Scared about the implants

[Hellga]

I have had problems with my front teeth ever since poorly made and inappropriate (as I now know) orthodontics device designed to correct my underbite when I was 7 essentially rubbed holes in my front teeth (8 &9) by the time I was 10 or so, so at the age of 19 or 20 I had to have crowns put in. The first crowns were OK and lasted some 8 years before I decided to replace them for aesthetic reasons (there was an ugly black line between the top of the crown and the gum line). Then I had a couple beautiful crowns that broke because they were placed on old posts that seemed strong but weren't. Then replacement posts broke too, and I was told that this is my last crown option, the next time something goes wrong, I will have to go for implants. Well, #8 root broke and a piece of it pushed through the skin at the end of 2019, so the tooth was extracted on January 13th. I had bone graft put in and gum graft, and got a flipper a couple days later.

My sutures started to come out only a couple days after the surgery. My gum looks pretty terrible now, 5 days out, though swelling is starting to subside, it looks like I have a triangle cut out (there was a hole before the extraction, even, from where a piece of the root poked through the skin) - not sure what happened to the supposed gum graft, will ask my dentist when they reopen on Monday. The flipper hasn't been adjusted yet but feels rather tight and I cannot eat with it - only drink. And I speak with a slight (at least I hope it's slight) lisp. I am sure glad I accepted a job offer before this all happened or I would not feel very comfortable going into job interviews like this! But this is also a complicating factor - I am moving to Boston from New York and will have to find a new dentist there to proceed with the implants.

So I am so worried about all the problems - the gum recession (will it be super-bad or can it get better? will gum graft help? will I have multiple ones?), the implant (I am only 36, I will need that implant to last potentially 50+ years!), the fact that anything can go wrong (though I do have titanium plate and screws in my arm which I broke last year and it has healed beautifully). that I need to find a new dentist in a new city... This is my front tooth, so aesthetics is very important, and I am single and actually hope to find someone to settle down with (started to work on that but then I lost my job and had to start looking for that instead!), and how do I go on dates when I cannot eat anything other than smooth soups? How do I kiss with this thing on? It will be months before implant can be put in given the bone graft... And then I will eventually have to go through the same thing with the other incisor... I should be getting my house in ship-shape for sale and move but instead I have been sitting for 10 days freaking out about all the things that could go wrong and feeling sorry for myself...

 

[MountainMama]

I am not a dentist and can’t answer all your questions but can relate with the front tooth implant. I had a childhood injury which chipped my front tooth. It was filled and forgotten...never hurt or caused issues. 30 years later it abscessed and I had to have it extracted after a failed root canal and apicoectomy. Due to the apicoectomies, I had a rather ugly depression in my gums above the tooth. It looked sunken in after the tooth was extracted, even after extensive bone grafting. The oral surgeon put the implant in at the same time he extracted and did bone grafting. The gums looked just awful and I was terrified that they would always look weird and misshapen. I was embarrassed to smile too much, even with the flipper, because the gums above it looked funny. If I didn’t show the gums everything looked great.
I just had the gums opened and the healing cap put in on Tuesday. The healing cap expanded the gums somewhat, giving me a better idea of what it will look like with the implant crown in. It looks much better! So yours will look different as well with the final implant and crown.
Another thing is that my gums filled in more and didn’t really recede at all in the four months between implant and healing cap. In fact, I have the opposite question. I am worried that the top of the crown “gum line” will be much lower than with my natural tooth next to it! I have to ask my dentist that question when I go for impressions in a few weeks.
Oh and it took about two to three weeks before I felt comfortable eating with my flipper but now I can eat just fine. It was suggested to me to use a small amount of denture adhesive on the palate of the flipper to make it more secure, as mine got looser throughout the day. I also have no issues kissing my husband now as well. It does get easier.

 

[Birmanclaws]

I can really identify with you - my front teeth problems started with bad orthodontics, although I am much older than you. Like MountainMama I went through root canal treatments and apicoectomies until the bone graft and implant options were offered.

Both my front teeth are implants, I had bone grafts on both teeth; the process does take time, but it is one of the easier (if expensive) dental treatments. I also had indents in my gums and thought I would end up with gum grafts, but due to the fantastic periodontist who did my implants, all came out OK in the end.

One thing that helped me get through this was the once the first implant was healed, I had a composite bridge (Two front teeth, for show purposes only) attached to that implant while the process for the second implant/crown happened. Then when the second bone graft/implant I had both crowns made and attached.

Talk to your dentist, they have lots of options they can go through with you.

 

[Hellga]

Thank you for sharing your experience, MountainMama and Birmanclaws. It is reassuring.

I called my dentist and went in today instead of Friday for follow-up... he thinks it is healing well, but he isn't sure about the bone, so I will be heading back to the endodontist in three weeks to see how it is healing, so if something isn't right, we can fix it now instead of three months from now. The flipper was adjusted today so it doesn't affect my speech now, I think, though eating still feels next to impossible. He did say it will get easier in a couple weeks, as the tissue heals.

He originally wanted to cement a temp crown in, but the tooth next to it is a crown, so it wouldn't work, and a different type of at temp wouldn't work with my bite after the lab tried it, so I have what I have. I have five different bites (whereas most people have maybe two) which further complicates the issue... I will get through it, but it sure is scary how long it will take... and I know I will have the same thing eventually with the other front incisor. Though hopefully no bone infection and apicoectomy on it, unlike this one... This one actually had a cyst on top so she had to go pretty deep into the bone...

 

[Hellga]

Just had my follow-up with the endodontist and she said everything is healing well, but I will probably need another bone graft at the time of implantation. Tentatively sometime in May, but I have to find another dentist now, because by May I will be in Boston...

Implants are such a major piece of work - just HOW does one go about selecting a dentist in a new city? I guess I can ask my new co-workers to see if they can recommend anyone.

 

[MountainMama]

Just had my follow-up with the endodontist and she said everything is healing well, but I will probably need another bone graft at the time of implantation. Tentatively sometime in May, but I have to find another dentist now, because by May I will be in Boston...

Implants are such a major piece of work - just HOW does one go about selecting a dentist in a new city? I guess I can ask my new co-workers to see if they can recommend anyone.

That is great that things are healing well! It is definitely a long process.

You might try looking up oral surgeons in your new location and ask their office if they could recommend dentists that do implants. They would work with the ones that do and could give you a starting point. Then you could look at reviews online.

 

[krlovesherkids777]

Hellga,

I think many dentists in the US offer free comphrehensive consults and exams for people interested in implants. I know mine does . and I've had 2 others a few years ago. it is worth a look into. I would also look at fb pages and website to see how anxious friendly they are in the process

 

[comfortdentist]

It sounds like you need someone who is willing to take the steps to get good conditions. You are young and once the implant is placed it is difficult to "fix" an aesthetic problem.

 

[Hellga]

My dentist did recommend a couple places - one in Boston proper, one in a suburb half an hour away where he knows dentists (not implant people, but regular dentists). Maybe they can recommend someone they know and I can look up reviews...

 

[Hellga]

It's been four years and lost past my update time. I went for an implant consultation in August 2020 (COVID and moving to Massachusetts impacted the timeline), the surgeon referred me to a cosmetic dentist and the two of them created a treatment plan for me, plus they involved an orthodontist to better align my jaws and teeth. It was a three year journey and I finally got my implant placed in May 2022 and final crown placed in February 2023. It's been almost a year, my front teeth (one implant and one crown) look beautiful and very natural, and implant has not given me any trouble so far. I needed not have been so afraid.