were talking about doing an implant or a bridge or something in the long run, but wanted to wait for me to lose all of my baby teeth first. I had that retainer from 5th grade through 7th grade. I was sooo self-concious about it. I wasn''t supposed to eat with it in, but I always did. Middle schoolers are horrible with teasing to start out with, so there was no way I was showing my face around school with that tooth missing. The tooth never broke off. I think I may have broken the retainer in other ways, but the fake tooth was fine.

They finally realized that I was actually missing both adult teeth (I''d had one of the baby teeth) so they just moved everything closer to the front to instead of doing bridges or implants.

 

[HappyAnniversary]

Flippers can be made where you can eat (carefully) with them.
I would highly prefer a periodontist for implants--they are focused on care of the supporting structures to the teeth which is what implants are all about.
Bone grafts are not difficult or any more uncomfortable--just adds to the cost but if you need it, you need it.
Implants are miracles! You are lucky to be living in the time/place where they are an option.
Good luck!

 

[scarleta]

Island Dreams: there is simply no replacement to your own tooth.You have to explore all options first ..
As for a choice who to see you need to meet at least two good and experienced surgeons/ Periodontists and see who you feel more comfortable with.If you don''t feel comfortable with the first two then keep looking.
As to your questions on what to ask I would ask the cost, complications and where are they taking the bone from for the graft?
What if the bone gets rejected?
How much bone loss do you have in that area? Ask if there is any potential problem to the surrounding teeth if you wait?
Ask them why did you get infection again after the work was done one year ago? Could this have been prevented??
What are the chances of getting infection in that bone again?after it gets grafted? Are the rest of your teeth ok? Or the infection may spread?
I would also ask if you have any alternatives ? Or only implant? What is the follow up after any specific foods that you may not be able to eat? Just explore it a bit more.
You need to feel very comfortable with the procedure and with the person who is going to do that procedure.
There are risks that you should be aware of before making any decision.
I hope it works out really good for you.

 

[BZ]

ID, I just thought I would add my story and my thoughts. I had a tooth, just left of the front that was cracked above the gum. The dentist tried to do a root canal. The idea was that they would do the root canal and then go in and fill in the crack (they were afraid the tooth might break some day while I was biting into an apple). The root canal happened, but then I had an infection and they decided they could not save the tooth. My dentist called me and told me about this new thing they could do with implants (this was 15 years ago). After lots of research, I decided to go through with it. I had an oral surgeon extract the tooth and he put in the implant. I wore a flipper for 6 months before they recovered the implant and put the crown on. I did do some teeth whitening to try to get all my teeth the same color. It was very painful for me, so it didn''t last long. Anyway, I have had this thing for 15 years. No trouble, no regrets and worth every penny (I was just starting out at the time, so it seemed like a huge amount of money). People don''t know it''s an implant and many of the dentists I have seen since are very impressed with it. Oh and I might add that I was not engaged, but living with my DH at the time and he put up with my missing tooth (with a few jokes now and then) at night.

My Mom also opted for an implant to replace the same tooth I lost when she fell down walking. She had to do the bone graft and flipper as well. But, in the end, she was really happy with the situation.

I know that a flipper sounds like a drag (I am pretty sure I ate with mine in since I was in a corporate environment and can''t imagine taking it out to eat) but in the end, it''s 9 months total to make a change that will last a really long time.

Good luck.

 

[eks6426]

Thank you everyone for your encouraging stories. I''m glad to hear the implant on a front tooth will most likely work out in the end. I''ve known that the implant was likely going to be needed for a few years now...I tried to save the tooth by doing a redo on the original root canal I had when I was 11 even though my dentist told me he didn''t think it would work. The bone around the tooth has been reduced due to continual infection. The dentist thinks its likely I''ve had a low-grade infection since the original root canal or maybe even before...basically my whole life.

I currently have 2 appointments...1 with an oral surgeon and 1 with a peridontist. Unfortunately they will cost me $200 each appointment. The oral surgeon appt is Nov 20 and the peridontist appt is Jan 2 (soonest I could get in for both). I''m somewhat tempted if the oral surgeon seems good to skip the peridontist appt but part of me really wants to get both opinions even if its costs an extra $200.

My regular dentist will make the crown but I am very worried about the color matching etc. TG--I will ask if I can go to the lab where the crown is actually made. I have bleach trays right now and plan on bleaching my teeth. Do you think I will still be able to use the bleach trays when the tooth is extracted as long as I take out the implant? Or should I bleacvh shortly before the extraction...or both? Or should I spring for the zoom bleaching--if yes when...before extraction or before the final crown is placed? What about down the road...I know with bleaching I need to touch up every 6 months or so...so with a crown it would stay "white" while my other teeth get dingy????

I''m so relieved to hear that I should be able to eat with the flipper in. That was the worst part of this to me...having that gapped tooth look during meals.

I just got braces off less than a year ago. I have a retainer that is basically a plastic that goes over all my teeth...like the Insignia invisible trays. Would it be better to see if the flipper can be my true retainer too for the 6-9 months?

 

[Harleigh]

Hi ID!

I''m so sorry you''re having to anticipate this ordeal, but according to my mom, who has had 4 implants, it is well worth it.

I believe she was involved in an ongoing process for about 9-12 months, of which most of she hated, but she now said she wouldn''t have it any other way. I believe she went to an oral surgeon, but she did not have the same issues as you, so that may be where a periodontist would be advisable...research is definitely a must!

So, with that said, if you can tough it out, I think it will be well worth it in the long run!

 

[BZ]

I''m glad you made an appointment to see the oral surgeon. From what I have heard, he may be able to tell you what to do about the bone loss you have had, so you may not need the periodontist. What they did for me, was extract the tooth and then have me do the whitening (this was 15 years ago, so the whitening wasn''t as great). When the whitening was done, the dentist sent me over to the lab to have the crown matched with my teeth. They were able to get really, really close.

I''m sorry I can''t help with the zoom whitening. Your dentist should be able to tell you which whitening will last the longest. I''m not sure you can use whitening trays after the crown in placed on the implant.

Good luck.

 

[eks6426]

So, I''ve been working on what to do about my front tooth. I''ve seen 2 specialists:

Oral Surgeon: I''ve seen an oral surgeon who confirmed that I do have bone loss and will need a bone graft. He recommends using freeze dried bone. He wants to use an Essex retainer with a fake tooth glued into it for me to wear while the bone graft & implant are healing. The Essex fake tooth will be curved to grow the gum tissue to the proper arch. He thinks we could do 1 stage implant which has the collar exposed during the heeling process although he''s not sure...will depend on stability. Once the implant is healed, my regular dentist would create the crown & install it.

Implant specialist: The implant specialist also confirms the bone loss. He recommends pulling the tooth and letting the current infection heal before doing a bone graft. For the bone graft we wants to harvest from my jaw rather than using freeze dried bone. After the bone graft, the implant goes in and wait again. To fill the tooth space, he actually recommends putting braces brackets on my 4 front teeth and then gluing on my actual tooth to one of the brackets (even though it is no longer attached to my jawbone). He wants to grow the gums down a bit over the braced tooth so there wouldn''t be the curve until he does the gum shaping during the crown procedure. When it''s time to do the crown, he''ll use a temporary first to help with gum shaping, Then finally he will do the final crown...although he highly recommends I go to a crown specialist that he calls an "artist"...the "artist" involves a flight to Colorado (I live in Indiana) and $3000 more.

The implant specialist charges DOUBLE the cost of the oral surgeon/home dentist option. That''s not including the "fly to Colorado" option. I think the implant specialist will probably do a better job overall but is it thousands of dollars better? The only way I have to finance any of this is on a credit card or a possible home equity loan. What would you do?

 

[scarleta]

Island Dreams; you did a good job getting 2 opinions.Personally I would not think of $$$$ right now ,but rather think of the outcome.. I like the implant Specialist''s approach better for few reasons.
Who do you feel more comfortable with? You can ask both of them if you could speak with couple of their previous patients who had similar procedure done in the past 2-3 years.
That should not be a problem with someone who is competent in his / her field. Make sure its no sooner than 2 years ago that way you get a more accurate report..It may help you make your decision.
Ask the implant specialist who would he use for his own crowns if the" artist" who he is recommending to you now was for some reason not available to do that.Ask him for someone who is local..
I like the idea of temporary crown first to let things shape up a bit.
I would just be honest with the implant specialist and let him know that his fees are bit too high for you.Could you qualify for a small discount possibly.
Just be comfortable before you make a final decision..

I know most people who are very happy with the outcome, but there are instances that for some reason the outcome is not great..Don''t get me wrong this is not meant to make you apprehensive in any way ,but just to make you aware.
Sounds like you are in good hands and have done your work and in some instances implants are the only way to go and they work really well..
Its your front tooth so you really want a good job..
Good luck to you..

 

[Deelight]

I would personally go with whoever you think can do the best job a smile lasts a lifetime and is one of the things we see first in people

GL with the procedure

 

[fisherofmengirly]

My story is similar to Robbie''s; I had baby teeth on either side of my two top front teeth, but adult teeth never came in. When it was time to get braces, because the baby teeth have no real "roots," my ortho suggested they be pulled, and then the other teeth moved forward to close in the gaps.

Well, that ended up not being a good option for me because I have a small mouth and it was starting to give me the "older lady" look that people sometimes get when their teeth crowd up in the front. It just wasn''t working right.

So, they moved the teeth to create gaps again and then I had two false teeth on my retainer. When my retainer came out (happily, like a month or two before our wedding!!), I was given the option between implants or marilyn bridges. My mouth is small, and the bone structure of my teeth is very small, so my Dr. suggested the marilyn bridges. That''s the cheaper route, and that''s the way I decided to go.

A marilyn bridge is basically a tooth that has "wings" on either side of the back of the tooth, which attach to the teeth on either side of the gap, creating a bond to hold the false tooth in correctly. No one can tell, at all that these aren''t "real" teeth.

I''ve had one of the bridges get loose numerous times, but they finally found a bond that worked for me. The other has never even been loose a little bit. Comparing to thousands and thousands of dollars for an implant on TWO teeth, this was the much less expensive way to go.

The only downside is that I can''t bite into apples anymore, but I''ve always been one to cut them into bits, anyway.

Good luck making the best choice for you. Find a Dr. you feel comfortable asking a TON of questions about, and make sure if anything doesn''t go the "right" way (like the loose tooth issue I sometimes have had), they will fix it, for free. It''s important to know they will stand by their work and work to make you happy.

 

[fisherofmengirly]

I forgot to add, I ate with my retainer in with the false teeth, all the time, every meal, and never once had an issue. Again, just have to be careful biting into things. That''s what will get you!!

 

[brazen_irish_hussy]

A close friend of mine had the same situation in high school. We were friends for 6 months before I knew one of her front teeth was actually attached to a retainer. It looked the same and she always wore it when eating. The only reason I found out is that when a guy was REALLY persistant (she was model material) she would open her mouth and let one of her front teeth drop out which usually did the trick!

 

[BriBee]

I have gone through this procedure. I had my top front tooth pulled and replaced with an implant. It was the tooth right next to the two main big front teeth (up front and very noticeable). I will say that the process was not fun, but it was worth it in the end. I would recommend a good oral surgeon, as that's who I worked with. My oral surgeon did the actual implant, and my dentist made the tooth that fits over it. It looks perfect now, and from what I've heard, it will last forever. Now a couple of my issues....I didn't have to have a flipper like you, but I did have to wear a temporary tooth over the implant for 6 months while everything healed, and the bone fused etc etc... The temp. tooth wasn't the same quality as the permanant one, so it was kind of see-through. Basically, the tooth looked blue/gray in color because you could see the metal of the implant showing through. This made me self concious because it looked like a tooth that's been injured and is basically dead (if you've seen one) so I went from a perfectly normal smile, to having the bad tooth pulled (even though it still looked normal) to having this weird colored one for a while. I got used to it of course, but friends did call me "blue tooth" sometimes. The other thing was that I couldn't really eat with that part of my mouth while it was healing and setting into the bone, so that made things more difficult as well. And, to top it all off, my insurance would not cover the procedure because they considered it to be "cosmetic." So I had to come out of pocket myself for it, somewhere to the tune of $6,000. It's pretty stupid that they would be willing to cover a crown that would need fixing/replacing every 3-5 years for the rest of my life, rather than cover this ONE time, PERMANAT fix! That's insurance for you. All in all, I am extremely happy with the results, the tooth is perfect, and I had great doctors. The only other tiny issue is that the tooth they put in will most likely be made to match your other teeth as far as color. So, if you ever want to whiten/bleach your teeth, the implant won't change color, and it could look funky if your other teeth became whiter. If you've ever thought of doing something like this, I would recommend doing it before hand so your implant can match your whitest teeth. I have done the Crest White Strips at home and gotten my teeth whiter without it being noticeable on my implant, but the professional whitening might be a different story.