Hi Judith,

I'll put my answers in CAPS after your statements. I must first make you aware that after reading your post I am compelled to give you as much information as I can about what you have described here. Please do not be alarmed by any of it. Just please stay on top of what you are experiencing through the healing phase and if anything seems a bit odd, do not hesitate to see your dentist about it. OK?? ~'.'~

1) The teeth were removed as 48 years ago they were capped and shortly thereafter I had a lot of pain. Over the next 4 years each tooth abcessed and had very poor root canal work done. When the last tooth died I was fortunate to find myself in the hands of a young dentist training to be a surgeon who found the whole area above the teeth both roots a bone were infected. He immediately did surgery to remove the infection and thankfully saved the situation.
<<HE DID WHAT IS CALLED APICOECTOMIES. THIS IS A SURGICAL PROCEDURE WHERE THE DENTIST ENTERS THE JAWBONE ABOVE THE ROOT OF THE INFECTED TEETH, SCRAPES AWAY SOME OF THE INFECTED BONE AROUND EACH TOOTH, CUTS OFF THE END OF THE ROOT OF EACH TOOTH, SCRAPES OUT SOME OF THE INFECTED MATERIAL INSIDE THE TEETH, THEN CLOSES THE END OF EACH ROOT WITH A BLOB OF MERCURY FILLING MATERIAL.>>

However, the gums recessed and in a few years I had to replace the caps to cover the black margins.
<<THE GUMS RECESSED BECAUSE OF THE LATENT CHRONIC INFECTION IN THAT AREA AND BECAUSE OF THE IRRITATION CAUSED BY THE MERCURY FILLING TO THE UNDERLYING GUM TISSUE. THIS IS THE TYPICAL SCENERIO OF ANY TOOTH THAT HAS HAD AN APICO. APICOECTOMIES CANNOT CURE AN ABCESSED TOOTH BECAUSE IT IS NOT POSSIBLE TO REMOVE ALL OF THE INFECTED MATERIAL FROM THE TINY MICROSCOPIC CANALS INSIDE THE TOOTH. TO MAKE MATTERS WORSE, THE MERCURY FILLING MATERIAL BECOMES EMBEDDED IN THE BONE AND OFTEN CANNOT BE REMOVED ENTIRELY.>>

This was 40 years ago and I treated these teeth with TLC and managed to keep them all this time. However, when one broke recently it was clear all of them had some decay around the tops of the caps and it did not seem appropriate to try to affix new caps on these old teeth. Hence the decision to do extractions and implants.
<<FORTY YEARS IS A VERY LONG TIME TO RETAIN ROOT CANALED AND APICOED TEETH. I IMAGINE THERE HAD TO BE SOME EXTENSIVE BONE LOSS ACROSS THAT ENTIRE AREA AFTER ALL THAT TIME.>>

I do not have periodontal disease but the gums around these 4 teeth always looked somewhat grey in colour compared to the rest of my gums and this area was probably irritated by the bonding done over the last few years to cover the dark margins.
<<THE GREY COLORED GUMS INDICATED ISCHEMIA. THIS IS CAUSED BY THE LACK OF BLOOD SUPPLY IN THAT AREA DUE TO THE CHRONIC INFECTION THERE. THE BONDING WAS NOT THE CULPRIT, IT WAS THE BACTERIA.>>

2) The implants were placed immediately when the extractions were done and some bone graft added. It was bovine material. I have a partial 'flipper' to use while the healing takes place over the next few months.
<<I HOPE YOUR DENTIST WILL BE MONITORING THE INTEGRATION OF THE IMPLANTS WITH RADIOGRAPHS AT LEAST MONTHLY FOR THE NEXT 6 MONTHS BEFORE ANY PERMANENT CROWNS ARE FITTED. YOU MAY BE IN A HIGH RISK CATEGORY FOR IMPLANT FAILURE DUE TO THE LONGEVITY OF THE RETAINMENT OF THE ROOT CANALED/ APICOED TEETH. HOPEFULLY YOUR DENTIST REVIEWED THAT INFORMATION WITH YOU PRIOR TO PLACING THE IMPLANTS. >>

3) It seems at the time of extraction the dentist said he had to 'clean up the gums' and it left an area over one tooth which is like a gully up into the gum line. At my last visit, a week ago, the dentist said it was starting to heal now and it looks a bit better to me. Hopefully the gum will grow together over this area in time. I asked if I should massage the area with anything but was advised to leave it alone.
<<THE "CLEAN UP OF THE GUMS" MEANS HE HAD TO REMOVE THE ISCHEMIC BONE AND GUM TISSUE THAT I SPOKE ABOUT EARLIER. TO LEAVE ANY OF THIS BEHIND COULD CAUSE THE BODY TO REJECT THE BONE GRAFT AND JEOPARDIZE THE INTEGRATION OF THE IMPLANTS. HOWEVER, YOU WILL NEED CAREFUL MONITORING TO MAKE SURE THE BONE GRAFT MATERIAL IS INTEGRATING PROPERLY WITH YOUR OWN BONE AND THAT THE IMPLANTS ARE SOLIDIFYING IN THE JAWBONE.>>

4) Could I also ask for your comments in general. I now have 4 teeth left with root canals and a total of 7 crowns. 4 of these crowns are nickle over my back lower molars. 3 of the crowns are procelain over gold. Now that titanium has been added to this mix of metals is this healthy for the long term or is it likley these metals may react badly together. May it be advisable to consider have the nickle crowns replaced?
<<I WOULD URGE YOU TO CONSIDER THE REASONS, BOTH PRO AND CON, FOR KEEPING OR REMOVING THOSE 4 ROOT CANALED TEETH. THEY ARE NOT HEALTHY IRRELEVANT OF HOW WELL THE ROOT CANALS WERE PERFORMED BECAUSE OF THE MICROSCOPIC CANALS, AS I MENTIONED EARLIER, CANNOT BE CLEANED OUT. THESE MILLIONS OF TINY CANALS HARBOR INFECTIOUS BACTERIA WHICH IS NOT GOOD FOR YOUR OVERALL HEALTH. YOU COULD ASK YOUR DENTIST WHAT YOUR TREATMENT OPTIONS WOULD BE IF YOU WERE TO REMOVE THEM. THOSE OPTIONS MAY HELP YOU TO MAKE AN INFORMED DECISION ON WHAT IS BEST FOR YOU.
CROWNS THAT ARE MADE OF NICKEL ARE TOXIC TO MOST HUMAN BEINGS. THE DISSIMILAR METALS THAT YOU SPEAK ABOUT IS AN EXCELLENT OBSERVATION ON YOUR PART!! THE ACTIVITY CAUSED BY THE MIXTURE OF METALS IS ACTUALLY CALLED "GALVANIZATION". THIS IS WHEN SEVERAL METALS ARE PLACES IN AN AREA, LIKE THE MOUTH, THAT ARE CONTRADICTIVE OR NOT COMPATIBLE WITH EACH OTHER. THE METALS GIVE OFF CONSTANT CONDUCTIVE SPARKS SIMILAR TO A BATTERY. THIS IS WELL KNOWN TO CAUSE OR WORSEN NEUROLOGICAL DISORDERS. YOUR PORCELAIN OVER GOLD CROWN IS ALSO A MIXTURE OF METALS WITHIN THAT GOLD SUBSTRUCTURE. IT IS NOT PURE GOLD ONLY ABOUT 50% AT THE VERY BEST. DO YOU ALSO HAVE MERCURY FILLINGS?>>

At this time the salty taste is not has bad as it was and is worse when I do not have the partial in place. Once my tongue touches the area of the implants and metal covers it is certainly more annoying and may have to do with the metal.
<< THAT SALTY TASTE HAS ME CONCERNED GIVEN ALL THAT YOU HAVE SHARED HERE. I CAN'T STRESS ENOUGH TO HAVE RADIOGRAPHIC MONITORING EVERY MONTH FOR THE NEXT 6 MONTHS TO SEE PROGRESSION OF THE HEALING OF THAT AREA.>>

I hope these comments clarify my circumstances. As you can tell I had bad teeth all my life the enamel was compromised when they came in due to high fevers I had as a child and probably bad nutrition in childhood, after the 2nd world war food was scarce and also dentists were not good in the UK.
<< I UNDERSTAND YOUR SITUATION, IT IS NOT UNCOMMON AT ALL. I DO BELEIVE THAT YOU HAVE DONE ALL THAT YOU COULD TO KEEP YOUR TEETH IN THE BEST SHAPE POSSIBLE.>>

Judith, please keep us informed on how you are doing. Please know that I have given you this information with the best of intentions. I just wish more dentists would share this with their patients prior to doing any dental work.

Best Regards,
Bryanna