OT has anyone here had tooth implants?

[EmGo]

EG definitely has a lot of nerve...

Jeeze you guys ... and I thought a glass jaw was the one thing I could share with Earnie Shavers. (Who just died recently, by the way. Another one gone )

Maybe I gave a wrong impression, the lady involved is a really good dentist, fixed some problems that the high-priced spread created (I grew up in Marin, we don' got no steenkin' flonkies), what I like best about her was the slow and careful approach, none of this one-day root canal crap, clean it out, let it heal up, come back in two weeks and finish, that kind of thing.

The thing was, she was so damn careful about getting all the bad bone out and I couldn't call it "pain" exactly, what with the three hundred little shots she gave every time I whimpered but damn that part about digging around in the bone ? And scraping ? and then gouging a little and scraping some more ? You know fingers on blackboard ? Multiply by a thousand. And there was no doubt that cow bone slurry was gonna go into that hole and fill it to max density, none whatsoever. The forging hammer saw to that.

https://files.catbox.moe/c8aqhf.mp4

From the standpoint of doing a good job, it was great. From the standpoint of having your body treated like a chunk of 7075 on an Ingersoll ? wa. Not much fun. And it's quite likely that most people do not have that reaction, plenty of people have told me they had implants and barely felt it. But my situation is not impossible, so.

I guess I'm just sensitive

 

[implmex]

Hi EmanuelGoldstein:
Interestingly the bone itself does not actually have any nerves in it.
It's the wrapping (the periosteum) that is innervated, and that is what is sending the pain signals and jangling your brain.

That's a trivial point of interest when you're hurting...the solution obviously is to administer more and better anaesthetic.

The most common way in the dental setting is to administer what is called a "Block" or "Nerve Block".
We aim a bolus of anaesthetic right around a major nerve trunk and block its ability to signal to the brain.

Sadly some people have a distributed nerve anatomy in some places so there isn't one nerve trunk to block, there are several like the branches of a tree.
Some have sensory nerves bundled in trunks where most people only have motor nerves.
Some have them running in different places than most others.

So the nerve block is not a sure fire thing, and the situation gets worse as you get out to the peripheral ends of the nerves...they can be running in all kinds of unexpected locations and of course, when you look in someone's mouth you can't actually see where they are.
So you aim your needle for landmarks and pray a lot.
Most times you hit paydirt...sometimes you don't.

When people do not freeze completely, it's almost always because of that reality...I had patients where I would routinely have to pound in 3 times the freezing I'd need for others of the same size and weight.
I also had the means to place my local anaesthetic closer to the brain...ie at a place where the human anatomic variability is less.
In the case of a mandibular (lower jaw) block I could use a Gow Gates or an Akinosi block if the standard mandibular block location wasn't working, but there are slightly greater risks that come with these blocks so many dentists don't like to use them.

For the totally intractable there was always the prospect of putting them to sleep completely...not trivial to do and with it's own non-negligible risks, but for some it was the only way.

I suspect, from the story you're describing, that you have "accessory" or "distributed" innervation so that a single block is not good enough to interrupt all the pain signals your body is sending your brain via every path available to it.
You can tolerate a less invasive dental procedure but you cannot tolerate surgical wounds with that kind of innervation and the limitations of block anaesthesia.

That is zero reflection on your toughness or your manliness...it is simply how your body is put together.

So now you know...kinda useless knowledge if you can't do anything about it anyway...but there it is.

Cheers

Marcus
www.implant-mechanix.com
www.vancouverwireedm.com

 

[Glug]

You have a VMC?

The rise of DIY dentistry: Britons doing their own fillings to avoid NHS bill

Over-the-counter kits intended as temporary remedies for lost fillings, caps and crowns being used to avoid costly surgery trips

www.theguardian.com

 

[michiganbuck]

USA dentists are not supposed to pull good teeth, but I know a fellow who found a dentist to do it and had the snap-in dentures put in. I haven't seen him in a number of years.
A Mexican dentist likely would do it for a low price...but in Mexico, one might get kidnapped for ransom, or killed for his wallet...
I guess one could be a smart ars at a tough Detroit bar and rid most teeth for free.

 

[boslab]

Listen to Marcus, he knows what he’s talking about, very knowledgeable as an orthodontist or dentist should be, I lost my teeth due to the advice of the cardiologist, who would think teeth and heart disease are related, so I had them removed, a very unpleasant process called dental clearance, it was difficult to justify removing good teeth. However I’m still here, they did offer implants on the NHS ( National health service) I haven’t taken up the offer, false teeth are a bloody nightmare as Marcus correctly states the bottom set are a bugger, floating about everywhere, if you can save them try to, once gone you can no longer eat properly, or even expirence a crunch ! You miss it immensely, even chewing gum becomes difficult, plus if your jaw dosent touch your upper mandible you find your “ stressed” anxious who would think loosing teeth caused anxiety, permanently, so try to get the ones you have fixed, capped, crowned or whatever it takes, I lost teeth that were essentialy good ( I had a total of 5 fillings at 47 years)
There are dentists who can fix them, any fool can pull them, I pulled a few myself, and it does hurt btw
Mark

 

[Bender]

A few years ago I had a bad toothache and went to the dentist. I swear, the dentist I went to was way more concerned about getting paid than my health. Every single thing he was like this costs this much and this casts that much and so on, every single thing. I should have took a laptop with me to make a spreadsheet. Anyways, the tooth that was bothering he said had to be pulled. I asked him if it could be fixed and he said it was a waste of time and it would just fall out eventually. I sure wish I would have gotten a second opinion. Well, it took three visits before he finally pulled the damn thing, and after he got done, he told me I should just have them all pulled out and referred to another place, probably his buddy. I can't remember how much the whole thing came to, but it was well over a thousand bucks. I never did get them all pulled out, and certainly would never go to that asshole again.

I've been thinking about implants myself, but the thought of someone drilling a bunch of holes in my mouth absolutely terrifies me. I'm sure Ive drilled millions of holes in my career, and anyone that has drilled a bunch holes knows how drilling a simple hole can go horribly wrong. Another thing is that if I did get implants, they would probably announce some new technology the very next day.

I hope everything somehow turn out well for you.

 

[MrStretch]

I went thru this last year when I could finally afford to get my mouthful of bad/rotting teeth fixed. I went to 2 of those all-on-4 places and 1 traditional reconstruction dentist. The all-on-4 places promise alot but gave me the willies with corporate new-agey bs. You have to pay 50% upfront at which point they pull all your teeth in one day and then you're pretty much locked in for the other 50% and I wasn't confident that they really stand by their work.
The more traditional dentist that I chose has been doing the reconstruction tooth by tooth and saving what he can. Lots more visits over the last 8 months than the all-on-4, but no contract and no bs. Funny that neither of the all-on-4 places mentioned that I had some teeth that just needed crowns and the existing bridge was still in good shape.

 

[gwelo62]

Vital Dental in Hungary. My friend is going. Airfare,10 days hotel and dental work 50 % less than a mile down the road.

 

[Deerehauler]

I knocked out my two front lower teeth in first grade (1973) after getting pushed into a table. A dentist in Hays, KS performed a root canal on the teeth and they held until around 2012. My dentist referred me to an oral surgeon who pulled out one affected tooth and put some stuff in the hole that encouraged bone growth. I went without a tooth there for about a year (saved up some $$) and went in for implant installation. The oral surgeon installed a stainless steel screw/stud and after a month or two, my dentist CNC'd a new tooth for me and installed it. I have had ZERO issues with it. BTW, the CNC mill that makes a tooth is a cool machine!

 

[sfriedberg]

I have one implant. Generally I don't have a problem with dentists working on my teeth. E.g., I had all four wisdom teeth pulled one day when I was about to leave the Air Force and the service would still pay for it. I ate dinner (gingerly, I will confess) that evening.
My experience with the implant is ... mixed. Pull the bad tooth and pack the hole. Wait months for that to heal up. Drill a hole and plant the post. Wait months for that to heal up. Discover that the post did not "implant" properly (or that they broke it loose by torquing it the wrong direction before getting a clue), while not under anesthetic in what was supposed to be a quick, routine preparation for the dentist who would actually plant the fake tooth. Got an emergency couple of shots, sweating and swearing for 15 minutes until the relief set it, then they pulled the post out of the broken socket and repacked the mess. Wait months for that to heal up. Drill a new hole and plant a new post. Wait months for that to heal up. Got the new post exposed for the dentist. Got the fake tooth 3D sculpted on the day by the dentist, trimmed and put in place.
So, it took me twice as long as the already pretty long (two multi-month blocks of healing) process, but no issues since then. I'm happy with the result, and am very glad I did not got with bridgework. They would have had to butcher at least two adjacent teeth to install a bridge.

 

[rons]

If some of your teeth are chipped at the bottom there is a simple procedure to slowly pull them down from the gum line
and they will elongate. There is a apparatus that is worn and it applies a small pulling force. Takes months but I've seen
the before and after on a person.The most length you can expect is about 3/16". The chipped part is filed down during the process.

I heard on a news program that by flossing your teeth everyday can increase a person's life span by 2 years. There are
germs that can enter your body through a gum line and end you life. If you get all implants then you can keep your two years.

I knew a supply house manager who had perfect teeth. Almost every time I spoke to him I looked at his perfect teeth.
He noticed that I always looked at his perfect teeth and one day told me that they were all implants. It had to be done
when he was young because his original teeth were messed up due to a disease or something.

 

[EmGo]

Drill a hole and plant the post. Wait months for that to heal up. Discover that the post did not "implant" properly (or that they broke it loose by torquing it the wrong direction before getting a clue), while not under anesthetic in what was supposed to be a quick, routine preparation for the dentist who would actually plant the fake tooth. Got an emergency couple of shots, sweating and swearing for 15 minutes until the relief set it, then they pulled the post out of the broken socket and repacked the mess. Wait months for that to heal up. Drill a new hole and plant a new post. Wait months for that to heal up. Got the new post exposed for the dentist.

Wow. Now I feel bad for snivelling. My lady did a great job, it was just that it was not pleasant. But maybe that was because she was so thorough. No one else had the fastener installed with a hammer drill tho ? May be a Chinese innovation ?

I do know bones don't have nerves. However like a spruce board, they transmit vibrations to places that do have nerves. Seems like I've got plenty elsewhere ... Any more anaesthetic and I'd have drowned. I s'pose they could have nerved me like an old race horse first but that didn't seem desirable ...

Got the fake tooth 3D sculpted on the day by the dentist, trimmed and put in place.

I went with the ceramic one, fused and fired and forged in the furnaces of hell. That way when I go the devil can come repo it.

 

[BT Fabrication]

Interestingly the bone itself does not actually have any nerves in it.
It's the wrapping (the periosteum) that is innervated, and that is what is sending the pain signals and jangling your brain.

That's a trivial point of interest when you're hurting...the solution obviously is to administer more and better anaesthetic.

The most common way in the dental setting is to administer what is called a "Block" or "Nerve Block".
We aim a bolus of anaesthetic right around a major nerve trunk and block its ability to signal to the brain.

Sadly some people have a distributed nerve anatomy in some places so there isn't one nerve trunk to block, there are several like the branches of a tree.
Some have sensory nerves bundled in trunks where most people only have motor nerves.
Some have them running in different places than most others.

So the nerve block is not a sure fire thing, and the situation gets worse as you get out to the peripheral ends of the nerves...they can be running in all kinds of unexpected locations and of course, when you look in someone's mouth you can't actually see where they are.
So you aim your needle for landmarks and pray a lot.
Most times you hit paydirt...sometimes you don't.

When people do not freeze completely, it's almost always because of that reality...I had patients where I would routinely have to pound in 3 times the freezing I'd need for others of the same size and weight.
I also had the means to place my local anaesthetic closer to the brain...ie at a place where the human anatomic variability is less.
In the case of a mandibular (lower jaw) block I could use a Gow Gates or an Akinosi block if the standard mandibular block location wasn't working, but there are slightly greater risks that come with these blocks so many dentists don't like to use them.
I suspect, from the story you're describing, that you have "accessory" or "distributed" innervation so that a single block is not good enough to interrupt all the pain signals your body is sending your brain via every path available to it.
You can tolerate a less invasive dental procedure but you cannot tolerate surgical wounds with that kind of innervation and the limitations of block anaesthesia.

So now you know...kinda useless knowledge if you can't do anything about it anyway...but there it is.

very neat, always wondered why when the dentist here tried to jab my back of the jaw why I never got frozen from it and only ever worked locally directly where they were working right below the tooth. everywhere else did nothing and had the dentist the one time say cant give any more then the 4 shots they already did for some reason. thankfully had to tell them do it right beside the tooth on the last one that finally worked.

 

[implmex]

Hi BT Fabrication:
What you're describing is a technique often called "infiltration anaesthesia" where you flood the area around a single tooth (or a few teeth) and interrupt the pain signals close to their source.
The reason why it's not always done that way, is twofold:
First, you can't always flood every nerve reliably because some are in places where the anaesthetic can't easily travel to.
Second you can't put in very much and your body is continually trying to flush it away via the bloodstream.
So the local anaesthetic formulation has a vasoconstrictor in it...usually epinephrine.
You can only put in so much before you risk shutting down the local circulation completely and killing the tissue in that area.
There's also a limit to how much you can pump in before you put them at risk for a medical complication from the vasoconstrictor's other effects.

So it's all a balance and you have to know enough to make it mostly work, but you pray a lot too.
It's much less of an exact science than they'd have you believe.

So I guess I've just about given an introductory course in local anaesthesia by now...hopefully I haven't bored anyone.

Cheers

Marcus
www.implant-mechanix.com
www.vancouverwireedm.com

 

[DDoug]

Wow. Now I feel bad for snivelling. My lady did a great job, it was just that it was not pleasant. But maybe that was because she was so thorough. No one else had the fastener installed with a hammer drill tho ? May be a Chinese innovation ?

I do know bones don't have nerves. However like a spruce board, they transmit vibrations to places that do have nerves. Seems like I've got plenty elsewhere ... Any more anaesthetic and I'd have drowned. I s'pose they could have nerved me like an old race horse first but that didn't seem desirable ...



I went with the ceramic one, fused and fired and forged in the furnaces of hell. That way when I go the devil can come repo it.

Maybe try black powder next time, the tooth is out in no time, blown clear of your face, and the wound is self cauterizing....

A win-win, what's not to love ?

 

[EmGo]

Maybe try black powder next time, the tooth is out in no time, blown clear of your face, and the wound is self cauterizing....

Taking the old one out was not a problem, trust me

 

[DDoug]

Taking the old one out was not a problem, trust me

Yes, however, my method also fixes the rest of your problems as well....

 

[sfriedberg]

No one else had the fastener installed with a hammer drill tho ?

They used a torque wrench on me. I asked to look at it. Looked like a scaled down mechanic's "snap" torque wrench, rather than the screwdriver style of torque driver. Stainless so it could be sterilized. Small, obviously. I can't recall today if it had a permanent spline socket on it, or if it was 1/4" drive with a removable socket.

 

[jim rozen]

One dentist I used years ago explained that the novocain with ephinephrine in it, is often used by dental students because they take a long time to do the work. He used anasthetic without.

 

[implmex]

Hi jim rozen:
Yeah you can get all kinds of different formulations for all kinds of different uses.
Novocaine is actually obsolete, and Lidocaine is most common now but you can get Prilocaine, Bupivicaine, Articaine and probably a bunch of others.
For some things you can even get Cocaine if you want it.

Each gets used in a different setting.
Some believe it makes a world of difference and others think it's all bullshit and stick with good old fashioned Lidocaine for everything.
I think the jury's still out on that one.

Cheers

Marcus
www.implant-mechanix.com
www.vancouverwireedm.com