Quote:
Originally Posted by Bryanna
Hi ellem,
You mentioned that you did alot of research to find this dentist. Did you research her credentials and reputation only OR did you research dental implants also?
I'm in the dental field 30+ years and feel compelled to share a few things with you based on what you have written here. I know you want to believe in this dentist and she may be a great periodontist! So my intention is not to discredit her in any way .... it's to help you become better informed.
The success of a dental implant depends on several things. Such as the patients overall health/medications; their oral health and oral hygiene; eating habits; lifestyle smoking/drinking alcohol; size/shape/thickness of the jawbone; and the health of the jawbone that the implant is going into.
With that said, it is not ideal to place an implant in the bone where there is an irritant such as a broken root tip. Root tips are a foreign body that often become infected. If that were to happen, then the implant would be compromised. At the same time, it is imperative that should the root break, it is removed properly to avoid traumatizing the nerve.
It is imperative that the surgical site for the placement of the implant be free of any possible irritants and be kept sterile during the entire procedure. A slight contamination can compromise the integration of the dental implant.
I am mentioning this to you because rather than her dismissing or making light of this issue about the root tip breaking off, perhaps she should have informed you of the possible consequences.
My dental experience is saying..... she is not confident in removing this tooth because of the curved root. In case you are not aware, generally, periodontists do few extractions and hesitate with extracting teeth that are likely to pose a problem. However, all too often the dentist knows if she were to have this tooth removed by an oral surgeon, then she would most likely lose out on placing the implant to that oral surgeon if it were to be an immediate placement.
Have you gotten other opinions from other dentists about the removal of this tooth? Is it possible to get a second opinion say from an oral surgeon?
To answer your question about post operative issues after extraction and implant placement....... I have had teeth extracted but have never had an implant. I have assisted on many of these procedures and can say that it is important to follow the post operative instructions to the T that are given by the dentist. Following them will diminish the pain and speed the healing. Being well prepared with a soft, healthy diet beforehand will also help. Keep yourself hydrated with water.... no soda or sugary foods as these slow down the healing process.
I hope not to alarm you........ this is a difficult decision to make and it can be scary. I'm just here to offer you my opinion based on my professional experience.
Perhaps you could have a phone consult with her about how often she extracts teeth with curved root tips and let her know you are concerned?
Bryanna
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Hi Bryanna,
Everything you have mentioned are things I did consider and were concerns of mine, and actually still are. I did research both, the dentist and implants.
Let me give you a little background. I take very good care of my teeth and gums. My gums are in great shape but I do clench my teeth so they have taken a little bit of a beating from that but I have worn a flat plane night guard for the last 10 years. I have a prosthodontist that handles all my restorations, an endotontist that has done my root canals, (I know how you feel about those and it has me scared to death) and a periodontist. I do have a high amount of respect for my endo though. He is actually very against doing any procedure unless it is absolutely necessary. Even root canals which is his job.
I did interview 3 perio's before I chose the one I am using. I also considered an oral surgeon but I was told (by my endo) that since perio's specialize in soft tissue they are the best to use for the extraction and implant. I was told by all three perio's that they try to do the implant at the time of extraction depending on the patient. I did also check with my prosthodontist about the removal of this tooth and asked him how difficult it would be, since he has done a lot of extractions and he thought she would be able to remove it no problem.
When she mentioned the root to me this is what she said. "If the root tip breaks off we may have to leave it. In my opinion I feel it is too much of a risk and could cause damage to the nerve, trying to retrieve it." she also said she will really take her time with the extraction, but the problem is that with the resorption, the teeth tend to "pop" while you are trying to remove them, since they are hollow inside. She does 200 implants a year. I didn't ask how many extractions she does, I didn't think to. I just assumed she did a fair amount. I can call her on Monday and she will answer any questions I have. She is very good about that. My surgery is scheduled for Tuesday.
Here is what I have read and been told.
1. It is better to have the extraction, let it heal, then have the implant, but 3 perios have said they try to do it at the same time if possible.
2. Oral surgeons specialize in removing teeth, especially difficult ones, but perio's are the soft tissue guys.
3. Leaving a root tip in can cause an infection. And implanting on top of that can be disastrous. But, removing it can cause nerve damage.
So should I just plan on talking to her on Monday and depending on her answers consider postponing and getting an opinion from an Oral Surgeon? The tip is very close to the nerve. I have an x ray that I was going to attach but I guess I cant until I get to 10 posts.
Thank you so much for all your help. I just want to make sure I do everything the best way possible and I get the best treatment out there. It can just be very confusing when you get conflicting answers sometimes and when dentists are trying to make money! lol
One last question about the pain. Can I expect it to be really sore, or more throbbing? I just want to be as prepared as possible. I have all my soft foods ready to go and filled all my prescriptions today. I plan to follow all the directions I am told so hopefully I will heal fast!
Elle