Dentures. I need advice. There, I said it.

I've been putting this off for years.  It's time.  I have problems, and I'm tired of dealing with them.  Also I feel like all anyone sees when I'm talking is my E36 M3ty teeth...

So, any advice on what to look for?  Avoid?  I have a crippling fear of dentists (surprise) but about 5 years ago I took the plunge to see if a bridge or 1-2 replacements were feasible, and was hit with "no you're beyond that, you need a full extraction."  It took me awhile to process that.

The place I visited did tell me I wouldn't leave the facility with no teeth, I would have some kind of temporary dentures until better ones were ready.  And full sedation was $1K extra, vs local, and I am ready to pay anything to not be awake for this.

You guys know something about everything, from brake line lengths on a Datsun 510 to how to make a good grilled cheese sandwhich.  Lay it on me.

SWMBO, in one of her many careers, was a dental assistant.  She also volunteered at a free clinic that pulled teeth at no-cost.  

The one thing that she's talked about a number of times was the fact your teeth are what helps maintain bone density in your jaw.  If you pull all the teeth, you may lose the look of your jawline & have other issues.  If even a few are salvagabe, it might be worth investigating a partial denture or bridge to help maintain bone density.  SWMBO isn't a dentist and I don't have any direct experience/knowledge....just one more data point that might help you ask good questions going forward.

Taking care of your health is important.  Frankly, the advice I see on this board is consistently very good.  

You can fly to Mexico for a month and have your dentures done cheaper there than having them done in Saskatoon...

Paging Docwyte to the courtesy phone, Docwyte to the courtesy phone please.

What clutchsmoke said.

Not a dentist, don't play one on TV but sometimes I feel like I put my dentist's kid through college...

I wear a mix of implants and a partial denture, interspersed with a bunch of remaining actual teeth. I think the most important part is finding a dentist you trust and who explains the options to you - because there usually are multiple options (at different price points, of course).

My dentist was very much of the opinion to salvage what was possible - which wasn't that much, long story involving Not The Pinnacle of German Dentistry - and then come up with a long term solution. Depending on what the option offered was and how many teeth were supposed to be removed, I'd suggest getting a second opinion. And possibly a third if at least one of them suggests extracting all teeth. In my case, my dentist put a lot of effort in to preserving my upper canines (which were salvageable with crowns) as they could serve as anchor points for my upper partial and also because it lessens the impact of the other extractions on the shape of your face (my understanding, as mentioned my expertise is at the receiving end of the treatment and impact on my wallet).

When I lived in Florence, SC in the late 70s- early 80s, it was known as tooth town.  We had multiple dental clinics that specialized in quick and cheap dentures.  Show up 3:00 am one day, have a set of choppers by the next evening.  People used to come from all over the country and spend the night in campers in their parking lots.  They just themselves locally when they opened up clinics in other towns.  I almost ran over one of their clients when he walked out of the door and out into the road in front of me while holding bloody rags to his face.   At least one of the clinics is still in business.  

In reply to Streetwiseguy :

No!  Just...NO!  Not to say there aren't good dentists in Mexico, but flying to another country to have dental work done is STUPID for any number of reasons that I'm happy to list if we go there.

Anyways, yes, keeping your teeth maintains your bone level, which is very important.  If, however, you're past the point of return and all the teeth need to go, the best solution is to have 4-6 implants placed, which then can hold the "denture" in place.  It can either snap in/out on the implants or can be screwed into the implants.

The latter is much more stable and basically gives you the best functionality.  However it's the most expensive, by far.  The snap in, implant supported one still isn't cheap but is far better than a "regular" denture.

I tell all my patients that dentures aren't a replacement for teeth, they're a replacement for no teeth.  I know that sounds like I'm splitting hairs, but it's an extremely important distinction.  A regular denture will NOT act like your real teeth.  You will not be able to eat the same way, talk the same way (at least in the beginning) nor taste your food the same way.

IV Sedation is wonderful and it's worth the cost.

In reply to docwyte :

Doc, I'm honestly curious. Let's go there. I know your business should discourage people from traveling overseas (just as mine should discourage people from hiring unlicensed contractors), but what are some of your reasons?

I am facing some very expensive dental work, and have considered it.   I know the guy is a professional, but $13,000 seems like a lot for 2 hours work. 
 

A very close friend recently had significant elective surgery in Mexico. US licensed doctor, professional hospital setting, English speaking, US board certified, state of the art equipment, and a price tag that was less than 20% of what it would cost in the states.  Why is that bad?

My friend had his done there a number of years ago, but he spends winters in Phoenix.  There is a town just across the river from a friends place farther south, El Gadonas or something, that is pretty much entirely made up of dentists, opticians, and surgeons.

His dentures have been fine.

i probably wouldn't do it.

Jerry said:

I've been putting this off for years.  It's time.  I have problems, and I'm tired of dealing with them.  Also I feel like all anyone sees when I'm talking is my E36 M3ty teeth..

lengths on a Datsun 510 to how to make a good grilled cheese sandwhich.  Lay it on me.

I'm skimming this and my brain says you want to trade a Datsun 510 for dentures.

Hi Doc , 

are you saying that Mexico is not the place to go , or no other country ?

 I have to say when I thought about it , my thoughts were what happens if I have problems ?
Unless it has changed , I was told a big part on getting implants overseas was that the implants were imported  from the USA and Europe and that was a big part of the cost , 

Anyway thanks for your thoughts,

OK, so beyond the obvious issues of whether the Doc truly has the training they say they have and infection control, whether the materials being used actually are the same quality is here, the biggest issue is follow up.  Implants and dentures aren't a "Here ya go, you're done, see ya later!" type of thing.  They take a *long* time.  Healing takes a *long* time and needs to be monitored.  Bone grafting can fail, sinus lifts can fail, implants can fail to integrate.  Then the crowns/teeth need to be made and placed.  There are numerous fitment issues with those.  Hell, just today I dealt with an implant crown issue on one of my patients, had to drill a hole thru the back of the implant crown, get to the abutment screw and retorque it, then back my way back outta there.  So what're you gonna do if that happens to one of your Mexican implants back here in the USA? You come to me with that and I'm not touching you and neither is anyone else here.  Are they using the proper materials for the crowns that we use here?  Noble metals that cost a lot of money?

Dentures require multiple visits to custom make and then multiple visits to adjust properly.  While some denture places here have an in house lab and can make a set of dentures inside of a day or two, is that happening there?  Then there's still the issue of follow up for fitment and adjustments.

No USA dentist will touch any work that happens out of country.  I touch that stuff, I own it liability wise and that's a huge NOPE for me or any other USA dentist who's got any decent head on their shoulders.  I can't tell you the horror shows of work I've seen from overseas dentists.  Not just mexico/central america but the middle east and other areas.  Patients are screwed, insurance got billed and won't pay for the replacements.  Doc's here won't touch the stuff with a 10 foot pole and then they end up paying USA prices, fully out of pocket to get their janky work redone.  And that's if things weren't done so badly that the teeth can still be salvaged, which I can attest to, is a very iffy situation sometimes.

You as the patient really can't tell if the dental work you've received is done properly.  You'd be really surprised at won't doesn't hurt or bother you in the least, meanwhile the margins aren't closed and bacteria is building a city underneath that bridge/crown/whatever they did.  Tooth is getting destroyed and by the time you maybe feel something and see someone here, it's too late.

Health care here is expensive but it also is in other 1st world countries too, it's just rolled into the higher taxes they pay in those countries.  No where more than healthcare is the adage "you get what you pay for" more true.  Don't treat yourself worse than you treat your pets or your cars, which is also something I sadly see all the time.

Thanks Doc ,  great post !

some of that was what I was worried about , but you added many things I did not think of ,

In reply to docwyte :

Thanks for the info

Jerry said:

Also I feel like all anyone sees when I'm talking is my E36 M3ty teeth...

I feel this from experience. I can say that dentures have given me a bit of a self confidence boost, whether or not others *were* looking at my teeth I don't know.

In reply to docwyte :

In the event something happened if some one was visiting the states and had dentures and was from say, Canada, is it still a no go? I don't for see anything catastrophic happening teeth / denture wise if I was vacationing, but on the same token, cutting a trip short due to a dental emergency would also suck. Especially if driving and had to drive home in pain. 

In reply to DjGreggieP :

Canada is not Mexico/Central America/Middle East.  What I mean by that is the quality of their dental work is similar to here, so as a provider I'm not worried about stepping into an enormous pile of poo.  Also a denture emergency is something like they dropped it and it split in two.  That's something that usually needs to be fixed in a lab, which can take several days and might not be able to get done before they leave to go back home.  At that point, they're just gonna wait till they get back home.

I'm extremely leery of playing with work that others had done elsewhere.  Lets take partial dentures as an example.  Those have cast frameworks but over time they get work hardened.  So like a paper clip that you bend back and forth over and over again.  So a new patient comes in with an old partial, which they love and other then being a little loose, fits perfectly.  They ask me to tighten it.  NO WAY!  Chances are, the second I touch it, the cast arm pops off immediately.  Lab won't attempt to fix it as they aren't willing to weld to old metal.  Now I have to buy the patient a brand new partial, plus look like an idiot.

No thanks...

Mrs. preach had a full extraction done about a year ago and still has the temps. Her smile is nice.

I am well on my way to needing them, I plan on posts and a gold tooth if I can.

"With a New York brim and a gold tooth display, no one gives me trouble 'cause they know I got it made" -ZZTop

In reply to spitfirebill :

My dad was probably on of those guys. He went to South Carolina with a bunch of other Goodyear guys from Akron and came home with a set of new teeth. He was only in his early 40s, but Appalachia didn't have dental care in the 1930s. 

Bit of an update.

I made a Facebook post basically saying the same thing, just more audience and full of people I actually know in person.  Another step to get through this.  Got some information, realized I had 3 friends in the dental field that PM'd me more information.  Made a list of places from their recommendations and Google darts.

Had an appointment last Friday at one 2 miles from my house.  Short exam, x-ray, and description of the procedures and $$ for options.  Implants are about $20K so that's out (for now).  They had Economy through UltimateFit dentures, I'm going with Ultimate.  Package deal with healing dentures, permanent set, checkups, adjustments etc was about $3400 and with extractions came to about $6200.  I can figure that out (likely dip into IRA).

Now I'm devouring information online for things like how long to take off work afterwards, what to expect, etc.  No general anesthesia but they offer Halcion or Triazolam for a bit extra, which I will gladly take.  My dental friends (and research) say that's pretty typical.

I think I'm going to schedule it for early October, we have our Cincinnati Comic Expo in late September and I don't want to spend 3-4 days at a con trying to find something I can eat.  Going to shoot for a Wednesday so I can take off W-T-F-S-S and see how I feel on Sunday.  I've read at least 5 days, some say a full week, some say as much as 2 weeks is best.  We'll see.

Hi Jerry,

Honestly I was pretty fine to work after 3 days, but it takes time to talk normally again & I had a hard time with eating anything chewy or crunchy for longer than normal. I think I had a tiny bone fragment, but not a serious issue (they work their way out or can be removed if they are big enough). In any case, if your teeth are in rough shape it's definitely worth it 100%. You will start to feel better both physically and mentally, and it's worth it even for the cosmetic part alone. I experienced pretty much no pain as long as you take the medications on time you will be fine. Don't try to stretch between meds, it's harder to stop the pain once it starts. If you have any specific questions I'm a good person to ask, not only have I gone through it, but I work in a dentist office.

Good luck, but you won't need it!

Today was the impressions.  After an hour wait in the lobby, they finally did a top and a bottom, then something extra with a 2 part epoxy gun that was some kind of bite impression. Seemed to only be on the left side, I think.  Had to take my glasses off so didn't get to see much going on.

They called me just as I was almost at work 25 miles away at 1015am "can you come back?  We need to redo the top impression."  Um no, I can't.  "How about 11am?"  No.  They scheduled me for next Tuesday 8am to redo, hopefully that one will go quicker.  And I know what to expect, blech.  I almost gagged on the top one, I was afraid she was going to be wearing my morning chocolate milk.

But, the big day is scheduled for October 11th.  She tried to talk me out of the oral sedation, I flatly declined and said drug me.  So SWMBO will be my chaffeur for the day.

Got the impressions redone Tuesday, they ended up doing both.  I recognized the lady from my first xray visit, I have a feeling the lady last week screwed everything up.  This time it felt like she used more clay/putty/epoxy/whatever and also did not try to make me vomit on her.  So that's a plus.

$6400 on the card and waiting until October 11th.

Yesterday's grocery shopping was very different. Add to this eggs and mashed potatoes, hopefully by the weekend. I've been told that I should add Ensure, protein drinks, and baby food.

Wednesday starts the main event. #dentureadventure

Yesterday was the day, not quite 24hrs ago.  I took the oral sedation pill after I got there and the dentist's assistant popped out "have you taken it yet?  We're having tech difficulties".  They were having IT issues and couldn't pull up my xrays.  They couldn't do the procedure without being able to see and make sure root lengths, etc.  Almost had to reschedule but it popped up about 10 min later.

Speaking of that pill?  It made me groggy, that's it.  I felt and remember everything!  They numbed the E36 M3 out of me and some came out without much drama, a few I grabbed the arm rests and tried to twist them off.  But the whole thing only took about 30min once they started.  I even asked to see the instruments they used at the end, I was curious.  I remember getting out of the chair, walking the hallway, think I said goodbye to the receptionist, and then a blank until I was crawling into bed.  SWMBO said I made it up two sets of stairs with only minor stumbling.

Took a bit for the bleeding to stop, she went out to buy some gauze and drop off a prescription for mouth wash.  I used a couple more pads and it finally seemed to stop, which is good because it was starting to hurt my face and make me gag a little.  Took 800mg ibuprofen and within an hour I was not bad at all, all things considered.

I fell asleep on the couch for a bit, she did remote work on her laptop & watched TV with me.  Eventually around 6pm I decided to try chicken broth and had started drinking tap water.  That went ok so I added apple sauce a little later.  I tried putting the dentures in but the edges are hitting sutures or something, or just swollen, so I left them out.

Today it feels a bit more swollen but still not bad and actually doesn't "hurt".  Just kinda sore.  Still glad I took the rest of the week off of work.  Now begins the next part of the adventure, getting used to the dentures and all the adjustments/etc.  Time for some more ibuprofen.

Showered for the 1st time since Tuesday, I'm sure SWMBO will appreciate it at the lunch visit.  Made coffee for the 1st time in two days, I appreciated that.

I have to admit I've only tried the temp dentures once yesterday afternoon, a bit afraid with the swelling and sutures, but will try again.  With the 800mg ibuprofen every 5hrs hours I've not been in much pain, at least not what I feared.  Hoping to try them again and eat something semi-solid like scrambled eggs.

(Anyone able to change the title of posts?  This is now more Denture Adventure than advice.  Might help others.)