I have put off doing something about my teeth for so long that now I have no choice. The amount of pain I was in drove me to my dentist. He doesn’t do dental implants so I went to see Clear Choice. Their recommendation is to take out both upper and lower teeth and replace them with an all-on-4 procedure. My dentist agreed that the upper teeth need to come out, but feels the lower teeth can be saved. I keep going back and forth. On the one hand, it would be nice to be done with dealing with these teeth, but I keep having this niggling feeling that makes me hesitant. I don’t know if that is a legitimate concern or just my fear of the dentist and actually going through with this. Do you have any recommendations?
Lewis
Dear Lewis,
I am glad you wrote and am sorry you have been in so much pain. There are a couple of things going on here. We’ll start with the uppers. From what you’ve said, your dentist does try to save teeth that can be saved. This is a good sign. There are some lazy dentists out there who’d rather just collect the fees from extractions than try and save teeth. If he is saying the uppers need to be extracted and replaced, I have some confidence in that. Your next choice with them is whether to go to Clear Choice or another dentist for your dental implants.
Clear Choice tends to push the all-on-4 procedure whether or not it is your best option. While there are times that the all-on-4 procedure is the right choice, it has its drawbacks. For instance. If one part of the appliance fails, the entire thing has to be re-done. Instead, I might look at getting implant overdentures for your top arch. Here is a comparison of the two:
All-on-4 dental implant appliance
With all-on-4, the implants are angled in a way that makes it possible for those who have already lost some bone structure to receive dental implants. As its name implies, it is done with 4 implants only.
dental implant overdentures
If instead, you were to get implant overdentures, there would be more security. While you could do it with four implants, you could use more as well. It’s generally suggested you get between six and eight implants. If one part of this appliance failed, you would only have to replace that part.
My suggestion for your uppers is to get a second opinion from a qualified implant dentist. See if there is someone in your area who is a fellow with the International Congress of Oral Implantologists. These are the top implant dentists in the country. You can feel confident you are getting qualified, experienced advice.
Your lower arch is a completely separate issue. If your dentist thinks those teeth can be saved, do everything in your power to save them. First, I will tell you why. Then I will go over how you can do it without the terror you currently feel going to the dentist.
When your teeth are first removed, your body recognizes that and immediately begins resorbing the minerals in your jawbone in an effort to use those minerals throughout your body where it perceives they will be more useful. After all, you don’t need those minerals to keep your teeth in place any longer.
While an efficient use of your body’s resources, it has the unfortunate side effect of shrinking your jaw bone. After ten or so years, you will no longer have enough of a jawbone to even retain dentures. This is known as facial collapse. Placing dental implants helps prevent that, but they’re expensive. It is significantly cheaper and more advantageous to save your natural teeth, if at all possible.
Dealing with Dental Anxiety
I understand the prospect of continuing dental appointments is probably not appealing to you. Fortunately, I have something that may help. See if your dentist offers dental sedation options. In your case, combining your anxiety with the amount of work you may need, I would recommend oral conscious sedation. It will allow you to sleep through your dental appointments while getting more done at each appointment. If he doesn’t offer this, you will be better served by going to another dentist. I’ve seen patients with crippling anxiety have their experience at the dentist completely changed.
This blog is brought to you by Sugar Land Dentist Dr. Siny Thomas.