The long road to a smile
It’s been almost exactly a year since I started a third round of dental implant surgery. It wasn’t fun..
This is a selfie I took two hours after finishing my third - and hopefully last - round of dental implant surgery. Nice innit? The genesis of this story goes back 10 years.
In 2012 I started losing teeth in my lower jaw at an alarming rate to the point where I needed a complete new set. At the time, implants were not recommended and I made do with a denture that needed daily maintenance. Anyone who wears removable dentures knows they’re a PITA and a potential source of unintended embarrassment. I developed strategies for avoiding those issues, mostly consisting of not eating apples, pork crackling, toasted bruschetta…you get the idea.
Not long after arriving in San Diego, the same problem occurred with my top set of teeth. I was losing teeth at the rate of one a month. At one time I looked like an ageing prize fighter who’d not taken care of his appearance. As a side note some might say they didn’t notice the difference. Be that as it may be. Something had to be done fast but what?
Living in San Diego meant being bombarded with ads from Mexican dentists, most of whom flogged implant surgery at a fraction of the price a US dentist would charge. Implant surgery is expensive so a trip to Tijuana, 35 minutes away, made sense on many levels. It also meant putting the equivalent of sticking a pin in a map and taking what I got.
At the time, the work carried out in TJ was OK. I made maybe a dozen or so trips in short order and was done and dusted both top and bottom inside six months. I felt comfortable with the dentist I chose as there were plenty of Americans turning up for treatment so assumed it can’t be all bad. But…a few weeks before I was due to return to the U.K. and perhaps 18 months after the main surgery I started to develop problems with teeth breaking away from the bridges. The TJ surgery fixed them without problem at no charge. I cautiously returned to the U.K. but resolved to get a check up. Just in case.
That check up never came because I’d only been back a few months and the lower denture cracked dislodging itself and leaving a quarter of my mouth toothless.
I found a local(ish) specialist who took one look and determined the bridge was irreparable but could be replaced. But - and here’s the catch - he needed to know which make of implant had been used in Mexico. I had no idea but emailed the TJ surgery to find out. After a bunch of back and forth I got the make details. Why does this matter?
According to the local guy there are some hundred makes/types of implant around the world and they’re mostly incompatible. (Sound familiar to the software geeks in my subscriber crowd?) Without that info, he couldn’t help. It also turns out that the Mexicans had put more implants in than seemed necessary but that’s a side issue. Replacing the lower bridge worked well. It felt more comfortable than the original and has been good ever since. I still require regular maintenance in the form of a quarterly clean and polish. I think of it like a subscription. I’m thinking my dental practice does too.
And then, in late 2019, disaster struck.
I was enjoying a sausage sandwich with Judith at an open air cafe when I suddenly felt a sickening crunch and a piece of the upper implant fell out. Back to the dentist and once again it was a case of what had the Mexicans done?
Emails and phone calls produced no result, the Mexicans eventually claiming they’d lost all their patient records in a computer system crash. The dentist who’d done my work had moved on and, when finally contacted, couldn’t recall the make of the implants she’d used. Net-net, the implants had to be replaced in toto. Getting from busted bridge to a schedule of appointments took 18 months with COVID in between.
My current dentist was happy to do the work but said it would take time as there was a risk I might require additional bone support for the upper jaw. Thankfully that was avoided. But what we anticipated as a six to seven month journey turned into a year long marathon. Why?
Removing and replacing implants is not trivial. Three implants more or less fell out (one was deemed defective) under the dentist’s ministrations but the final one needed the dental equivalent of a pile driver to remove it. Just to add to the fun, when I first turned up for that work, I had a bad reaction to the adrenaline that’s included in the local anaesthetic. I was shaking uncontrollably as though sat naked in a howling gale at the Noth Pole. I also felt very weak and could barely stand. We called the surgery off for that day. When I next turned up 10 days later I made it clear that if I had the same reaction then all bets were off. Thankfully that wasn’t the case. The dentist adjusted the anaesthetic compound. It meant additional, unpleasant anaesthetic injections but at least the primary work was over.
We then had to wait to see how my mouth would respond before the next session that replaced the old implants. In the interim, I had a removable denture. Ugh! The next surgery was completed in September and my dentist cheerfully announced that I’d have my smile back by Christmas at the latest. That didn’t happen.
It seems I have what are called ‘active gums’ which meant that my body kept trying to grow flesh over the new implants. By this stage, my gums had also become quite sensitive. Chewing toast was a grim experience and much as I enjoy a good steak, it was almost impossible for me to chew anything other than the smallest morsel. It’s perhaps a good thing that fine dining restaurants put out tiny plates of food.
A series of test fittings then followed, including a full refit as the dental lab buggered up the first bridge. That knocked the timing further off course and meant that until yesterday I still had no permanent bridge in the upper jaw.
The final surgery involved more injected anaesthetic and a slicing of flesh away from three of the implants so that the bridge could be fitted. It’s not as bad as it sounds and there was very little blood loss. It was sore and I felt crappy for the rest of the day.
I’m now the proud owner of some fairly expensive (and impressive) teeth which I may well leave in my will. One thing’s for certain. I’m not going through this again.
There’s no getting away from the fact that implant surgery is non trivial and is, at certain points, incredibly painful, regardless of modern anaesthetics. The Mexican experience was certainly painful. This set of surgeries has been bloody awful. My dentist tells me I don’t help myself as a life long smoker yet truth be known I smoke a fraction of what I was consuming 4-5 years ago. I guess it doesn’t help that I’m closing in on 70 years of age and starting to accumulate fresh health issues, none of which are, thankfully, debilitating but annoying.
So what’s the big lesson? Surgical tourism is quite the thing in Europe. I’m told the current favourite place to get dental implants is Turkey. It’s a false economy. I can’t imagine what it would be like to go through what I’ve experienced the last year if I was committed to overseas trips. If I’d returned to Mexico I’d be looking at a horrendous travel cost. Staying local saved me hard earned money.
Perhaps more important than proximity is the fact I can easily discuss and understand the ramifications of each step in the process with a fluent English speaker - even though my dentist is Danish but with Egyptian heritage. My dentist has been qualified in implant surgery since 2003 so has oodles of experience. He also keeps himself regularly updated on techniques. My Mexican dentist had 10 years but that was either insufficient or not of a quality I need. Could I have done better? Who knows?
While I’ve ended up paying the equivalent of a 1990 mortgage on a reasonable U.K. house up North I’m still ahead of the nosebleed cost I would have forked over in the US. And with no guarantee of quality. It’s a small consolation but good enough for me.
The final lesson should be obvious. Any dental practice saying you can walk in with crap teeth and walk out with a pristine, implanted smile is blowing smoke up your ass. It’s just not possible. Yet, it’s a common ploy to part people with their cash.
Now - join me in a big smile. It’s been tortuous but I’d argue worth it. No more night time dropping a set of choppers into cleaning solution and an untroubled choice of any food I want to eat.