During your dental implant fusing period, did you have a gap in your smile?

Oral and dental care
1

I need a dental implant.  My dentist says that I will have to wait six months for the titanium to fuse with the bone before the crown can be placed.  

I can understand that,  but he also says that  there can not be a temporary crown of any kind, and I will necessarily continue to have a highly visible gap in my smile at that location for the entire six month duration, because any temporary tooth substitute attached there would disrupt the process of fusing the implant to the bone..

Is this really the normal "standard of care"?   Or is he being unnecessarily over-cautious?

If you have had dental implant surgery, or have discused it with your dentist,  I would love to hear from you as to whether this is a universal practice, or whether there is some (possibly standardized) way to avoid presenting such a gap to the world.

If you had an implant,  were you provided with any means of not presenting such a gap to everyone you met?  If so, did such means have any negative impact on your treatment?

 

2

Thanks for asking that question. I'm facing probable extraction of a damaged upper first incisor in the next few months, and replacement with an implant, so this is very pertinent to me too. I'd always understood that some kind of temporary crown could be applied. As the other upper first incisor was extracted 60 years ago and replaced by a removable denture - which will no longer fit once its neighbour has been removed - I'm going to be faced with having a massive gap in my smile if your dentist is correct!

3

Go see another dentist.  I have had numerous dental implants.  Seven years ago I needed to have four front teeth removed and (being very vain) was completely unprepared to go for six month with a gap.

>>My dentist says that I will have to wait six months for the titanium to fuse with the bone before the crown can be placed.<<

In my experience this is only the case with 'load bearing' or grinding teeth.    I had a molar implant and had to wait three months for the ceramic tooth to be fitted.  

I had three front same day dental implants, during which they replaced my front teeth with temporary plastic crowns over the implants.  I was also told I could have had a temporary bridge, which is a transparent mould filed with tooth coloured paste. NO ONE SHOULD BE WITHOUT TEETH!  Find another dentist. 

>> he also says that  there can not be a temporary crown of any kind, and I will necessarily continue to have a highly visible gap in my smile at that location for the entire six month duration, because any temporary tooth substitute attached there would disrupt the process of fusing the implant to the bone.<

Rubbish. Find another dentist 

>>If you have had dental implant surgery, or have discused it with your dentist,  I would love to hear from you as to whether this is a universal practice, or whether there is some (possibly standardized) way to avoid presenting such a gap to the world  ,If you had an implant,  were you provided with any means of not presenting such a gap to everyone you met?  If so, did such means have any negative impact on your treatment?<<

Apart from the fact that one day implants are the norm (where a temporary tooth is placed until the bone can support the permanent crown)  there is also the option of a denture which has no impact at all on the fusing bone. 

No one should be wirhout teeth during treatment, especially front teeth. 

Please see a new dentist...preferrably an implant specialist. 

 

4

Thanks for that, Lesley. I thought that was the case, but wanted to have all my arguments prepared in case I do end up having to have the damaged tooth extracted.

5

I had four damaged front teeth, but one root was salvageable.   In order to avoid further bone depletion for the surrounding implants,  I had a procedure known as a buried root.  This is exactly what is sounds like - the 'tooth' bit was removed, and the root was nipped off a millimter or so below the gum line.  An implant placed either side, and a porcelain bridge over the three teeth meant a firm foundation for all.  I could write a patient view book about my experience with dentistry.  My implant advice would be...dont smoke or stop smoking.  Get at least two opinions.  See an implant specialist. Don't believe the hype and go abroad - UK densitsty is the best.  Take offered sedation   Invest in expanding floss.  Good luck     

6

Thanks to Lesley for her informative reply.  I had the feeling that leaving a gap in the smile could not be right.

I've been seeing my dentist for over 30 years, and up until now he has done well by me.

He does not do the actual implants himself, but works with one of two implant surgeons in different neighborhoods who evaluate the condition,  take their own conical scans,  do bone grafts, and do the implant itself,  but not the final crown or other work that does not require their implant expertise. That work is done by my dentist.

He just got back from a continuing education class and told me that he is immediately changing the way he does some things based upon what he had just learned in that class,  so he is definitely not "hopelessly set in his ways".  I do, however, think he needs to learn what patients elsewhere are expecting (and getting) as far as a complete smile prior to final crown placement goes,  including what those patients' dentists do to ensure that providing a complete smile does not compromise the integrity of the implant. 

Towards that end, I am hoping that anyone reading this forum who has had an implant can write a sentence or two stating how their smile was assured (temp crown, or protected soft crown substitute, or whatever).  If people are willing to do so, and there are different methods of accomplishing it,  I'll tally up the relative popularity of each method I'm told about.

I'm sure that there are other dentists whose patients could benefit from the same data, so I'll post a summary for the benefit of those patients, as well.

So,  to anybody reading this who has had an implant, please write a sentence of two about this.  The more people write, the easier it will be to get my dentist (and perhaps some other patients' dentists, as well) to improve  procedures for providing implants 

7

Thanks Lesley. Fortunately I've never smoked and certainly don't plan to start now! I'm already "abroad" in a European country whose dentistry really is the best, so no worries there. There are two hospitals in this city that specialise in implants so I'd already decided I'd get an opinion from each.

Unfortunately I had a paradoxical reaction on the one occasion I had procedural sedation (for a gastroscopy three years ago). Probably due to the fact I was only allowed a half-dose because of my advanced age. It felt as if it knocked out my higher centres, leaving the primitive, fight-or-flight limbic system in control. (Kill, kill, kill!) Took six people to hold me down and I would have gouged the nurse's eyes out if she hadn't been kneeling on my arm. Worst 20 mins of my life, never doing that again! But I'm not at all nervous about dental procedures so won't need sedation anyway.

I won't be able to have the buried root thing because the damaged tooth is wobbly, but still interesting to hear about the possibilities for future reference. I'm hoping not to lose any more front teeth (!) but one never knows what's going to happen as part of the ageing process.

Where does one find expanding floss? (I'm in the UK every couple of months.) That sounds interesting, as I have several areas between my natural teeth where I can barely get floss in at all and if I do manage, it breaks off when I try to get it out. I'd never heard of the expanding kind before, but it sounds as if it might be useful.

8

It's great stuff, literally puffs up around the tooth to access all areas and is great for dental implants.  All supermarkets do their own brand - just as good as the famous name brands.  Youll get it in most chemists too I would imagine.