[vichen]

Hello Bryanna,

Not sure if you remember me. I was that root canal queen who have all my 10 root canaled teeth removed last summer. Original I was hoping I can get used to partial denture and get my health improved. However, I invested nearly 10K with dentures, two valplasts, one cast metal. None of them pain free. Valplast constantly cause gum pain even after 10 times adjustment. Cast metal is a really big chunk of metal and also cause weird sense when my tongue touches the plate.

Now I'm seriously thinking about implants. Originally I was scared of putting metal in my jawbone, but now I have no choice, I'm thinking if I can accept this big piece of metal denture in mouth, I would rather accept implants, at least they are comfortabe.

My dilemma is, me and my husband are planning to do an IVF this year, I'm 43, I don't want to further delay this project. But I'm confused whether I should do implants before or after pregnancy. If before, I'm worried pregnancy will negatively affect the bone regrowth with posts. If after pregnancy, which will be two years later, I'm worried too much bone loss already.

Sorry I throw you a really complicated story, but if you can give me any positive suggestion or information, I would be very appreciated. I really need a montor at this important crossroad.

Thanks!

[Bryanna]

Hi vichen,

Yes, I do remember you.

There are several issues to contend with that you may or may not be thinking about. I will list them to make it easier to follow.

Regarding your dental health:

1) Anytime you have teeth root canaled there is most likely going to be unfavorable changes that occur in the bone and tissue surrounding those root canaled tooth. Those changes can also spread to the adjacent teeth and so on. Unfavorable in these circumstances means deterioration of the integrity and health of the affected areas. The likelihood, the severity or how far it has spread varies from one person to another and unless it can be seen visually or radio graphically, it cannot be diagnosed. Sometimes the evidence of this is seen within a few months to a year or so after the rc teeth are removed. Sometimes it is just a slow progression over many months or many years. Other times the progression seems non existent or unnoticeable.

2) The most common reason a partial denture will not fit comfortably is due to the UN-evenness of the bony ridge that results from the deterioration of the bone (as I stated above) and also from the removal of the infected tooth. The integrity of the shape of the bony ridge is compromised and there will be unresolved bone loss. Which makes the contour of the ridge uneven.

3) A partial denture is designed according to the dental impressions and measurements taken of the persons mouth. However, over the course of a year or longer the loss of bone continues to occur altering the shape of the ridge even more. The degree of bone loss varies from one person to another depending on their dental issues and their overall health.

Have you consulted with a Prosthodontist about making a partial denture? These dentists have extensive education and experience in fabricating dentures more so than general dentists.

Regarding dental implants and pregnancy.

1) At 43 you are already in a high risk category for problems with your pregnancy and/or your child. Add IVF to that mix and it is imperative to take the absolute best care of yourself prior, during and after the baby is born. That means in all areas.... mind, body and spirit.

2) Dental implants in your case will be risky even if you weren't contemplating getting pregnant due to the fact that they are replacing root canaled teeth. See the reasons why in #1 above about dental health. Dental implants are an invasive procedure and yes, they are metal or zirconium posts drilled into your jaw bone. In healthy jaw bone and in a healthy (not pregnant) person they can be done relatively easily and without problems.

3) The components (hormones and surgery) that go into doing IVF are invasive and not without risk to the women. The status of her physical and mental health will have a major impact on the whole concept from beginning to end.

4) Even under ideal circumstances, it takes about a year for the bone to solidify around a dental implant. You are not in the ideal category due to the teeth having been root canaled. Anything that compromises that healing stage can result in infection, bone loss and an implant failure.

5) The other issue to be concerned about is how the healing of the dental implants will affect a pregnancy... or how the pregnancy will affect the healing of the implants..... especially if there are problems with either.

There is no ideal resolution here. The timing is not ideal for many reasons both dentally and physically. Perhaps you should consult with a Prosthodontist about modifying or remaking a new partial for you before you make any further decisions. Please take everything into serious consideration, decide what you believe is most important to you at this time and go with your gut instinct.

Bryanna

Originally Posted by vichen

Hello Bryanna,

Not sure if you remember me. I was that root canal queen who have all my 10 root canaled teeth removed last summer. Original I was hoping I can get used to partial denture and get my health improved. However, I invested nearly 10K with dentures, two valplasts, one cast metal. None of them pain free. Valplast constantly cause gum pain even after 10 times adjustment. Cast metal is a really big chunk of metal and also cause weird sense when my tongue touches the plate.

Now I'm seriously thinking about implants. Originally I was scared of putting metal in my jawbone, but now I have no choice, I'm thinking if I can accept this big piece of metal denture in mouth, I would rather accept implants, at least they are comfortabe.

My dilemma is, me and my husband are planning to do an IVF this year, I'm 43, I don't want to further delay this project. But I'm confused whether I should do implants before or after pregnancy. If before, I'm worried pregnancy will negatively affect the bone regrowth with posts. If after pregnancy, which will be two years later, I'm worried too much bone loss already.

Sorry I throw you a really complicated story, but if you can give me any positive suggestion or information, I would be very appreciated. I really need a montor at this important crossroad.

Thanks!

[vichen]

Originally Posted by Bryanna

Hi vichen,

Yes, I do remember you.

There are several issues to contend with that you may or may not be thinking about. I will list them to make it easier to follow.

Regarding your dental health:

1) Anytime you have teeth root canaled there is most likely going to be unfavorable changes that occur in the bone and tissue surrounding those root canaled tooth. Those changes can also spread to the adjacent teeth and so on. Unfavorable in these circumstances means deterioration of the integrity and health of the affected areas. The likelihood, the severity or how far it has spread varies from one person to another and unless it can be seen visually or radio graphically, it cannot be diagnosed. Sometimes the evidence of this is seen within a few months to a year or so after the rc teeth are removed. Sometimes it is just a slow progression over many months or many years. Other times the progression seems non existent or unnoticeable.

2) The most common reason a partial denture will not fit comfortably is due to the UN-evenness of the bony ridge that results from the deterioration of the bone (as I stated above) and also from the removal of the infected tooth. The integrity of the shape of the bony ridge is compromised and there will be unresolved bone loss. Which makes the contour of the ridge uneven.

3) A partial denture is designed according to the dental impressions and measurements taken of the persons mouth. However, over the course of a year or longer the loss of bone continues to occur altering the shape of the ridge even more. The degree of bone loss varies from one person to another depending on their dental issues and their overall health.

Have you consulted with a Prosthodontist about making a partial denture? These dentists have extensive education and experience in fabricating dentures more so than general dentists.

Regarding dental implants and pregnancy.

1) At 43 you are already in a high risk category for problems with your pregnancy and/or your child. Add IVF to that mix and it is imperative to take the absolute best care of yourself prior, during and after the baby is born. That means in all areas.... mind, body and spirit.

2) Dental implants in your case will be risky even if you weren't contemplating getting pregnant due to the fact that they are replacing root canaled teeth. See the reasons why in #1 above about dental health. Dental implants are an invasive procedure and yes, they are metal or zirconium posts drilled into your jaw bone. In healthy jaw bone and in a healthy (not pregnant) person they can be done relatively easily and without problems.

3) The components (hormones and surgery) that go into doing IVF are invasive and not without risk to the women. The status of her physical and mental health will have a major impact on the whole concept from beginning to end.

4) Even under ideal circumstances, it takes about a year for the bone to solidify around a dental implant. You are not in the ideal category due to the teeth having been root canaled. Anything that compromises that healing stage can result in infection, bone loss and an implant failure.

5) The other issue to be concerned about is how the healing of the dental implants will affect a pregnancy... or how the pregnancy will affect the healing of the implants..... especially if there are problems with either.

There is no ideal resolution here. The timing is not ideal for many reasons both dentally and physically. Perhaps you should consult with a Prosthodontist about modifying or remaking a new partial for you before you make any further decisions. Please take everything into serious consideration, decide what you believe is most important to you at this time and go with your gut instinct.

Bryanna

Thank you for your detailed information, Bryanna, I really appreciated. I have been thinking to postpone the IVF plan because it will be an frozen embryo transfer and embryo was made at 2013 with good quality. I think I first have to give myself a strong and good health but not mentally, physically miserable about dental things. To be honestly, all my dentures are made by good technicians, good denturists. I wen to five times from first impression to final product, but still not fit well. I think probably it is because my remaining teeth are in strange display which make it not easy to design a nice partials.

Anyway, it's been a year since my extraction. If from CT scan, the doctor thinks the bone is Ok to start procedure, do you think I can go ahead. From your reply, I feel you are saying if the teeth was ever root canalled, it's not a good idea to do the implant replacement. Denture will be the best choice after removing these root canalled teeth, is that what you mean? perhaps I should wait couple of more years to let the bone recover or it's never gonna heal up Well if the tooth ever been root canaled, even remove it. The potential infection will trapped there forever?

[Bryanna]

Vichen,

I agree that it is important to be very healthy before, during and after pregnancy. You will have enough to deal with and really don't want to add any additional risks if you can help it.

The changing anatomy of your mouth and the remaining teeth can be problematic when fabricating a partial denture. Did the same denturist make several partials for you? What is his or their reason for them not fitting well?

Two things I want to caution you about.

One is the Ct scan. There is quite a bit of radiation with that type of scan. The after affects of radiation do not leave the body immediately. Depending on the type of scan, the radiation can linger in the body for various amounts of time. It would be wise to find out how long the radiation lingers in the body from the dental 3D tomography scan and avoid pregnancy until after that time frame has passed. Also, if within the last few years if you have had other radiation exposure from medical or dental scans, the radiation is considered cumulative. That means that with each exposure your body was subjected to another dose of radiation on top of the previous ones. The body's natural removal of cumulative radiation exposure is longer compared to having just one exposure over the course of several years time.

Two... As I explained in my previous reply to you, there is always a potential for bacteria to still be lingering in areas of previously extracted root canaled teeth. Anytime a dental implant is replacing an extracted root canaled tooth, there is a higher risk of post operative problems, infection and failure of the implant compared to a dental implant replacing an extracted non infected tooth.

Bryanna

Originally Posted by vichen

Thank you for your detailed information, Bryanna, I really appreciated. I have been thinking to postpone the IVF plan because it will be an frozen embryo transfer and embryo was made at 2013 with good quality. I think I first have to give myself a strong and good health but not mentally, physically miserable about dental things. To be honestly, all my dentures are made by good technicians, good denturists. I wen to five times from first impression to final product, but still not fit well. I think probably it is because my remaining teeth are in strange display which make it not easy to design a nice partials.

Anyway, it's been a year since my extraction. If from CT scan, the doctor thinks the bone is Ok to start procedure, do you think I can go ahead. From your reply, I feel you are saying if the teeth was ever root canalled, it's not a good idea to do the implant replacement. Denture will be the best choice after removing these root canalled teeth, is that what you mean? perhaps I should wait couple of more years to let the bone recover or it's never gonna heal up Well if the tooth ever been root canaled, even remove it. The potential infection will trapped there forever?