Dental implants - how to quiz the dentist
Discussion
Hi,
I have a dentist appointment to investigate options for an implant.
I've read earlier queries about how much, what they cost etc so confident i understand the likely costs and processes.
Thing is, what should I be asking the dentist in question to be sure they're right for the task. Its already bern intimated by his junior that if it's a more difficult job then an expert from Harley Street visits instead. Can't help but think i should just see said expert from the outset. I've not met the senior partner before and this surgery has only ever pulled a wisdom tooth for me before.
Have seen peterpeter's earlier posts about BACD. Is that guarantee enough?
By way of background, a tooth broke about 12 years ago and a crown was fitted. A crack occured between it and the base of the tooth at the gum line. I now have an abcess and signs of infection from an xray on one of the roots. Im told the options are 1) extract and leave the gap, 2) have a single denture 3) pay for specialist to look at option for repair and replace crown ( although original looks to be fixed in such a way that removal will likely make replacement a non option and cost over £1k or 4) an implant at £2-2.5k.
Any advice from the resident dental professionals would be welcome.
Cheers
I have a dentist appointment to investigate options for an implant.
I've read earlier queries about how much, what they cost etc so confident i understand the likely costs and processes.
Thing is, what should I be asking the dentist in question to be sure they're right for the task. Its already bern intimated by his junior that if it's a more difficult job then an expert from Harley Street visits instead. Can't help but think i should just see said expert from the outset. I've not met the senior partner before and this surgery has only ever pulled a wisdom tooth for me before.
Have seen peterpeter's earlier posts about BACD. Is that guarantee enough?
By way of background, a tooth broke about 12 years ago and a crown was fitted. A crack occured between it and the base of the tooth at the gum line. I now have an abcess and signs of infection from an xray on one of the roots. Im told the options are 1) extract and leave the gap, 2) have a single denture 3) pay for specialist to look at option for repair and replace crown ( although original looks to be fixed in such a way that removal will likely make replacement a non option and cost over £1k or 4) an implant at £2-2.5k.
Any advice from the resident dental professionals would be welcome.
Cheers
I'm currently undergoing implant treatment. Going tomorrow for the crown to be fitted.
From my research £2-2.5k seemed to be about the going rate. I got mine off groupon for £1k. Seems a bit mad and to be honest I wasn't overly keen but it seemed a lot better than the other options. As it turns out the dentist is good and the treatment is going very well.
Can give you more detail in a few days once the crown has been fitted.
From my research £2-2.5k seemed to be about the going rate. I got mine off groupon for £1k. Seems a bit mad and to be honest I wasn't overly keen but it seemed a lot better than the other options. As it turns out the dentist is good and the treatment is going very well.
Can give you more detail in a few days once the crown has been fitted.
Hi Yadi, I place implants amongst other things.
If the tooth is fissured and had an abscess and you want something which is no going to cause problems down the line, I would avoid trying to retreat the tooth and recrown. You are asking for trouble.
Can you describe which tooth it is?
What condition are the teeth either side in? Are they filled or crowned or anything?
If the tooth is fissured and had an abscess and you want something which is no going to cause problems down the line, I would avoid trying to retreat the tooth and recrown. You are asking for trouble.
Can you describe which tooth it is?
What condition are the teeth either side in? Are they filled or crowned or anything?
Thanks for replying driller, hoped you'd be along shortly based on earlier threads.
Abcess has a fissure (dentist classed it as chronic?) which i assume is why it drains itself a day or so after it comes back again. From the centre it's 5th from front lower right. Teeth either side are good and they were keen to avoid using one or both to create a bridge.
Edit- the implant suggestion makes sense long term - just not sure on choosing the right dentist.
Abcess has a fissure (dentist classed it as chronic?) which i assume is why it drains itself a day or so after it comes back again. From the centre it's 5th from front lower right. Teeth either side are good and they were keen to avoid using one or both to create a bridge.
Edit- the implant suggestion makes sense long term - just not sure on choosing the right dentist.
Edited by 'Yadi on Wednesday 5th September 15:20
You should be asking what sort of experience he has. Included in this is amount of training and any qualifications.
How many implants placed and what success rate is?
Who manufactures the implants he uses?
The fact that he has support from the Harley Street bloke (presumably someone with more experience) implies he won't be doing stuff beyond his capability.
I've placed a few implants in the past (no time for private now) and the single tooth replacements were very straight forward once all the planning was done.
ETA
My training took 2 years.
How many implants placed and what success rate is?
Who manufactures the implants he uses?
The fact that he has support from the Harley Street bloke (presumably someone with more experience) implies he won't be doing stuff beyond his capability.
I've placed a few implants in the past (no time for private now) and the single tooth replacements were very straight forward once all the planning was done.
ETA
My training took 2 years.
Well with the words abscess, fissure and chronic in the same sentence I would definitely say the tooth is irretrievable. Sounds like your dentist has realised this.
5th tooth from the middle is going to be you second premolar on that side (about half the size of a molar?), as long as you haven't had a premolar out for orthodontics in which case it's the first molar.
I totally agree that if the teeth either side are untouched then avoid damaging these by placing a bridge. Twas the reason I asked.
As far as choosing an implantologist goes, he should have access to a dedicated surgery room which is disinfected before each procedure so ask where the implants are placed. This should not be done in an ordinary dental surgery.
Single use drills are a good idea and are what I use.
Ask how long they've been placing implants and what system they use. It's not the end of the world but ask if they use one of the "Big Four" systems.
The tooth is going to need extracting and you will have to wait 2 odd months for healing and a radiograph (preferably a panoramic) should be taken to assess bone levels and visualise anatomical structures most notably in the area in question the MENTAL FORAMEN. This where the nerve inside the lower jaw comes out of a little hole (formen) and supplies the lower lip and surrounding structures.
A lot of care has to be taken to avoid this nerve and there must be sufficient bone available to place and implant of reasonable length (8-10mm) whilst avoiding it.
If things look half good on the panoramic, you should be sent to have a jaw scan which will give further detail for planning and to see once and for all if the work can be done.
So, ask about the quantity (and quality) of bone around this nerve for placing the implant. Obviously they won't be able to answer this before the tooth is out and the bone healed.
ETA The time it took my addled brain to write all that, you got in first Rollin!
5th tooth from the middle is going to be you second premolar on that side (about half the size of a molar?), as long as you haven't had a premolar out for orthodontics in which case it's the first molar.
I totally agree that if the teeth either side are untouched then avoid damaging these by placing a bridge. Twas the reason I asked.
As far as choosing an implantologist goes, he should have access to a dedicated surgery room which is disinfected before each procedure so ask where the implants are placed. This should not be done in an ordinary dental surgery.
Single use drills are a good idea and are what I use.
Ask how long they've been placing implants and what system they use. It's not the end of the world but ask if they use one of the "Big Four" systems.
The tooth is going to need extracting and you will have to wait 2 odd months for healing and a radiograph (preferably a panoramic) should be taken to assess bone levels and visualise anatomical structures most notably in the area in question the MENTAL FORAMEN. This where the nerve inside the lower jaw comes out of a little hole (formen) and supplies the lower lip and surrounding structures.
A lot of care has to be taken to avoid this nerve and there must be sufficient bone available to place and implant of reasonable length (8-10mm) whilst avoiding it.
If things look half good on the panoramic, you should be sent to have a jaw scan which will give further detail for planning and to see once and for all if the work can be done.
So, ask about the quantity (and quality) of bone around this nerve for placing the implant. Obviously they won't be able to answer this before the tooth is out and the bone healed.
ETA The time it took my addled brain to write all that, you got in first Rollin!
I am half way through this process having had a tooth removed about three months ago myself (sounds like the same one/it's neighbour)....though I have been told to wait six months before going to see the implantologist to do initial x-ray's/scans etc.
The dentist I use is quite a big practice (or at least has grown into one) they have referred me to an implantologist based in Clapham. I had to actually go to the implantologist to finish the extraction as the tooth fractured and he had some special drill which needed to be used to minimise bone damage which I think ties in with what the learned members of this forum have said.
The dentist I use is quite a big practice (or at least has grown into one) they have referred me to an implantologist based in Clapham. I had to actually go to the implantologist to finish the extraction as the tooth fractured and he had some special drill which needed to be used to minimise bone damage which I think ties in with what the learned members of this forum have said.
'Yadi said:
Well i'm back from consultation.
They use Biomet 3i as product. Dentist has been doing implants for 4 years. Studied for 2 years in Florida before that. 25 years plus as dentist overall. Price worst case estimate is £3.6k though!!!! Half as much again as I'd been expecting.
For one tooth that sounds rather expensive. Is this because the worst case would involve bone grafts? Even then it seems expensive.They use Biomet 3i as product. Dentist has been doing implants for 4 years. Studied for 2 years in Florida before that. 25 years plus as dentist overall. Price worst case estimate is £3.6k though!!!! Half as much again as I'd been expecting.
Bear in mind I've not seen you so can't comment definitively.
Could get Driller to do it and have a lovely week in France for that price.
:-). I havent signed up with anyone yet.
There is a bone graft listed - not sure if this is because the infection in the root is making the bone density look a likely problem.
I have a breakdown of the estimate. The bulk of the extra grand seems to be "stage 2 implant exposure abutment" , then "implant stent" and then the bone
Graft. The stage 1 implant placement and implant based restoration stage 3 cost £1250 each. Other costs are molar extraction and panoral image.
He did say he may not need some of the stages but best i was prepared for total costs over 8 months
There is a bone graft listed - not sure if this is because the infection in the root is making the bone density look a likely problem.
I have a breakdown of the estimate. The bulk of the extra grand seems to be "stage 2 implant exposure abutment" , then "implant stent" and then the bone
Graft. The stage 1 implant placement and implant based restoration stage 3 cost £1250 each. Other costs are molar extraction and panoral image.
He did say he may not need some of the stages but best i was prepared for total costs over 8 months
I agree with Rollin that that seems rather expensive. You'd get 2 done for that "chez moi" albeit without bone grafts.
I also don't see the use of an implant stent for a single implant which has teeth either side. I certainly wouldn't other to use one in this case, I don't know what Rollin thinks about this?
It would be really useful to have a radiograph of your tooth and bone support as it is now
I also don't see the use of an implant stent for a single implant which has teeth either side. I certainly wouldn't other to use one in this case, I don't know what Rollin thinks about this?
It would be really useful to have a radiograph of your tooth and bone support as it is now
Unfortunately don't have access to any of those :-)
Looking like at least 3 visits - extraction, implant after infection cleaned up and then a final one to fit the crown part. I assume the bone graft material goes in as a 4th between extraction and implant if its required.
That'd mean 3 holidays in France then ? :-)
Looking like at least 3 visits - extraction, implant after infection cleaned up and then a final one to fit the crown part. I assume the bone graft material goes in as a 4th between extraction and implant if its required.
That'd mean 3 holidays in France then ? :-)
'Yadi said:
Unfortunately don't have access to any of those :-)
Looking like at least 3 visits - extraction, implant after infection cleaned up and then a final one to fit the crown part. I assume the bone graft material goes in as a 4th between extraction and implant if its required.
That'd mean 3 holidays in France then ? :-)
You're looking at more than four visits probably. In that position, if bone augmentation was needed, I would do it using a membrane at the same time as placing the implant so that would save an appointment.Looking like at least 3 visits - extraction, implant after infection cleaned up and then a final one to fit the crown part. I assume the bone graft material goes in as a 4th between extraction and implant if its required.
That'd mean 3 holidays in France then ? :-)
Otherwise you'd be looking at something like the following:
App 1: Extraction with or without temporary denture (probably not worth it here).
Wait 2 months.
App 2: Radiograph to check bone/healing situation
If all ok, CT scan of point of interest.
App 3: Implant placement 1 or 2 stage with or without bone augmentation.
Wait 3 months for osseointegration
(At this point if a 2 stage implant procedure was performed an extra appointment is needed here to place a healing abutment)
App 4: Impressions + shade
(Optional try in appointment not absolutely necessary)
App 5: Crown placement.
TBH if a bone graft is needed I would recommend you have a two stage implant procedure done, that way there is no risk of any force being placed on the healing abutment whilst the implant is osseointegrating.
Edited by Driller on Sunday 9th September 11:20
I didn't know we had resident dentists here
I have a situation I would appreciate some help with. As I live abroad, I don't always understand what is being done or what questions I should be asking.
Anyway, after a lifetime of no fillings or anything, about a year ago I suddenly broke "tooth 30" (first molar, bottom right) whilst eating. Half of it was missing. Didn't hurt though. I saw the dentist, and I think he filled the gap and molded it into a tooth shape. To be honest I'm not too sure what he did, but it needed an injection, he used what looked like filler and a UV light to set it, and I left with a whole tooth again. Cost about £70.
Since then tooth has gotten slowly more sensitive to cold. At first I noticed it when rinsing after brushing. Now I notice it all the time, even cold air when breathing is painful (and it's not cold out yet!). No problem with eating or biting though - it is not pressure sensitive. I'm already using sensitive toothpaste.
The last time I saw the dentist he mentioned that if it got more sensitive it would need to come out. Is this really the case? Am I going to be asking the same questions as the OP soon?
I've got an appointment on Thursday, so any ideas would be welcome. If it has to come out, is it true that extractions on the bottom jaw are more painful/ difficult than at the top?
I have a situation I would appreciate some help with. As I live abroad, I don't always understand what is being done or what questions I should be asking.
Anyway, after a lifetime of no fillings or anything, about a year ago I suddenly broke "tooth 30" (first molar, bottom right) whilst eating. Half of it was missing. Didn't hurt though. I saw the dentist, and I think he filled the gap and molded it into a tooth shape. To be honest I'm not too sure what he did, but it needed an injection, he used what looked like filler and a UV light to set it, and I left with a whole tooth again. Cost about £70.
Since then tooth has gotten slowly more sensitive to cold. At first I noticed it when rinsing after brushing. Now I notice it all the time, even cold air when breathing is painful (and it's not cold out yet!). No problem with eating or biting though - it is not pressure sensitive. I'm already using sensitive toothpaste.
The last time I saw the dentist he mentioned that if it got more sensitive it would need to come out. Is this really the case? Am I going to be asking the same questions as the OP soon?
I've got an appointment on Thursday, so any ideas would be welcome. If it has to come out, is it true that extractions on the bottom jaw are more painful/ difficult than at the top?
Driller said:
You're looking at more than four visits probably. In that position, if bone augmentation was needed, I would do it using a membrane at the same time as placing the implant so that would save an appointment.
Otherwise you'd be looking at something like the following:
App 1: Extraction with or without temporary denture (probably not worth it here).
Wait 2 months.
App 2: Radiograph to check bone/healing situation
If all ok, CT scan of point of interest.
App 3: Implant placement 1 or 2 stage with or without bone augmentation.
Wait 3 months for osseointegration
(At this point if a 2 stage implant procedure was performed an extra appointment is needed here to place a healing abutment)
App 4: Impressions + shade
(Optional try in appointment not absolutely necessary)
App 5: Crown placement.
TBH if a bone graft is needed I would recommend you have a two stage implant procedure done, that way there is no risk of any force being placed on the healing abutment whilst the implant is osseointegrating.
Thanks again driller Otherwise you'd be looking at something like the following:
App 1: Extraction with or without temporary denture (probably not worth it here).
Wait 2 months.
App 2: Radiograph to check bone/healing situation
If all ok, CT scan of point of interest.
App 3: Implant placement 1 or 2 stage with or without bone augmentation.
Wait 3 months for osseointegration
(At this point if a 2 stage implant procedure was performed an extra appointment is needed here to place a healing abutment)
App 4: Impressions + shade
(Optional try in appointment not absolutely necessary)
App 5: Crown placement.
TBH if a bone graft is needed I would recommend you have a two stage implant procedure done, that way there is no risk of any force being placed on the healing abutment whilst the implant is osseointegrating.
Edited by Driller on Sunday 9th September 11:20
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