Implants abroad and being undecisive

tuom

HI

I am thinking of having dental implants done abroad and have been quoted
€6000 for full mouth (upper and lower) implants.

The dentist has told me that it will all be done in the one day and I will come back to see them again after three days, they have said six implants
top and bottom and the teeth fitted over these and that this will be a permanent fixture.

I have been in touch with the dentist and have emailed lots of pictures of
my teeth as they are (what few I have left) and the top denture I am wearing.

I am very lucky in that family have offered to help with the costs as I have suffered a lot over the past few years with my teeth.

Having said all this and having spoken to three people and seen the work they had done by this dentist (this work was seen by an irish dentist also who said it was good work) why am I still hesitant in booking a date, anybody else out there feel like this

georgieporgy

Welcome to boards.ie as a new subscriber, Tuom.

You are having 12 implants (6 upper and 6 lower) and approx 20 units of fixed bridgework (10 upper and 10 lower)?

All done in 3 days? Just clarifying if that is what you are having.

tuom

Yes that is what the dentist is proposing to do, i think i asked you previously for your advice and thanks for that.
My mouth situation is as follows
Full upper dentures last four teeth removed recently
Six lower teeth remaining at the front
One back tooth remaining at each side at far back(these are not good
and are very sensitive and the gums become infected very easily and often)
The six remaining at the front are not strong.

The dentist is proposing removing the remaining teeth and putting 6 implants in the upper and lower and yes i was told that the first day the
upper would be finished and the lower started and that after three days it
would be finished.
I hope this is clear, as I said I sent a lot of pictures and emails and this is
what has been proposed for 6000 euro (discounted )

BryanL

So will you have dentures when it's all finished?
Bryan

davo10

tuom, I'm going to leave a side the costs issue and just give you a few pointers on treatment.
a) prior to extracting existing teeth, impressions should be taken, bite registration blocks made and articulated study models produced in a lab. This is essential for treatment planning and as a record of jaw relationships and vertical dimensions. A diagnostic wax up is a vital part of planning.
b) if vertical dimensions have changed over the years due to loss of posterior teeth, a new set if dentures should be made at correct vertical dimension and should be worn for at least 3-6 months to "train" the muscles of the jaws to function normally again. These can be adjusted to raise/lower bite planes as necessary and will give the lab a template when they are making your permanent restorations later. if the dentist messes up the vertical dimension, you are in for a lifetime of problems (sore jaw joints, fractured teeth, difficulty chewing etc).
c) After your own teeth are extracted, the bone must be allowed to heal for 3 months prior to implant placement. If not the bone will be "soft" in these areas and implants are likely to fail, especially if immediately loaded. from a cosmetic point of view, the gums/bone shrink after extractions so if the prosthesis is placed to quickly, later you get unsightly gaps above/below them.
d) implants should be allowed to integrate in the bone for at least 2-3 months prior to loading, any sooner than this is hugely risky.
e) A full month reconstruction is very difficult and extremely precise work, it should only be undertaken by specialists and certainly not as part of a holiday over one week.
f) There should be a try-in/trial period for this type of prosthesis where any adjustments can be made prior to final placement.
g) Good cosmetics are essential, if this prosthesis is fixed in position it will not be easy to get out and change if you do not like the look.
h) Remember the implants are integrated in bone, if results are not good, the long term problems can be devastating.
i) After 3 days, you will walk out with swollen tissues, non-integrated implants loaded with a prosthesis which will not have been planned to any degree, the vertical dimensions and occlusal planes will at best be guessed by the lab, cosmetics may not match up to expectations as you are unlikely to see teeth prior to final fit on third day.

Here is the kicker, if you have any problems, once you tell a dentist here or in the North etc about how your treatment was carried out, you will be advised to return to the dentist who did it, I could not see anyone taking on the corrective work after such disregard for the basics of good implant planning and treatment.

The price may seem like a bargain now but it will not be if full mouth recon goes wrong and the chances of that would be very high if treatment is carried out as you describe.

tuom

BryanL wrote: »

So will you have dentures when it's all finished?
Bryan

I have been told that the dentist will fit permanent implants I certainly
would not pay 6000 for dentures I already have them on top that is why
I am so desperate to do something as my mouth is very uncomfortable at
present

tuom

thank you for such a detailed reply , is what the dentist telling me impossible to create
I have seen a dentist here in southern ireland who has quoted me 10000euro for bridges and crowns for lower front , the bridges if the back two were strong enough.

The dentist abroad has said that it will be six implant rods with permanent implants over them
from your answer it does seem impossible

davo10

tuom it's possible, but the chances of it being right are considerably less than the chances of it being wrong. Would you bet € 6000.00 on a 50/1 shot without knowing anything about it?, if it lost, you are out of pocket, if this goes wrong, well....

i understand people travelling for small stuff which doesn't involve much planning, it makes financial sense, but your case is not small stuff, it is the biggest and most difficult/complex treatment there is, where fractions of millimetres and the precision of contacts will be the difference between success and failure and that's leaving aside the pitfalls which could occur with the cosmetic result.

tuom

I really appreciate your comments, I realise how serious this is so perhaps that is why i am hesitant.
I would really love to have the implants done at least on the upper or am i
being impatient.
My own dentist will not do the "real denture" for another few months I was going to wait anyway and see how that will be.
You have all given me a lot of good advise and I will think again and do some more research.
Thank you,

Bards

I am currently in the final stages om two implants. started the process in Jan 2008.
Prelinary stages

Cat scan was done
moulds taken

1st surgical visit (May 08) underwent the 1st implant(tooth missing) and the 2nd tooth removed , I required bone grafting on the implant site. Operation took around 3 hours

follow up visit one week later to see how things were progresing, X-Ray was taking of the implant to make sure it was positioned correctly.

2nd Surgical visit was about 5 months later, 2nd implant with bone grafting required. - again about 3 hours

gap of about 3 months now

3rd Surgical visit placement of abutment #1 onto 1st implant and placement of temporary crowns onto 1st abutment - more x-rays

gap of about 6 weeks

4th Surgical visit placement of abutment #2 onto 2nd implant and placement of temporary crowns onto 1st abutment - more x-rays
again a follow up visit and x-rays a week later

more moulds taken and bite checked. - lots of photos for lab

gap of about 6 weeks

Will have permanent final crown by the end of July 2009

I just don't know how you can have all this work crammed into a few days

Edit: further info on who I use below

http://www.revahealth.com/dentists/ireland/county-waterford/waterford/south-east-dental-solutions

tuom

Bards wrote: »

I am currently in the final stages om two implants. started the process in Jan 2008.
Prelinary stages

Cat scan was done
moulds taken

1st surgical visit (May 08) underwent the 1st implant(tooth missing) and the 2nd tooth removed , I required bone grafting on the implant site. Operation took around 3 hours

follow up visit one week later to see how things were progresing, X-Ray was taking of the implant to make sure it was positioned correctly.

2nd Surgical visit was about 5 months later, 2nd implant with bone grafting required. - again about 3 hours

gap of about 3 months now

3rd Surgical visit placement of abutment #1 onto 1st implant and placement of temporary crowns onto 1st abutment - more x-rays

gap of about 6 weeks

4th Surgical visit placement of abutment #2 onto 2nd implant and placement of temporary crowns onto 1st abutment - more x-rays
again a follow up visit and x-rays a week later

more moulds taken and bite checked. - lots of photos for lab

gap of about 6 weeks

Will have permanent final crown by the end of July 2009

I just don't know how you can have all this work crammed into a few days

Edit: further info on who I use below

http://www.revahealth.com/dentists/ireland/county-waterford/waterford/south-east-dental-solutions

Thank you , I can see the points you are making I suppose that is why I have become more hesitant, I thought that this trip would be the answer to all my problems and that I would have a lovely smile again but the more I am thinking about it , it is starting to look impossible perhaps even dangerous ??

How Strange

I'm facing a similar situation myself. My dentist told me I need implants for my two front teeth. Without exception when I say this to family and friends they insist I should go abroad and save a fortune. A quick search on the internet showed me that this process can take 6 months to a year so factor in flights, hotel stays etc and suddenly going abroad isn't so attractive. That's not even considering time off work, possible additional sick leave due to pain etc.

Without a doubt if I just wanted my front tooth replaced because it was discoloured then I'd go abroad and get it down over a week but I'd feel far more secure paying a bit more and having an Irish dentist do the work and know that he/she is a phone call away if anything goes wrong.

My work is for medical reasons - gum disease, continual bone loss - and Hibernian Aviva told me that if it is for medical reasons then I will be subsidised. They can't give me a figure until the dentist/specialist assesses what needs to be done.

Also, any treatment like this still qualifies for tax relief at the highest rate until the end of 2009 under med1.

tuom

How Strange wrote: »

I'm facing a similar situation myself. My dentist told me I need implants for my two front teeth. Without exception when I say this to family and friends they insist I should go abroad and save a fortune. A quick search on the internet showed me that this process can take 6 months to a year so factor in flights, hotel stays etc and suddenly going abroad isn't so attractive. That's not even considering time off work, possible additional sick leave due to pain etc.

Without a doubt if I just wanted my front tooth replaced because it was discoloured then I'd go abroad and get it down over a week but I'd feel far more secure paying a bit more and having an Irish dentist do the work and know that he/she is a phone call away if anything goes wrong.

My work is for medical reasons - gum disease, continual bone loss - and Hibernian Aviva told me that if it is for medical reasons then I will be subsidised. They can't give me a figure until the dentist/specialist assesses what needs to be done.

Also, any treatment like this still qualifies for tax relief at the highest rate until the end of 2009 under med1.

thanks for that I suppose my case is serious as I have no remaining teeth on top and hate the denture, I too would prefer to have the work done in IReland , when you mention Hibernian is this medical insurance ?

How Strange

yes, Hibernian Aviva health insurance

Solas8

Hi I had implants carried out abroad and it is a mess. It is now costing me 3 times more to have if fixed if they can. Ask then who they are indemnified by. The cow boys will not tell you.

Solas8

Hi Mary
I wanted 6 implants but was advised to have two and two bridges. It was attractive in terms of money 5000 as opposed to 8000 in the north but it will cost me 6000 just to fix, if they can one side!!! It depends how long you have been without teeth as you may need bone replacement. My friend had bone replacement in Belfast and it took a few months and 3 visits but she is delighted. This is the dentist I am attending now. I am not sure if I can send you this message because of rules but I will try.

You have good advice above. I posted reply also here as I am new to this and not sure if I can reply yet.

I would be happy to talk to you when I can.
Take care

bmm

How Strange wrote: »

My dentist told me I need implants for my two front teeth.

Hi How Strange, could u tell me the prices you were quoted for 2 front teeth as i am begining to look into the exact same procedure?

How Strange

bmm wrote: »

Hi How Strange, could u tell me the prices you were quoted for 2 front teeth as i am begining to look into the exact same procedure?

I'm only having one done at the moment and I've been quoted €1700 for the implant and €750-895 for the crown. I'll get a definite price for the crown later this month. If I were getting two, afaik, the implant would do both and I'd pay for two crowns but my dentist doesn't think it's aesthetically good to have both front teeth crowned and he would rather avoid/delay until it's absolutely necessary.

davo10

A patient of mine was quoted £ 1200 for implant, £ 450 for abutment, £ 700 for crown in the North (€2850 excluding consult and xray). See how many clinics in South will do it for same price/less (make certain it is done by someone with qualification eg Specialist Oral Surgeon, not by dentists who have been on a couple of weekend courses and claim to be "experts"), you might be surprised.

btkm8unsl0w5r4

davo10 wrote: »

A patient of mine was quoted £ 1200 for implant, £ 450 for abutment, £ 700 for crown in the North (€2850 excluding consult and xray). See how many clinics in South will do it for same price/less .

I would actually charge less that that in the south east (yes I am a fully bonded specialist, and my implants are placed by surgical specialists), I tend to give all in prices to people (per implant fully restored), a patient wants a tooth not an implant, whats the point in quoting for the implant alone, the abutment alone or the crown alone??? The only reason is to make is seem cheap and hit you for the "extras" later once you have started. What a joke.

I don't charge extra for x-rays, that's another one that gets me. I need the x-ray to do the job, its included in the price its not an optional extra.

Anyway lets leave the price comparison stuff for the consumer issues forum (if you want to think like a consumer rather than a patient )

tuom

Hi

Can you explain what you mean please.

I have full denture on top only immediate as six months is not yet up.

Lower i have six in front then gaps at each side and one back tooth at
each side (these i may add are ultra sensitive since i got full denture)
My own dentist says these two are not great.

if these two back ones were removed :

a. could an implant be put in to replace these back two

b. could some form of bridge be put it to join the implants to the
front six teeth.

Hope that makes sense.

Tuom and Thank You

davo10

Tuom, in general people tend to tolerate upper full dentures quite well so after tissues have healed and resorption (shrinkage) has abated, a new full denture may fit comfortably. Alternatively you could have four implants placed in the upper jaw supporting an implant retained denture. This will hold in position infinitely better, will not cover palate etc.
If you are considering implants in lower jaw, it may be better to remove teeth with poor prognosis, then place implants on both sides for bridgework (you do not need to have an implant for every tooth missing). All this of course is subject to bone/health being in good condition.
As your occlusal vertical dimension is no longer stable (tissues shrinking under upper denture) this treatment must be done with great care to obtain the best results. If it is done badly TMJ problems, fracture of teeth, poor cosmetics will likely occur.