I am way past due in getting around to writing the next part of this story. As you might recall from the first 2 parts, I had one baby tooth that I had never lost as a child due to the permanent tooth never coming in. Back in April, the tooth started bothering me and the dentist informed me that it was going to have to come out. I had it extracted in early-May.
On August 22, I had oral surgery to put in a dental implant, the first part of the process of replacing the lost tooth with an artificial one. This was the most invasive, and only surgical, part of the procedure. The surgery involved the insertion of a titanium artificial root into the jawbone through an incision at the gap where the extracted tooth used to be. Once the surgery has fully healed and the oral surgeon confirms that the bone has fused appropriately with the implant, my regular dentist will be able to affix a crown to the root, completing the process of replacing the lost tooth.
After I had the tooth extracted in late May, I had to wait a minimum of 6 or 7 weeks to allow it to fully heal before proceeding with the implant. That timing pretty much ran right into a vacation that we had planned for the end of June as well as the July 4th holiday, so I ended up deciding to just put up with the gap in my teeth for a bit longer. I finally contacted the oral surgeon’s office and set up an appointment for a consultation at the end of May.
The oral surgeon that I went to specializes in implant procedures. I think that might be the only thing he does, although I’m not entirely certain. Dental implants are expensive and generally considered by insurance companies to be an "elective" procedure (more on that later), so there actually was kind of a salesmanship element to the consultation. I even felt a bit like I had been to a luxury dental office, with such amenities as bottled water offered while waiting for the dentist and even sunglasses provided during the exam to shade by eyes from the examination light.
After the examination, the oral surgeon told me that I was a good candidate for the procedure and spent a little time going over the procedure in more detail. One key topic that he brought up in this discussion was the available options for anesthesia for the surgery. He indicated that general anesthesia wasn’t usually needed for this (I’m not entirely sure, but I don’t think he even offers that as an option), but he did pretty strongly recommend the use of an oral sedative during the surgery in order to help me to relax and also to help to avoid movement during the procedure.
I then met briefly with a member of the office staff who went over some of the financial details of the procedure with me. She indicated a cost of a little over $2000 for the implant. Many dental insurance plans apparently do not cover implants, considering them to be fully optional, cosmetic procedures, even though they are now widely considered to keep the gums/jawbone much stronger and are also longer lasting than dental bridges. Fortunately, my insurance does cover about 50% of the cost, although apparently it is 50% of what the insurance company thinks the cost should be rather than 50% of what the oral surgeon actually charges (and the patient has to make up the difference). There are also annual maximums that come into play. As of the time that I’m writing this, my insurance company still hasn’t finished processing the claim and I don’t yet know how much they will cover.
After the financial discussion, we then scheduled the appointment for the procedure. I decided that I wanted to have it done on a Friday, which would then give me a couple days to recover without having to take more than one day off from work. We initially scheduled an appointment for the next Friday after the consultation, but they called the next day and let me know that the office staff had incorrectly recorded the itinerary for an upcoming vacation the oral surgeon was taking and would have to push it back a couple weeks. The August 22 appointment was the next available Friday. I wasn’t entirely thrilled that the only time available was 7:30am, but I still took the appointment since the only alternatives were to either switch to another day of the week or put the procedure off for almost another month.
A few days before the procedure, the oral surgeon called in four prescriptions to my pharmacy. These were the sedative (triazolam), a strong pain reliever (Hydrocodone), a prescription-strength version of Ibuprofen, and an antiseptic mouth rinse (which tasted awful…) that I was to use twice a day for the next two weeks. The Hydrocodone was intended for use as needed during the first couple days after the procedure while the Ibuprofen was to be taken on a regular schedule for the first several days to help reduce inflammation. I was generally impressed that they called in all the prescriptions ahead of time, preventing the need to get them filled in the time shortly after the surgery. Of course, the prescription for the sedative had to be filled ahead of time, so it was pretty obvious to take care of the others at the same time.
On the morning of the procedure, I was supposed to take the sedative approximately one hour before the appointment time. With morning rush hour, that was roughly the amount of time we thought it was best to allow to get there, so I took the pills right before leaving home. As you might expect, I wasn’t allowed to drive because of the sedative, so my wife took me to the appointment. During the drive over there, I really didn’t notice that the sedative was affecting me at all, which surprised me a bit. I did know it was working as soon as I tried to get out of the car, though. I basically couldn’t stand up on my own power and I ended up having to pretty much hang on to my wife’s arm in order to make it into the dentist’s office.
I don’t actually remember very much of the procedure itself. I have some very vague recollections, mostly of the early steps, such as the injection for numbing the area. I don’t know if I actually fell asleep, but I certainly wasn’t very aware. I recall being surprised at how quickly it went and then more surprised when my wife told me the procedure took over an hour. I also have pretty much no memory of the drive home, so that further indicates how out of it I was. I do vaguely remember them going over the care instructions with me after the surgery, but was so out of it that the information didn’t sink in. In fact, I finally got around to reading through the instruction sheet the next day and realized that I hadn’t really done a very good job of following them, particularly when it came to the procedures for cleaning the teeth on that side and such.
After arriving home, I promptly went up to the bedroom and fell asleep for a couple hours. There really was no bleeding at all (unlike my experience after the extraction) and the anesthetic had me numb enough that I wasn’t in any pain. I did take doses of the pain medication before falling asleep in order to help head off pain as the anesthetic wore off.
A couple hours later, my wife came upstairs to let me know that she was going to head out to Wendy’s to get lunch for her and our son. She mainly wanted to check to see if I wanted her to bring me back a Frosty, figuring the ice cream would feel good after the dental procedure. She was pretty surprised when my answer was “yes”, but I then added “and also bring me a bacon cheeseburger”. At that point, I still wasn’t feeling any pain, but I had managed to work up a pretty big appetite. I did have to cut up the burger into small bite-sized pieces, but I otherwise had no trouble eating it and, in fact, I was so hungry that I almost inhaled it.
I never really had any serious pain from the surgery, although I think a lot of that was thanks to the fairly strong medication that was provided. The dentist’s office pretty strongly encouraged me to be proactive with the pain medication, at least for the first couple days in order to minimize any discomfort. For this reason, I took the Hydrocodone at the minimum intervals throughout the weekend, although I did switch to only using it at night once I went back to work on Monday. I did have some occasional aching in the jaw, but that never became too awfully bad.
The stitches were really the biggest source of post-surgery discomfort. For one thing, they had essentially thread them between some of the adjoining teeth in order to hold them in place and that did irritate the gums quite a bit. I also had a really hard time keeping my tongue off of the stitches and the looser strings became pretty stiff. I went back to the office to have the stitches removed on the Wednesday after the surgery (5 days after) and that was definitely a big relief.
I don’t think I’ve really said much about the implant itself. With the crown not having yet been attached, it feels very much like I have a big metal screw in the gap where the tooth used to be. The surface of the implant is a flat, circular piece of metal with a threaded hole in the middle. The last part of the process will be the placement into that threaded hole of a metal shaft to which a crown will be cemented. This part will be completed by my regular dentist.
At about the 8 week mark after the procedure, I had a follow-up appointment with the oral surgeon. At this appointment, an X-ray was taken to confirm that the implant is properly placed and that the bone has healed correctly around it. He also used an instrument to verify the strength of the implant and that it will properly hold the shaft/crown. All that checked out, so I am now clear to schedule the appointment for what will hopefully be the final part of this story.