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Old 05-24-2004, 11:06 AM   #1
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Skyla HB User
Please help scared periodontal disease & implants (long)

I have been reading this board for about a week now, and have seen how helpful you all are so I figured it was time I asked for help.

Here's abit of background, I have been sick since the end of March, It started with a leaking from in between my gums. The dentist drained it and gave me antibiotics. 5 days into the antiobotics I couldn't breathe and my ears hurt I went to my regular doc and he changed the antibiotic and put me on a steriod...I had a reaction to the steriod so I went to ER room who then diagnosed me with a sinus infection that had spread. They said to follow up with my doctor, so I went back to my docter who then again changed my antiobotic...He put me on Biaxin for 20 days, but my ears still didn't get better so he sent me to an ear, nose and throat guy, the ear nose and throat guy said I had conductive hearing loss and he thought it was due to the infection in my mouth...So back to the dentist who said the infection was gone...I knew the infection wasn't gone so my husband suggested I see his periodontist (he was just diagnosed with the diease a few months ago)

So I went to his periodonist and he diagnosed me with advanced periodontal disease last week. I was told by the periodontist that I needed scaling and root planning on the bottom, and then surgery. He said I need to loose 2 of my bottom molars...The scaling and root planning and surgery for the bottom comes to 3000.00. The implants on bottom another 6000.00 Now the top he said I could keep 6 he needs to pull my front 4 and my 4 top molars. He discussed getting partials and then implants. He said if I kept the 6 I would need a 4 bridge in the front and then sinus lift on each side the cost of this is about 28grand..He said it would be better to pull them all and get an attached denture the cost of this he said about 38grand. I told him I couldn't afford those figures and the only way I could see is keeping the 6 and doing the implants over a longer period of time..Also my top molars are not loose, but there's an infection that I've had for months on one of the right molars..My regular dentist had drained it and gave me antibiotics but the infection is still there...The periodontist said all the molars should come out even if not loose to get rid of infection, and because there's a lot of bone loss, and because he's worried because of my age that I could have a stroke by the time I'm 55. He sent me to a prosthodontist who wasn't very encouraging, I asked him if he could make the 4 teeth in the front and he said yes but question is how would they look....Huh I thought it was there job to make them look good???? Anyhow I spoke to my periodontist today and he wants to do the surgery on bottom next. I already had the scaling and root planing last week...But I told him, I needed to figure out what we're doing with the top if I'm keeping the 6 I'd rather get the scaling and root planning on them to get rid of the bacteria that is making me very sick. I feel like I'm in limbo, I don't know which way to go? My periodontist kinda sounded annoyed and said he'd have to call me back after he spoke to the prosthodontist.....

I guess I'm looking for advice here...Do these prices seem right to you? I realize I live on Long Island, NY where everything is more expensive but 38 grand for a fixed denture that will sit on top of the gums sounds steep to me..Also I just feel if I keep the 6 if something goes wrong I still have options...He said out of the 6, 4 are good 2 are questionable. But he also told my husband he had 10 questionable teeth so far he has lost one..I can't sleep or eat due to all the stress this has caused.. I was hopeing there was someone on this board who might have some advice or have been thru the same thing.

 
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Old 05-28-2004, 02:28 PM   #2
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Re: Please help scared periodontal disease & implants (long)

Hi, the first thing you need to do is stop being stressed out. That does not help the infection. If your gums are that infected, it seems to me you need the full gum surgery, that's when they cut the gum away, scrape and clean your roots, get rid of all the disease and sometime pack it with antibiotic when they stitche everything back together. I just had that done yesterday morning at a cost of 2100.00 (bottom only). If I were you, I would not even think about implants until I get rid of all infection, and stay infection free for a few months, or you will waste your money on implants.That root planning and scaling or what ever, I've had that done too, but it does not work for major infection. I have never heard of an infection you could not control after surgery. Has your perio. prescribed Peridex or some sort of mouth wash, that would help a lot after any scaling or gum surgery. I use mine all the time, because I have so many implants, I have to stay gum disease free. Also a lot of people wear a 4 teeth bridge in the front and are very happy with it.If you can't get rid of the infection on your molars, you may have to get them extracted in order to control the infection, but as far as I know, gum surgery should take care of the infection so you could keep these molars, especially if they are not decayed.If you have to have teeth extracted now, and cannot afford implants now, your oral surgeon could also pack the site of the extraction with syntethic bone also, so that bone won't be a problem later with placing implants. Bone graft for each tooth here runs about 300.00 per tooth. It also means your gum does not shrink after extraction. I don't know how long you can wait before having the implant placed after that bone graft, but I'm sure your surgeon can tell you. Don't let you perio. rush you. The main thing right now is to control your infection with minimum extractions if any. Maybe It's time for you to consult with another periodontist who can control the disease and for a different approach to you dental treatment. Some people take 3 years or more to get all their implants in, because of the cost. good luck Marti

Last edited by martid; 05-28-2004 at 02:29 PM.

 
Old 05-28-2004, 03:23 PM   #3
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Re: Please help scared periodontal disease & implants (long)

Martid I had the root scaling and planning on the bottom only last week, he wants to do the surgery next on the bottom.I know about the root planning and surgery as my husband just finished his last surgery yesterday packing and all...But I think hes keeping how bad he feels from me as not to scare me. The cost of the scaling & surgery bottom only is 3000.00 with I paid already. The infection is on one of my right top molars. My reg dentist had tried to drain it 2 months ago and gave me antiobotics, but this hasn't helped...I had another scipt from my dentist so I took that, but am off now and have nothing for it. This he wants to pull, along with the other 3 top molars...My top molars are not loose but he says theres so much bone loss there, they will give me problems later on, plus he said because of my age (45) hes worried I could have a stroke by the time I'm 55. One of my front teeth are very loose and the other 3 are looseing...Each day that goes by seems they get worse... It seems he wants to finish the bottom and move on to the top, but in the meantime I still have an infection. He said if it really borthered me he would pull it soon.

This peri seems to be one of the tops on LI....I do have his website but don't think I can post it here...He has been very nice, he opened up one night to discuss the different options with me...And today my husband called him at HOME because he was worried about me...The prosthodontist set me off last Saturday when I asked him if he could make the 4 teeth in the front and he said yes but question is how would they look...Since then my imagination has been running wild, I can't eat or sleep...The peri asked my husband if I would like to talk to him, which at the time I didn't...But he told my husband to reasure me that all options we discussed were still options....and no matter what he would make me a nice smile...He said if I would like to talk to him to call him anytime, on his home or cell phone # which he gave us both.

Anyhow thanks for listening to me. Its hard for people who never went thru this to understand...It was such a shock to me to be told I needed to loose so many when I have all my teeth now except one that was lost when I was 18.

Skyla

 
Old 05-28-2004, 05:29 PM   #4
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Re: Please help scared periodontal disease & implants (long)

Hi Skyla, well you have to get rid of the infection, period.. !! ----- Why can't the perio do a surgery on that top molar and clean it when you go for the bottom surgery ??. ---- I would not have the other molars pulled just because you have lost bone unless you could replace them right away with implants, especially if they don't give you any pain and are not infected.We all loose bone as we age, you are 45 and I am 52, and back molars are hard to clean and hard to floss, most people have lost bone around them and they can still function just fine in their 70's. If your top front are really loose evidently you have gum infection there too. If they have to be pulled, a bridge would work just fine at a much cheaper price than implants for right now. Your prosthodondist should do a nice job for you. The main thing is to get you gums in shape so you don't loose anymore teeth. The gum surgery is supposed to thighten your gums against your teeth so that no food will get in there. My lower 2 front were a little loose because I had so many gum surgeries and I really lost a lot of gum, but they are much stronger now. I remember a dentist wanting to pull them 12 years ago and do a bridge there but I would not let him extract them. Well, they are still there today, and no other dentists suggested I had them pulled. Did you talk to the perio, about placing bone grafts if he extracts any tooth to keep the bone in that site ??. Good luck and try to relax, and keep us posted. Marti

 
Old 05-28-2004, 07:10 PM   #5
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Re: Please help scared periodontal disease & implants (long)

Thanks Marti for such a quick response. Thats exactly what I want to do is get rid of this infection it's driveing me nuts...He had said orginally that if I was older my treatment would be different. He said because of my age he was worried about stroke if I kept the molars. Besides haveing alot of bone loss on the molars, they have deep pockets and he said some had furcations. I had asked him if I could hold onto some of the molars until I could afford the implants, plus I would have someplace to eat and he said if he went up there they would abcess. I aksed him if that could be controlled and he said possibly and maybe we could keep one out of the 6. He did say when he pulls them he is going to do a bone graft. He said once in awhile we get lucky doing that and can avoid a sinus lift. By the way I just looked at my husbands bill and he charges 450.00 for a bone graft. I was actually shocked he said I could keep my lower 2 front teeth as they have alot of movement and the roots are showing but he said there is some bone down there he could work with, and the pockets there are mostly 3's 4's. I sure hope they will tighten up as I wouldn't dare try to eat on them now...They just got loose hummmm maybe 4 weeks ago....I really think stress has alot to do with it...It's funny both mine and my husbands went around the same time, we both been under alot of stress this year, with a death in the family, illness of other family memebers etc....My front top I knew about they had shifted forward quite awhile ago....So yes I'm kicking myself for that...Of cause I blamed it on money, time etc, but it was really fear. I can't have a bridge in the front, not really sure why not I'm guessing the span is to great but the only option I was given was a partical. I have a meeting with the prosthodontist on Tuesday not looking forward to it...Besides what he said I just didn't feel comfotable with him. Every thing I said he would say I hear you, but I don't really think he was listening.

Anyhow I want to thank you again, you have been very helpful so far, and tonight I was actually able to go out to dinner with my husband and parents and actually eat half a meal. If I could get a half nights sleep tonight I think I would feel a hell of alot better. I went out and bought some Vitamin C and some CoQ10, I know its no cure but maybe it will do something to help my body fight till I can get this resolved.

By the way what type of upper did you decide to go with??

Skyla

 
Old 05-29-2004, 11:10 AM   #6
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Re: Please help scared periodontal disease & implants (long)

Hi Skyla, if you don't feel comfortable with that prosthodontist, go somewhere else. It's very important to feel at ease with your dentist. Why is that perio. talking about stroke ?? Do you have a medical condition.?? A large percentage of the population have gum infections and disease and do not get strokes. To answer your question, I wear an upper denture on top of my implants (nothing is attached to the implants yes) while the bone is growing around the implants.I just decided to pull every thing from the top and go with implants, instead of doing a little bit of this and a little bit of that a little fixing here or there, my upper teeth had been worked on so much through the years, they just could not be fixed anymore. My bottom teeth are in good shape. What I don't understand about your perio. is why did he do a root plan. and scal. and then turn around and have to do surgery right away. That seems to cost you another 1$1200 to $1300.00 for nothing. That's why you total cost for the surgery is 4000.00. The surgery does the same thing as the root plan. and scal. and more, so I don't get that at all. Good luck to you, things will work out and you will take care of it, it just takes time, trust me, been there, done that. Marti

 
Old 05-29-2004, 12:06 PM   #7
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Re: Please help scared periodontal disease & implants (long)

Hi Marti,


Since I have been sick my Blood pressure has been on the high side..My medical doctor thinks its stress induced, and the fact that I'm not eating or sleeping much...I had an appointment with him last friday for a recheck but they cancelled on me. I'm also a smoker so I wanted to discuss a plan with him to stop smoking I certainly ain't gonna spend all this money, and let smoking ruin it. The peri took my BP at the 1st visit and it was in normal range. On my peri website it says>>>So I guess thats his reason.
Heart Disease and Gum Disease

For a long time we've known that bacteria may affect the heart. Now evidence is mounting that suggests people with periodontal disease - a bacterial disease, may be more at risk for heart disease than patients without periodontal disease. One study showed that heart disease was 25% more common in people with gum disease. Men under the age of 50 had a 75% greater risk of heart disease than men with healthy gums. Another study demonstrated that men with gum disease had twice the death rate from heart disease than men without gum disease. These studies suggest that gum disease could be a strong a risk factor for heart disease as smoking which is blamed for 40,000 heart-related deaths per year.



As far as doing the scaling I guess it saves him time to have the hygienist do the outer surfaces. The scaling and root planning took alittle less then an hour each quad. My husbands half mouth surgery took 2 1/2 hours.

Actually I was curious as to what your finial restoration would be, seperate implants, fixed denture or removable.

It sounds like you have found a great peri and your treatments are working. I wish you continued good luck.



Skyla

Last edited by Skyla; 05-29-2004 at 12:19 PM.

 
Old 05-29-2004, 06:29 PM   #8
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letsconnect HB User
Re: Please help scared periodontal disease & implants (long)

Gum disease and heart disease are correlated. Correlations do not necessarily indicate cause-and-effect relationships. To say that gum disease causes heart disease/strokes/etc. is not correct. I'd disregard the stroke scaremongering and get a third opinion (esp. since the dentist's and the periodontist's opinions seem to diverge a lot).

 
Old 05-30-2004, 02:46 PM   #9
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martid HB User
Re: Please help scared periodontal disease & implants (long)

Hi Skyla, many studies suggests that it is not gum disease that causes heart problems but they found that a greater percentage of people who have gum disease have a tendency to have a poor diet and lack of exercice than people without gum disease, while people with healty gums have a tendency to eat a better diet, (no soda, no smoking, no junk food) and exercice more, so that explains why they are not as much risk of having heart problems. I do not believe gum disease causes heart problems but the things that may lead to gum disease may cause other health problems.Some people hear about one study and run with it, I prefer to check all sides of the story. As far as quitting smoking, that would help your infection a great deal, and would help control the gum disease. I was smoking until feb. 02 this year, smoke for 30 yrs, and since I had so many implants placed feb. 03, I never had another cig. since, did not use patch, pills or anything except the will power. I wrote a check for $19,000.00 that day to my perio. for my implants, and was not going to waste my money by smoking and taking a chance of my implants failing. Talk about a deterrant (spell). As far as my restoration, I don't know what I am going for yet. I have a few months to decide. My prosthodontist had enough implants placed by the perio so that I could go either way, removable or fixed. The fixed restoration, bridge with crowns is twice as expensive as the fixed, unless I go out of the country to do it, which I probably will do. Take care, Marti

 
Old 05-31-2004, 01:43 PM   #10
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Re: Please help scared periodontal disease & implants (long)

Hi Marti,
That all makes sense to me.

But I guess the furcations don't help my molars either ...


Congrats on your quittin smokeing...I think thats gonna be a big challenge for me considering the stress I'm under right now.

Do you know anyone who has either fixed or removeable??? I only know someone who had there molars done so those as I understand it feel more like your own teeth. I was just wondering how real either a fixed or removeable feel since they sit on top of the gums.

Skyla

 
Old 05-31-2004, 07:51 PM   #11
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Re: Please help scared periodontal disease & implants (long)

Hi Skyla. First of all, whatever you get in your mouth, fixed or removable, it will NEVER feels like your own teeth at first. But after a while, wearing what ever you choose will seem like part of you and you will get used to it, even a conventional denture. I am definitely getting the fixed bridge with crowns to replace my bottom molars. This is where he placed the implants last thursday. They won't be ready for anywhere 6 to 9 months. I'm in no hurry. I am willing to wait as long as it takes, and get the bone strong around the implants before I put the crown on them and use them. I know someone who has had all their bottom teeth extracted at the bottom, have 5 implants and wear an upper denture anchored to a bar attached to the 5 implants. She seem to be satisfied with that, and evidently it works really well, it does not move, and she gets to remove it herself and it's easy cleaning around the implants (you have to clean them just like your teeth) and the overdenture. when you have the fixed bridge attached to the implants, it costs twice as much as the bar and overdenture and is much more difficult to clean under the bridge. Takes special tools and care. I guess It's a matter of choice. Also the overdenture attached to the bar has much less hardware (compare to a fixed bridge with 14 crowns attached with many, tiny screws that could brake and fall off) so I think less hardware, the less can go wrong.I don't mean that fixed bridge are automatically a bad choice, this is just my own opinion. The overdenture attached to the bar is much stonger also than the bridge, that I have read studies that seem to suggest that. Actually the overdenture is much like a bridge since there is no plastic palate to it, just teeth and a little plastic gums. Any way ,whatever you choose, there will be maintenance, and at first it won't feel like real teeth., but they will be stronger than natural teeth, they cannot decay, and they will become part of your body. Some people get crowns or veneers and are not pleased because they don't feel like their teeth used to. Hope that answered some of your questions. Marti

 
Old 06-01-2004, 07:20 AM   #12
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Re: Please help scared periodontal disease & implants (long)

Thanks Marti,
Any info is helpful as I am very early into this. I guess it's so hard for me as I am coming from a full mouth of teeth (well missing one). I can see problems with both I guess...My peri had given me a little booklet about implants and that had said the removeable still has movement. I'm still so scared, maybe even more so now. I'm thinking of keeping the 6 on top he said I could keep incase of some sort of failure. This way if something goes wrong I could always go with the partial. I'm not sure yet if I'm a candidate for replaceing the 4 front with a bridge type implant and the back molars with seperate implants. If I did that and lost any of the 6 later on not sure if it would be a problem peri said no...All the prosthodontist said about that was then he'd have to redo the whole thing...I guess I don't understand that as I'm thinking they could just put in a seperate implant there. Like I said earlier it seems there pushing me to get rid of teeth that still have life. Anyhow I have an appointment with the prosthodontist tonight and am scared to death of what hes gonna say.

I thank you once again, I know no-one who has been through any of this except for one person who had her back molars done and those are in the gum so there more like real teeth. I wish I could keep my 6 and do that. It would probably cost the same but I'm not sure its possible in my case or how strong it would be, or how it would look. You have been very helpful and must have the patience of a saint.

Skyla

 
Old 06-01-2004, 10:17 AM   #13
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Re: Please help scared periodontal disease & implants (long)

Hi Skyla, the removable can't move, it's attached to a gold bar with many attachments, and the bar is attached to 6 or more implants. I have never read anywhere that it moves at all. You should ask him exactly where he got that information. You should keep the teeth that are sound and have your dentist work around them. Natural are always better than anything else. Remember dentists can be wrong, and sometimes if you go to multiple dentists you get multiple opinions and treatment plans.It's your mouth and your money, tell what you want and expect. I am sure you will make the right choice, Keep me posted and good luck to you, Marti

 
Old 06-02-2004, 06:54 AM   #14
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Re: Please help scared periodontal disease & implants (long)

Hi Marid,
Well I went to the prosthodontist last night, he was very nice. We basically talked about just the option of keeping the 6 which he says aren't that great. I told him my fears of if the implants didn't take and I pulled the 6 I would have no choice but to wear a denture. He said he could understnd this. So we talked about doing an implant in the front. I have alot of bone loss and tissure loose there but he said if the peri could build it up he could make a beautiful front. He said he would use 2 implants for the 4 front as it would look cosmetically nicer but it wouldn't be as strong....So yet another discussion...I'm so trying to be as informed as I can....This is so hard.

Now if went with the full upper. My peri thought I might be able to get by without doing a sinus lift if we cantilevered one back tooth, but the prosthodontist said if we did that I wouldn't really be able to really chew on it...So if I went with the full fixed, with the sinus lift that would bring the cost up to between 50-58 grand...

Thanks for listening to me and my fears
Skyla

Last edited by Skyla; 06-02-2004 at 07:58 AM.

 
Old 06-02-2004, 12:40 PM   #15
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Re: Please help scared periodontal disease & implants (long)

Quote:
Originally Posted by martid
the removable can't move, it's attached to a gold bar with many attachments, and the bar is attached to 6 or more implants. I have never read anywhere that it moves at all.
The booklet he gave me says A 2nd option involves placeing four to six implants, depending on your jaw size or shape. After healong is complete, the implants are connected with a custom made support bar, allowing the denture to to snap firmly into place. This is called an overdenture. The advantage of this option is that it is much more stable then the first option, allowing very little denture movement. Your denture will still be removable for easy cleaning and maintence.

So I guess I got confused with the 1st option as thats not stable...Not hard to confuse me these days LOL...But it does say very little movement.

 
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