Check! I have returned from the implant surgeon. He extracted my front tooth. It only took 30 minutes to complete the procedure. He put my tooth in a small box so I can take it to my orthodontist appointment tomorrow.
Things are getting serious now. There is no way back. I already made some new appointments.
In June I will have a checkup appointment. That time the surgeon will check the bone healing. And if everything is fine the implant can be inserted.
Then I have to wait for the implant to heal. If everything is going fine the crown can be installed after mid-September! That means I can start making an appointment with my dentist to create the final crown!
I was pretty afraid for the appointment today. I was worried about:
What if the surgeon hit the other teeth? Breaking other teeth by accident?
What if the surgeon broke / damaged the extracted front tooth?
But everything went fine! I look pretty silly now because of that one big gap in my front top row. Really strange feeling and sight! I think I will be happy with the braces being installed tomorrow… Or not?
On Wednesday 16th of November I finally received my final treatment plan. My orthodontist and implant surgeon finally made up their mind and came up with the final treatment plan. The implant surgeon sent me an email and a few minutes later my orthodontist called me to explain what will happen.
The main reason why they started discussing my treatment again is because I have sent them an email asking how the bottom braces will interact with the implant. My orthodontist convinced me to start wearing braces both top & bottom to get the best result.
January things will finally start
So they have decided to move on with the treatment as follows:
January 18th:
Extraction of front tooth 21 at implant surgeon office.
Installation of the implant (without temporary tooth) and install some bio material to fill some missing bone.
Installation of a healing abutment.
I will have to take the extracted tooth with me. The rest of the day I will have a gap at location 21.
January 19th:
Appointment at orthodontist.
My extracted tooth will be used as pontic. This means, the tooth will be attached to a bracket on my top-row archwire. This way the gap will be hidden.
Installation of brackets and wire on top row (with the pontic). I will need the top braces for minimum 6 months.
Installation of brackets and wire on bottom row. I will need the bottom braces for minimum 9 months.
After this procedure I will have to:
Get used to the braces 🙁 (Oh my!)
Wait for the implant abutment to heal (takes about 6 months)
Optional: This step depends on the healing process. Checkup the tissues around the implant and gum correction (takes about 2 months)
Checkup healing of implant. Then wait another 2 weeks minimum / 3 months maximum
Installation of definitive porcelain crown.
Everything will be fine!
Summarised this means I will end up in full metal braces. So I will get braces installed on top and bottom teeth. My worst nightmare will come through. I have decided not to think too much anymore and to move on with the treatment.
Yesterday, I visited my general dentist (30 minutes appointment) to get my yearly checkup and as expected she was happy to see my gum and teeth are in good shape. She wished me good luck with the implant and braces and reassured me everything will be fine! Wish me luck!
It looks like January 2023 will be the real start of my treatment. I have visited my Ortho last week. We decided to start with the treatment of my bottom teeth. For now it will be a single-arch treatment because I have to wait for some feedback from my implant surgeon. The ortho appointment only took 30 minutes. We discussed the options and signed the contract!
The decision to move forward makes me nervous because it is pretty definitive. But I’m also happy because this was taking way too long. Tomorrow I’ll call my implant surgeon to discuss the treatment / extraction of my front tooth (and when to schedule it). My ortho told me the top teeth don’t necessarily need braces, but to make things perfect she suggests to go for it. I will check with the surgeon at what faze the top braces can be installed. My ortho didn’t want to start with the top arch because of the bad front tooth.
I have selected the basic damon metal braces. Because they won’t stain after drinking coffee (yes, I drink lots’o coffee!) and eating some spicy food! Metal braces are less expensive than ceramic braces, this is also a reason to not go for ceramic.
I btw, the braces treatment of my bottom arch will take +/- 9 months. That is acceptable… Isn’t it?
More I can’t say. A lot will depend on what my implant surgeon will say. As you know I also have schedule a second opinion implant surgeon appointment in January next year! More info to come soon!
It has been little bit silent again. Most of the time I have been waiting and waiting and waiting. I don’t have all answers yet. Don’t know if I have to start the braces treatment. Or do I have to start with the implant immediately? This week might be the week to get the final treatment plan!
First the implant surgeon didn’t send my medical record to my dentist. So I had to ask her over and over again to share it with my dentist (and orthodontist). We have been waiting for this report since my in-take appointment in July. Delays, delays, delays 🙁
I have been sending emails and made some phone-calls… Now finally end of September we received the report. The report states that:
My front tooth needs to be extracted to get rid of the root infection.
Orthodontic treatment is still possible but can be done independent from the implant placement.
Now what does the orthodontist say?
So I tried to contact the orthodontist… Again: It took weeks to get a response. Looks like there was a misunderstanding. After receiving the Implant report my orthodontist thought that a braces treatment was not necessary anymore. This is strange because she suggested to get braces installed to make room for the implant? Remember?
I managed to have a call with the orthodontist last week. I asked her what to do: Do I need to start a braces treatment or not? Is there any reason to skip the braces and move on with the implant? She told me she will contact the implant surgeon and see what to do. On Thursday 27th of October (This week!) I have an appointment with the orthodontist to see how we can move on. Let’s see what this week will bring!
I started this journey in July 2021. Hoping to find a solution to fix my front tooth. In the meantime I know it cannot be saved. To come to this conclusion I had to pay +/- 1000€ (in total). Now I was hoping to get my final treatment plan. But for some reason things are slowing down. At this very moment I still don’t know when my braces will be installed nor do I know when the implant can be installed. As I’m getting older AND I’m not THAT keen on starting a braces treatment at adult age… I’m getting a little bit frustrated.
Last week I called to the implantologist again asking about the medical file that should have been sent to my dentist end of July. The receptionist told me the file was NOT YET (?) sent to my dentist and/or orthodontist. I can’t believe she didn’t do this even after sending her 2 emails. And things even got worse… she will be on honeymoon for the next 2 weeks. (1 week passed already).
I also sent and email to my dentist, asking her (again) if she received my medical record from the implantologist. But also there… no reaction!
I felt very frustrated so I called another implant surgeon. I did some research on the internet. The surgeon is working in a hospital close to the orthodontist practice. But again… another “problem” popped up. I asked for an appointment… They have scheduled me on January 4th !!!!!! 🙁 They can’t be serious? That means I’m almost trying 2 years to fix that tooth!!! I really don’t want to think about this and hope that my dentist or the surgeon will contact me ASAP.
I feel ready now. The sooner I get news from the orthodontist and implantologist, the better! I’ll just jump into the treatment with or without adult braces but hopefully with a new front tooth implant!
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! 😉
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 🙁
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.
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 🙁 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! 🙁 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 🙁 Will keep you posted!
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 🙁 That way my appointment already started disappointing 🙁
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 🙁
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…
I’m back from the dentist! This was my 3rd opinion and I have the feeling it was a good visit. The dentist explained me about my dental health and how I should proceed to fix some things.
First, my front tooth. It looks like it is still not stabilized and I should look into it asap. I received a letter explaining the situation and to get a second root canal treatment. So this morning I immediately made an appointment with an endodontologist. This will happen on November 19th.
Second, I have some amalgam fillings in one of my molar teeth. It needs to be removed and replaced with a “composite” type of filling. The main reason is to prepare my mouth for “eventually” starting to wear braces. See below. So I already scheduled an appointment to replace the amalgam too (February 10th 2022).
Third, My crooked bottom teeth. The dentist told me that the gum and bone health is good. If I want to fix my bottom row/arch I can receive orthodontic treatment. She told me that my bottom teeth will continue to shift and things will get worse in the future. The treatment is not urgent, but if I want to do it I shouldn’t wait too long. I also asked if it is common to get braces at my age. She told me not to worry about wearing braces at my age. She suggested to keep the orthodontist appointment (May 2022) and to decide later on. It gives us an extra few months to fix the other issues mentioned above.
Forth, Sooner than expected I received a 3D scan of my mouth:
3D scan to get an overview of my dental situation
Front tooth 21 degrading. Bone loss.
But before I can go on I will need the endo-treatment again. Depending on that appoitment/treatment I will get a better picture on how to proceed. This situation brings me in a chicken and egg situation:
If I start wearing braces, the front tooth will automatically fall out because of the forces. So I will have to go for the implant.
If I don’t get the implant, the front tooth will degrade and will fall out in the next years. So I will have to go for the implant.
If I don’t start wearing braces, but I ask the dentist to remove the tooth, my implant will not look 100% nice. So I’ll need braces.
I really hate this situation. But it is what it is. Below I’m sharing you some pictures of my current teeth.
Amalgam filling (left tooth in photo) needs to be removed to prepare for (evantually) starting to wear braces.
Side view of my mouth.
Dead front tooth. Probably needs to be replaced with an implant.
Front view of my teeth. Here you can clearly see the bottom crooked teeth and my front tooth 21 that needs to be replaced with an implant.
Dead front tooth number 21.
What do you think after seeing these picture? Would you go for the braces? Please let me know or write a comment!
