Petrified at the thought of implants. Please reassure me!

[JohnPrescottsPyjamas]

I’ve had two previously filled molars (upper and lower on opposite sides) collapse on me in the last 6 months. Previously, no particular issue with my teeth apart from the usual stuff and generally fit and well.

My dentist is lovely and has used some sort of resin to rebuild the damage but says she is not confident that it is a long term solution and I may need to look at either a bridge or implants in the near future. There is insufficient tooth for a crown.

I don’t really fancy a bridge as it looks like it involves the teeth either side - unless I’ve got that wrong - so I’m assuming I will probably go for implants.
The thought of teeth removal and posts being inserted into my gums fills me with horror as I find the dentist’s chair traumatic enough plus the choking feeling with the water! Is it really that bad and am I working myself up into a pointless panic?

Thanks!

I've had two bridges for years - one is a three tooth bridge on the bottom (molars 5-7), the other is a two tooth bridge, at the top (molars 5&6). I've not had any problems with them, and mostly forget they are there.

Thanks for the reply. What does it involve? I thought I would have to have teeth either side filed - and therefore potentially damaging them.
if you are completely happy, that sounds a lot more reassuring.

I have two implants, both of which are about 8 years old. Hand on heart, it was fine. The implants were done in stages and I am very happy with them. They feel just like my other normal teeth. I am meticulous about regular hygienist visits and clean my teeth extremely thoroughly twice a day.

I am being honest about not having pain, mild discomfort yes, pain no. I followed all the advice I was given to the letter.

I had an implant 7 years ago. Never felt a thing! I found a root canal worse. I love my implant, worth every penny.

I am quite old and have had a lot of advanced dental treatments in addition to the usual fillings etc. These include root canal treatments, crowns and 2 implants.
So long as the specialist/dentist doing your implant is very experienced and competent in the procedure, it is not a big deal. You are numbed with local anaesthetic (obviously this has to work or they can't do it) and you just feel a bit of pushing and pulling when the implant is fitted. You can't see what is happening in your mouth as you are tipped back.
The worst bit is probably the initial extraction. After that in my experience it gets easier whether you need grafting or not. It does take time (months not weeks) though if it is done properly. Cheapest will not be best. Your general dentist should have someone she refers to for implants but you can go wherever you wish. Ask friends for recommendations - you may not realise that people have them.
I experienced no pain during the procedures and minimal to zero discomfort afterwards for which you take painkillers if you want.
Hope this helps.

I also love my implant! Not bad having the work done. I, like a PP keep it meticulously clean and have had no probs, had it about 8 years.
I also had a tooth kind of break in half - had a very old filling and I think the wall of it was thin etc etc. Anyway, I thought there was no way I could have a crown (and the NHS dentist agreed - said implant or bridge or denture). But I went to a private dentist who said there was just enough, he built it up a little and I now have a fantastic crown - all done on the same day. Good result for me - just saying in case you are under NHS it might be worth checking in to.

Thank you, that’s exactly what has happened to one of my molars. It was a very old filling and the side of the tooth just came away last week, leaving a thin wall. I am on Denplan with a private dentist although I don’t think it covers crowns, implants and bridges. I’m resigned to the inevitable cost but a complete wuss about the potential procedure.

I appreciate all your replies. I’m hoping and feeling more reassured by you all that my anxiety is probably unnecessary. ☺️

My crown was £750 just so you don't have a heart attack if you go down that route!

i'm in the process of having an implant for an upper molar.
the first part was done under heavy sedation, i have zero recall of it.
the entire process i was told will take 12 months so far pain free and just waiting for the bone graft and implant (the metal base bit) to set.

There are multiple options when a tooth gets to the end of its useful life.

1. leave - if it is not likely to cause problems then it is ok to do nothing
2. extract and just leave the gap - I have one molar missing I wouldn’t dream of replacing it with anything
3. bridge - this involves removing a significant amount of healthy tooth from those adjacent to the gap and will shorten the life of these teeth. Ten years down the line you may be back to square one.
4. implant - they can and do fail. They are very high maintenance and you need specialist hygienist visit at least once a year to prevent peri implantitis ( same as gum disease in natural teeth

Ask you dentist to talk you through all options. Ask for the risks associated with each treatment then have a think about it. A good dentist will give you plenty of time to consider all the options before planning treatment. Make sure you get a treatment plan with a breakdown of costs and most importantly do not let an implantologist touch you if they haven’t sent you for a CT scan first. We now have specialised dental 3D Ct scans that are used to plan implant cases. If they appear to be a bargain price the be cautious. Same old story “ if it looks too good to be true it probably is”.

Are they visible in your smile? I have missing molars but never considered implants etc as they aren't seen.

"They are very high maintenance and you need specialist hygienist visit at least once a year to prevent peri implantitis ( same as gum disease in natural teeth"

why do you think they are higher maintenance than regular teeth and what makes you think the usual hygienist is unable to floss/clean the area/gums as usual.
i've not heard or been told any of this by my highly qualified implant team or my dental team which is equally involved.

Um I'd be very careful who's doing the work too many dentists really don't have enough experience. OH dentist referred him to a highly qualified guy.

I've had six implants and a bridge. I had sedation because I'm a wuss

I got an implant to replace an upper molar last year. I really don't think sedation is necessary unless you are completely phobic! I just had a strong anaesthetic injection and it was fine. Extraction was the worst part especially as what was left of my tooth disintegrated 🙈 The actual implant was a breeze and much less intrusive/ painful than a root canal.

You'll be fine.

I know I can ask my own dentist but out of curiosity, did you have your implants fitted at the same time as the extraction or did your dentists prefer to let the wound heal for a few weeks?

At least 3 months' healing after extraction in both my implant cases which were 10 years apart.

Same here

Funny that I’ve just seen this thread!

I have an extraction today at 12:40pm and it’s on one of my front teeth. I chipped it when I was a kid, had a cap put on and then over time it got infected because it wasn’t done properly. I had a couple of rooth canals and a few months ago got told that my tooth has completely died and needs to be removed because it’s starting to impact my gums.

As it’s the front tooth, I really can’t leave it empty and have a gap there😅 my dentist has made a denture for me (free of charge because I have a child under 1 but would have cost £280). The denture will get put in place after I have the extraction so I can have something to fill the gap.

My dentist is referring me to get an implant because I didn’t want a crown or a denture permanently. I haven’t had the procedure for the implant yet obviously but it all sounds okay. It’ll cost £2.5K though as implants aren’t done on the NHS as they’re considered a cosmetic procedure. It better be worth every penny!

why do you think they are higher maintenance than regular teeth and what makes you think the usual hygienist is unable to floss/clean the area/gums as usual.
^
Because they are higher maintenance than natural teeth-it's advanced restorative treatment 🤷‍♀️
Specialist tools and training are needed for scaling and periodontal treatment, plus patients need to be fully aware of the need for specialist maintenance /replacement throughout life before undergoing this. Patients need to ensure they have funds set aside to address this. Patients who've had multiple implants placed and paid thousands for implant retained dentures /bridges/crowns-need to know that if they lose/fracture /have an Implantation fail, there is no NHS funding to cover this. This is definitely something people who unfortunately go onto develop devastating or chronic illness , can no longer work, become reliant on benefits -do not think about.
Sorry to be an arbiter of doom, but those of us who work in the Community Dental Service doing special care dentistry, quite often in a domiciliary setting with those patients who've always been fit and well previously but are now have multi- comorbidities, are starting to see this clinical situation more and more often. It's only going to become more prevalent with the rise of 'turkey teeth'. It's all going to be a very difficult scenario to manage with the limited services and number of special care dentists around in E+W; I will be retired by then thankfully. The best thing to do in dentistry is always the least destructive/ high maintenance treatment option where possible.
In about the last 10years has periodontal management of implants been covered in the hygiene/therapy and BDS undergraduate courses. There are still lots of NHS dentists and therapists who very rarely will come across patients with implants. This type of dentistry comes with higher risk, hence why dentists doing implants pay higher indemnity fees. It's also why implant dentistry in unqualified /inexperienced hands, is a common theme for those dentists finding themselves up before a GDC hearings.

The hygienist at a private practice should be capable of dealing with patients' implants in conjunction with check ups with your dentist. I have started seeing the hygienist 3 monthly instead of 6 monthly even though my dental hygiene is very good. It is a maintenance precaution basically so is an ongoing cost to factor in.
I also would be very careful who I allowed to do implants on me and would never go abroad to somewhere like Turkey. As I said above, cheapness is not usually a good sign of quality care.

@Shewhois21 ”The best thing to do in dentistry is always the least destructive/ high maintenance treatment option where possible.”

This is why I’m very reluctant to consider a bridge. My teeth either side of the damaged molar are currently good and sound. I understand that they would need to be reshaped to accommodate and attach the prothesis and I really feel I would rather leave them well alone.

Fingers crossed the resin composite remould holds firm for as long as possible.

There are also resin bonded bridges -Maryland type things-usually no prep or little prep involved of adjacent teeth to missing tooth. Whether that is an option for you in the molar region, would need clinical evaluation by your own dentist. Good luck anyway.
PS if you did go for implants, personally I'd have IV sedation for the procedure.

An implant dentist/specialist who recommends sedation as necessary probably doesn't have very good local anaesthetic technique. Most people do not need sedation for implants. I speak as a patient who wants painfree care.

@notagain2020
Sorry, I'm not an implant dentist and I don't know why you're under that impression, you've obviously not read my posts but just thought you'd get a little nasty comment in.
You're like one of those people that because they went to school once thinks they know everything about teaching. 🙄

Nonsense the Dean of dentistry did my implants. My sedation was carefully monitored.