[KSMacy]

I am 64 yrs old and am scheduled with an oral surgeon for extraction of my teeth with bone grafting for upper and lower in preparation for implants later.

I am writing here (thank goodness I found this forum) for information. I don't understand some of what will take place as this is a 'first' for me. I've had extensive dental work over the years, but never bone grafting or implants.

My husband and I moved to Florida from NY 5 months ago. We did not know anyone to get referrals so went through the phone book to find a dentist. The oral surgeon was recommended by the general dentist we found.

I have reservations about the whole procedure as we are both retired and money is very tight. I knew I needed to have my teeth removed as they reached a point of no return.

I have at least 5 infected teeth. Three on the top (front tooth, left canine , and a broken rear molar. They were all post/crown and have come out. I stick them back in with Fixodent. I know, bad idea, but I couldn't walk around without a front tooth.

After reading the posts on this forum, I called the oral surgeon and requested a consult to go over what was going to be done. When I arrived today, I was told he was busy but spoke to a woman who worked with him (not sure of her credentials but she seemed informed). I asked her why bone grafting would be done at the time of extraction if there was active infection. I said I learned that bone grafting might not take in infected teeth.

She said they do it all the time and it doesn't make any difference if the teeth are infected. She said they extract the tooth, clean out the site until clean blood and place the graft; 'to wait is a mistake as the socket would collapse and require a larger graft if done 3 months later.' She said, the fail rate is the same for infection as for non-infection. The surgeon does not guarantee success as grafts can fail for any reason.

She said I should start on antibiotics (Clindamycin) tomorrow and continue to take it until the day of the surgery (next Wed).

I don't know if the information I was given is to be trusted. I don't know how to proceed.

Jane

[Bryanna]

Hi Jane,

I am in dentistry and will try to explain issues concerning bone grafting.

When you remove a tooth the loss of bone is at least if not greater than 50% which makes replacement of the tooth a bit complicated.... especially if the replacement is going to be a dental implant. If you remove multiple teeth
in the same area, the bone loss can be even greater.

The purpose for doing the bone grafting is to encourage the growth of your own bone to integrate with the graft material as a means of replacing the bone that would be lost if no graft were put in.

Ideally, the site to be grafted should be healthy at the time of the grafting. The more disease that is present in that site the slower the site will heal and the higher the failure rate.

When teeth are infected for a long period of time, the surrounding bone becomes infected also. Depending on the individual case the infected bone and necrotic tissue can sometimes be removed in pretty much in it's entirety during the removal of the teeth. If this thorough surgical debridement can be achieved and a healthy blood supply can be obtained, then the bone grafting has an average to high success rate.

The only real way to tell if the above can be done.... is during the removal of the teeth when the surgeon physically sees and feels the porosity or density of the bone.

In general.... it is ideal to place the graft at the time of the extractions providing the opportunity is a healthy one at the time. If the surgeon feels the graft may not take or may become infected because he cannot achieve an adequate surgical debridement, then he may remove the teeth and post pone the grafting for a few weeks or so or completely nix the grafting idea altogether.

Surgeons hope to achieve thorough debridement... that is the goal. Most of the time this can be done..... and when it cannot, then it's a judgement call by the surgeon.

At this point.... the best thing you can do for yourself going into this surgery is to be as healthy as you possibly can be and the earlier you start the better. Eat only nutritional foods, drink plenty of filtered water, and avoid processed/sugar and preservative ridden foods from your diet. Before the surgery it is best to prepare a nutritious meal plan for yourself that consists of soft foods only that you can eat for the few weeks post op the surgery. It is ideal to have the foods prepared and frozen so you can just take them out and heat them up.

Some food ideas....and there are lot of great healthy recipes on line...

Home made soups with lots of veggies. Freeze in individual portions.
Home made stew.... same thing.
Have ingredients to make smoothies..... fruits (fresh or frozen), flaxseed meal, protein powder.
Have lots of veggies and fruit in the house for meals and for juicing.
Eggs, potatoes, fish, organic sugar free yogurt, things like this that do not require a lot of chewing.

Ask your husband to eat the same diet as you..... and make things easier for yourself

I would also suggest taking a probiotic beginning today and continuing for several months or longer. The antibiotic can cause digestive upset even after you stop taking it.... the probiotic can help prevent or reduce that problem from occurring.

I hope this information is helpful for you. I know this is a scary journey. If we can be of help to you, please just check back and let us know

Bryanna

Originally Posted by KSMacy

I am 64 yrs old and am scheduled with an oral surgeon for extraction of my teeth with bone grafting for upper and lower in preparation for implants later.

I am writing here (thank goodness I found this forum) for information. I don't understand some of what will take place as this is a 'first' for me. I've had extensive dental work over the years, but never bone grafting or implants.

My husband and I moved to Florida from NY 5 months ago. We did not know anyone to get referrals so went through the phone book to find a dentist. The oral surgeon was recommended by the general dentist we found.

I have reservations about the whole procedure as we are both retired and money is very tight. I knew I needed to have my teeth removed as they reached a point of no return.

I have at least 5 infected teeth. Three on the top (front tooth, left canine , and a broken rear molar. They were all post/crown and have come out. I stick them back in with Fixodent. I know, bad idea, but I couldn't walk around without a front tooth.

After reading the posts on this forum, I called the oral surgeon and requested a consult to go over what was going to be done. When I arrived today, I was told he was busy but spoke to a woman who worked with him (not sure of her credentials but she seemed informed). I asked her why bone grafting would be done at the time of extraction if there was active infection. I said I learned that bone grafting might not take in infected teeth.

She said they do it all the time and it doesn't make any difference if the teeth are infected. She said they extract the tooth, clean out the site until clean blood and place the graft; 'to wait is a mistake as the socket would collapse and require a larger graft if done 3 months later.' She said, the fail rate is the same for infection as for non-infection. The surgeon does not guarantee success as grafts can fail for any reason.

She said I should start on antibiotics (Clindamycin) tomorrow and continue to take it until the day of the surgery (next Wed).

I don't know if the information I was given is to be trusted. I don't know how to proceed.

Jane

[KSMacy]

Originally Posted by Bryanna

Hi Jane,

I am in dentistry and will try to explain issues concerning bone grafting.

When you remove a tooth the loss of bone is at least if not greater than 50% which makes replacement of the tooth a bit complicated.... especially if the replacement is going to be a dental implant. If you remove multiple teeth
in the same area, the bone loss can be even greater.

The purpose for doing the bone grafting is to encourage the growth of your own bone to integrate with the graft material as a means of replacing the bone that would be lost if no graft were put in.

Ideally, the site to be grafted should be healthy at the time of the grafting. The more disease that is present in that site the slower the site will heal and the higher the failure rate.

When teeth are infected for a long period of time, the surrounding bone becomes infected also. Depending on the individual case the infected bone and necrotic tissue can sometimes be removed in pretty much in it's entirety during the removal of the teeth. If this thorough surgical debridement can be achieved and a healthy blood supply can be obtained, then the bone grafting has an average to high success rate.

The only real way to tell if the above can be done.... is during the removal of the teeth when the surgeon physically sees and feels the porosity or density of the bone.

In general.... it is ideal to place the graft at the time of the extractions providing the opportunity is a healthy one at the time. If the surgeon feels the graft may not take or may become infected because he cannot achieve an adequate surgical debridement, then he may remove the teeth and post pone the grafting for a few weeks or so or completely nix the grafting idea altogether.

Surgeons hope to achieve thorough debridement... that is the goal. Most of the time this can be done..... and when it cannot, then it's a judgement call by the surgeon.

At this point.... the best thing you can do for yourself going into this surgery is to be as healthy as you possibly can be and the earlier you start the better. Eat only nutritional foods, drink plenty of filtered water, and avoid processed/sugar and preservative ridden foods from your diet. Before the surgery it is best to prepare a nutritious meal plan for yourself that consists of soft foods only that you can eat for the few weeks post op the surgery. It is ideal to have the foods prepared and frozen so you can just take them out and heat them up.

Some food ideas....and there are lot of great healthy recipes on line...

Home made soups with lots of veggies. Freeze in individual portions.
Home made stew.... same thing.
Have ingredients to make smoothies..... fruits (fresh or frozen), flaxseed meal, protein powder.
Have lots of veggies and fruit in the house for meals and for juicing.
Eggs, potatoes, fish, organic sugar free yogurt, things like this that do not require a lot of chewing.

Ask your husband to eat the same diet as you..... and make things easier for yourself

I would also suggest taking a probiotic beginning today and continuing for several months or longer. The antibiotic can cause digestive upset even after you stop taking it.... the probiotic can help prevent or reduce that problem from occurring.

I hope this information is helpful for you. I know this is a scary journey. If we can be of help to you, please just check back and let us know

Bryanna

Thank you so much for your informative reply. I guess the bottom line for me, is to trust the oral surgeon. My plan (if I can afford it) is to have implants placed for the lower denture. I don't think he can place the implants at the time of the surgery and he has to do the bone grafting first. I had asked why the grafts couldn't be placed, only where the implants would go. I can't see paying for grafts in areas where there will be no implants. I'm not sure I got a clear answer. I was so nervous I might have missed the reason.

Thank you again. I'm so glad I found this site and do feel a bit better about this whole thing.

Jane

[Bryanna]

Hi Jane,

It sounds like you are not sure of the procedure that is going to be done. Is the surgeon placing implants in areas where teeth are already missing? Or is he just placing them where he is removing teeth?

Bryanna

Originally Posted by KSMacy

Thank you so much for your informative reply. I guess the bottom line for me, is to trust the oral surgeon. My plan (if I can afford it) is to have implants placed for the lower denture. I don't think he can place the implants at the time of the surgery and he has to do the bone grafting first. I had asked why the grafts couldn't be placed, only where the implants would go. I can't see paying for grafts in areas where there will be no implants. I'm not sure I got a clear answer. I was so nervous I might have missed the reason.

Thank you again. I'm so glad I found this site and do feel a bit better about this whole thing.

Jane