Second OS did say there’s something they do where they break the bone around the floor of the sinus and displace it upward so that it heals there and creates a locally thicker spot to cover more of the root.
As both OS explained to me when extracting molars, much of my roots are actually in the sinus itself, literally. They said this isn’t normal but also isn’t extremely rare, although my case is unusually severe. Both have said to me extracting the tooth will open a passageway between my mouth and my sinuses (and therefore nose), except to the extent that the blood clot stays in the passageway until it heals closed. They both gave strict instructions to avoid air pressure in either my nose or mouth for the first few days to avoid blowing the clot out and creating an active communication. I don’t even want to know what it’s like having an open hole connecting nose and mouth.
One of my symptoms, by the way, is tooth pain when I use a sinus rinse. That’s one of the clues to the issue. Though, it’s X-rays that are the most definite indication (bearing in mind that it can be confusing due to relative positions of different structures along the line of sight of the X-ray).
Here’s a reference to the condition and its consequences:
“Occasionally an upper tooth will have roots that are located near or actually within the sinus cavity. Removal of these teeth can cause an opening to develop between the mouth and the sinus. Your post-operative instructions may include sinus precautions. You should avoid blowing your nose for two weeks…”
My dentist did not give me a firm quote (yet) but estimated that, with my insurance covering half of the procedure, I would be about $1000 out of pocket. I am getting nervous about the cost now because it seems that it should cost more than this. And I know that I would have at least 2 people to pay as my dentist doesn’t do oral surgery.
I also have seen Little Shop of Horrors. I was very relieved that the extraction was nothing like that. The oral surgeon was just like grabbed the tool, grabbed the bad tooth, made a very disconcerting popping and breaking noise in my mouth and out came my gross tooth.
I have had a sinus lift and implant done on the upper left, and have had a bone graft (ridge augmentation) in prep for one on the lower right. It takes a while, there are at least a few months between the procedures (on the upper it was extraction/sinus lift/post installed/implant placed). There has been no pain in any of the procedures, a little post-op soreness after the graft but nothing to speak of. I think it is definitely worthwhile.
In 90 minutes I have my third extraction, plus a consult on sinus lift and implant. On the basis of most of the sinus lift experiences here, and the few success statistics I’ve found online, I’m inclined to try.
Good luck! I went with extraction and fixed (not removable) bridge based on time, cost and dentist recommendation. The tooth was beyond saving, that part was not in question. Bridge vs. implant was. So far I have not been disappointed.
As you surmised, varies widely. Single implant and single crown around here in the $3000 ballpark. Saw a billboard near Casa Grande AZ last year with single implant and crown for $1995. I don’t know enough about insurance to make a good answer.
I have been there. If you have a decent amount of bone, get the implants. The issue will only get worse. But hold out for two or three real painkillers.
My dentist actually cracked my upper jaw implanting the post. Blackened my eyes and left me on a lukewarm liquid diet which could not include alcohol because the painkillers had Tylenol. I still don’t regret it.
So it has been a hot minute. I had to wait for my dentist appointment and again for the consult appointment with the oral surgeon. Things look good, other than a bit of thinning where my teeth used to be. He said he may need to add bone but he isn’t sure. They also gave me an estimate for the cost.
$1575. Ouch. However, that is without insurance. The receptionist said that she needed to submit a pre-authorization for this procedure and that it make take about 6 weeks to know if insurance will cover the cost. That puts us right at Christmas. I went ahead and made the appointment for the 28th of December. I am REALLY hoping that insurance will kick in their half.
I’m really nervous about the procedure. Because of the thinning of the bone, the surgeon said he wants to do the implant under local anethesia so that we can talk about it if a bone graft is needed. I don’t know that I want to be awake for this but the surgeon and the nurse both said it was way easier than the extraction. I don’t know if I believe them.
When I got my implant, the periodontist deliberately scheduled things so the second part (putting in the implant post) occurred in the next year. That way, the initial extraction was on one year’s insurance deductible, and the second part was on the next year’s. If your insurance is re-zeroed at the New Year, it would probably be a good idea to check how that will apply to paying for your implant. The dentist’s office can probably advise about that.
Hmmmm - you should be able to discuss the possibility of a bone graft and give blanket permission to do so or not depending on the surgeon’s judgment at the time.
I’ve had two implants.
One was after a failed crown then root canal; I had the tooth extracted and did nothing with the missing tooth for a couple of years. It was a “6 year molar”, tooth #3, so there was a gap; evidently that particular position, being the oldest molar in each quadrant, tends to get more wear and tear.
I had them sedate me for the post planting. Insurance paid for the sedation that time, surprisingly (though not the later one, which involved a simultaneous extraction!!). I have pretty significant dental anxiety, though, and as I told the oral surgeon, I’d scare off the other patients if he had to chase me as I bolted, screaming, down the hallway. I think I left it most of a year before having the actual crown made. It all went fine. Upper teeth tend to have a slightly higher failure rate than lower, so I was quite relieved.
The other implant was tooth #14 - the other upper 6 year molar. I’d had 2 and a half root canals: the first one did not solve the problem; with the second one, the endodontist got partway, said it needed something done to the root tip instead, so he went into the gum from the side on another visit. Bleh. When THAT only gave me a year or so relief, my dentist tried to push me to go BACK to the endodontist - and was surprised when I basically threw a tantrum and refused.
Same oral surgeon for that tooth as before, though he was doing the extract first. I opted for sedation. Going in, the discussion was “if you can do the implant at the same time, fine, you’ll use your judgment”.
I lucked out and he was able to do both. There was indeed a bone graft involved: standard with extract + implant at the same time. I didn’t need one with the first tooth because the socket had had years to fill in.
My husband just had an implant done - well, the extract and the post. As with me, they were able to do both at once, though the oral surgeon said it was not terribly likely. Lucky again, I guess. As with me, there was a bone graft involved.
The other difference between my two implants was that with the first one, the metal bit was completely covered while it was healing. When the requisite number of months had passed, he gave me a local and opened the gum above the post, and put the above-gum portion of the post in place. With the later one, once the swelling went down after the extraction, the top of the post was already uncovered. I don’t know if that’s because of the timing of how I did it, or the hardware had changed betweentimes.
In all 3 cases, we’ve split it up over 2 benefit years - our insurance has an annual maximum of 2,000 per person, so we have less out of pocket.
Of note: the oral surgeon who does the implant is NOT the one who makes the crown: your regular dentist does that. It’s weird as hell to have this little metal nub on top of your gum until the crown is made.
Add me to the OP as someone seeking advice on a dental implant. Last week, the crown on a molar (tooth #19) in my lower-left jaw popped off during a cleaning revealing a split tooth. Since then, I’ve been advised by my dentist and one I consulted for a second opinion that the tooth can no longer hold a crown for a long period of time and needs to be replaced by either a dental implant or a bridge. The bridge option would be easier but would involve having to “damage” two adjacent healthy teeth and install two crowns. The implant option has been recommended by both dentists but would involve more intensive oral surgery and possible complications like the ones discussed in this thread. Whatever I option I take, I don’t want to do anything until after the holidays. I’ve recently had unrelated oral surgery and both dentists have said there’s no urgency requiring me to getting the procedure done immediately. Also, I’ll be getting a Christmas bonus and will be in a better position financially, (I also have partial dental insurance.) I’m just not sure what choice to make.
I am waiting at the pharmacy for them to fill my prescriptions from the oral surgeon. All in all, it went really well. I hated the numbing shot, as I always do. I iced up really nice though and only felt pressure through the procedure. I did panic a bit and gag right at the beginning. I ended up not being able to use to bite block as it made me gag. Instead, I had to hold my mouth open the whole time. They showed me the xrays with the implant in. It looks huge compared to how it felt in my mouth. Honestly, I could close my eyes and just about convince myself that it was just a filling.
I really hope they fill my prescriptions soon, I’m already starting to feel sore.
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Thanks for the update. Love the term iced up, reminds me of Mel Hawkins, dentist in Toronto and God of local anesthesia. Canadians generally say frozen for what Americans call numb. Being from Michigan I find it interesting you used both numb and iced in your post. Don’t mind me just ramblings of an old dentist.
I was borrowing the surgeon’s language there. My regular dentist also says iced up. I think my regular dentist is from Canada though, which might explain it.
I am not excited about how much pain I’m in. I rarely take narcotics but this time has called for it. Ouchie!
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