Implant or not to Implant?

[kateps]

Question for the Dr.-I have 5 baby teeth currently in my mouth, where perm. teeth never grew in. I am 27 y/o female. I am going to go through an orthodontic treatment and it has been suggested to me that I may need to get implants for some of my baby teeth at the end of this process. I saw a prosthodontist who recommended I get all 5 done at once over a span of one year, because the bone will slowly deteriorate with my baby teeth in place, and the sooner the better to reduce bone grafting down the road. He did say that my bone mass currently looks good but will eventually lessen.

Honestly, a big hesitation in doing this is that it will ultimately cost about $35,000-$40,000 for all 5 implants NOT including my braces!!! ahhhh! And I am going back to business school and just dont have that kind of money sitting around. Insurance does not cover this. So, my question is, if I wait a few years for more $ savings or until the roots really die on my baby teeth and they have to be removed, will that have a bad impact on my bone mass in my jaw? I understand why the prostho would recommend getting all implants but is it all necessary now??

Sorry for such a long post, I just am overhwelmed!
Thank you.

[ricardo2]

Hi,

I'm 26 and I had my baby canines removed a few weeks ago, when they exposed the adult ones in the roof of my mouth.

If you've still got your baby teeth, then can they not try and bring down the adult teeth with the orthodontic treatment, like me? Providing you don't mind gaps while the braces work their magic, then that might give you the best result. Maybe as you've got a few then that might not be option as I imagine a lot of space would need to be created- I would check with your ortho.

I was told by my ortho that it is better to try and save the natural teeth, before considering the implants. I don't know whether the same will apply to you, but it might be worth asking. (It would be a lot cheaper too!!)

I was warned that if my baby teeth were left in then there was a risk of root damage to the adjacent teeth..... Mine were badly decayed anyway, so it wasn't really an option leaving them in.

Hope this helps a bit.

Good luck!

LUCY xxx

[kateps]

Thank you for sharing your story, it is nice to hear that other people are in the same boat. I actually do not have permanent canines, so the option to pull them down is not there. They could keep the baby canines for a little while, the are not in bad shape and some bonding could build them up so they are more like the size of the other teeth. Every dentist I have seen says they try to keep baby teeth that are in good shape, as long as possible before implanting. The prosthodontist I saw said that was crazy b/c the bone will slowly deteriorate with no perm tooth there. I dont' know if he's right or if he's just running a business...

[Dr. Randall]

Well, I will assume that none of the permanent teeth developed. In that case, there may not be a way to close up the space from an esthetic point of view and implants are a great way of replacing teeth. 5 implant with restorations would be in the 12-15k range for a fee (35k seems awfully high) and if you have a dental school in you area, you could get the implants done for much less. I would see if your orthodontist would recommend someone else for you to get an opinion from.

Also, as long as the baby teeth are in, the bone is being saved. So you could get the orthodontics done, and then wait a year or two to save for the implants without worrying about the bone in the area. Once the baby teeth are lost, then it becomes more urgent to deal with.

Randall

[kateps]

Thank you Dr. Randall for replying so fast. No, permanent teeth did not develop. Easthetically, implants are definitely the way to go and I think the canine implants will have a positive impact on my facial feature as it is a little sunken there b/c i have baby canines. I don't think any baby teeth are at risk of falling out quite yet. I know 35k is very expensive and the prostho even said he was the most expensive and the best, but I don't want to skimp (gulp) on fake teeth I am (hopefully) going to have forever. I wonder if there is a big difference in what you get for what you pay for...

I am going to consider one thing at a time, get some more opinions and go from there. Deep Breaths..

[Chris]

I'm curious if bone loss varies from person to person. I have had a bridge for over 24 years. Subsequently I had to have another tooth pulled a year ago next to the empty space. My surgeon told me that even after 24 years of missing that one tooth I still have good bone to do the implant. I would think that after all those years I wouldn't have much bone. How do you figure?

[ArchWired28]

I know this is a very old post, but the question of bone loss puzzles me as well. I have 2 missing teeth and am contemplating implants vs bridges only because they supposedly save the bone. I do not want to have a collapsed face with the witche's chin. On one tooth, the root is still there; on the other, the tooth was extracted a year ago but the bone graft was placed. I still have at least a year until implants are done, but am wondering the following:
1. will I need bone grafts on both teeth?
2. sinus lift. On my x-ray about 6 months ago no sinus lift surgery was indicated to do implants. Could it change in 1-2 years when I am ready to start the implant? I am a 29 yo female in good health.
In general, how fast things change with bone loss? If enough bone is there now, will it still be there within a 1-2 year timeframe?

Thanks!

[ashesgap]

I just saw my oral surgeon last week and he checked my 3-d x-rays...even after never having upper laterals and spacing, my bone is in very good condition and much bigger than what's even needed for the implants. It was actually better on the side that's had the baby canine with no root, than the side that had the adult canine just floating around.
Concerning the sinus lift...from the conversation the assistant and I had sometimes they find out during the placement of the implant that the lift is needed. Luckily canine implants aren't in the spot that would need that, which the Dr. let me know a few minutes later. The upper molar area is where you have to worry about that, and I guess sometimes the implant will travel up, and get caught in there. The handouts they give you are pretty intense, and kinda scare the crap outta me, but I still think they're worth it for longevity and aesthetics.

[ArchWired28]

ashesgap
good for you! Right now a single thought about the sinus lift surgery and its added cost makes me shiver I am missing the 1st and 2nd upper premolars that are in the sinus area. The sinus lift was not indicated 6 months ago but who knows what is going to happen in the next year or 2. Thankfully, my bones are ok so I am hoping that I will not need the sinus lift. I will probably need bone grafts, but I am ok with that.

[bellakai]

Even if you do get a bridge, the amount of bone that will be lost isn't going to happen soon and it will happen extemely slowly over time. Seriously,sometimes different websites that give information on these issues seem to try to scare people. But I asked my periodontist these questions more than once and he told me that if I were to get a bridge, I wouldn't lose much bone at all because I would have the other two teeth holding the bridge in place on either side.

[Larkwind]

You're definitely not alone. I'm 27 y/o female with three baby teeth still hanging around. Because two of them are identical teeth on the bottom jaw (pre-molars) and one baby tooth on the top jaw that had the adult tooth grow in crooked next to it, my orthodontist said that closing the gaps left from baby teeth on the bottom and aligning the crooked adult tooth on top with braces would be a cheaper alternative to implants.

The oral surgeon said he agreed with my ortho's opinion. He said he wants the baby teeth out regardless, not because of jaw erosion, but because they are a "food trap" and can cause decay or damage to the teeth next to them. So I'm happy that they agree with a less-expensive, long term treatment instead of just jamming fake teeth into my head. I understand that this may not be an option for you since you have more teeth to remove and the braces may not correct all the space left behind. Good luck with your dental work!