It’s definitive: My tooth is lost :(

Last Tuesday (July 5th) I visited a new periodontist office. My last visit in May at another periodontist office ended-up with double feelings. She suggested to get a second periodontist appointment with focus on implants… I was able to schedule that appointment pretty quickly. That appointment happened last Tuesday.

Arriving quiet on time I ended up in the dentist chair. An assistant told me she would take some X-rays first. (I even didn’t see the perio yet!). Immediately I felt very nervous and didn’t want to get X-rays again. So I started explaining her that I already had many X-rays taken in the last few months. I asked her if she was able to see those pictures in my medical file, but for some reason she couldn’t fine any usable picture except from the pictures taken at my very first dentist appointment.

I was not able to convince her. She told me that they needed other pictures that are compatible with their medical systems. In my opinion this gave me a very strange an uncomfortable impression. So I had to get out of the chair and follow her. Again X-rays like those I had before at my first ortho appoitment. But I really had to go through with it. After taking the X-Ray the assistant invited me to get back to the chair. Then she took another kind of photo-machine and explained me she would take +7000 pictures (!) with a special device (some kind of toothbrush). Thank God this was not an X-ray device. It took 10 minutes to take the pictures ending up with a 3D rotating model of my teeth. Pretty cool! I think this was the only type of pictures I never experiences before! πŸ˜‰

Then the assistant disappeared… and I had to wait for 20 long minutes! Again waiting, waiting, waiting. Remember? Finally the periodontist arrived and started examining my mouth. (Like my previous first perio appointment). She told me my gum, bone and teeth were pretty stabilized. I was happy to hear that. But then she added: “But I’m afraid the pocket around your tooth 21 is way too deep, the tooth is lost :(“

This moment was the first moment that I really felt I have to give up my tooth. She explained me what to expect from an implant. I even was able to explain her that I’m interested in some kind of extrusion procedure (As described here). I also explained about my crooked teeth and that I’m seriously considering getting braces IF I can combine it with a fake tooth and the extrusion procedure. After discussing the eventual procedure she told me she will get back with a pricing estimate.

In the meantime I received the estimate. Also the plan was included:

  • The implant procedure will cost me 1780€ (!). Extracting the tooth / putting the implant in place / temporary crown / some biological bone placement.
  • Also there might be some extra gum procedures needed depending on how easy my gum will heal. (+370€ optional).
  • Also finale check. (+80€).
  • The final crown should delivered & placed by my dentist. Don’t have price of the final crown yet. So it looks like this is going to be an expensive adventure πŸ™

I have sent back an email asking about “where the braces treatment comes in” and who to contact now? The dentist? The periodontist? The orthodontist… Many questions for sure! So waiting for the response now. I think this story can go 2 ways:

  • Ortho / Perio / Dentist agree on the extrusion procedure with braces. This way I will benefit from fixing some crooked teeth, extrude tooth 21.
  • Ortho / Perio / Dentist don’t agree on the extrusion procedure with braces. Then I don’t think it will be worth to start a braces treatment. I that case my tooth will be extracted manually starting the implant procedure immediately.

Waiting for the email response and get some feedback from dentist. But one thing I know for sure: I have to give up my tooth and look into the implant procedure.

My first visit @implant surgeon

As mentioned in my previous blog post I have canceled my visit at my paradontologist end of this year. It is all taking too long so I called my dentist and asked her what to do. She suggest to make an appointment with an implant surgeon and to discuss next steps with him/her. I have scheduled this appointment a few weeks ago but didn’t update my site until now. So tomorrow: my first visit @implant surgeon.

I’m very curious about what will happen. Probably I’ll have to explain everything over again, but OK I’m getting used to it. I’ll mention the story of the bone grafting (about the braces and the visits i have had at the periodontist). The visit tomorrow might drop some light on the questions I have. I hope I don’t have to undergo X-rays again…

Will keep you posted!

Waiting waiting and waiting

On 26th of May I decided to send an email to my orthodontist. I have told her that I prefer to give up my front tooth and go for the implant. I’m getting impatient and don’t want to wait for the periodontist appointment end of this year (October 2022). The periodontist already responded to my email telling me he will cancel the surgery. (I don’t think he is happy with my decision). My orthodontist sent me another email and told me I should talk to my dentist now to get me in touch with an implant surgeon. After my x visits to dentists, orthodontists, endodontologists, periodontists,… I’ll end-up with a visit to an implant surgeon… How complex can it be? Waiting, waiting and waiting.

So the next thing I did was sending an email to my dentist to bring me in contact with an implant surgeon. But my dentist will be on holiday until June 7th… So I have to wait again to see what will come next.

I know, that with this decision (to give up my front tooth), things will get serious. I’ll have to wait for my dentist now to bring me in contact with the implant surgeon. After that, my orthodontist told me she will contact the surgeon and see if she can use braces to try to save as much bone as possible. I described this special “bone grafting”-procedure on my previous blog post (option 2). This would be the only and really only reason why I would consider starting to wear braces at my adult age πŸ™ My worst nightmare is coming closer and closer.

But I know I HAVE to do something. Waiting is not an option anymore. I want to find a solution to stabilize the bone loss around my top front tooth.

Use braces to extrude my tooth?

Today I have returned from my periodontist appointment. The appointment started exactly at the schedule hour. First he checked all the pockets on each and every tooth. Then he checked my gum and stability of my teeth. Most of my teeth are acceptable (pockets varying from 2mm to 3 mm. Some are 4mm), except from the pocket around my front tooth πŸ™ It didn’t workout as expected. After 3 months it looks like I’m still nowhere. I came to the conclusion I better give up my front tooth definitely. So what are the next steps? What are my options? What did I learn today? An important question came forward: Use braces to extrude my tooth?

Option 1: Try to save the tooth by adding bone graft material to the vertical pocket, next to my front tooth. A 2h procedure. The periodontist will have to do some “magic” with my red and white blood cells to create some kind of bone graft that can be put in place. Because the periodontist is pretty busy, this can only happen end of October! πŸ™ The final outcome of the procedure is still not 100%. So even after this procedure I might still loose my front tooth after waiting for another 6 months. Having to restart over again and moving to option 2.

Option 2: I learned about this option “by accident”. While finishing my appointment, the orthodontist did hear about my bone graft conversation and the next steps as described in option 1. She told me there is a possibility to use braces to “generate” some bone. I have found some information about this procedure here! The bracket can be used to pull my front tooth down slowly. While moving downward some bone will be generated. This might be sufficient to put an implant in place.

Option 2 as suggested by the orthodontist today. Bone grafting while wearing braces!

To be honest, I started thinking about option 2 while driving home. Option 1 is not 100% sure it will work. My general practitioner (doctor) will have to be involved (to take blood). The periodontist will have to cut in my gum. I will have to wait for X months again AND it will cost +600€ again… Even when the procedure is successful my front tooth might give up one day (in 5, 10 or 20 years) ending up with a gap in my front row,… Getting an implant at 60 years old, won’t be so easy.

Option 2 might short-cut time (yes time is ticking and I want to move forward) & will fix the dead tooth, and the issues with my crooked tooth. Also it will start to bring some stability in this whole story. Way to many uncertainties and I hate it.

Today I was hoping for the perio to tell me he was able to save my front tooth. Not needing implant, not needing braces. But it looks like I’m going to give up on this idea, move forward. Get the braces and fix the tooth with the implant!

What I will do next? I will call the ortho-office tomorrow and ask if we can skip Option 1 and just move on with Option 2. That means I’ll have to find some guts to explain I decided to go for the braces and implant πŸ™ Will keep you posted!

My second orthodontist opinion

On April 21th I had my second opinion appointment at an orthodontist. After arriving in the ortho office I waited in the waiting room. I had to wait for more than 45 minutes! (You have to know I had to do this appointment during my working hours.) Each and every other patient was allowed to get in first πŸ™ That way my appointment already started disappointing πŸ™

Finally the doctor picked me up and asked me to get into the chair: “So, tell me what can I do for you?”. The ortho-office is located in the same office as my general dentist. I was hoping she knew about my situation or at least she got informed by my dentist. NOT. That was the second disappointment. I had to explain everything from A to Z (again). About the front tooth, the implant and the braces. She inspected my teeth in detail and concluded… “Oh, you don’t need braces! Just go for the implant and everything will be fine! Hopefully you can keep your front tooth and no implant is needed!”.

A 14 minute examination to conclude I don’t need braces. This outcome contradicts (First orthodontist appointment) 100% with the conclusion of the other orthodontist (the one at my periodontist office). So that’s the 3rd disappointment. Oh and she invoiced 45 € for a 14 minute examination πŸ™

I have to wait now for my appointment at my periodontist on May 16th. Hopefully he can clarify what to do. Strange that 2 orthodontists have 100% different conclusions. Isn’t it? In one way this makes me nervous because I don’t know what option will be the best?

But it gives me hope too. Because this might mean I DON’T need to start braces treatment! And of course THAT would be great news! But what about the implant? Time will tell…

Some changes to my website theme

Today I played around with the layout and theme of my adultwithbraces.com website. I didn’t like the previous theme so I wanted to change it. This way my website is fully prepared for the future and hopefully I can share many more stories and experiences about my exciting journey. I might have to add some picture(s) on the front page and I’ll check that out later on. I hope you like it!

Only 8 days to go to get my second opinion… To brace or not to brace? To implant or not to implant? πŸ™‚ That are the questions running through my mind!

Adult braces dilemma

Today I was thinking about my next appointment end of April. It will be my second orthodontist opinion to check what I should do with my situation. Every time when I start thinking about this appointment I get pretty nervous. I’m afraid that my second opinion orthodontist will confirm what I already heard from the other orthodontist. Sounds little bit confusing but that is exactly like how I feel today. But did you know there exists some kind of “Adult braces dilemma?”

I’m wondering if this second orthodontist will move / shift equally fast like the first one did. You already know that my first orthodontist appointment went incredibly fast (the intro talk, taking pictures, x-rays, molds, … in just 40 minutes!).

I have found a very interesting article about this topic: “The adult case acceptance dilemma”. This article explains in detail how an orthodontist should handle to keep an adult on board. How to put adult patients in braces ASAP after finishing the first appointment. I do recognize a lot of the items discussed in the article:

  • β€œAre there any other treatment-related questions I can answer for you?”
  • β€œYou are ready to get started. I would like to take the impressions today.”
  • β€œI will leave you with (TC’s name), and she will review the steps we need to get started.”
  • β€œI promise we will take great care of you. I know you will be happy you decided to do this.”
  • β€œI’ll look forward to seeing you in the back.”

It is funny to read what my first orthodontist told me πŸ™‚ As my appointment went almost the same. The article explains a lot. I invite you to read it, before you go to an orthodontist πŸ˜‰

Amalgam Before & After

As you have been reading on this blog I had my molar amalgam removal appointment yesterday. Things went fine and fluent! As promised I would share the before and after images… Amalgam Before & After. You can find them down below!

The appointment went pretty fluent. My dentist used a green latex dental dam to protect me from swallowing amalgam particles. The aesthetic result is way better than expected. My next appointment with my general dentist will be in November. We discussed the progress on the periodontal treatment. So we’ll have to way for my next appointment (ortho2) end of April and the perio mid-May!

Before and after

I will get my amalgam removed

Tomorrow I have a new appointment at my dentist. I will get my amalgam removed from one of my back molar teeth. To be honest I don’t 100% understand why it needs to be removed but I think it is related to the braces treatment I might have to start later on.

I’m not soooo keen on getting the amalgam removed. Especially when you start reading about this topic and how many things that can go wrong. The procedure should be done in a careful and perfect way to avoid getting toxic debris in my body. My dentist told me during my last appointment that she will use a rubber dam to protect me from those toxic items. I guess I’ll have to trust my dentist and pray that my tooth will not be damaged. If the tooth gets damaged I might need a crown to fix it. I’m not looking forward to those extra costs πŸ™

I received a reminder about the appointment tomorrow. There was an error in the email, stating that I have an appointment with the Orthodontist. I called the dentist office and they confirmed I’ll have the Amalgam appointment. During that call I asked to put my orthodontist (second opinion) visit one week earlier. Luckily that was possible because week of 25th April I’m not available and focusing on other stuff. I’ll update My journey in appointments-page after finishing this post.

Yesterday I took a picture of the Amalgam tooth. After my appointment I’ll add another post to show you the before and after photos πŸ™‚

I’m curious about what information my dentist received about both the periodontist and orthodontist appointments last month. More info soon!

My second perio-cleaning

Last Monday I had my second perio-cleaning. This time the right-ride of my teeth (both top and bottom) have been treated. I was supposed to have my talk with the orthodontist before the perio treatement, but for some reason there was no time left to talk to the orthodontist.

The periodontist put my gums “a sleep” with some nasty syringe stings. I had to wait for 15 minutes to move on with the treatment. While I was waiting the assistant explained me about how to clean my teeth, how to brush as efficient as possible. She also mentioned the importance of cleaning my teeth as soon as I get started with the braces treatment. It was the first time the braces were mentioned so explicitly. I concluded from this talk that orthodontic braces might start getting pretty serious. This made me slightly nervous and stressed.

My periodontist told me not to worry yet because I have to make sure the past two gum cleanings have to be evaluated first in the next 2 months.

After the gum cleaning I had a short talk with the orthodontist-assistant. She explained me I cannot start with the implant/braces because the periodontist asked to wait. But we glossed already over the pricing and some important topics like:

  • Make sure you clean your teeth (preferably 4 times a day) to avoid white spots on your teeth.
  • You have to come back every 4 to 6 weeks to re-activate the braces.
  • After braces treatment you have to wear a retainer (She showed me an Essix-retainer.)
  • Risks involved: Root resorption is possible, white spots.
  • I have to go to the dentist minimum 1 time a year.
  • Treatment might only take maximum 1 year.
  • During retention period I have to go to the orthodontist on regular basis.

So this means, I’ll have to wait to get clearance and move on with the braces and/or implant. My next appointment with the ortho and perio is scheduled on May 16th. But first I’ll have my dentist appointment start of March to get my Amalgam filling removed from one of my molars.

To be honest I was hoping to get a more detailed treatment plan. But it looks like things have to calm down now. I have my second opinion ortho appoitment scheduled end of April. Maybe it is ok/better to hear from this ortho before proceeding May 16th?