Hi lelo,
Welcome to neurotalk!!

To make things easier to read, I'll put your statements in <<< >>> and I'll follow in caps with my reply.

<<<<I have recently been told I need full mouth extraction. 2/3 to 3/4 of bone loss. Not much for shrinkage to gums. My teeth are not that decayed... just have lost so much bone they tell me it won't hold teeth forever. No pain or bleeding even.>>>>

YOU HAVE WHAT IS CLASSIFIED AS SEVERE BONE LOSS AND MOST LIKELY SOME OR MANY OF YOUR TEETH ARE BASICALLY HELD IN BY A LITTLE BONE AT THE END OF THE ROOTS AND MOSTLY GUM TISSUE. THE DEEP POCKETS WITH LITTLE GUM SHRINKAGE MEANS THERE IS ALOT OF BACTERIA LIVING UNDER THE GUMLINE. IT IS NOT UNCOMMON FOR THIS TYPE OF PERIODONTAL DISEASE TO BE BASICALLY SILENT IN THAT THERE IS LITTLE TO NO BLEEDING OR PAIN. BUT YOU SHOULD KNOW THAT THE DISEASE IS VERY ADVANCED WHICH I WILL EXPLAIN LATER HOW THIS PLAYS A ROLE IN THE LENGTH OF YOUR DENTURE AND IMPLANT BRIDGE TEETH.

<<<<I want full dental implants.>>>>

OK. HOPEFULLY YOUR DENTIST(S) HAVE REVIEWED YOUR HEALTH HISTORY EXTENSIVELY AND YOU ARE A GOOD CANDIDATE FOR IMPLANTS. I MENTION THIS BECAUSE NOT ALL DENTISTS REVIEW THE HISTORY AS WELL AS THEY SHOULD.

<<<<Here is what my periodontist and dentist have suggested -

first step: fabrication of immediate detures ( for when they remove all my teeth )>>>> OK, THIS IS GOOD.

second step: full dental extraction, bone graft EVERY tooth socket and sinus augmentation.>>>> AGAIN, IF THIS MUCH BONE GRAFTING NEEDS TO BE DONE, IT INDICATES THAT THE PERIODONTAL DISEASE HAS DETERIORATED MOST OF THE BONY RIDGE AND THERE IS NOT MUCH LENGTH OR WIDTH REMAINING OF YOUR OWN NATURAL BONE. THE GRAFTING IS DONE TO TRY AND REGAIN/REGROW SOME OF THE MISSING BONE SO THE IMPLANTS HAVE SOMETHING TO INTEGRATE INTO. DEPENDING ON HOW MUCH INFECTION IS PRESENT DURING THE EXTRACTIONS, THEY MAY OR MAY NOT BE ABLE TO PLACE THE BONE GRAFT MATERIAL AT THAT TIME. WHICH WOULD MEAN THAT THEY WOULD DO THE EXTRACTIONS, LET THAT HEAL FOR A FEW WEEKS AND THEN GO BACK IN AND DO THE BONE GRAFTING. BONE GRAFTS NEED TO BE PLACED IN HEALTHY BONE OR THEY WILL BECOME INFECTED AND FAIL. DID THEY DISCUSS THAT POSSIBLE ISSUE WITH YOU?

SINUS AUGMENTATION FOR THE PLACEMENT OF DENTAL IMPLANTS ..... THIS IS USUALLY DONE WHEN THE SINUS MEMBRANES HAVE DROOPED DOWN AND FILLED THE GAPS WHERE TEETH USE TO BE. DEPENDING ON THE HEALTH OF THE BONE IN THESE AREAS, SOMETIMES BONE GRAFTS CAN BE PLACED AT THE SAME TIME. BUT AGAIN, THE BONE NEEDS TO BE HEALTHY ENOUGH TO RECEIVE THE BONE GRAFT OR IT WILL BE REJECTED.

<<<<third step 4 months later implant 8 lower and 8 upper endosteal implants>>>>> I KNOW ALOT OF DENTISTS WHO RUSH TO PLACE THE IMPLANTS AND MOST OF THE TIME IT'S NOT WORTH IT. ESPECIALLY IN CASES WHERE THERE IS ALOT OF DISEASE AND BONE LOSS PRESENT AT THE TIME OF THE INITIAL SURGERY. IT IS BEST IMO TO WAIT AT LEAST 6 MONTHS POST OP EXTRACTIONS AND BONE GRAFTING BEFORE PLACING IMPLANTS. THE LONGER THE AREAS ARE ALLOWED TO HEAL, THE MORE SUCCESSFUL THE INTEGRATION OF THE DENTAL IMPLANTS WILL BE. COMMON SENSE..... WHY RUSH THE PROCESS AND RISK FAILURE?

<<<<forth step 3 months later attach fixed dental bridgework>>>>
AGAIN, 3 MONTHS IS GENERALLY NOT LONG ENOUGH FOR THE DENTAL IMPLANTS TO PROPERLY INTEGRATE WITH THE JAWBONE, ESPECIALLY IN EXTENSIVE CASES SUCH AS YOURS. TO WAIT 6 MONTHS POST OP OF THE PLACEMENT OF THE IMPLANTS BEFORE DOING ANY RESTORATIVE TREATMENT IS BEST, IMO. IT ALLOWS TIME FOR THE IMPLANTS TO INTEGRATE SOLIDLY ENOUGH TO HOLD THE PROSTHESIS AND IF FAILURE SHOULD OCCUR, IT GENERALLY OCCURS IN THE FIRST 6 MONTHS POST OP IMPLANT PLACEMENT.

<<<<The only concern he has is because of loss of bone in upper jawbone, the length of final upper restoration may appear as though the teeth are longer than normal. He says there may be other restorative options if this is a concern to me.>>>>
OK, THIS IS WHERE THE LOSS OF BONE AND LACK OF GUM SHRINKAGE THAT I MENTIONED EARLIER COMES INTO PLAY. ONCE THE TEETH AND EXTRA GUM TISSUE (DEEP POCKETS) ARE REMOVED THERE IS NOT GOING TO BE MUCH NATURAL BONE LEVEL LEFT. THE BONE GRAFTING CAN ONLY REPLACE ABOUT 30-50% OF THE ORIGINAL BONE. THEREFORE, THE BONY RIDGE WILL NEVER BE AS WIDE, THICK OR SHAPED LIKE NATURAL BONE. IT WILL HAVE A FLAT SHAPE TO IT INSTEAD OF RAISED. THIS MEANS THAT THE TEETH WILL BE LONGER THAN NORMAL TO ACCOMODATE THE SPACE THAT SHOULD BE BONE. IF THE TEETH WERE NOT MADE LONGER, YOUR BITE WOULD BE NONEXISTENT.

<<<<Well, the final quote was $ 98,000.>>>> WOWZA!!!

<<<<YES, I am concerned that after $98,000 the upper teeth look longer than normal !! I am hoping for your thoughts on this?? Have you heard of this.. and why wouldn't he quote me this "OTHER" option to begin with?? After all... $ 98,000 should be the CADILLAC of restorative treatment..?? YIKES...>>>
HIS TREATMENT PROPOSAL IS THE CADILLAC OF RESTORATIVE TREATMENT! HE HAS NO CONTROL OVER THE LENGTH OF THE TEETH PERSAY BECAUSE HE HAS TO MAKE THEM ACCORDING TO YOUR SKELETAL STRUCTURE WHICH INCLUDES THE DETERIORATION OF YOUR JAWBONE, YOUR TMJ, FACIAL MUSCLES, ETC, ETC. IF THE TEETH ARE TOO SHORT, YOUR BITE OR OCCLUSION WILL BE VERY OFF AND THIS WILL CAUSE A COLLAPSE IN YOUR SKELETAL STRUCTURES. THIS COLLAPSE LEADS TO ALOT OF PROBLEMS WITH CHEWING AND EVENTUALLY LEADS TO IMPLANT FAILURE FROM THE UNNATURAL FORCES WHEN CHEWING ON TEETH THAT DO NOT FIT INTO YOUR NATURAL OCCLUSAL PATTERN.


<<<<I am also hoping you can give me an idea of HOW MANY full mouth dental implants surgeries performed would be considered an EXPERIENCED level??>>>> MANY!! FULL MOUTH RECONSTRUCTION SHOULD NEVER BE DONE BY AN AMATEUR. I KNOW THEY HAVE TO LEARN ON SOMEBODY, BUT I CAN TELL YOU IT WOULDN'T BE ME!! DUE TO THE COMPLEXITY OF THIS TREATMENT, MOST OF THE TIME THE TREATMENT PLAN DOES NOT GO AS EXACTLY PLANNED DUE TO SOME UNFORESEEN CIRCUMSTANCES. THE DENTIST NEEDS TO BE EXPERIENCED ENOUGH TO BE ABLE TO DEAL SUCCESSFULLY WITH WHATEVER CIRCUMSTANCE SHOULD ARISE. THE ONLY WAY HE KNOWS HOW TO DO THAT IS ....... FROM EXPERIENCE.

<<<<Considering I am willing on spending $ 98,000 and need FULL MOUTH.. I want to find the most experienced dentist in this arena possible. ( AS WELL AS ONE WHO IS CONCERNED WITH THE BEST LOOK AT COMPLETION )>>>
I AGREE 100%!

<<<<Any questions you think I should address with him or any other dentists I am considering ?? I want to speak with a few dentists...>>>>
ASK..... HOW MANY OF THESE CASES HAVE YOU DONE AND WHAT IS THE SUCCESS RATE? HAS HE HAD TO ALTER THE TREATMENT PLAN IN MANY OF THESE CASES AND IF SO, WHY? CAN YOU SPEAK TO ANY OF THESE PATIENTS? CAN YOU SEE PHOTOS OF BEFORE AND AFTER OF PATIENTS WHO HAVE UNDERGONE SIMILAR TREATMENT? HOW READILY AVAILABLE IS THE DENTIST IF YOU SHOULD HAVE A POST OPERATIVE COMPLICATION ON A WEEKEND? WILL YOU SEE HIM OR A COLLEAGUE? DOES THE DENTIST HAVE A PROBLEM IF YOU CHOOSE TO WAIT 6 MONTHS BEFORE PLACING IMPLANTS AND THEN ANOTHER 6 MONTHS BEFORE DOING THE PERMANENT BRIDGEWORK? IF SO, WHY RUSH THE CASE?

ALSO...... MAKE SURE YOU HAVE A VERY CLEAR UNDERSTANDING OF WHAT THE FEES WILL BE AND WHAT THE PAYMENT ARRANGEMENTS ARE BEFORE YOU START THE TREATMENT.

Lelo, I hope this helps with your concerns. Please keep in touch with us throughout this process....... there is alot to be learned from it for many people!

Bryanna ~'.'~