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Dentistry/Bridge, implants, several surgeries

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QUESTION: I was in the middle of a bridge replacement (# 7 and 8 missing), # 6, 9, 10 serve as anchor teeth.  (long story but I'll keep this short).  After my dentist took the permanent bridge off, I had gradually experienced pain (any pressure to tooth, #9) , which was a prior root canal.   My dentist also performed a new root canal on tooth #6, another anchor tooth, which never had any problems prior, but developed issues after the root canal was done.  

The temporary bridge that I was placed in was not comfortable at all.  My lower front teeth hit hard behind my upper front teeth (when I closed my mouth for a normal bit, my front teeth came together but my back teeth didn't).  The top teeth constantly knocked into my lower teeth and to the point that they hurt without even doing anything like chewing.  I eventually avoided eating anything I had to chew.  I also started clenching my teeth at night and would wake up in throbbing pain on those teeth (and my jaw muscles).  

In the meantime, I had to have a bone graft because the severity of the bone loss where the missing teeth were (one bone graft, and had a second one several months later (chin was a donor).  During that time, I had to ware the ill fitted bridge for 11 months.  The pain in the anchor teeth increased, and I also had a large between the teeth and gum line were sever decay grew around the anchor teeth.  

After one year, since the beginning of this bridge replacement treatment, the anchor teeth had to be retreated  (#9 was abscessed and #6 was leaky).  I had found a new dentist who is a prosthodontist.  I finally have a comfortable temporary bridge that fits in my mouth now.

After the retreatment of those anchor teeth, I had gum augmentation surgery.  

To the present, it has been 1.75 years.   I still have pressure and pain in those two anchor teeth even after that retreatment.  

At this time, the prosthodontist does not recommend a bridge anymore because the anchor teeth have had too much endodontic treatment.  He recommended  implants where the two missing teeth are and to cap the two anchor teeth (which are symptomatic).  

However, after having a 3D scan, he has determined that I do not have enough bone for implants.  He recommended another bone graft, the first part of the graft is to place synthetic bone up through the palate, which I just had finished last week, (needless to say, I am in pain all over again).  

After I heal a couple of months, he wants to do additional bone grafting , coming in through the front.   After a few more months of healing, he will perform implants, and on top of it, I will still need gum augmentation (sever gum recession over #7, 8).  After all this, it still doesnít resolve the problems I have on the two ruined anchor teeth.   

Which brings me to my question.  I have been through so much and donít know how I can take anymore surgery.   Are there any other alternatives, besides pulling all my teeth?   I feel like I am on a never ending nightmare.  Can my front mouth/gums really tolerate more surgery (over 6 to 7 surgeries)?  And what do I do about those two damaged anchor teeth, how can they be fixed?  I donít know how much more my mouth can take.

Thank you

ANSWER: Sam -  I am so sorry to hear about all you have endured.  It sounds like you have been treated by doctors who are really not skilled in all they have done.  First of all, the original dentist obviously was lost and traumatized your bite and teeth.  The prosthodontist sounds like an unskilled surgeon and the surgery he has attempted did not succeed in in being adequate for implant insertions.  My suggestion is that you only see a board certified oral and maxillofacial surgeon to evaluate your bone and the graft he did.  It is a little difficult for me to give you advice about those anchor teeth without at least seeing xrays and pictures of those teeth.  

My suggestion is for you to see a board certified oral and maxillofacial surgeon to evaluate if those teeth can be saved.  You don't want to just throw money, time and pain away with questionble teeth if they are beyond saving.  If you cannot find one, get back to me, tell me where you live and I will send you names of board certified surgeons to evaluate your situation.

---------- FOLLOW-UP ----------

QUESTION: Thank you for answering my question.  Yes, that first dentist was a terribly sad and traumatizing experience.

To give you a little more history, the first bone grafts were performed over a year ago (one was not successful and one was, to some degree -- my chin was used as a donor site) and I though it would have done the job, but I guess it didn't for bone shrinks without implants or teeth present.  

But this particular bone graft was just performed last week was to fill in a defect on the palate, large space, which was from the first bone graft that failed.  And the next recommendation is to do a bone graft so implants can hold. Unfortunately, I really like my new dentist.

I am having a hard time understanding how this can all be resolved.

Could you please send me the names of board certified oral and maxillofacial surgeon to evaluate my situation.  I'm in the Seattle area.

I can send you a copy of my x-rays of those teeth that were retreated by an Endodontist and pictures.  

Thank you and hope you have a Happy Thanksgiving.

Answer
Ssam - The following are board certified oral and maxillofacial surgeons, one of whom should be able to help you.

1) Dr. Dale Bloomquist - (206) 215-2088

2) Dr. Peter Hertz - (206) 443 - 2410

3) Dr. Jack Neal - (206) 363-3010

I wish you well and hope one of these doctors can evaluate you and evaluate your situation to insure proper healing to save teeth.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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