Vowel Lady,

Your situation is so unfortunate and probably more common than diagnosed. It is understandable for you to feel upset and be leery of trusting anyone!

Your friend who went to the dental school for dental treatment was unusually fortunate to see someone who didn't try to sell her on a rct. Evidently this student/dentist is of the mindset that fractured teeth are not usually salvageable. He also understands the risk of using bone graft material in a patient who has an autoimmune disease and chose to forgo the graft. Not all patients are good candidates for bone grafts and each patient needs to be screened on an individual basis.

Do you know which dental school she went to? Was it in the US? NYU in NYC or Temple in PA by any chance?

Bryanna

Hi Bryanna!

No problem about missing my old post. People have lives to lead so I appreciate all feedback you folks give me. I am so glad I found this forum. You and vowel lady have been great to talk with about my dental experience.

This surgeon is real old school. He's been doing this since the early 70's and his office decor and materials reflect it. The place is old school but looks clean as you can get if you didn't do any updates for 40 years. I saw nothing that could be described as high tech except for those magnifying things he has on his glasses to see up close.

The floor was swept clean and may have been washed. Rugs looked vacuumed. No mice or cockroaches running around on the floor. It's just an old surgeon with an old office. Picture umm... lots of yellow plastic that used to be clear but has aged through the years. No plastic chairs though. They were comfortable. The guy seemed nice enough though. He put is hand on my shoulder letting me know things are okay when I was reading that disclaimer of all the bad things that could happen with a bone graft. Geesh, I'm freaking out now..not totally. I'll be okay.

It is a HUGE indentation. I'd take a picture of it but I think you'd freak out if you saw it. :O Maybe I will anyway and upload it. Might be interesting to get some feedback.

The bone spur things. Are they okay to stay in? Man, I'd hate to have even more surgery done. I'm thinking I should have gone to this holistic place in Haverhill, MA that my sister went to but it's a little after the fact at this point. They charged her a lot but she was very happy with the work and they were super sterile. They had this mercury protocol thing they used. They gave her vitamins and herbs to take home. Stuff like that.

The surgeon didn't give me any options on bone graft material. The stuff he recommended to me what human cadaver bone. He did get into great detail though as to how it was sterilized and not to worry about it. I don't think he's got any skeletons in his closet that he's scraping material off of. The price was going to be either $550 or $975 depending on whether he has to put a ....barrier...in? Anyway, he agreed to do it for $550 b/c he know about the fiasco I went through with the dentist I saw before him and now I'm even more broke. :O So he said to the nurse something like... "we'll use more packing material?" Hopefully it's just more cadaver material to fill the hole and not newspaper. I think I mentioned he had me sign a long liability waiver... :O I did speak with the nurse about other options and she mentioned sometimes they will do a bone graft using the patients own bone form another donor site but that would be a hospital visit. Think I'll pass on that option.

Speaking of passing. I think you're probably going to pass out after reading all this.

My friend did not go to any of those schools you mentioned. PM if you would like to know where. The dentist was unusually quiet, but then again, she was frightened and was not in the mindset to ask questions. She is so fortunate that she got good dental care.

As part of my routine, I go to acupuncture now three x a week. I am spending $240 a week that I can NOT afford to spend. However, along with my meds, this seems to help with the severe pain.
She (The Acupunturist/Dr.) has other patients with facial neuralgia...that's why I chose her. Today I asked her what percentage came to her after a dental experience. She said one patient had a brain tumor removed and ended up with the neuralgia. ALL the others were due to bad dental experiences.

Hi asquirrel,

Post a picture of it..... I've seen everything, this will not scare me...

There is nothing wrong with old or worn .... but there is a concern in dentistry about dentists who have not updated their office (since the 70's or 80's) for the simple reason that carpets hold bacteria, mold, chemicals, and are highly contaminated with mercury after all the years of using these materials. So updating means cleaning up the contamination, not just making it pretty or new. These same dentists tend to perform antiquated procedures and also tend to not update too much of anything, including their sterilization techniques. I mention these things because most people do not think about them.... and I get the feeling you might me one who does... ??

The "high tech things on his eyes" that he uses to see with are called loops. They use them when their eyesight is going bad :/ Only kidding....... hee hee. Actually they are used frequently by most dentists because they can make the object about 4 times bigger than normal size.

I'm sure he's very reassuring... that is truly a credit to his character to be so compassionate with you.

The "packing material" is not newspaper........ although the older dentists use to use ... ...... ......! Nah, I'm sure it's not that.
Actually he may be referring to "collagen" which is used often on top of a bone graft to help keep the area filled with blood so it can heal well.

The bone spurs may need to be removed if they are bothersome or large. He may do that when he does the graft.

I cannot tell you where to go for your dental care and it's important for you to feel comfortable wherever you go. But becaue I've been in dentistry for 30+ yrs and have worked in many offices both as a temp/fill in and permanent assistant, I can tell you that I personally would not choose a dentist who has not updated his office in 20 yrs because I know first hand what's behind door #2....! Now maybe this guy is different... ?

Keep us posted and thanks for always making us laugh ~'.'~

Bryanna

Hi Bryanna!

Sorry, this time I missed your message!!!

Today with the help of my wife I was able to get some pictures of the extracted tooth area.

FYI, this area has been healing since 1/25. I have an appointment set up with the oral surgeon on 3/14 to do the bone graft. I'm again seeking your opinion as to whether the extraction looks normal (plus a million more questions at the bottom of this odyssey).

What I'm trying to show in the pics is that there's like a gouge, a "V" shape and at the top there's a couple of bumps that look like bones still in there. I get all queasy when I touch them. Eww... I'm just thinking with that huge gouge there...there's no way I could put a nesbit / flipper thing in there so it would sit normally and I could chew on that side again.

So I called a local place where I live that has a indigent clinic and they said they were not qualified to give an opinion....??? Would have been nice since it would have been like $45 for a consult. Okay..so, there's this place in MA that my sister went to. But they would charge about $200 for a consult. I'm struggling financially and my HSA account is getting precariously low. I have super high deductible health insurance in case I get run over by a bull or something and end up in ICU. But I digress.....

I'm just trying to figure out if getting a bone graft is a waste of time at this point because the area seems too cut up with the "V" and warped and with the hole that nothing I put in would fit evenly. Also, the bumps on that top of my gum (the bone thingies...I was able to get the one white bump / bone on the right to show in the pic but the left wasn't showing up...must have taken 30 shots just to get these to come out clearly) have those bone thingies in there and they'd rub against whatever I'd ultimately stick in there, whether it's a bridge, a denture, a flipper.....or other...things that you put in the area of a missing tooth.

I don't want to put an implant in there because 1. it's going to be WICKED expensive (4k+) and 2. I am super worried that there's going to be a problem that I can't fix (like this horrible weird "V" thing I can't get rid of that nothing will fit evenly and comfortably. Plus, those bone spurs would rub against whatever appliance I put in there. Then I touch those bone spurs and the "V" it makes my knees get weak and think I've got mangled gums now )

So I'm freaking out basically. My sister says..."hey, you might not want to go back to that guy and go see the holistic dentists I went to. It's only going to be about $200 per consult. (she's doing well financially). Maybe they'll give you a discount if you have them do the work." And then I'm thinking, "They did good with my sister but what if they do the work on me and then they screw my gums up even more?? The first guy is an oral surgeon (a doctor) but he's old school and did that "V" thing on my teeth with those elevator things. But if I go to the other place I could end up getting Doctor Giggles as my dentist!!" Actually, the person who extracted my sister's teeth looked like Dr. Jonathan Crane / Scarecrow from Batman Begins. She was creeped out but he did a good job. (see below why I know this)

So I'm at a get together with my sister and I wanted to look at her extracted gum hole. (yeah, I'm weird like that). So I looked and it looks like they did a good job with her extraction. She didn't have any "V" thing and no bone spurs. I asked if she wanted to see my gouge but she declined. Anyway, sufficient to say I'm didn't get the relief I was hoping for thinking my gums are just fine after looking at hers.

Woah, I just wrote another book. Sorry.

So, what I'm concerned..freaking out about is.

1. The time clock. The deadline to my gums flattening out from no graft must be getting close. If I don't do something soon I'll have a flat gum! So I gotta do something fast!

2. The "V" bone spur thing. Nothing will fit in there right even with a bone graft. Those bone things make me freak out and I'm sure it's gonna hurt if I put something over it like a flipper or a bridge. And I'm afraid if I ask the oral surgeon to fix it he's gonna get ****** and annoyed and grind them down with a sander or something! Or worse! (I don't know for sure what worse could be...but I can imagine some things. I don't want so say here because it might happen). :O

3. Who do I go with for the bone graft? Do I stay with the oral surgeon or go with the holistic dentists? (I guess that depends on whether you think it's pretty normal the way things look right now).

4. should I get a bone graft? Do I need one if I'm totally not going to get any more surgery in my mouth (especially no implants which get screwed into my jaw... :O) That would be a recipe for disaster. But maybe the graft will help with a flipper or a bridge or a nesbit or whatever else to make things nice and even and smooth so I can chew on my left side again. So whatever I put in there should ultimately will be comfortable. That's why I was thinking about the bone graft.

5. I probably missed something but I'll wait until you take a look at the pics and see what you think. Maybe there's cause for concern or maybe not. With this dental adventure things just haven't gone so well. You know the history. The only thing good so far is that tooth is out (which should have been extracted to begin with) and I'm not feeling any pain there now.

Anyway, sorry again for the novel. I start and then realize how much I wrote. :O

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Hi asquirrel,

Sounds like you are having some challenging times in your life..... but fortunately you still have your humor ) And you always make me laugh
AND thanks for posting those great pictures!!!! You and your sister did good!

I see all of your concerns and will answer your questions in capital letters. No I am not hollering, it just makes it easier to distinguish between your words and mine.

<<1. The time clock. The deadline to my gums flattening out from no graft must be getting close. If I don't do something soon I'll have a flat gum! So I gotta do something fast!>>

IT IS BEST TO HAVE THE GRAFT DONE WITHIN THE FIRST FEW MONTHS OF THE EXTRACTION. GRAFTING ALSO HELPS TO FILL IN THE MISSING BONE SO THAT THE SITE DOES NOT BECOME CONCAVE.

<<2. The "V" bone spur thing. Nothing will fit in there right even with a bone graft. Those bone things make me freak out and I'm sure it's gonna hurt if I put something over it like a flipper or a bridge. And I'm afraid if I ask the oral surgeon to fix it he's gonna get ****** and annoyed and grind them down with a sander or something! Or worse! (I don't know for sure what worse could be...but I can imagine some things. I don't want so say here because it might happen). :O>>

THE V IS NOT THAT BAD AND IT'S GOING TO FLATTEN OUT/FILL IN A BIT MORE. YOU MAY ALWAYS HAVE A SLIGHT INDENTATION THERE BUT THAT SHOULDN'T POSE A PROBLEM IF YOU WERE TO WEAR A NESBIT OR PARTIAL DENTURE. IF YOU DID THE IMPLANT THEN THAT AREA OF GUM TISSUE MAY BE ALTERED SLIGHTLY BUT NOT ALL THAT MUCH.

<<3. Who do I go with for the bone graft? Do I stay with the oral surgeon or go with the holistic dentists? (I guess that depends on whether you think it's pretty normal the way things look right now).>>

I WOULD CONSIDER SEEING THE HOLISTIC DENTISTS BECAUSE...... YOU DO HAVE SEVERAL LITTLE BONY SPICULES PROTRUDING FROM NOT ONLY ALONG THE GUM BUT FROM THE EXTRACTION SITE ITSELF. THESE ARE SPLINTERED BONES AND TEND TO INDICATE A FORCEFUL EXTRACTION. SO I WOULD BE BIT HESITANT TO MOVE FORWARD WITH THIS PARTICULAR DENTIST. ON HIS BEHALF....SOMETIMES TEETH ARE REALLY FUSED TO THE BONE AND IT CAN TAKE SOME FORCE TO GET THEM OUT. BUT I CAN SEE BY THE REDDENED AND INFLAMED AREAS ALONG THE BONY RIDGE THAT THERE WAS QUITE A BIT OF TRAUMA TO THIS AREA DURING THE EXTRACTION.

<<4. should I get a bone graft? Do I need one if I'm totally not going to get any more surgery in my mouth (especially no implants which get screwed into my jaw... :O) That would be a recipe for disaster. But maybe the graft will help with a flipper or a bridge or a nesbit or whatever else to make things nice and even and smooth so I can chew on my left side again. So whatever I put in there should ultimately will be comfortable. That's why I was thinking about the bone graft.>>

BONE GRAFTING DOES HELP TO ENCOURAGE NEW BONE GROWTH TO HELP REPLENISH A SIGNIFICANT AMOUNT OF BONE THAT IS LOST ONCE THE TOOTH IS REMOVED. THE MORE BONE RESTORED, THE BETTER FIT FOR ANY REPLACEMENT. WHETHER OR NOT TO DO A BONE GRAFT IS SOMETHING THAT A DENTIST WOULD HAVE TO DETERMINE BASED ON X-RAYS AND PHYSICAL EXAMINATION OF THAT AREA.THE HEIGHT, WIDTH AND THICKNESS OF THE BONE. KEEP IN MIND THAT THE NESBIT IS NOT MEANT TO BE KEPT IN WHEN YOU EAT. IT IS WORN TO PREVENT THE MOVEMENT OF THE TEETH ON BOTH SIDES OF THE SPACE FROM CLOSING INTO THE SPACE WHILE KEEPING THE OCCLUSION LINED UP. IT IS ALSO FOR ESTHETICS SO THAT YOU DON'T RESEMBLE A PUMPKIN WHEN YOU SMILE :>

<<5. I probably missed something but I'll wait until you take a look at the pics and see what you think. Maybe there's cause for concern or maybe not. With this dental adventure things just haven't gone so well. You know the history. The only thing good so far is that tooth is out (which should have been extracted to begin with) and I'm not feeling any pain there now.>>
NO YOU HAVE NOT MISSED ANYTHING! THE SITE LOOKS PRETTY NORMAL WITH THE EXCEPTION OF THE BONY SPICULES (WHICH FREQUENTLY OCCUR). THE NEW DENTIST WOULD PROBABLY DISCUSS REMOVING THOSE SPICULES....AND USUALLY THIS IS NOT A BIG DEAL. OR HE MAY SAY LET'S SEE IF THEY WORK THEMSELVES OUT OR EVEN LET'S RECHECK THEM AGAIN IN 4 WEEKS OR SO. AN XRAY COULD BE HELPFUL IN DETERMINING HOW MANY THERE ARE AND HOW DEEP THEY ARE.

Okay?? Feel better now?? By the way... how did you acquire the
name "asquirrel"??

Bryanna

Hi Bryanna!

Thanks so much for the fast reply and for your comforting advice!

I’ll start at a random spot. I usually have a nickname called "angrysquirrel" on gaming sites. I am a big fan of squirrels. I live in NH and we have lots of them. They’re so cute! Plus an angry squirrel paints a very vivid picture in my minds. Cute and strange at the same time. Possibly a dangerous adversary or trustworthy backup in an online game. People like to have angry squirrel on their team. 
So the “asquirrel” is just a shortening of the angrysquirrel. Plus, I think if I named myself “angry squirrel” on here, nobody would want to talk with me. 

Now for the dental stuff:

So, I'll be cancelling the appointment with the oral surgeon and going to the holistic dentists then. I’ll schedule a consult with the spicules and the bone graft. Hopefully, they will give me a discount seeing as they did my sister’s work. This is getting really expensive but I’m I don’t have much choice if I want to chew on left side of my mouth with teeth instead of gumming the food to death. 

Thanks for the info on the Nesbit. I was thinking that because it looked squishy and comfortable but it’s not going to help me chew on the left side. So if I don’t want to go the surgical route should I be looking for a partial denture? Would that be the most comfortable and least invasive solution? If those spicules don’t come out, will my gum get irritated if I put the denture over it? The spicules….does the body just push them out sometimes? That’s pretty neat! So…if they don’t come out on their own do they have to cut my gums open and remove them?!?!? Yikes! Good thing I’ll be in the chair when I faint… :O I’ll keep you posted!

Hi asquirrel,

Interesting squirrel thing you have... "cute and strange at the same time"

I like the "angrysquirrel" nickname.... gives the impression of someone who is a bit .... squirrely ) You can be on my team anytime!!!

You can tell the holistic dental team about your recent dental experience and how it has left you a bit unsure about how to move forward with this due to these bony spicules. Let them do some xrays first. Then question removing the spicules and if the bone graft could be placed at that same time. Question bone graft options and ask for their recommendation in your particular case. It is always important to give full disclosure of your medical history including all medications as this can have a profound affect on your dental plan and the ultimate outcome.

MOST dental offices other than managed care clinics, will offer some discount for paying cash up front. So don't hesitate to ask for something like that. I've worked in dental offices in various areas from small rural towns to very affluent and it is common for people to ask for this type of discount.... so don't even think twice about it!

Based on the photos that you provided... you are not really a candidate for a removable partial denture because you have full dentition on your upper right side. These appliances are designed to replace missing teeth on both sides of the arch. The nesbit would work well in replacing this tooth but as I said, it is not recommended that you eat with it in because it could dislodge and you could choke or swallow it.

Other replacement options would be:
1) A conventional 3 unit bridge. This would require the tooth adjacent teeth, #'s 13 and 15, to be cut down. The bridge would crown #13 and 15 and would hold a fake tooth in the middle replacing #14.

2) Another type of bridge called an inlay/onlay bridge. This would require the tooth adjacent teeth, #'s 13 and 15, to be cut down less than the conventional bridge and it would also hold a fake tooth in the #14 spot.

The bony spicules...............
Sometimes the body does push them out. Other times they need to be removed if they are a constant irritant and source for infection. An xray will show their size and depth. Most of the time this is not a big deal. The area is anesthetized and they are removed with a dental tweezers. But first the xray to see where they are.

So there you have it! Did I explain all of that ok? Let me know if you have any other concerns.... )

Bryanna




961448]Hi Bryanna!

Thanks so much for the fast reply and for your comforting advice!

I’ll start at a random spot. I usually have a nickname called "angrysquirrel" on gaming sites. I am a big fan of squirrels. I live in NH and we have lots of them. They’re so cute! Plus an angry squirrel paints a very vivid picture in my minds. Cute and strange at the same time. Possibly a dangerous adversary or trustworthy backup in an online game. People like to have angry squirrel on their team. 
So the “asquirrel” is just a shortening of the angrysquirrel. Plus, I think if I named myself “angry squirrel” on here, nobody would want to talk with me. 

Now for the dental stuff:

So, I'll be cancelling the appointment with the oral surgeon and going to the holistic dentists then. I’ll schedule a consult with the spicules and the bone graft. Hopefully, they will give me a discount seeing as they did my sister’s work. This is getting really expensive but I’m I don’t have much choice if I want to chew on left side of my mouth with teeth instead of gumming the food to death. 

Thanks for the info on the Nesbit. I was thinking that because it looked squishy and comfortable but it’s not going to help me chew on the left side. So if I don’t want to go the surgical route should I be looking for a partial denture? Would that be the most comfortable and least invasive solution? If those spicules don’t come out, will my gum get irritated if I put the denture over it? The spicules….does the body just push them out sometimes? That’s pretty neat! So…if they don’t come out on their own do they have to cut my gums open and remove them?!?!? Yikes! Good thing I’ll be in the chair when I faint… :O I’ll keep you posted![/QUOTE]

Hi Bryanna,

Sorry for the late reply. My dad just went into a hospital ICU and lots of things have slid off the grid, including my email back to you. Sorry about that. I'm going to follow your advice and have the work done with the holistic dentists. Hopefully, they will be able to remove the spicules if necessary. From what I've been reading online I thought it was a job for an oral surgeon because they are going to have to cut into the gum. But maybe not from what you're telling me. Doesn't hurt to check. In either case, I'll have the bone graft done with the dentists. I'm probably getting close to falling out of the window before the area goes flat but until my dad is out of the woods everything else is on hold. Anyway, I'll keep you posted on my progress. Thanks so much for your help!

Hi asquirrel,

Oh no! I am so sorry to hear about your dad being ill. I will keep him in my prayers. Please take care of yourself.... I know how difficult it is for a loved one to be in the ICU. Keep yourself focused on positive things

It is okay for a general dentist to remove the bony spicules so long as he is comfortable doing that. The same goes for the bone graft. However, when you see the new dentist, you can discuss this subject with him and ask for a referral to an oral surgeon who thinks like minded to him.... if that happens to feel like a better choice at the time.

You have some time to do this.... so no falling out the window!!!
Your dad is the priority right now so that is what you focus on. This other stuff can wait.

Please keep in touch here and let us know how your dad is doing...ok..

Be well .....
Bryanna