Hi lelo,

I am so glad that you are not hesitant to ask your dentist questions..... so many people shy away from doing that and it is so important to take part in your care..... at least in my opinion it is.

One of the concerns that I would have is the mere 4 month post op between extractions and the placement of the dental implants. It sounds like the dentist has treatment planned quite a bit of oral surgery to be done at the time of the extractions. Which is understandable considering the severe periodontal disease that has caused deep pocketing (extra gum tissue) and moderate bone loss. Keeping all of that in mind...... the surgical sites will need time to heal from the extractions, the sinus lifts, and the bone grafts. Yes, there is bone loss after all extractions. However, the placement of the bone graft material is meant to alleviate some of that bone loss and if it's disturbed too early or placed in unhealthy bone, it will fail. If dental implants are placed too soon into the new graft material, they will not hold. Under less extensive circumstances, bone graft material generally takes 4-6 months to integrate with the jawbone. Even at that stage of healing, the bone is not completely solid but in healthy bone it will continue to solidify around a dental implant for another several months or longer. What type of grafting material does the dentist plan on using? Did you discuss the possibility of not being able to place the grafts at the time of the extractions if there is infection from the periodontal disease? Is he placing temporary implants first?

I'm going to copy and reply to this statement you made....
<<<He has personally done many "all top" or "all bottom". He has never done an entire mouth at once. RED FLAG for me !!!!!!!!! His answer to this is that he never finds people have the $$$$ to do this full treatment. Yes, it is expensive. However, no one else has ever been in my shoes ??? I am VERY worried about this. I do live in a large city in the midwest. These are seasoned and well recommended periodontist and dentists. I was VERY surprised to hear they have never dealt with FULL MOUTH dental implants.>>>
THIS LACK OF EXPERIENCE DOING THE WHOLE MOUTH SHOULD BE A RED FLAG TO YOU. DOES IT MEAN HE IS NOT CAPABLE OF DOING IT? NO...... BUT WILL HE BE ABLE TO HANDLE AN UNEXPECTED TWIST IN THE TREATMENT PLAN IF ONE SHOULD ARISE? MAYBE. WILL HIS PARTNER STEP IN AND WORK WITH HIM IF NEED BE? THE OUTCOME OF YOUR CASE NOT ONLY DEPENDS ON THE SKILL OF THE DENTIST.... IT ALSO INCLUDES.... HIS TOLERANCE AND WILLINGNESS TO MAKE CHANGES..... HIS LEVEL OF PERFECTION, WHAT IS ACCEPTABLE OR NOT ACCEPTABLE TO HIM.......... AND THE QUALITY OF THE MATERIALS AND CRAFTMANSHIP OF THE DENTAL LAB THAT WILL BE FABRICATING YOUR CASE. I WOULD ASK TO SEE PICTURES OF HIS WORK. ALSO ASK WHY HE USES THE LAB THAT HE DOES OVER OTHERS IN YOUR AREA AND ASK IF THEY ARE LESS EXPENSIVE THAN OTHERS IN THE AREA. IF HE SAYS THEY ARE CHEAPER, THEN THAT WOULD TELL ME HE SETTLES FOR LESSER QUALITY THAN YOU MAY BE INTERESTED IN.

He probably has never been able to sell this magnitude of a treatment plan before. Not that some of his patients wouldn't benefit from it but you are his first! He is jumping in his boots over this treatment plan....believe me!! The main thing is that he being able to deliver the quality of care all the way around because this is not something you want to do more than once.

Let me know your thoughts on all this...... we'll talk more.

Bryanna