My impressions have been taken so something may have already been made, but I need to know the difference in acrylics and porceline. (Refer to prior message.) Meeting with the head of the pros department and his intern was seemingly a waste of time. They wouldn't be specific, they just said I was getting acrylics. Period. Didn't answer my questions. Are acrylics okay or will they look terrible or what?

Also, the surgeon said I would need to be put to sleep after everyone had agreed that I could do it without the drugs. I'm afraid of being put to sleep because of prior bad surgical experience. He said if we had to do any more than pull the teeth, he'd rather ansthesize(sp) me.

My appointment is on the 15th, but they're going to get me in sooner if they have a cancellation. My time is running out, and that's exactly what I feel like doing!

Anxiously - Jon

Hi Jon,

I feel so bad that you are having to put up with such nonsense. Just because you have chosen to receive your dental care at the dental clinic does not in any way mean that everything should not be fully explained to you prior to consenting to treatment.

The acrylic teeth will be ok ....... that is what is used most often. Porcelain teeth are more costly and only used if the person is willing to spend more for them. The long term wear ability of either material depends on the person's bite and if the appliance fits well into their occlusion then either choice would be ok. The one issue that I would stress to you would be esthetics. If you are concerned about the "natural" appearance of the teeth, then you need to stress that concern making sure that you have been heard. If esthetics is not a major concern for you, then don't worry about it they will look fine. Don't worry about the material of the teeth..... it's the least of what is going on!

As for being put to sleep.......... again, they should have been very specific with this issue and asked you about all of your concerns with it. The IV meds used in dentistry of this type will induce a "twilight" sleep which is different than the heavy general anesthesia meds used in a hospital setting for other types of surgery. The twilight meds allow the patient to become very relaxed and have no recollection of the procedure. Some people do fall asleep, but it is not exactly medication induced it just happens due to being in a very relaxed state. You are still given adequate amounts of novocaine to numb the areas of your mouth that are being worked on. Once the surgery is done, most people are easily alerted and fully conscious within a few minutes. There are no lingering affects of these meds like general anesthesia.

However, whatever your previous issues were with anesthesia of any kind, it is important to convey them to the oral surgeon prior to him giving you the twlight meds in your IV.

Jon, it is so important that you go into this feeling positive about the outcome. The doctors have not been accomodating to your questions and concerns, but that doesn't mean you stop expressing them. If this is the path that you need to take to get your dental work done, then make your thoughts be heard irrelevant of whose toes you may be stepping on. The outcome will be ok....... it's just getting to that point that is unnecessarily stressful. Believe me, what you are experiencing is common practice for dental schools all across the country!! But it will be ok!!!

Please keep us posted on how you are doing! Try not to worry, it will be ok!

Bryanna

Bryanna, thank you so very much for hearing me, for your quickness in giving me the information I badly need, and for some reassurance while I'm in this condition.

The aesthetics aren't all that important at my age. If the acrylic will allow me to eat without fear of breakage and pain, it will be acrylics!

I have PN along with other things, so I'm feeling it already when he talks about the possibility of moving a nerve, doing a bone graft, etc. I have no choice in the matter, seemingly, so again, if that's what has to be done, it will be.

Put me on your prayer list along with all the others who are surely there. I'll let you know what happens.

Again, many thanks! Jon

Hi Jon,

Well you are certainly welcome..... glad to be of some help to you!

If I remember correctly, you are having dental implants placed to help retain a denture. There may or may not be a need to place bone graft material. It all depends on how thick and solid your existing bone is in the places they want to put the implants. The condition of the bone can be seen pretty well on the radiographs that they have already taken, so they should have some idea of what they are dealing with. Sometimes, the bone looks a bit different once the incision is made an the area is exposed. Did they talk to you about your options with the bone graft material? There are various types, some are synthetic from things like coral calcium and others are from cadaver sources. Generally, a surgeon prefers to use one over the other, but it depends on the circumstances of the case. If they haven't already discussed this with you, then please ask them to inform you of what they will be using before they start the procedure. Make sure that they know about your full health history and the PN, etc.

You mentioned "moving nerves" during the surgery. Please do not be concerned about this. I really cannot think of any reason why that would occur. They may be concerned about nicking a nerve in the mandible canal of the lower jaw but generally they don't place implants in that area of the mandible. There are lots of nerve fibers everywhere, but they regenerate quickly providing your immune system has the ability to heal them. But don't stress about that at all..... it will be ok!!

I wish you could feel more confident about the work you are having done and about those who are doing it! This is a HUGE undertaking and you should have been treated better. If it's any consolation....... many private practices handle their patients similarly alot of the time. Patients often feel like they are not entitled to ask questions because it takes up too much of the dentists time. Well BS to that!! Take up his time until you feel confident in what is being proposed. Believe me...... no dentist has ever just sat willingly in the dental chair without knowing and understanding what his options were. There are times when the xrays only tell part of the story and the mouth tells another.. so not all treatment is textbook.

If you feel unsure about anything, please write down your questions and take them with you at your next appointment. Tell the dr you have some concerns and want to address them prior to starting anything because you want to go into this with a positive attitude so you come out with a good outcome!

I remember my mother going into heart surgery and saying to her surgeon.... <I have to trust that you've done this before and by now should know what you're doing. However, trade places with me for just one minute.......... pretty scary huh?> He sat down next to her and said....... <what can I do to make you feel more comfortable?> She said, <during the surgery simply reassure me from time to time that I'm doing well.> He said <you got it.> Well, after her surgery he came to me and said... <your mother did remarkably well! She had no blood loss and her arteries grafted beautifully!> He said from now on, he will always reassure his patients during their surgery because he has no doubt that it works! Such a simple thing that can make the world of difference!

Since you cannot seem to rely on your oral surgeon to do too much of any patient sensitivity stuff, you need to reassure yourself and it would be helpful if you started to do that today and every day until this whole ordeal is behind you.

Please keep us informed on how you are doing. I will certainly keep you in my prayers and I know you will be ok!!

Bryanna

They recommended 5 implants in lower jaw with permanent bridges between. I asked for ALL implants, and they said that just wasn't necessary, it would take too long and this would work just as well. That was the pros department.

The surgeon offered no options. Said he'd remove bone from my jaw and implant immediately if necessary. That I would not feel pain from where he took it. That part is hard for me to believe since I have PN and no immune system. (Not necessarily from the PN.) That he couldn't tell definitely about the nerve until he got in and saw it. That would be what would take more time. He mentioned a $300 xray which MIGHT show him more, but he didn't recommend it. Said I might just have the extractions and implants to deal with. He just didn't know. The present xray shows the nerve very close to the implant depth, but, again, he won't know until he sees it.

I did write now all my concerns and made an appointment with the pros department. Our discussion did nothing to assure me. The department head is very much in the "power" mode and that along with talking down to some one is not a nice thing to do. I gave him my concerns, he addressed them, told me what was happening and dismissed me quickly. My drive was almost 2 hours each way. Can I put our a contract for him????

When I had the first 6 teeth extracted, I told the surgeon pretty much what your mother did. I was just under local anesthesia, and he did talk to me all through it, told me what he was doing, what else had to be done, etc.,etc. I agree that it helps speaking to them JUST before they start, and I will certainly do it again.

I'm the only one who can deal with my attitude. You've helped so much by giving me some information that they didn't. If I hadn't found you when I did, I'd probably be dealing with a stroke instead of this surgery!

If you thing of anything else relevent, please let me know. I'll keep you posted. Maybe some of this can help someone else in a similar situation.

Jon

Bryanna, I have another catastrophy. Two 'topless' teeth have become infected. They and the other three remaining teeth in my lower jaw are the ones due to be taken out and the inplants put in on Tuesday

The dentistry school is on vacation this week because of the Masters Golf Tournament. I've called and called. No answer.

My GP gave me a shot of antibiotics with followup pills of amoxycillin. That was yesterday, and I still see infection and feel more pain than I should at this point. Is there time enough by Tuesday for this infections to be gone? I know all the problems that can be caused by infection during surgery, but I don't know if there's more I can do to help cure it quicker. I'm taking the antibiotics and I'm rinsing with salt water.

I'm afraid the infection will have subsided to the point where they can't see anything. Doesn't it still lurk around? And, should I call off the surgery if they don't. I'm terrified to put this off any longer, so my inclination is just not to tell them. Also terrified that they'll say it's okay when it isn't.

I'm between a rock and a hard place! Any suggestions, please. Anyone.

Jon

Jon. since today is the 17th I am assuming you had out your teeth by now. How did it go??

I had 2 out last month, they were in front, top, capped and I think they were infected, the roots I mean. I am having a bit of pain yet in that area but it is subsiding slowly. I had the 2 teeth added to my partial that day so I had them a few days after. As far as implants, I am considering it BUT since it will be 4 upper front, I KNOW it's going to involve MUCH pain since the nerves go directly to those 4 front teeth. I had the other two out years ago. When I inquired about implants, they told me the teeth had to be gone for months and gum totally healed BEFORE they do them. I could have had 2 done a few years ago but I figured I'd wait and have all 4 done at the same time so they'd TOTALLY match. Now I'm not so sure after all the reading I have done about them. I would LOVE so much to have the 4 back permanently. It's such a psychological issue when you lose your front teeth. I have stopped dating or even Thinking about it. I stay away from people as much as possible. Losing my front teeth has been a terrible blow to my self esteem, which wasn't doing so well to begin with.

OK, sorry Jon, I didn't read this before I posted:

Yea, that sounds like a Nighmare alright. BUT, If you went to an Insurance Fueled Dental Clinic, that's what you get. I went to one 5 times, no 6, TRYING to get them to pull ONE tooth and they gave me the runaround . I had to pay someone each time to bring me and each time they took my BP and said "Nope, it's too high, we can't pull it today." I was so Mad I will NEVER go back there again. I have had that tooth OUT and a few more since and never had a bleeding problem. I really don't believe it. I think It's just some kind of Scam to get you to keep coming back so they can charge insurance JUST for the visit. Milk the situation, if you know what I mean.

Bryanna,

Thanks, I do need to vent more and more. But to answer your questions:

I don't feel I can effectively write to the dean or anyone there. I'll get bogged down in details. And I still have to go back Thursday. Dr. X is the head of the surgical department. He leaves in June, and Dr Y takes his place.

X is the one who told me he just would not do the implants without "relaxing" me because it was too long. As he left for his emergency, the last thing he told Y was not to try any implant where the bone didn't look good. When Y decided he would operate, he said his anesthetic team had gone because I took too long to read all those papers and ask questions. I would have been okay with that if he's just deadened me enough. The assistant who drove me nuts was the college student (not dental school) who worked there and also took the final xray. He wasn't trained or accredited in anything.

Pros looked in and gave them the implants and a plan(?). When I asked about the denture, everyone just brushed me off -all in their own way.

Do you have any idea what the "bone" stuff was? They'd all told me the only option I had was my own bone graft. He dusted it in all the inplants but that was after he'd sutured them. Except for the one he goofed on. I can feel it in places on top of my gum. Tried to pull them off, but it hurt too much.

Next Thursday I'm to meet with Y to check on the healing. Then upstairs to pros for - I don't know what. Presumably, to put in denture? Why did they insist that it had to be placed immediately after surgery? There are so many inconsistent orders and explanations through the whole thing.

They explained strongly why they could not put any implants in without doing all of them as I'd suggested. Now, since they put the last one in at the wrong angle , how are they going to deal with that? And, you know that if I complain to Y about all this, he'll brush it off again. Plus, he'll probably be the one to continue to "fix" it. I dread it - I dread it....

All I can see is more time, more pain, more occlusion problems, more money, etc., etc.

After telling me they saw no sign of infection before or after, they prescribed more amoxycillin. All the while saying that I really didn't need it!
Thank God for my GP here who gave it to me beforehand. The lortab they gave me for pain wasn't as strong as what I have to take daily, so I took mine. Y said I shouldn't need anything stronger, so I took my own demerol, too. That's not fair to my GP. He'll make it up for me if I need it, but he's very uneasy about pain meds, and this shouldn't be his problem.

I wish I could somehow get to someone with authority who would listen to both sides. Nobody is overseeing this and correcting what is wrong. It's disgraceful for the dental school to offer services that aren't supervised, seemingly. It's very awkward to complain about things just before the one who did these things starts to work on you again.

Wow! Another long, long one.

Hi Jon,

You have not been treated fairly at all. You have been told things that have not happened and had things done to you that were not explained fully. I can hear your frustrations and see that you are a bit confused about what is going on. ALL understandable on your part and so truly unfortunate!!

The first thing I want to stress to you is to not try to pull anything off or from the surgical sites. If they used bone graft material, it was placed around the implant prior to the suturing. Sometimes a collagen plug or material is placed over the graft and under the suture. This is what you may be trying to pull out...... don't!! Sometimes the top of the implant itself is sticking out of the gum and again this should be left alone. You should have been given strict post operative instructions and obviously you weren't.

I cannot beleive that you were told you would be having light sedation and without any discussion with you, the sedation is cancelled because you took too long filling out the paperwork?? The anesthesiology team is there in the clinic all the time and they should have followed through with the original plan. That whole thing is just BS!

The college student who assisted had no business being there chairside. If he took xrays on you and he is not licensed by that state to take xrays then he took them illegally. More craziness!

When you see Dr Y next week, it would behoove you to let him know how unhappy you are with the way you were treated. I know you are trying to be civil and not make any waves, but Jon, you have been mistreated and you have alot of dental work yet to be done. I would hate to think that this is how things are going to continue.

I would also question Dr Y about the placement of that 5th implant in the unhealthy bone and if he thinks the angle will be ok. Ask him what type of bone graft material was used so you have it for your own records.

I wish I could help you out with all of this. I feel you have not been treated properly and it upsets me to think that they will get away with it.

I recently had a situation with my adult daughter at a dental school clinic in NYC. She was injured at a softball game and ended up in their ER dept. The CT scan confirmed that she had a fractured jaw and the oral surgeon immediately gave her two options. Either perform surgery placing screws in her jaw or wire her jaw shut. It's a GOOD THING I am in this business and know what the hell I am talking about because both of those treatment options would have been the worst thing to do in her case because the bone had not displaced, it was fractured but intact. Of course the surgeon and I went round and round for awhile but he agreed to release her on observation. Well, that was 4 weeks ago and she has done great!!! She has seen the oral surgeon once a week since then and the scans show that her bone is healing fine and she has no residual problems! But can you imagine if I had not been there??????????? Unbelievable!!

Jon, please take good care of yourself and please heal well in spite of all that you have been through! Please keep in touch and let us know how you are doing.

Bryanna

Bryanna, let me first assure you that I only kept feeling that stuff on top with my tongue. I didn't attempt to take it out. I did give it a lot of thought, though. It's still the same, but I now feel it's part of the suture. I've had plenty of sutures before, so I know how they are, but this is different. I'll let you know what it turns out to be.

On the positive side, I finally found a patient advocate at the dental school. Yesterday I talked with her and she said she'd talk to her boss (asst., patient services) and he or she will call me back. I found her by a fluke. She's not listed anywhere that I've looked on the internet. I couldn't keep her long enough to tell her everything, so I have no idea unless someone calls whether or not this did any good.

Thursday I am to see pros and surgery. Presumably, pros will put in the temporary denture. Presumably, surgery will glance in my mouth. I'm not sure what I'm going for unless for that.

If I've not had a call back from advocacy, I'm in deeper trouble. It'll mean they're like everyone else there. Also, I'll be seeing this surgeon who - incidentally - was not in my files that she pulled up. The name of the one in charge was one I'd never heard of, and I could only remember that the one who operated had a-sort of- hispanic name and his first name was Martin.

Again, I'm trying to push myself into a positive frame of mind, but it's getting harder when things I've worried about turn out to be worse.

Another thing is that this week everyone is getting ready for homecoming which is next week. You may remember that they closed for the week of the Masters Golf Tournament. The pros department was closed for the first two week of March, most of December, the month of July last year, and that's just my experience. I really don't think they do much business.

The way I got to speak to anyone yesterday was by calling the Dean. She wasn't available for a patient because of these homecoming activities. I was switched over to the patient services office. The head of it wasn't there. The only one there available was this patient advocate.

The dental school operates under the medical school. Do you happen to know how this state if rated professionally for these schools? A little late, but I'd like to know.

Your daughter was SO lucky you were there. Otherwise, she might be the subject of yet another letter here. Hope she continues to do well.

My pain isn't so bad now. Most of the swelling is down. The bruising continues to change colors. Most of the pain left is on the top edge of the gum. It still hurts to touch, so I dread the dentures being put on.