General Dental Implants

[Eric]

I've had issues with bad teeth since childhood and have had most pulled by the time I was 35, my mother lost all of hers when she was 16 so it runs in the family. So I finally decided to get a couple of implants that will hold the lower denture in place. The procedure was to pull the two teeth and then replace them with the implants drilled directly into the jawbone with supplemental bone grafting at the same time, which was done on Tuesday.

I don't like to mess around with narcotics so I've been getting through on Tylenol and Ibuprofen but wow, there's a lot of pain from this procedure. I suppose it should be expected as they're opening up the gums and drilling into your jaw bone but in the long run it should be a nice permanent replacement for stability down there. Just now starting to feel like it's recovering for the first time this week.

 

[AG_PhamD]

I've had issues with bad teeth since childhood and have had most pulled by the time I was 35, my mother lost all of hers when she was 16 so it runs in the family. So I finally decided to get a couple of implants that will hold the lower denture in place. The procedure was to pull the two teeth and then replace them with the implants drilled directly into the jawbone with supplemental bone grafting at the same time, which was done on Tuesday.

I don't like to mess around with narcotics so I've been getting through on Tylenol and Ibuprofen but wow, there's a lot of pain from this procedure. I suppose it should be expected as they're opening up the gums and drilling into your jaw bone but in the long run it should be a nice permanent replacement for stability down there. Just now starting to feel like it's recovering for the first time this week.

Glad to hear you’re teeth will be back in business. It’s great how far dental technology has come. The cost of implants I imagine is far more painful than the actual pain hahah. Teeth are important in quality of life and self perception.

My sister is a DMD, MD oral surgeon. She has a lot of patients who forgo narcotics for a number of reasons. Ibuprofen usually does a pretty good job. Most people only have a few days of acute pain as it is.

There’s a great drug called Exparel (liposomal bupivucaine) I know she uses a lot. It’s similar to lidocaine except for lasting an hour it lasts 3 days, thus greatly diminishing the need for narcotics. Non-liposomal bupivicaine usually lasts like 3hrs. The only problem is insurance bafflingly does not usually cover it and it costs about $350 or so. And there’s no risk of dependence/addiction and little risk of other problems. The way I see it, if you’re spending many thousands of dollars on implants, $350 is a drop in the bucket.

That said, overwhelmingly most people can take a opioid pain killers for a short duration with no problems. If you have a history of addiction then there’s a reason to be much more cautious. But I don’t think avoiding them is unreasonable if you think you can handle the pain in other ways. Why take something you don’t need? Besides the risk of dependence/addiction they cause a lot of unpleasant side effects for many people like nausea/vomiting, sedation (not necessarily bad thing but not necessarily good if you’re trying to function), severe constipation, etc.

 

[Eric]

Glad to hear you’re teeth will be back in business. It’s great how far dental technology has come. The cost of implants I imagine is far more painful than the actual pain hahah. Teeth are important in quality of life and self perception.

My sister is a DMD, MD oral surgeon. She has a lot of patients who forgo narcotics for a number of reasons. Ibuprofen usually does a pretty good job. Most people only have a few days of acute pain as it is.

There’s a great drug called Exparel (liposomal bupivucaine) I know she uses a lot. It’s similar to lidocaine except for lasting an hour it lasts 3 days, thus greatly diminishing the need for narcotics. Non-liposomal bupivicaine usually lasts like 3hrs. The only problem is insurance bafflingly does not usually cover it and it costs about $350 or so. And there’s no risk of dependence/addiction and little risk of other problems. The way I see it, if you’re spending many thousands of dollars on implants, $350 is a drop in the bucket.

That said, overwhelmingly most people can take a opioid pain killers for a short duration with no problems. If you have a history of addiction then there’s a reason to be much more cautious. But I don’t think avoiding them is unreasonable if you think you can handle the pain in other ways. Why take something you don’t need? Besides the risk of dependence/addiction they cause a lot of unpleasant side effects for many people like nausea/vomiting, sedation (not necessarily bad thing but not necessarily good if you’re trying to function), severe constipation, etc.

Good advice/feedback here, it's appreciated. The pain lasted much longer than anticipated and I had no idea I will not be able to eat solid food for at for 3 to 4 months, this was a real blow and I've had to completely come up with a diet that works but still can't help losing weight as a result. I only have myself to blame here but once all is said and done I'm hoping the payoff will be worth it.

 

[Chew Toy McCoy]

"Looking forward" is probably the wrong term here, but I'm sure I'll be replacing the whole enchilada at some point. Even good dental insurance is usually inadequate and you end up shelling out a small fortune in teeth maintenance over the years and unless you've been a dental hygiene and checkup nazi for your entire life at some point you're just continuously patching the dam. In some cases I wonder if it's just overall more cost-effective to yank them all and replace them with a better option than what mother nature provided. If nothing else I don't think teeth have evolved to keep up with the average modern sugar and soda intake.

 

[thekev]

In some cases I wonder if it's just overall more cost-effective to yank them all and replace them with a better option than what mother nature provided. If nothing else I don't think teeth have evolved to keep up with the average modern sugar and soda intake.

Google for what that looks like, noting that a full set of implants on both arches along with whatever else accompanies the restoration (eg fixed denture, crown and abutment, whatever) according to google is $50-100k in the US. Implants are considered to be a great success, because they provide a high level of stimulation to the jawbone, which would not be provided by other options (still not as much as real teeth). Your bones rely on stimulation. Without that, you lose your jawbone, and you don't want that.

 

[shadow puppet]

Good advice/feedback here, it's appreciated. The pain lasted much longer than anticipated and I had no idea I will not be able to eat solid food for at for 3 to 4 months, this was a real blow and I've had to completely come up with a diet that works but still can't help losing weight as a result. I only have myself to blame here but once all is said and done I'm hoping the payoff will be worth it.

I’m in awe of your courage, Eric.

About 4 years ago, I had a serious cyst infection in my lower left jaw. Four dental specialists didn’t want to touch me. The cyst had entwined itself around 4 teeth in my lower jaw and I never even felt it until it popped through my lower gum line like an abscess. There was no pain so who knows when it began or how long it had been growing. It ended up being a very infected apical cyst but presented like a really aggressive cyst who’s name I’ve blanked from my memory.

Long story short, I went to sleep for 3 hours while the oral surgeon carefully & painstakingly extricated the cyst. Worst case scenario, I would’ve awakened to 3 lower teeth extracted. Then followed by a two year process involving cadaver jaw bone grafting and finally, implants. I am more terrified of implants than I am of open heart surgery.

So kudos to you @Eric, for holding it together as well as you have. I only wish I had that kind of courage & tenacity.

Sending positive healing mojo for lessened pain & better eating options soon!

 

[AG_PhamD]

Good advice/feedback here, it's appreciated. The pain lasted much longer than anticipated and I had no idea I will not be able to eat solid food for at for 3 to 4 months, this was a real blow and I've had to completely come up with a diet that works but still can't help losing weight as a result. I only have myself to blame here but once all is said and done I'm hoping the payoff will be worth it.

3-4 months?! Woah, I’ve never heard of that for a couple implants- soft diet yes (usually for a couple weeks), non-solid diet (aside from several days after the surgery)- no. How many days post-op are you?

Soft diet including things like pasta, bread, fish, eggs, ground beef, etc. Obviously follow your dentist/doctor’s instructions but you may want to clarify with them. It’s not uncommon for providers to gloss over things.

If you truly must say on a liquid diet for an extended period, Ensure type drinks are pretty common means to supplement calorie and protein intake an gain/maintain weight.

 

[Eric]

I’m in awe of your courage, Eric.

About 4 years ago, I had a serious cyst infection in my lower left jaw. Four dental specialists didn’t want to touch me. The cyst had entwined itself around 4 teeth in my lower jaw and I never even felt it until it popped through my lower gum line like an abscess. There was no pain so who knows when it began or how long it had been growing. It ended up being a very infected apical cyst but presented like a really aggressive cyst who’s name I’ve blanked from my memory.

Long story short, I went to sleep for 3 hours while the oral surgeon carefully & painstakingly extricated the cyst. Worst case scenario, I would’ve awakened to 3 lower teeth extracted. Then followed by a two year process involving cadaver jaw bone grafting and finally, implants. I am more terrified of implants than I am of open heart surgery.

So kudos to you @Eric, for holding it together as well as you have. I only wish I had that kind of courage & tenacity.

Sending positive healing mojo for lessened pain & better eating options soon!

Thank you. Yeah, they used bovine bone for me I think but it was necessary to bulk up the area. They had enough to proceed with the implants as well at least so they did it all in a single visit. Otherwise, they only do a bone graft first, then you have to heal anywhere from 6 to 9 months before they go back in and add the implants. Once all healed they'll add a lower denture onto the implants which should be nice and stable.

What a scary experience that must have been for you, sounds rare too, never heard of anything like that. Glad it worked out and you were able to save your teeth though.

3-4 months?! Woah, I’ve never heard of that for a couple implants- soft diet yes (usually for a couple weeks), non-solid diet (aside from several days after the surgery)- no. How many days post-op are you?

Soft diet including things like pasta, bread, fish, eggs, ground beef, etc. Obviously follow your dentist/doctor’s instructions but you may want to clarify with them. It’s not uncommon for providers to gloss over things.

If you truly must say on a liquid diet for an extended period, Ensure type drinks are pretty common means to supplement calorie and protein intake an gain/maintain weight.

You are right, under normal circumstances. In my case I only had two remaining lower teeth, which are what they pulled and replaced with implants, and a partial denture. So it basically restructured part of my jaw with the additional bone graft in there and they said I can not wear any prostheses in that area until it all heals up.

I'm about a month and a half post-op and it's healing up nicely on the outside but it was really painful for about 3 weeks.

I have been drinking Ensure as well and it does help, the biggest drawback is when I want to take weekend trips I can't just make a couple of sandwiches and go, I have to plan and make a bunch of soft food that must be microwaved, etc.

It is what it is but if it all takes it should be really solid when all is said and done, they say these implants should last a lifetime.

 

[AG_PhamD]

Thank you. Yeah, they used bovine bone for me I think but it was necessary to bulk up the area. They had enough to proceed with the implants as well at least so they did it all in a single visit. Otherwise, they only do a bone graft first, then you have to heal anywhere from 6 to 9 months before they go back in and add the implants. Once all healed they'll add a lower denture onto the implants which should be nice and stable.

What a scary experience that must have been for you, sounds rare too, never heard of anything like that. Glad it worked out and you were able to save your teeth though.


You are right, under normal circumstances. In my case I only had two remaining lower teeth, which are what they pulled and replaced with implants, and a partial denture. So it basically restructured part of my jaw with the additional bone graft in there and they said I can not wear any prostheses in that area until it all heals up.

I'm about a month and a half post-op and it's healing up nicely on the outside but it was really painful for about 3 weeks.

I have been drinking Ensure as well and it does help, the biggest drawback is when I want to take weekend trips I can't just make a couple of sandwiches and go, I have to plan and make a bunch of soft food that must be microwaved, etc.

It is what it is but if it all takes it should be really solid when all is said and done, they say these implants should last a lifetime.

Gotchya, that makes a lot more sense having the jaw work. I didn’t realize you had that extensive of a procedure. Yeah, I guess there’s not much avoiding what you have to do.

Are you taking any type of OTC painkillers?

I can definitely sympathize with dental pain from having braces, wisdom tooth removal, and a root canal infection, but never for more than a few days. But it sounds to me like it will be worth it in the end. Keep your eye on the prize!

 

[Eric]

Gotchya, that makes a lot more sense having the jaw work. I didn’t realize you had that extensive of a procedure. Yeah, I guess there’s not much avoiding what you have to do.

Are you taking any type of OTC painkillers?

I can definitely sympathize with dental pain from having braces, wisdom tooth removal, and a root canal infection, but never for more than a few days. But it sounds to me like it will be worth it in the end. Keep your eye on the prize!

I only took ibuprofen and tylenol which barely dented the pain for the first few days but I am careful not to go near narcotics so I just dealt with it, the pain lasted about 3 weeks and slowly subsided, glad to report I'm pretty much all pain free now.

 

[AG_PhamD]

I only took ibuprofen and tylenol which barely dented the pain for the first few days but I am careful not to go near narcotics so I just dealt with it, the pain lasted about 3 weeks and slowly subsided, glad to report I'm pretty much all pain free now.

Good to hear you’re not in pain. Prolonged or chronic pain can definitely take its toll.

So I assume you haven’t had the implants put in as you wait for the graft to heal? Hopefully the pain in this round will not be as prolonged.

Just some pain management options for the future that might be worth talking to your doctor about (some docs are better with alternative pain management options than others)- In addition to the Exparel I mentioned before, another great potential option is Ketorolac (aka Toradol) which is a crazy NSAID that has analgesic efficacy on par with morphine without being a narcotic and having psychotropic effects. It comes as an injection or oral tablets. The downside is it can only be taken for up to 5 days as beyond that you have an increased of GI ulcers (like all NSAIDs, just much faster due to the potency) and if you have kidney issues it’s not a good choice. I’ve taken it before and it works wonders. Naproxen is usually considered one of the better NSAIDs for longer term use if the pain is prolonged- but there’s a ton of options in the NSAID department. Another option is gabapentin aka Neurontin, typically best for nerve pain but can be helpful for other types of pain.

 

[Eric]

Good to hear you’re not in pain. Prolonged or chronic pain can definitely take its toll.

So I assume you haven’t had the implants put in as you wait for the graft to heal? Hopefully the pain in this round will not be as prolonged.

She installed them right after pulling the teeth and then supplemented with bone, she then added a membrane to cover them and then sewed the gums up over all of it. So they're installed and ready to go once the bone grows and attaches (osseointegration) for approximately 4 to 6 month.

She'll then do a small procedure to expose them and screw in the abutments and then cap them. Then I go to the dentist for a fitting for the denture on top of them.

Just some pain management options for the future that might be worth talking to your doctor about (some docs are better with alternative pain management options than others)- In addition to the Exparel I mentioned before, another great potential option is Ketorolac (aka Toradol) which is a crazy NSAID that has analgesic efficacy on par with morphine without being a narcotic and having psychotropic effects. It comes as an injection or oral tablets. The downside is it can only be taken for up to 5 days as beyond that you have an increased of GI ulcers (like all NSAIDs, just much faster due to the potency) and if you have kidney issues it’s not a good choice. I’ve taken it before and it works wonders. Naproxen is usually considered one of the better NSAIDs for longer term use if the pain is prolonged- but there’s a ton of options in the NSAID department. Another option is gabapentin aka Neurontin, typically best for nerve pain but can be helpful for other types of pain.

Good info here, I appreciate it!

 

[shadow puppet]

I'm also very careful with narcotics but I gladly took the Oxy my hand surgeon prescribed following each of my hand/wrist surgeries. Three days following surgery when the surgical drugs wore off and my pain went Defcon levels since he sawed off my ulna bone on each side, I took the Oxy. But I was very careful with it and still have more than half bottle left that I haven't touched since.

After spending two days in emergency care earlier this year for my first ever GI NSAID bleed, I stopped taking all NSAIDS. It's amazing the ulcer didn't happen sooner considering I've been on one form or another of NSAIDS (Naprosyn, Celebrex, Ibuprofin, etc) since 1990. Now I take a 20:1 Canna edible if pain hits. I cut the edible in thirds and only take a third at a time. That's all that is needed. Being a 20:1, I don't get high so I can still work. Considering I only weigh 94lbs and I'm very petite, if they don't make me high, I doubt they would get anyone high. But the cool thing is they do the trick and I feel are much safer (more natural) than NSAIDS.

 

[DT]

Yeah, I probably take too many NSAIDs, though I tend to go on benders (no pun intended) depending on what I'm doing week-to-week.

Wow, 94 lbs, I'm a ... bit more.

 

[shadow puppet]

Yeah, I probably take too many NSAIDs, though I tend to go on benders (no pun intended) depending on what I'm doing week-to-week.

Wow, 94 lbs, I'm a ... bit more.

My laugh reaction is at our size comparison. Yep, I'm tiny (and on the shorter side being barely 5'3").

Re: the NSAID ulcer
I did it to myself. I became so sick of all the pain and having over 24 joints with rheumatoid arthritis, I was popping too many. Advil, Extra strength Tylenol, Celebrex, you name it. It was flat out stupid but lesson now learned.

Weird thing is, once home from the hospital stay, and cold turkey stopping all NSAIDS, I felt absolutely fine. I have them on hand if needed but I prefer the canna edible route and my Rheumatologist is perfectly fine with my choice. Humira takes care of the rest.

 

[DT]

I'm totally down with your alternative treatment

 

[Arkitect]

I only took ibuprofen and tylenol which barely dented the pain for the first few days but I am careful not to go near narcotics so I just dealt with it, the pain lasted about 3 weeks and slowly subsided, glad to report I'm pretty much all pain free now.

Glad to hear the pain is almost all gone.
Dental work… yeah… not fun.

I have a looooow pain threshold, so my instructions to the medical team is always, "Give me all the drugs."

Had some root canal work done earlier this year for a cracked rear molar — I'm a habitual tooth grinder/clencher — but it seems there is a recurrence of inflamation so removal and then an implant might be needed. Aaaargh! The financial pain on top of the physical pain is just insult to injury.