Dr Hu

Hi All,

I have a very good private dentist of many years, but just want some advice before I go and splash the cash! (and know what to expect!)

You can't beat asking the scoobynet massiiive for advice/**** taking to prepare for the worst

I'm 41 and still have 2 baby teeth - both pre-molars.

The one at the top (eye tooth?) has become relatively loose after biting hard on some cold chocolate on friday - I felt it go! I thought it may re-tighten over the weekend, but no difference really, and its difficult not to play with it with your tongue... hahaha

I definately have no adult tooth below it, as my dentist has been saving it & x-ray'ing it for years, but he did say eventually it will probably fail.... looks like its time has come.

So my questions are:

Will it ever re-tighten? - I don't think it will as I can feel its 'edges' on my gum line...

Whats the best way of replacing it? - its in my smile area, so I deffo want it replaced.
I remember back in the mists the dentist telling me that there were a couple of ways:

1 - Bridging it, but that hacked about the two teeth next to the gap
2 - Implant

They both sound expensive! - I vaguely remember him saying that an implant is best at around £2k.... gulp.....

Anyone had either of these done, with bad or good stories.... or just give me some general advice... costs... etc

Cheers

Chip

Had this last year with my eye tooth. Had bridge fitted to the tooth next to it (molar) and have had no problems whatsoever with it. At first I thought no way would the tooth stay in place but up to now has been great. The new tooth is porcelain and cost about £500 to have fitted.

Chip

Midlife......

iTrader: (2)

The problem with baby teeth is that thay can be quite small so space for an implant is quite tight. The smallest implant we use here is 3.3mm diameter, you need about 1.5mm either side so that's a 7mm space. The other is that because the adult tooth fails to deveolp the associated bone may fail to develop as well so tissue might be in short supply to screw an implant in.

The above depends on clinical circumstances.

The other alternative is adhesive bridgework where the artificial teeth are bonded to the adjacent teeth, the problem is that the glue is unpredictable and the bridges can drop out. Traditional bridges where teeth are prepared (cut down) is not usually a pragmatic option for a lot of people but if the adjacent teeth have big fillings they they could be considered.

If you have the bone and the cash, implants are essentially a "fire and forget" solution to failing baby teeth in the adult dentition. We expect the implants temselves to last 35-40 years and the artificial teeth in the mouth (attached to the implants buried in the bone)to last 12-15 years.

Oh.......and no they generally don't re-tighten

Shaun

Dr Hu

Hi Midlife....

I have just tried to measure it (badly) I reckon its a 7 to 8mm gap where my baby tooth is now...

Its the 5th tooth back from my front teeth...

How much does an implant generally cost - ballpark here.....

I think I'd rather pay to fit & forget TBH - i'm fed up with the flippin thing..

I'd heard that the 'bridging' option was frowned upon these days due to the damage done to adjacent teeth... but it was generally the most affordable option, so its the one that gone done - be interesting to hear a dentists take on that....

Cheers

Midlife......

iTrader: (2)

I'm in the middle of a clinic

Back later


Shaun

jef

iTrader: (13)

35-40 years, wow thats a long time, i was just about to get an implant and it comes with a 5 year garuntee altho they said it should last 15

luckily my root was good enough to have a decent length carbon fibre post fitted then a crown, so considerably less expensive

my quote for implant was over 3k and could take a total of 6-9 months to complete at worst

didnt sound like fun

Dr Hu

No root on my baby teeth - so no go there....

I didn't realise that implants took a long time....??

I just thought they screwed a **** off big post into your jawbone, then stuck a tooth on top... jeez how long can it take....

Seriously tho - does it take that long?

Jer

Normally it takes three months for the bone to grow round the implant so you would be wearing a denture for that time. You do get immediate loading implants but you can't use them if you bite on the tooth.

What area you from?

Dr Hu

Shropshire/West Midlands......

BOB.T

What's the going rate for getting a tooth ripped out? Top row, second from back.

pslewis

Implants range from around £800 from an Implant Clinic to £2,000 from your friendly local Dentist (who may only do a few a year!!).

I know where I would go ... to those carrying out 5 a day for £800!!

It does take a few months to carry out as the jawbone needs to bond to the Implant.

As an Engineer this technique is well known to me (although not on humans!) .... Helicoil Insert, stud screwed on, crown fixed to stud. It really is as simple as that and shouldn't cost what some Dentists choose to charge IMO.

Dr Hu

Cooo - liking the sound of £800 (well compared to 2K+ anyways...)

How soon after the tooth falls out do you need to have it started as this tooth seems to be getting looser by the hour

Dr Hu

Bob T - depending where your from I'd say 10 or 15 pints down the Bigg Market, then a tasty fight with the nails hard locals ought to do it.... (n.b no guarantee on which tooth is lost )

Midlife......

iTrader: (2)

Pissy.......£800 get real

I just add the teeth to the implants !!

Ok, I take an impression of an implant in the mouth, it gets sent to Brighouse in West Yorkshire, they make a model which gets scanned and the info sent to Sweden, a computer there CNC mills a titanium or Zirconia block (custom abutment) to fit on the implant, this if flown back to West Yorkshire where it is tested for fit and the abutment scanned and the info sent to Sweden and a computer mills a Titanium or Zirconia cap which is flown back to West Yorkshire and tested for fit and if OK a human adds layers of porcelain to make it look like a human tooth ......

If it looks ok I attach it, if not it goes back for colour and shape modification.

Then it goes in

Usual cost to me for the above work is about £400....factor in the cost of someone putting in the implant surgically and any profit involved (I'm NHS so patient's don't pay) and £800 is way off the mark.

Shaun

Midlife......

iTrader: (2)

Anyway.........having fended off Pissy !!

The missing second premolar (number 5) is the commonest missing tooth, about 7% of the population have one missing. The usual options are to glue the missing tooth to the molar behind to fill the space if the molar has no filling, if the molar behind is filled then it can be prepared (filed down) for a bridge or an implant can be placed. The difficulty is the the sinus, the air space in the cheek, reduces bone volume in this particular area so there may be a lack of bone and grafting ( google sinus lift) may be needed for an implant.

One option for you to explore if treatment on the NHS as you technically have a condition called "hypodontia"......lack of teeth, which may be catered for by your local hospital.

Shaun

pslewis

Didn't know implants were available on the NHS?

If so, that's good news as the maximum is around £200!!

Try a google search and you will find plenty of Implant Clinics across the country doing this work for way less than the local Dentist - and are doing it every day, all day.

Example:- http://www.vitaleurope.co.uk/?w=216&...FQoa4QodKzD-aw

Have a holiday AND not get shafted by UK Private Dentists.

markjmd

iTrader: (11)

Are there really two round trips from Yorkshire to Sweden, and two CNC milling operations, or did the sentence you meant to write go a bit off track somewhere?

pslewis

He's a Dentist ... he probably just adds extra operations to boost the costs and profits without thinking

cster

Well I guess that makes him better qualified to offer an opinion on the matter, than your being a complete moron qualifies you to do so.

cster

Well since he has told you he his working on the NHS in an NHS hospital, how do you figure that out?
Keep taking the Lithium buddy

Chip

So about £200 for the implant and the rest on flights

Chip

Dr Hu

OK - so if I decide to go ahead and pay for an implant what goes in its place for the 3 months it takes to get done? Do they fit anything temporary?

Also dont like the sound of a 'bone lift'..... how the **** do they do this.....

Myles

iTrader: (40)

I had an adhesive bridge to replace a lower incisor about 7 years ago, and it didnt hold for very long. It was done by an RAF Dentist (now an olympic cyclist, pointless bit of trivia there), and she told me that it was not foolproof, and that the two surrounding teeth would move together over the following years. They have moved a couple of mil, but not so much as to close the gap, so I look like a pirate/pikey.

Midlife......

iTrader: (2)

Markjmd

For the vast majority of anterior cases the abutmnent is returned to the UK and inspected and any finishing by hand deemed necessary carried out. It is then re-scanned and the coping for the crown constructed.

Sometimes the abutmant itself is the basis for the crown (molars and premolars usually) and there is only a requirement to mill once.


Myles

Yep......adhesive bridgework is one of the most unpredictable restorations we do, they are forever falling off but the saving grace is that you don't have to chop teeth about to get them to fit


Dr Hu

Very often a small temporary denture is worn while the implant is integrating into the bone and the final crown is being constructed. In many instances a bone graft is not necesarry as the surgeon can either choose a wider screw or can manipulate the bone and lining of the sinus.

I see quite a few patients who have opted for cheap implants, The NHS do not fund putting it right and all the NHS will do is remove things and throw them away...

Shaun

pslewis

I guess, by adhesive bridge - you mean a Maryland Bridge? If so, some damage is done to adjacent teeth to remove the enamel on the rear to enable the adhesive to 'take' .... or so I though?

Cheap Implants do not always mean crap Implants .... simply that some Dentists charge less as the volumes are greater.

Midlife......

iTrader: (2)

Correct Pete, preparing the enamel surface improves longevity of Adesive AKA Maryland bridges by 300% The amount of preparation is minimal, does not require LA and can be polished off later if the bridge fails or flooded over with flowable white filing material.

Traditional bridges require the tooth to be prepared to a tapered cone shape, lots of destruction and a statistical chance of killing the nerve of at vleast 25% over a five year period.........not good

Ask me what I would rather have..a cheap TPS implant or a more expensive nobel biocare Nobel active / Ti-unite Mk III and I think you can guess the answer.

Or would I have a silver palladium cheap crown or a CNC milled zirconia / titanium crown and again I would pick the more expensive option.

You pay for both better materials and the knowlege of the guy who is using them.........Look at poor Scoobylou's thread about her dad


Shaun

pslewis

I take your point about the materials, but - I would respectfully suggest, that the materials are small fry in relation to the Labour charges the Dentist chooses to make.

In the very same way that, when I design a piece of Engineering, my Design work costs a huge amount more than the materials used to build ... the materials less again than the craftsman building.

The materials are important, yes, but wouldn't change the price that significantly .... you pay what the Dentist wants in way of payment for his time - Implant Clinics do many a day (so, should be highly experienced - more so than a local Dentist who does 2 a year).

Midlife......

iTrader: (2)

"Local dentists" who do Implants usually have someone who comes to the practice as a bought-in type of service. One practice near me uses a guy from Dumfries and another uses a dentist from the Manchester area.

As for specific "implant Clinics", the lower end usually use imported dentists and cheap materials so yet again you pay's your money.

Higer end "Implant Clinics" are usually more expensive than other providers like here:

http://www.smilespecialist.co.uk/pri...ue-prices.html

http://www.finlaysutton.co.uk/more_i...current_id=112

Materials cost do figure, say I make a Computer generated CNC milled component with attachments to hold a denture that could set me back £4k ..

Shaun

pslewis

I use sophisticated 3D modelling CAD systems which produce models which can be CNC Milled and/or rapid prototyped .... there is no way on earth these models should cost anywhere near £4000!!

Maybe I should branch out and exploit this money making area?

Also, the Local Dentist who buys-in Implant Specialists take a whacking big fee for doing nothing more than turning over his surgery for an hour ...... like I said, better to go straight to the source of the specialist ... the Implant Clinics.

RobsyUK

iTrader: (2)

the wife has a cap. i cringe when i read it needs to be screwed into the bone...