Seeking Advice on Dental Implant and Oral Surgeon

[Toast]

DH takes great care of his teeth and sees the dentist regularly for cleanings and routine care. He developed a terrible toothache last weekend and saw our dentist this morning. X-rays show the tooth is infected. She prescribed antibiotics and thinks DH may need an extraction followed by a dental implant. The dentist gave him a referral to see an oral surgeon. The tooth is a lower first molar that had a root canal with a post added and then crowned when DH was 18 years old. That was almost 35 years ago.

Neither of us has ever had an implant nor do we personally know anyone who has had a dental implant. To further complicate the matter, we have only lived here for a few years so we don't know many people to ask for advice or know the reputations of local oral surgeons.

We searched and read through old threads on this forum. The truth is that we still don't know enough about dental implants to even be able to ask targeted questions, but here are a few:
1) Are there any specific questions we should ask the oral surgeon?
2) Any cautions to be aware of regarding getting an implant?
3) How important are second opinions in this type of situation?
4) Typical cost range?

We'd appreciate any and all thoughts about dental implants. If anyone actually lives within a couple hours of the PDX area and knows of an oral surgeon with a great reputation, we'd appreciate you letting us know. Please feel free to DM us. We are willing to drive up to a couple hours for better care.

Thanks in advance!

 

[OldShooter]

Find a nearby dental school clinic and try to make an appointment to get a second opinion and to get your questions answered. Here, maybe: https://www.atsu.edu/arizona-school-of-dentistry-and-oral-health/dental-clinics or here: https://www.mwuclinics.com/arizona/services/dental

If that is not possible, ask if any of the professors also have private practices and try there. Third choice might be a recommendation from your PCP.

 

[Toast]

Find a nearby dental school clinic and try to make an appointment to get a second opinion and to get your questions answered. Here, maybe: https://www.atsu.edu/arizona-school-of-dentistry-and-oral-health/dental-clinics or here: https://www.mwuclinics.com/arizona/services/dental

If that is not possible, ask if any of the professors also have private practices and try there. Third choice might be a recommendation from your PCP.

Thank you for the links! Getting a second opinion makes sense. We're just feeling a bit overwhelmed.

 

[OldShooter]

Thank you for the links! Getting a second opinion makes sense. We're just feeling a bit overwhelmed.

No problem. But that was the result of a quick Google search only, almost certainly not comprehensive. So don't neglect additional homework.

 

[Bamaman]

I sheared off a tooth at the gum that had previously received a root canal. I was referred to our local dental surgeons--M.D.s from very expensive medical schools.

It cost $850 to get the rest of the tooth pulled and a "graft" getting ready for an implant.

The implant would be $2,250 and they said it'd take 6-9 months for the implant to grow before the tooth abutment could be screwed in. The abutment is another $850.

I would then go to my regular dentist for a crown to be installed on the abutment--another $850. TOTAL PRICE OF IMPLANT: $4,800. (The surgeons have a $450,000 full head MRI and too many employees--big expenses.)

An friend referred me to his dentist on the south end of Chicago that does implants for $999. He numbed me up. Then he drilled a hole and stuck the implant in--6 minute job. It was much simpler than getting a simple filling. I did go back 6 months later, and he took an x-ray and checked the implant for $99.

My personal dentist screwed in the abutment when he installed the crown for $400 with my dental insurance picking up half.

I honestly don't know why more dentists don't do implants since single tooth implants are so easy to do. I cannot tell the difference between it and a natural tooth.

My suggestion is to shop around.

 

[Aerides]

I would extract and ensure the surrounding area is uninfected before deciding, but assuming it's fine, proceed with the implant. So you solve the immediate problem and pain, but have time.

As far as finding a surgeon, google reviews will take you far enough for your area.

 

[Toast]

I sheared off a tooth at the gum that had previously received a root canal. I was referred to our local dental surgeons--M.D.s from very expensive medical schools.

It cost $850 to get the rest of the tooth pulled and a "graft" getting ready for an implant.

The implant would be $2,250 and they said it'd take 6-9 months for the implant to grow before the tooth abutment could be screwed in. The abutment is another $850.

I would then go to my regular dentist for a crown to be installed on the abutment--another $850. TOTAL PRICE OF IMPLANT: $4,800. (The surgeons have a $450,000 full head MRI and too many employees--big expenses.)

An friend referred me to his dentist on the south end of Chicago that does implants for $999. He numbed me up. Then he drilled a hole and stuck the implant in--6 minute job. It was much simpler than getting a simple filling. I did go back 6 months later, and he took an x-ray and checked the implant for $99.

My personal dentist screwed in the abutment when he installed the crown for $400 with my dental insurance picking up half.

I honestly don't know why more dentists don't do implants since single tooth implants are so easy to do. I cannot tell the difference between it and a natural tooth.

My suggestion is to shop around.

Thank you for sharing your experiences!

 

[Toast]

I would extract and ensure the surrounding area is uninfected before deciding, but assuming it's fine, proceed with the implant. So you solve the immediate problem and pain, but have time.

As far as finding a surgeon, google reviews will take you far enough for your area.

Thank you! We've been reading reviews all day. One DDS MD is standing out. He has extensive training and good reviews. Our dentist recommended a DMD. We're leaning toward make appointments with both.

 

[athena53]

My implant price in the KC area is about $5K, so close to Bamaman's first one. I've had 7 over the years and that price has remained steady- the first one was about 15 years ago.

The bone graft is to make sure there's enough jawbone to support the implant- my oral surgeon always uses them and yes, it costs. My oral surgeon has an armload of waivers you need to sign acknowledging what might go wrong, including "dry socket", when the implant is in the upper jaw and a sinus is pierced. He does panoramic 3-D X-rays that he can then rotate and view from all angles to see how close the sinuses really are. My last one was in a space where they usually can't squeeze one in (#18, with 18 and 19 being replaced) but interestingly, he said because I was lean he could do it. Apparently adipose tissue in the mouth can crowd it.

Anyway- long, detailed and probably not related to your case but these are examples of things the $99 guy may not do or consider. I spent too many years in insurance and I think about what can go wrong with an implant so I want an expert. I love mine. They just sit there and do what they're supposed to do and don't get decay.

I do get cleanings 4X/year now- cheap prevention.

 

[Toast]

My implant price in the KC area is about $5K, so close to Bamaman's first one. I've had 7 over the years and that price has remained steady- the first one was about 15 years ago.

The bone graft is to make sure there's enough jawbone to support the implant- my oral surgeon always uses them and yes, it costs. My oral surgeon has an armload of waivers you need to sign acknowledging what might go wrong, including "dry socket", when the implant is in the upper jaw and a sinus is pierced. He does panoramic 3-D X-rays that he can then rotate and view from all angles to see how close the sinuses really are. My last one was in a space where they usually can't squeeze one in (#18, with 18 and 19 being replaced) but interestingly, he said because I was lean he could do it. Apparently adipose tissue in the mouth can crowd it.

Anyway- long, detailed and probably not related to your case but these are examples of things the $99 guy may not do or consider. I spent too many years in insurance and I think about what can go wrong with an implant so I want an expert. I love mine. They just sit there and do what they're supposed to do and don't get decay.

I do get cleanings 4X/year now- cheap prevention.

We really appreciate your detailed response!!!! Knowing what to expect is extremely helpful.

 

[rodi]

Following this thread... Older son has had 3 molars removed due to ameloblastoma tumor, and a recurrence a few years later. In both surgeries he lost teeth and major amounts of mandible. We're going to evaluate if his jaw bone has regrown enough from the surgery last fall at his maxillofacial appointment in August. But implants are in his future for sure. Hoping they can be covered under medical insurance since they are due to surgical procedures.

But I'm expecting serious sticker shock.

 

[zinger1457]

Seems like a quick jump to the extraction and implant, I would definitely get a second opinion. I had a tooth that was capped and had a root canal and then became infected (abscess) years later. The dentist removed the cap and drilled out the post so he could drain and treat the infection. The remaining tooth was still in good shape so he put another cap on it. That was 15 years ago, no problems since.

 

[Amethyst]

I am unable to have implants, due to a small jawbone.

However, my late husband had several very successful implants to replace teeth that had been through several rounds of restoration.

Never the slightest problem with any of them.

 

[Dawg52]

I've had three with the first one about 8 years ago. Total cost including crown was $3,500. My last one was 3 or 4 years ago and it required a sinus lift that added $700 to the cost. So around $4,700. With inflation and all $5k sounds about right as already mentioned.

 

[Toast]

Seems like a quick jump to the extraction and implant, I would definitely get a second opinion. I had a tooth that was capped and had a root canal and then became infected (abscess) years later. The dentist removed the cap and drilled out the post so he could drain and treat the infection. The remaining tooth was still in good shape so he put another cap on it. That was 15 years ago, no problems since.

We're happy to hear that you were able to avoid losing your tooth. You've given us hope that the took can be saved. Dentist said one of DH's roots looked good on this morning's x-ray, but she couldn't tell if the root with the post was cracked. She said the oral surgeon would take a panoramic x-ray to get a better look.

 

[fh2000]

I had 2 implants done in the last 5, 6 years. Both are still solid. I think each cost around $5000. Insurance paid $2000 each and I paid the rest. Today, with no insurance, I will use my HSA fund if I ever have to do again.

 

[youbet]

OP,

Real (the $5k kind) implants are the way to go if you can afford it. I've got several. Totally trouble free. While I noticed that my periodontist was driving a Jaguar, it's been worth it. Quality of life destroying dental problems in geezerhood are something I've wanted to avoid and, at 75, so far so good.

The biggest problem is that the process takes 9 - 12 months.

 

[Irishgirlyc58]

I had to have an implant in my upper front tooth due to resorption. Where the tooth attacks it’s own roots.
I went to the dental specialist my dentist referred me to and he and his staff were great. I went back for several years for a check up in he finally released me-as long as I promised to see my regular dentist every 6 months which I do.

Same as others have said- specialist dentist pulled the tooth and put in the implant. I had to wear a fake tooth for 4 months until it all healed. Then my regular dentist screwed in the abutment and put on the cap.

I can’t remember the exact cost but I think I paid $2,000 out of pocket. Insurance paid at least that much. It started in one calendar year and finished in another so my $2,000 dental coverage limit reset before the abutment and cap cost. Didn’t plan it that way but it was nice!

The worst part for me was the fake tooth. But it was sure better than not having a front tooth!
My implant looks fine but I still miss having my own tooth.
It’s been 7 years.

 

[target2019]

Once you identify the best oral surgeon, the cost is the cost. Different surgeons follow different schedule as they carry this out. Mine:
1) Dentist made impressions
2) Surgeon removed tooth and added marrow
3) Healing
4) Implant
5) Post added
6) Cosmetic tooth added by dentist.

Our surgeon waits several months for the healing phase.

Total cost for mine was about $3K, but that was 5 years ago. Wife's was more, but she's stretching it out and all bills not in yet.

 

[Aerides]

The biggest problem is that the process takes 9 - 12 months.

Well, yes but it's basically 2 or 3 events spaced out. Extract, plug the base with a new anchor is day 1. Sore weekend, eat soft foods for a day or 3.

Then wait for a few months, then get the new tooth.

It's best with a lower tooth not to go longer than necessary, to avoid any issues with it's upper partner.

Mine was about $4k, in 2016, insurance paid part of it as I was still on employer/cobra. But even then my part was about $2500. Honestly looks and feels better than the root/crown I had for decades.

Similar to the OP, mine was replacing a tooth that had a root canal 20+ years prior which was now coming loose. As long as I have the jaw and gums, a straight implant to fully replace a tooth is the way I'd go. No bridge or multi-tooth implants in chunks, I hope.

 

[athena53]

Quality of life destroying dental problems in geezerhood are something I've wanted to avoid and, at 75, so far so good.

The biggest problem is that the process takes 9 - 12 months.

Agreed on both- I love fresh (or slightly-cooked) vegetables and you need working teeth for those. I've also known people with ill-fitting dentures- with some, they slip and you can hear clicking noises when they talk. Not sure if it's because they can't afford new ones or the jawbone has shrunk to the point that no dentures fit, but it's sad to watch. I know that has to limit what they can eat and can't be good for their nutrition.

Yes, the time frame is a pain but worth it. I always wonder how those "implants in a day" businesses do it. My last implants included extraction of a badly-infected tooth holding up one end of a bridge and I appreciated the caution of the oral surgeon in stretching out the time frame.

One weird factoid which is a minus for me: blood banks will defer you from donating after a bone graft because it comes from cadavers, even though the bine is ground up and sanitized.

 

[BooBoo]

My DW had two dental implants done about 10 years ago. Fast forward to present. One of her implants fell out in April. She had to have emergency oral surgery with two doctors (oral surgeon and sinus doctor) to fix the "hole" the implant left. She had had minor issues of the years and no doctors could determine the root cause. The root cause was her body had been rejecting the implant causing an major infection. Here bones supporting the implant had rotted away over the years. The dirty little secret no mentions is about 10% of implants fail. The other implant is fine.
Boo

 

[athena53]

The dirty little secret no mentions is about 10% of implants fail. The other implant is fine.
Boo

My oral surgeon included the possibility of failure in his list of caveats. TeacherTerry has mentioned problems with hers too, although I believe hers were implants to secure full dentures.

Was your wife on meds to increase bone density, by any chance? They can cause osteonecrosis in the jawbone. Thanks for the heads-up, though. It sounds like if I ever have vague health issues that can't be diagnosed I better get a panoramic X-ray of my jaws.

 

[Bamaman]

I just returned from England, and I was talking to someone over there. Obviously there is a large medical tourism business where people fly to Budapest or Istanbul where the can get dental care (and implants) for very low prices.

He said you can easily tell who has TurkeyTeeth because their teeth are so perfect and so white.

You hear of those getting 4 implants in order to secure false teeth spending $20K+. So many of are now flying to the Mexican bordertowns for dental care. Many of their dental facilities are fabulous, however it's word of mouth as to who the dentists are really good. It's a way to save big $, however.

 

[CaptTom]

I'm following this thread closely. I'm in the middle, waiting period on a molar implant. The extraction went well, if a bit more work than anticipated. The oral surgeon was a young guy, and he was great. They actually take some blood and put it in a centrifuge to extract the growth factor and platelets. The growth factor is mixed with bone to make the bone graft in the jaw. The platelets are used to make a covering over that, with the gum stitched up over it.

I'm healing well. I have an appointment next month to see how it's going, then we schedule the implant. At that point I could decide not to bother. I'd be fine just chewing on one side. But I want full functionality. I'll be going through with the implant this fall.

The price will be in the range others have quoted. They were very up-front about that.