All-on-4 questions. Please help!

Dentdisaster

Hi

I'm hoping someone with expertise or experience of getting this kind of work done can help.

I have bad gum recession, deep pockets, badly crowded teeth and badly misaligned teeth. This applies to top and bottom. I also have a crown on an upper lateral incisor that has gone black in the gum, I need two upper wisdom teeth removed and the general state and presentation of my teeth is poor. My teeth bleed from at least one place every time I brush them.

I have had periodontal cleanings maybe 10 times at huge cost, both from a periodontist and from various dentists. This cures the bleeding for a couple of months and then it returns. Regular dental cleanings make no difference to the bleeding (and therefore gum disease). The gum recession is very pronounced on my rear teeth upper and lower and has recently started to recede on my front upper teeth at a very fast rate.

My concern is that I'm getting bounced from dentist to dentist with the same prognosis and treatment plan every time - another periodontal cleaning. What's unusual for me is that I seem to develop plaque almost overnight. I've tried to explain this to my dentist in the past and she didn't believe me so we arranged that she would remove the plaque from the particularly badly affected area and I would return 2 weeks later after regular brushing/hygiene to see what had happened. Needless to say she was stunned.

The reason I tell the above is I'm concerned that a) my teeth are now very embarrassing to me and b) all of the treatment plans I've received only aim to preserve what's left, not make any improvement and c) with the recurring plaque issue there's little or nothing I can do to fight further gum recession.

My question is, can I resolve the above by getting all-on-4/6 implant dentures on both the top and the bottom? I know it's like asking how long a piece of string is but what is the range of cost I can expect to pay for this work in Ireland? Logic would seem to suggest to me that I would be better off to get this work done than to continue the never-ending losing battle I'm currently engaging in because the points where my jaw is exposed to infection would be reduced from every tooth to just the points where the implants are located, therefore being easier to clean. Am I right?

I'm 40 years old and otherwise healthy.

Apologies for the wall of text. I understand that I need to see a dentist who offers this kind of treatment and I do have a consultation booked but unfortunately at €120 a consultation I can't go getting 4+ different opinions and for what could be €15000+ of cost, any general advice/experience would be much appreciated.

Thanks

Given the issues you describe, I suspect an implant surgeon will be concerned about the high risk of peri-implantitis and failure of the implants. Unless you can control plaque accumulation and improve periodontal health, implants would be contraindicated. I think you will need to increase your budget as well if you want to replace all teeth with fixed implant supported prosthesis.

Dentdisaster

Dav010 wrote: »

Given the issues you describe, I suspect an implant surgeon will be concerned about the high risk of peri-implantitis and failure of the implants. Unless you can control plaque accumulation and improve periodontal health, implants would be contraindicated. I think you will need to increase your budget as well if you want to replace all teeth with fixed implant supported prosthesis.

Thanks Dav010.

Short of brushing my teeth 18 times day, which would itself cause gum recession, what can be done about plaque? My current and previous dentist said it must be something to do with the particular mix of saliva and whatever in my mouth. Would you agree?

And how much more do you think I'd be looking at for the job?

Have you seen complete removal and replacements like this done previously? My current dentist hasn't and when I put it to her that the she seems to be suggesting I just put up with the state of my teeth she just shrugged

Dentdisaster

Dentdisaster wrote: »

Thanks Dav010.

Short of brushing my teeth 18 times day, which would itself cause gum recession, what can be done about plaque? My current and previous dentist said it must be something to do with the particular mix of saliva and whatever in my mouth. Would you agree?

And how much more do you think I'd be looking at for the job?

Have you seen complete removal and replacements like this done previously? My current dentist hasn't and when I put it to her that the she seems to be suggesting I just put up with the state of my teeth she just shrugged

Yes I have seen full replacement of teeth many times, I have worked with Specialist Implant surgeons for nearly 20 years. I’m afraid I cannot help you with the reasons why plaque builds up so quickly as it may be multifactorial, the concern would be that it would build up around your implants causing infection, bone loss and ultimately failure unless it is prevented.

In relation to costs, this will depend on where you have it done, I suspect the overall cost of full fixed implant supported prosthesis on both jaws will be quite a bit more than €15k if done by an implant surgeon and prosthodontist. Your Dentist will be able to refer you.

Dentdisaster

Dav010 wrote: »

Yes I have seen full replacement of teeth many times, I have worked with Specialist Implant surgeons for nearly 20 years. I’m afraid I cannot help you with the reasons why plaque builds up so quickly as it may be multifactorial, the concern would be that it would build up around your implants causing infection, bone loss and ultimately failure unless it is prevented.

In relation to costs, this will depend on where you have it done, I suspect the overall cost of full fixed implant supported prosthesis on both jaws will be quite a bit more than €15k if done by an implant surgeon and prosthodontist. Your Dentist will be able to refer you.

All bad news then. Yeah if it's like 30 grand it's out of the question. From what I gather I'm only in the ballpark at 15k if a dentist who specialises in implants does it and that's probably unlikely given my circumstances.

Thanks though, much appreciated

Fitz II

There is a old saying in implant dentistry, implant are a great replacement for missing teeth, but no replacement for teeth.

I would be very worried about extracting all the teeth and replacing with implant unless the plaque was under control. Plaque grows at a fairly predictable rate, so the problem here is likely your cleaning technique rather than the time and effort you put in.

You should seek an opinion with a implant specialist or restorative specialist, one that your dentist reccomends. On big treatment like all on X consult fees are small fries and well worth the effort.