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Implant dentistry: Warning: False teeth can wreck your gums. But there IS an answer – if you can conquer your fear of the dentist

By August 19, 2014 No Comments

At the age of 20, I was going to have to spend the rest of my whole life looking like Albert Steptoe. Or at least that’s what I told myself on the day a dentist grabbed my cracked front tooth, tore it out without warning and gave me a denture.

For the past 18 years I’ve lived with a plastic plate on the roof of my mouth and an utter fear of visiting the dentist.

I’ve wanted to lose the false tooth and the fear – but time and again my courage and finances failed me. Ten years ago, I enquired about how to replace the cosmetic denture, but the procedure sounded terrifying.

 dental-implants

Back then, getting a more permanent tooth would have involved cutting in half two good neighbouring teeth and building a cosmetic bridge with a false tooth over the gap. No, sireee, that wasn’t for me.

Finally, though, I’ve been nagged into submission by my wife. She never minded the look, but I had complained about the denture a lot. Also, while in most areas I’d become less bothered about my appearance the older I got, I found I really wanted to have a full set of good teeth again.

That front tooth had been knocked out twice – both times playing hockey. When I was 12, a ball bobbled up, I wasn’t wearing a gum shield (idiot) and it cracked my top front left tooth in half.

The cosmetic dentist removed the nerve and patched the gaps with filling material. That lasted until a university hockey match, when I took a stick to the chin. I was wearing a gum shield this time, but the tooth wobbled loose.

I waited months before visiting the same dentist. He pushed the tooth then, without warning, ripped it out. There was a searing pain and my mouth filled with blood.

That was enough to fill me with a permanent dread of the dentist. In 15 years, I probably had two check-ups.

But it did at least prompt me to take good care of the teeth I had left – steering clear of fizzy drinks and sweets, and becoming a meticulous brusher. Probably more by luck than judgment, I never seemed to suffer any problems.

The denture itself – a plastic plate with a plastic tooth attached to it – was a neat fit, and unless you really stared, you couldn’t tell the plastic tooth from the real ones.

Most acquaintances never knew I had it – save for the odd mortifying moment (spitting it into a drink as I chatted to a colleague at a Christmas party or losing it over the side of a boat on holiday).

But there were times it could cause throbbing pain, particularly where the top of the plastic tooth rubbed against my gum, and discomfort at the back of my mouth where the plate met my teeth.

Worse, dentists call them ‘gum killers’, because dentures make gums recede and can cause infection from the constant pressure.

There are an estimated 11 million denture users, and according to the charity British Dental Health Foundation, most will experience some degree of difficulty. ‘While dentures are a good solution for people who need them, they are no substitute for natural teeth,’ says the charity chief executive Dr Nigel Carter.

Problems include poor fit, ulcers and difficulty with chewing or speech. ‘And the earlier teeth are lost, the more problems are likely to be experienced in later life as the supporting bone for a denture shrinks away.’

Having a dental implant fitted involves drilling a hole in the jawbone and inserting a screw, which will then hold a replacement porcelain tooth in place…As many as one in ten adults suffers from dental phobia: it is the third most common phobia after agoraphobia and heights.

A phobia of dentists is triggered by many things – the sound of the drills, fear of choking, chronic embarrassment, the needles. Mine is all about fear of pain and the powerlessness.

You can get it treated. A specialist clinic at Guy’s and St Thomas’ Hospital in London treats 3,000 to 4,000 patients a year for dental phobia and has long waiting lists.

Or you can find a cosmetic implant dentist who is particularly supportive…There were risks. The dental implant might not fix in my mouth, it could get infected. Then there was talk of making incisions and fixing things in my mouth.

They sounded terrifying …’We’re going to do a tooth in a day,’ he said. I was staggered, having imagined weeks of appointments. Implant surgery has come on hugely since I last checked.

These days, using the latest X-rays, 3D imaging and piezo drill technology – a special type of precision drill …If needed, bits of bone from my jaw could be bone grafted on to the implant site to help the healing process and plasma from my blood used to help heal the area. This would also speed up the healing of my gum.

He’d then put in a tiny screw and cement an implant on top.

I’d be in at 8am and home by 6pm. The success rate is 95 per cent, though all I could think is that this meant one in every 20 fails and ends up falling out.

And dental implants are not cheap. Classed as cosmetic surgery, they are not funded by the NHS. A basic implant costs around £2,000.

On the day of the surgery, I was given a sedative. It didn’t knock me out, but made me forget. One minute I was in the waiting room nervously reading the paper, the next I was being escorted to a room to sleep off the drug. I’d been in surgery three hours and the screw was in.

I had to wait a few hours for the swelling in my gum to settle down. By 5pm, a temporary plastic tooth was glued on top and I went home with a soft toothbrush to use, antibiotics, painkillers – and very precise instructions to eat soft foods and take care in trying not to bump the tooth for a couple of months.

Some gums bleed in the days after, but luckily mine didn’t.

A few weeks later, after the bone had grown around the screw – to ensure it was firmly in place and my mouth had healed – I had a permanent porcelain tooth glued over the screw. It should last ten years or more. You can’t even tell it’s not a real tooth as it was carefully matched to the colour of my existing teeth.

Oddly, losing the denture has proved a bit like losing a limb. Now it’s gone, I constantly think it’s there  – and when I realise it isn’t, I fly into a quiet panic thinking everyone can see me toothless. And then I remember…

The new tooth does need extra care – particularly flossing, to make sure nothing gets stuck around the top of it.

But not having that horrible plastic plate in my mouth has been joyful. I can barely believe I put off having the surgery for almost two decades….Read more

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