Implant Consult -need help with questions to ask
Posted in the Dentures Forum
#1 May 5, 2010
I have an implant consult tomorrow and need some help with questions. I'm hoping that those of you who are already on the implant path can help me compile a list of questions you wished you asked, or did ask, or things you are learning down the road. Doc said I have 3 choices (1) Cadillac of teeth which is an 16 implants (8 top/8 bottom) supporting a full bridge (2) 4 implants top (+4 for bottom) to secure an over denture denture - can't recall if that's a bar or not :((1) the cheapest, my denture modified and secured by 4 implants (plus 4 if I want top also). This option can be upgraded later on to the Cadillac version. I don't have prices yet.*Is scared*
Here's what I have so far. Please help me with questions.
After implants are in, healing time
Pressure caused by implant (I remember someone here complaining about this a long time ago - Angel maybe?)
What teeth are made of? Will they discolor, chip? Cost and time needed to fix basic issues?
Lifespan of implants and the full bridge?
Bridge is like natural teeth? No speech or eating issues?
Bone grafts/sinus lift? He didn't mention needing this but I better ask.
My story: periodontal disease, full mouth extractions summer 09, wore the immediate denture for a few days after, then a few times over a month and haven't put them in again. Just can't seem to muster up the nerve. I'm 32, just graduated college before this happened, and worried that if I don't get implants I'll lose so much jawline that I won't be able to live with myself later. Everyday with this is a physically and mental struggle. I'm just trying to make it better.
#2 May 5, 2010
The first thing you need to ask is why isn't my immediate fitting me correctly.
I think you have some great questions there. I did not have any problems with the implants after they were put in ... well, stupid stuff, like sometimes they felt cold ... don't remember them being any kind of problem. They're easy to have put in (for the patient)- bone has no feeling so the only trauma to your mouth is tissue. So healing takes a couple of weeks at the most ... my dentist waited 6 mos before he would activate them. That was the worst part. If you can beg borrow, or steal the money I'd get this started - it's a fairytale ending.
I don't know what I'd ask .... how much of a discount will you offer me is one, I guess! Good luck .... tell us what you find out. Nothing is exactly like your natural teeth, but this is pretty darn close.
#3 May 5, 2010
Thank you. I appreciate your help! I actually don't know if the immed fits today or not. It was physically painful right after the extractions. I tried relines and adjustments but the reline stuff made me sick. I tried the pink gel that is supposed to numb my gums but I thought to myself "should I really have to mask the pain to keep them in? I shouldn't have to live like this." And I never put them in again. I'm all healed now so who knows how they'd feel. I just can't seem to muster the strength to put them in again. I literally vomit each time I try, I cry, and it takes a good 10 minutes to calm down enough to try again.
Since: Jun 09
#4 May 5, 2010
Give yourself a 2-3 weeks. You will be tender and it took almost three weeks for some of my sutures to dissolve. My implants are exposed; are your's going to be exposed or closed? When closed, the gum in opened later to expose them.
I have eight implants on top - no pressure. You will not even know you have a screw in your jaw bone. As Angel said, it's the tissue that is sore and swollen.
Teeth can be made of acrylic or porcelain. The porcelain is more expensive and repairing them is very costly. I am having an acrylic set made first so I can wear them and have all adjustments made until I love them. Then the porcelain set will be made to be identical. If you have good oral care, the teeth should not discolor or chip, but it can happen.
Today's implants are expected to last a lifetime. Failures do occur. I should think the bridge would last as long.
As close to natural teeth as you can get. If the bridge is placed immediately, your diet will be limited to soft food during the osseointegration period of 4-6 months. Since you've not worn your denture since last summer, your tongue might need to adjust to having teeth in your mouth. That may mean you have a few speech issues to work out with some letters S, F and a few others.
I've had many bone grafts and both sinuses lifted. The toughest part was not being allowed to blow my nose for two weeks during allergy season.
Additionally, you should not have any implants placed without the oral surgeon having a 3D scan of your mouth. From that 3D scan, a guide should be made which your oral surgeon will use. If your dentist offers PRP (platelet removal and reinjection of platelets after the surgery, you should do that.) It hastens the healing and minimized swelling and bruising. You should ask what brand the implants are, what they are made of and what size they are. My first two implants were placed by a regular dentist with implant training and they were too narrow, too short and placed at an incorrect angel.
If you haven't asked already, ask about IV sedation. My first two were placed without it and it was a nightmare. My other six were placed under IV sedation and it was awesome. I felt nothing, remembered nothing and the two hour surgery seemed like a couple of minutes.
Ask about pain medication following the surgery. Many give Vicodan and that makes lots of folks vomit. I took 50 mg Demerol with 2 Tylenol for two days, after that 800 mgs ibuprofen worked well.
It will be better. Please keep us posted.
#5 May 6, 2010
1st consult for implants and here's what I was told.
I asked if he could do an implant supported full bridge with less that 8 implants and he said maybe 6 depending on bone but he wouldn't change the number unless he was positive it would be suitable and he wouldn't do less than 6. The only way he'd do four is if I was securing a denture only. I think Angel said she only has 4 and Merry said she has 8 so I'm going to ask around some more.
He wouldn't be able to tell me about bone grafts until I had the 3-D image/Cat Scan. But sinus is good and bone looks good on x-ray especially on bottom. And he said grafts were no problem. I guess that means it doesn't have to come from my body?
He didn't say he didn't offer acrylic but he said they'd be porcelain and why would anyone want plastic (acrylic) teeth? He did tell me there would be a temp full bridge placed so we could work on speech/tightening the implant. He said it could be adjusted to make sure the lips hit on the right places to make the sounds...and to check for gum lines, etc. but he didn't say what the temps are made of.
He said PRP (platelet removal and reinjection of platelets after the surgery) was an option we could discuss. He kind of acted like he does it when it's necessary and not as a rule. Not sure about that though.
Implants brand is noble, size is determined after the 3-d scan/cat scan and they are made of titanimum. IV sedation is all he does and Tylenol/Ibuprofen for take home meds. He said if I wanted something stronger I could have it but people seem to not need them.
One implant is approx $1750.00 + 700.00 abutment and $600 for denture so it's about $3000 total. What I didn't understand is how 2 implants cost 6100. I guess I'm paying $600 for the denture every time it gets a modification? I should have asked but didn't think of it till now.
3 implants was 8150, 4 was 10,500. So 4 on top and 4 on bottom to support a denture is $20,000 each ($40,000 total) and it can be upgraded from this (o ring gasket denture) to the full implant supported bridge with 8 implants which is $35,000 top and $35,000 bottom ($70,000 total). Wowser.
Thanks for the help with questions. I guess I kind of knew the cost and I'm not sure how I'll afford it. How are you all paying? Bank loans? Care Credit? Credit cards? They gave me a care credit app and a Chase Health Advance app. She told me to apply for Chase first and Care Credit second and my credit would only take one hit. The interest is kind of crazy on those (14% CC and 11-27% for Chase) and there is no way I could pay back in just a couple years (no interest) at $500-$800 a month. That's my mortgage payment. The financial lady said I can call her anytime so I might call and clarify some of the things I forgot.
#6 May 6, 2010
Merry I noticed you mentioned you borrowed the money. I don't want to pry so you don't have to answer. I'm wondering was it a bank loan? Did you just walk in and say I'm having dental work done? Or was it a home equity? Something else?
#7 May 6, 2010
I paid cash. I saved up for this. But had I needed to I would have used the Care Credit.
I have the acrylic temp. It is for all of the things he mentioned - and today, it did crack down the front tooth - but better this one than the "real" one. I can attribute this crack to the fact that it felt like the bite was off a little .... something I was going to call about today anyway ...
Your dentist does not sound high - except on your implant supported denture .... I think mine total was about .... hummm, maybe 13k? Something like that. I still think you need to get an estimate from a Implant only clinic .... you may be surprised since that is all they specialize in. If the bone under the sinus looks good on x-ray, you probably are good to go for implants, but packing artificial bone in a deficient bone area is not a problem .... I had it done. He is probably sedating you because he is doing so many implants at once ... normally you don't need it. I've had 8 put in (not all at once) and needed no sedation and no pain killers, not even Tylenol. But 8 might be a whole different story. My sister just had 2 implants and a sinus lift done, no sedation and no painkillers ....
Yes, I have the 1 on 4 method ... these are the original implants that were put in for my implant supported denture.
Sounds like you are a very astute patient ... that's good, you won't have any surprises.
Keep us posted - and if there is ANY way, get the implants. Spend the money on YOU. You will never be sorry. I promise.
#8 May 6, 2010
Sorry, that's All on Four ....
Since: Oct 09
#9 May 9, 2010
If you can avoid the implant denture, but get something like Angel or Merry, you will be on the right track.
I hate my implant dentures.
(and they are thinner than most implant dentures, they are top grade)
in case you have not read way back on the threads...
I made sure than my acrylic had no Bisphenol A or phthalates. However, there is still leaching of chemicals with acrylics. Some people are sensitive to the leaching.
Since: Oct 09
#10 May 9, 2010
Vivi, The lady in this video reminds me of your story.
Since: Jun 09
#11 May 9, 2010
Vivi, your dentist sounds like he knows what he's doing and his cost is close to what mine was for the surgeon.
To help you understand the costs:
The first 3D scan was $400.
The second 3D scan was $275.
My implants are also Nobel and he charged me only what my insurance would cover (if they covered them and they don't) but it saved me @$1419 each.
Each bone synthetic graft was $440.
There were four reguided tissue regeneration/resorb charges @$339 each. I'm thinking this was the sinus lift on both sides.
There were two other bone grafts @$2500 each.
General anesthesia was $234 for the first half hour and $76 for each additional 15 minutes.
Nitrous oxide was $39 and a drug injection was $37.
The PRP was $600.
There were a couple of consultation charges @$56.
I got Care Credit and they gave me a year to pay off the balance of $4600 with no interest. The majority of the money I borrowed from a friend at no interest; I was very fortunate that this friend offered to help me. Otherwise I would have taken a second mortgage on my house or refinanced it to get the cash out, spreading the payments over 30 years and that wouldn't have increased my monthly payment by much at all.
My prosthodontist bill is separate and is close to $33K which includes the final porcelain bridge and also a temporary acrylic bridge.
Hope this helps you.
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