Expert: Zev Kaufman, D.D.S. - 11/6/2008

Question
I had a lose crown (dangling!) and an implant was recommended.  The oral surgeon did this in conjunction with a bone graft.  He seemed to have problems getting "set" right but I managed well after.  Then about two months later, I noticed I could "feel" it in the bottom of my nose.  I mentioned it and he said I was wrong (but I don't feel anything on the other side of my nose!).  Then about a month ago, the gum was gray and he said he wanted to do another bone graft on top of the implant "just to make sure".  The surgery was agonizing and after my lip, nose, cheek were so swollen, my face was unrecognizable - my eye turned black and blue and Ihad bruises on both sides of my face.  A week later, the nose and upper lip were still very swollen (took antibiotics religiously!).  Then I felt this warm "rush" in my mouth and an awful taste and it was about two tablespoons of a bloody liquid,and my lip was noticably less swollen looking and my nose was back to normal.  He said it wasn't an absyss and put me on stronger antibiotic.  Two days later and I still have swelling and drainage.  I am very worried that something is very wrong and the implant is being rejected and it was so expensive.  My dentist highly recommended this oral surgeon and he has a big practice.  What can be wrong?

Answer
Dear Sunny:
There is definitely something wrong with the surgical site.  I place implants on a routine basis, and not all integrate, but they should not give you such problems.  Even the best operators are only human.  You have to go back and talk to the Oral surgeon.  If he is not receptive, you have to go to a second opinion.
There are three specialist that you should see and I will list them from the most preferred choice down.
1.  A surgically trained Prosthodontist (the specialist in restorative, cosmetic, and implant dentistry)  This is a very small group of specialists who are trained in the restorative aspects of implant treatment and the surgical procedures. www.prosthodontics.org is the website for the American College of Prosthodontists and it will have a link to locating a Prosthodontist in your area.  Even if the Prosthodontist is not surgically trained (most are not), let him/her refer you to a surgically trained colleague.  They will know the best person (Periodontist/oral surgeon) to look at your problem.  If you cannot get a Prosthodontist, then go to ...
2.  Periodontist.  The specialist in gum surgery.  Most Periodontist these days are trained to solve problems associated with implants.  However, they have to work with a restorative dentist (a Prosthodontist or a good General dentist), since they do not make the restorations on top of the implants, and the restorative dentist should decide which implant to place and where. www.perio.org  will have a link to locating a Periodontist.
3.  Oral Surgeon.  www.aaoms.org will have a link to locating an oral surgeon, but again, the surgeon has to work with a restorative dentist.
Do not wait!  Go and speak to your oral surgeon, or look for a second opinion.
If you have any troubles, please contact me at the office and I'll refer you to a Prosthodontist in you area. www.DrZevKaufman.com will have my info.
Best wishes for a speedy recovery,
Dr. Zev Kaufman