OT has anyone here had tooth implants?

[jim rozen]

I had mentioned my dislike for lidocain (what he was actually using I believe) because of the long-lasting after-effects. He mentioned about the adrenaline, that he does not use. I still have routine work done without anasthetic, the modern high-speed water cooled drills are amazing. He was old-school, got his degree originally in germany, emigrated to the US after the war, got a US dental degree, and was at Ft Monmoth NJ for a while before settling in westchester county, NY.

 

[snowman]

Not everybody is the same when it comes to dental pain. I can handle surgery on most parts of my body without pain meds, but the slightest toothache and I'm begging to be knocked out completely. I won't even get my teeth cleaned without nitrous anymore.

If you want good anesthetic, you mix your bupivicaine or lidocaine with an opiate. Mixed 50:50 with buprenorphine you can get 24 hours of anesthesia. Though we now have liposomal bupivicaine as well which is getting us out 72 hours. (vet med, but MOA is the same)

Thanks for the notes on the physiology and TMJ specialist. I'm calling tomorrow to get an appointment with an ENT as I'm also having ear issues that I suspect are linked. I'll get them to order the imaging and find out who they recommend. This morning I woke up and can't get my teeth to close.

 

[metalmagpie]

I have had several implants done in Mexico. My experience has been very positive. I get my dental work done in Los Algodones (very near Yuma, Arizona). My dentist is very skilled and experienced and speaks excellent English. The clinic is spotless and completely state of the art. He was trained in the US and his prices are a small fraction of US prices. A single tooth implant is about $1800. Los Algodones is filled with dentists, opticians and pharmacies. Hundreds of American and Canadian medical tourists walk across the border every day to save money.

metalmagpie

 

[implmex]

Hi metalmagpie:
You make an interesting observation.
Way back when, in dental school, we were trained to be contemptuously dismissive of anyone not within our professional fold...trained here, licensed here paying our dues here, getting our continuing education here, and on and on.
EVERYONE else, European trained, American trained (I'm Canadian), South American trained, Asian trained was by definition an idiot, a charlatan, and a money grubbing asshole.
Even a Canadian trained member of the profession who stepped outside their bailiwick was ruthlessly stomped...a CDA who (God Forbid!) picked up a sickle scaler and knocked some grot off a tooth got "the treatment".

Then I got in the real world.
I saw some utterly garbage dentistry from some of the very same people who indoctrinated me in school.
I saw some superb dentistry from some of those raggedy ass imports.
I got the rough edge of the Dental College because I dared to offer a service no one else could...implant disaster recovery.
I could offer it because...I had a machine shop, and knew how to make new instruments for new tasks and replacement parts for systems where the companies had gone belly up, and weirdass custom bits when the surgeon screwed up, and could retrieve broken implant screws etc etc.

How dare I. How DARE I!!! presume to know the turf better than a Specialist... even though they were all referring to me under the table because I could fix shit they couldn't.

Anyway to drag this back to the topic...there are some first class dentists in Mexico.
If you encounter a sniffy attitude from the local heroes (and you will), bear this story in mind before you believe them.
Your instincts about how to judge a dentist are exactly the same as you'd use in the USA...are they personable, do they seem to know what they're talking about, are you getting conned or railroaded, is their place clean and modern, are they recommending treatment their predecessor did not and can't prove the need for, in English (this one is a big red flag).
Everything else is a crap shoot...don't believe for a moment that a credential from your home country guarantees honesty, decency or even competence.

After all we had a student in my class we called "Massacre"...cute as a button, book smart as hell but dumb as a box of rocks.
She could do herself an injury just trying to put her pants on the right way round in the morning.
She graduated near the top of her class.

Trust your gut...it's all you have to judge with anyway.

Cheers

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

 

[EmGo]

After all we had a student in my class we called "Massacre"...cute as a button, book smart as hell but dumb as a box of rocks.

Oh, that reminds me ! As a knowledgeable person in the field ...

Something I puzzled over at the time but put into that box of repressed memories ... do you think the nurses (the smarter ones anyhow) push their boobs into you during moments of extreme stress, to divert your thoughts from the mayhem happening in your mouth ?

I wasn't complaining, just wondered ....

 

[Joe Miranda]

Hi metalmagpie:
You make an interesting observation.
Way back when, in dental school, we were trained to be contemptuously dismissive of anyone not within our professional fold...trained here, licensed here paying our dues here, getting our continuing education here, and on and on.
EVERYONE else, European trained, American trained (I'm Canadian), South American trained, Asian trained was by definition an idiot, a charlatan, and a money grubbing asshole.
Even a Canadian trained member of the profession who stepped outside their bailiwick was ruthlessly stomped...a CDA who (God Forbid!) picked up a sickle scaler and knocked some grot off a tooth got "the treatment".

Then I got in the real world.
I saw some utterly garbage dentistry from some of the very same people who indoctrinated me in school.
I saw some superb dentistry from some of those raggedy ass imports.
I got the rough edge of the Dental College because I dared to offer a service no one else could...implant disaster recovery.
I could offer it because...I had a machine shop, and knew how to make new instruments for new tasks and replacement parts for systems where the companies had gone belly up, and weirdass custom bits when the surgeon screwed up, and could retrieve broken implant screws etc etc.

How dare I. How DARE I!!! presume to know the turf better than a Specialist... even though they were all referring to me under the table because I could fix shit they couldn't.

Anyway to drag this back to the topic...there are some first class dentists in Mexico.
If you encounter a sniffy attitude from the local heroes (and you will), bear this story in mind before you believe them.
Your instincts about how to judge a dentist are exactly the same as you'd use in the USA...are they personable, do they seem to know what they're talking about, are you getting conned or railroaded, is their place clean and modern, have your buddies had a good experience but did their local dentists point out legitimate shortcomings in the work that was done in the foreign place, are they recommending treatment their predecessor did not and can't prove the need for, in English (this one is a big red flag).
Everything else is a crap shoot...don't believe for a moment that a credential from your home country guarantees honesty, decency or even competence.

After all we had a student in my class we called "Massacre"...cute as a button, book smart as hell but dumb as a box of rocks.
She could do herself an injury just trying to put her pants on the right way round in the morning.
She graduated near the top of her class.

Trust your gut...it's all you have to judge with anyway.

Cheers

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

Marcus - if you would just offer your services out of the back of your machine shop you would have a steady stream of people coming to you and paying cash. Just sayin' ... of course that is near blasphemy to even mention.

 

[implmex]

Hi EmanuelGoldstein;
None of the ones I ever hired did things like that.
While I love the concept of a magnificent pontoon just as much as any other heterosexual male, the workplace isn't a good one to just let the hornies run.

The really good assistants have no time for that shit while they're working, and as a guy who has to manage a bunch of them, the stunts lose their charm pretty quickly when everyone else is busting ass to get it all done safely, well, and profitably with minimum drama.

So the "tits queens" that showed up in their stripper gear wouldn't even get hired.
There were some gloriously well put together ones, but they ALWAYS made poor CDA's or hygienists, so, much as the eye candy could be enjoyed I kept them out of my life and I was happier for it.
In fact, I let my office manager and my existing staff vet all the new hires...they could sniff out that shit from a mile... they were utterly unimpressed and would say so.

I kept a happy place and those staffers were GOOD!

Cheers

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

 

[implmex]

Hi Joe Miranda:
I'm not even slightly tempted, flattering as your comment is.
I truly do appreciate the sentiment...but no thank you very much.

I was not built for the profession...it took way too much out of me personally and I was so relieved to hang up my drill, even though I had status and money and all that other good stuff.

Now I get to play with cool toys and figure out an interesting new challenge just about every day...it's like building model airplanes except you get paid for it.

Life is good!

Cheers

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

 

[jim rozen]

"The really good assistants have no time for that shit while they're working,"

My regret: my last dentist, and his tech assistant, retired together. (the new crew seems pretty darn good though) and it was amazing to watch the two of them working together. Hardly a full sentence was uttered during an entire procedure, each one knew what the other was thinking almost all the time. Like ballet in the room.

 

[doug925]

My teeth are a mess and I was thinking about doing the full mouth implant deal. Is this better than dentures? Is it painful to do? What does it cost?

I had an implant put in last year. I spent about $4K and it took 4 months.
In my case, I had already had a root canal, and a crown only had about a 50/50 chance of success, where the implant had a 90% success rate.

I know there are places where it could have been done for 1/2- 2/3rds, but didn't know that when I scheduled my implant. LOL

All in all, it went fine. I only used acetaminophen and ibuprofen for what little pain I had.


Doug

 

[EmGo]

The really good assistants have no time for that shit

Shows ta go ya the world has all different people. I actually appreciated it ....

I kept a happy place and those staffers were GOOD!

Same here .... another funny thing was, coincidentally they all spoke japanese, so when the whole group hopped to a different language, you knew something was up. Altho they'd gossip about their weekend in japanese too, just to throw you off.

That was a while ago tho, before she got interested in money. I can understand that but it's still sad

 

[Video_Man]

I had two titanium posts installed today, after several months of waiting for the bone implants to heal. I can say that it's not my favorite way to spend an afternoon, but with good pain management by the periodontist it was not terribly uncomfortable. Eating soft food for the next week and writing that big check was the most painful part. I have had two other implants in the past and as compared to the teeth they replaced, just way better. Good luck with whatever you decide.

 

[tomjelly]

I got an implant 8 or so years ago, has performed fine. I hear now they can do the implant post same day immediately following the extraction, I'd definitely opt for that if it is a thing now and it works properly as it would cut down the overall time by quite a bit. I haven't heard any reports of how well it works though.

 

[DJ2]

I had one implant done, great dentist, it went very well. About $4 or 5K in Canada. My sister-in-law had a full mouth done, different dentist, all her teeth were removed at once for dentures that would be anchored by a few implants into her jaw; it was a complete and utter shit show disaster. In the middle of the work, the dentist relocated to another town (she had pre-paid a lot of the money to the dentist). Some of the implants did not take, her jaw is a mess, in pain a lot of the time. Other dentists are trying to fix her up. At least three or four years running now. I suggest looking at any other options to save as many teeth as possible. Do one or two implants at a time? Not the cheapest way.

 

[implmex]

Hi again Everyone:
There are a lot of stories out there and some of them are legitimate horror stories of greed, hubris and incompetence.
However, there are a lot of failures that were not the fault of the dentist and not the fault of the patient.

In the early days a bit before I graduated (1991) it was still the Wild West and there were some real fucking Yahoos out there preaching the gospel and not knowing shit.
There were some utterly bizarre implant systems that did not work worth a crap and there were some chest thumping heroes with their cult-like followings...mostly OSA's (Oral Surgeons with Attitude).
Sales guys were selling, engineers were engineering, surgeons were surgerizing, Prosthodontists were prosthodontizing and implant companies came and went with some frequency.
I built custom parts for I don't know how many systems where the company went belly up before the patients got their final fake teeth installed.
It was a time of shakeouts...bad ones went the way of the Dodo and good ones survived, prospered and got better and better.
That was true as much of implant dentists as it was of implant companies.

Gradually a consensus emerged about how to do it and succeed, the "heroes" have mostly been replaced by serious dentists who know what they're doing and have a good roadmap to follow, and the systems are reliable and don't break like popcorn anymore.
The bullshit marketing hype has mostly been replaced by solid science and every modern implant out there will integrate just fine if the physiological conditions permit.

So some of the shitshow stories are relics of that earlier age.

Failures now are most commonly caused by a few things:
1) The dentist lets himself get talked into cheaping out on the number of implants and tries to swing too many teeth off too few implants.
So the implants get overloaded and fail.
2) Some dentists still can't get it through their thick heads that the patient lost his teeth for a reason, and if you don't trouble yourself to find out and fix the root cause, the implants are gonna fail just like the natural teeth did.
The biggest reasons remain neglect, and smoking and bruxing (grinding your teeth) and all those other things you need to know about before you treatment plan any patient for anything.

3) Anatomical and physiological and pathological root causes of failure have become surprisingly rare, especially now that so many smart dentists are aware of the pitfalls and don't just pound in a few for some quick cash, when they KNOW they're gonna fail.
Nobody with a brain puts implants into anatomically deficient sites anymore, bone grafting and sinus lifting is much more of a routine thing now, surgeons respect the needs of the restoring dentists and place implants you can actually bolt teeth to, Juvenile Periodontitis is routinely screened for, smokers are refused treatment...the list goes on and on.

So it's become much more predictable and everyone is better off for it.
But shit still happens...when an implant fails to integrate (doesn't "take") it's not always easy to explain why...everything from poor surgical technique, to undiagnosed impaired bone healing, to unexpected trauma, to unexpected medication effects or radiotherapy effects or environmental factors; pretty much anything you can think of has at some time or another been credibly linked to a failed case.

When it happens, everyone needs to calm down, find the root cause and then plan around it.
Fortunately it's become relatively rare and we know the turf a lot better.

Cheers

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

 

[Terry Keeley]

It seems lately there's a new faster procedure where they pull the bad tooth and insert the post all at once, rather than pulling, packing with cow bone, allowing it to heal for a few months then doing the implant.

Have you heard if the new way is working out?

 

[implmex]

Hi Terry Keeley:
The rumbles are that the failure rate is almost as low as it is with the standard surgery and healing time.
A lot depends on what is dome and how (and why)...grafted sites are not happy if they don't get a chance to heal first, and some places in the mouth have particularly strong or weak bone.

Personally, if I was going to go to the trouble and expense of implant treatment I'd let the implant integrate undisturbed before I would consider swinging teeth off it.
I see no reason to hurry, and I want to work every angle in my favour.
Letting the implant integrate undisturbed is one of those angles.

Cheers

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

 

[plastikdreams]

Hi Terry Keeley:
The rumbles are that the failure rate is almost as low as it is with the standard surgery and healing time.
A lot depends on what is dome and how (and why)...grafted sites are not happy if they don't get a chance to heal first, and some places in the mouth have particularly strong or weak bone.

Personally, if I was going to go to the trouble and expense of implant treatment I'd let the implant integrate undisturbed before I would consider swinging teeth off it.
I see no reason to hurry, and I want to work every angle in my favour.
Letting the implant integrate undisturbed is one of those angles.

Cheers

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

When I got my implants it took months for the pig bone to heal, then they put the implants in and they waited months until the unscrewed the caps and screwed the teeth on. Probably took 6 or more months. I was an abscess patient though.

 

[SeymourDumore]

Personally, if I was going to go to the trouble and expense of implant treatment I'd let the implant integrate undisturbed before I would consider swinging teeth off it.
I see no reason to hurry, and I want to work every angle in my favour.
Letting the implant integrate undisturbed is one of those angles.

Marcus

As someone who's about to see the inside of the surgery center for the first visit in 3 weeks, I am very much in the camp of the doubters as to how is it possible for some of these new facilities that offer the "overnight" treatment for your face?
I don't see how can their ( ClearChoice as an example ) procedure substitute the months of healing and integration it takes for the "traditional" dental implants?

 

[steve45]

I had one implant done about a decade ago and couldn't be happier with it. I've been going to the same dentist for about 25 years and we've become friends. We have lunch together periodically, and I trust his judgement. He always sends his clients to specialists for such work. He says that you never know what you might run into that doesn't show up on an X-ray, and specialists deal with such problems every day. Better results and cheaper in the long run.

I had a friend (now deceased) that had a whole mouth job done about the same time I had my one tooth replaced. He was in his 70s at the time and had a 'quickie' job done. The results were not good and he had trouble eating the rest of his life.

I have a close friend that is just finishing her upper jaw 4-point implant. The removal surgery was rough, she was allergic to the pain medicine that they gave her. She also said that since the work was so close to her sinus, she sneezed constantly for about 2 days. It's been 13 months since she had her teeth pulled and I think she has finally finished her final adjustment. She is very pleased with the results, and her teeth look great! I have before and after pictures and you really can't tell the difference (obviously depending on camera resolution).