Dental implants??: Hey everyone, hope all doing ok... - LUPUS UK

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Dental implants??

Carbar profile image
22 Replies

Hey everyone, hope all doing ok. I have a quick question for you all. Has anyone ever got dental implants? How were you after the procedure. Did you get bad flare up from the impact of the procedure. I was told today i need four and if I decide to go for implants that the procedure to implant four will be carried out in one go. Me personally, I think that it is a bit much. I'm not sure as I never got implants before. I'm just very nervous about it and worried as I don't know how I will recover. Would love to know your experience and if implants is worth going for.

Thanks guys

❤️❤️❤️❤️❤️

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Carbar profile image
Carbar
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22 Replies
Barnclown profile image
Barnclown

Hello carbar

I can totally relate to your concern, and I think you're right to be v cautious. I have had quite a big serious experience with my version of lupus + immunodeficiency & an implant. The questions you are wrestling with are v close to my heart

Am going to pose you a few ?s. I hope you don't think I'm going overboard, but my experience was so extreme that I've kind of ended up feeling extremely cautious about implants. And, over the 4 years since my implant experience, I've discovered that caution really is recommended in patients like us. But I'm no expert...and I recommend you discuss these ?s with experts you trust before going ahead with these implants. If you haven't done so already, I'd start by seeking advice from your GP, your rheumatology clinic and any other medics who know you & understand the short & long term risks/benefit ration re dental implantation in lupus patients. When I was researching this, I discovered there are no risk free solutions....I finally opted for the dental implant fully aware of the risks because other options seemed just as risky to me. I only had 1 upper molar replaced...and that process took months to finalise...which is probably why an oral surgeon would recommend getting all 4 done in one go. There is LOTS of really good analysis of the risks & benefits & alternatives re implants online...explaining it all much better than I ever could. So, as a fellow lupus patient, I'll just pose you the ?s I've discovered have been crucial in my case,

In my experience, v few oral surgeons & dentists have much experience or knowledge of patients like us. The tendency of many is to assume treatment will go normally. My experience is that they should only proceed with extreme caution. Yes, I'm glad I have my implant, but I wish my medics had been more alert to the possibility I could end up with such severe complications that I'd have to spend 5 months on high dose daily oral antibiotics after completion of this implant....even now, I understand the jawbone infection (osteomyelitis) + sinusitis which required this treatment are probably capable of flaring together again sometime. Meanwhile, I'm living with chronic sinusitis

Here are the ?s:

what sort of oral surgeon has recommended you have these implants i.e. is it an NHS oral surgeon? has this medic (oral surgeon or whoever) showed clear understanding of your lupus diagnosis & your immunosuppression treatment plan? Do both your dental care team & your oral surgeon tell you that your oral hygiene routine is very conscientious & entirely satisfactory? Do you have good manual dexterity, and feel capable of maintaining a fiddly implant hygiene regime ongoing?

If all of the answers are yes, I think that's fairly good indication your oral surgeon is relatively alert to the complexity of your case...which can only be good

How old are you & do you have osteoporosis? If you do have osteoporosis, are you being treated with bisphosphonates?

If any of those answers are yes, be very very cautious about any oral surgery & make sure your GP, rheumatologist & oral surgeon know all this

Are these implants going to be placed in your upper jaw? If they are, has your oral surgeon scanned to check the density of bone between your jawbone & the sinus above it? Do you have a tendency to sinusitis?

If any of those answers are yes, be very very cautious about any oral surgery & make sure your GP, rheumatologist & oral surgeon know all this

do you have a history of oral infections, and have any of the teeth this oral surgeon plans to replace already been chronically infected? If yes, has the surgeon investigated to see whether the infection has spread to the jawbone in which the infected tooth/teeth is/are embedded? Are you on daily immunosuppression? Do you have sjogrens? Do you have a primary immunodeficiency?

If any of the answers are yes, be very very cautious about any oral surgery & make sure your GP, rheumatologist & oral surgeon discuss all this with you before you proceed

could go on & on...but am sure that's plenty for now....apologies if this all seems too intense...I really am glad of my implant, I just wish my medics & I had had these sort of discussions before we proceeded with implantation

Am looking forward to reading the other replies you get

🍀🌻

anniesensi profile image
anniesensi

Hi there,

I used to be a dental nurse, so I can give you some very general advice, but please bear in mind I don't know your mouth!

Dental implants are very invasive, you would need to come off warfarin for the procedure. That's the first consideration. Implants are also very expensive and are liable to gum disease in the same way teeth are.

Our advice was generally for people to consider a chrome cobalt denture before thinking of implants. To replace a few teeth. They fit well, they can stay in at night. Surrounding teeth must be strong as the denture uses them for support.

If you haven't considered this option have a chat with your dentist about it?

I'm certainly not saying that this is the case here - but implants, as good as they are make £££ for a dentist and may not be the only choice for you.

I hope that helps?

X

Barnclown profile image
Barnclown in reply to anniesensi

Great reply, Annie.👏👏👏....I wish I'd had this advice before i had my implant..and went through the ordeal I've outline above. But my sjogrens is so bad, + my ehlers danlos type hypermobility means I have even more complex oral issues...that the thought of managing any sort of oral appliance is almost as worrying as implantation...

This is such a thorny problem for some of us...nutrition is so important...and without getting our oral regimes right, good nutrition is extremely problematic...

🍀🌻

Carbar profile image
Carbar

Hi barnclown and annesensi.

Thank you so much for your advise. I have already a cobalt chrome denture. I have it for the past 5 years the only problem is my teeth supporting the denture are now weak and decaying. Due to my sjogrens which is now bad my gums are receding. Even though I try to keep on top of my oral hygenie I can't seem to win to protect my teeth. I have had many scans, X-rays completed incase I go for implants. My dentist is aware of my lupus/sjogrens. Don't get me wrong I'm not being made to go for implants, But it would be nice not to have a denture any longer as I feel my mouth is so dry with the denture anymore, even though I take everything going for dry mouth. My oral dentist also wrote to my rhemuy regarding my condition. I also have osteoporosis. Just been diagnosed for this. This was also taken into consideration by my oral dentist. He wrote to my rhemuy outlining his concerns about biophosates so If I wish to go for implants my rhemuy will put me on different treatment where the implants will not be affected.

It's really hard to know what's best to do. Would love not to have a denture. Soooo confused...

As I have lupus for past 21 years and on steroids for this length has not helped my oral condition.

Thanks guys for your reply, really appreciate it.

Barnclown profile image
Barnclown in reply to Carbar

Great reply, carbar....I can totally relate to the way you're thinking...am anticipating something similar in the not too distant future....your medics sound as if they REALLY TRULY are proceeding with due caution: it's vvvv impressive when they liaise with each other to the extent that yours are! This is a BIG credit to all (including you)....you are vvvv well informed & your medics are engaging actively in your decision making. Whatever you decide to do, seems to me you'll get good support

I hope you'll keep us posted

Carbar profile image
Carbar in reply to Barnclown

Hi barnclown, yes I will definitely keep you all posted. I am delighted with how my dental implant practitioner is liaiseing with my rhemuy. It makes me feel more confident in him. It is a lot of money I know. The replys have been amazing and it is so humbling to read everyone's experience and for that I am truly grateful. Thank you also for all your help. As I think about it more my heart is telling me to go for it. Hope you are keeping well....

Barnclown profile image
Barnclown in reply to Carbar

your kindness in the face of your current ordeal makes me feel very humble. i can only thank you for this discussion which is encouraging me enormously to think positively even with my highly creepy implant experience etched on my soul...i didn't include the fact that this implant shock horror stuff happened 4 years ago at exactly the time my infant onset lupus was finally being recognised as THE underlying cause of a lifetime of dodgy and quirky health. i kept saying to my oral surgeon: i'm being investigated for something called lupus, is this relevant to what you're doing? he'd look at me (i could almost hear his thoughts: hypochondriac) and say: no, i think you could only have skin lupus. (what did he know about lupus anyway! whatever, i'd never even heard of lupus, so i knew even less).

but the shocking mess of the molar he extracted revealed it had remained infected for something like 20 years post-rootcanal treatment. now i know that if he really knew anything about lupus, this was when he could've had a light bulb moment & realised that stubborn infection can be such a feature of SLE.

anyway, by the time i'd started oral systemic treatment for lupus (daily hydroxy at that point), the bone graft was done and the implant was in + looking v good...the jaw bone + sinus infection took 3 months to flare severely. so there i was, just having discovered that in fact i'd been diagnosed with lupus as an infant & teen, a condition i'd never heard of....i'd invested what seemed a fortune on this implant...and been told i had osteomyelitis in my face due to the failed root canal + untreated lupus...and was being referred to a maxillo facial consultant to have my face rebuilt or whatever, I imagined...all while on months of oral high dose flucloxacillin which requires an arduous regime of fasting before & after each tab (now, of course my case would get IV fluclox!)

your implant question has given me a chance to reach a sort of closure re that whole experience...and helped me accept that, like you, i will definitely consider implants again, when the need arises, which i think it will (so long as I also have prophylactic antibiotics). and this wonderful discussion you;ve started will stand me in good stead. meanwhile, i feel your discussion will help many others grappling with this decision.

i'll just wrap this up by saying that i LOVE my implant! and am SO GLAD i have it. the extra oral hygiene routine it needs fits in fine with my sjogrens oral care anyway. and, aside from the infection, the whole long drawn out business of spending months going through the implant stages went fine...with no severe pain at any point. now i would be happy to have several implants in one go should this be appropriate...better than going through those months of all those stages of implantation over and over again...4 consecutive implants would nearly take 2 years, i think....which would be very wearing, to put it mildly.

thanks so much carbar, and good luck with everything

anniesensi profile image
anniesensi in reply to Carbar

Hi Carbar,

It sounds like you have thought about this carefully, and that your dentist is being careful.

Have you tried Corsodyl mouthwash for receding gums? It is the active ingredient of Chlorohexidine that really does work. It is the only mouthwash that treats swollen gums and gum disease - along with good oral hygiene. Most mouthwashes just taste nice, this one tastes foul, but really does work.

If you go for implants the mouthwash will help keep the gums healthy. It's especially good if you have difficulties flossing etc. It also gets rid of mouth ulcers. When gums recede so can the bone around the roots of the teeth which is why teeth and even implants can become wobbly.

Good luck, and whatever you decide to do you're doing it with careful thought and so I;m sure you will be happy with your decision. It is your decision after all!

Annie x

Carbar profile image
Carbar in reply to anniesensi

Hi Annie

Thank you so much again for your reply and advice. Very much appreciated. Yes, I was told to use fluoriguard by cold gate. I actually used to use corsodyl but because I had a cavity which is now rectified that was the reason for the Colgate mouthwash. I will certainly go back on the corsodyl again. I do remember it tasting nasty but eh ho it's got to be done. Also, may I ask annie what in your opinion would be an excellent toothbrush to purchase if wish to invest?

Thanks again for your kind wishes and support. If you have any other tips please don't hesitate to pass on. You know this would be a great topic to hold at a lupus event x

anniesensi profile image
anniesensi in reply to Carbar

Hi Carbar,

So sorry, I didn't pick this message up until now.

The best toothbrush? A small head and soft bristles to massage gums with is best. Even a baby toothbrush.

Other than that, really, the best toothbrush is an oral b electric toothbrush. Especially for those of us with some limited dexterity. You can also buy corsodyl gel which is great on an interdental brush.

xxx

Carbar profile image
Carbar in reply to anniesensi

Hi anniesensi

Thanks again for your advice. Your a star. Hope you are doing well. Keep in touch xx

Tigerlily4 profile image
Tigerlily4

Extremely positive experience of a dental implant, about to have another and I'm not free of mushy gum problems due to steroids, chronic mouth ulcers, bouts of oral thrush or ridiculously-widespread allergies. Had my first 4 years ago and absolutely no problems since. Wouldn't hesitate to recommend them over any other "missing tooth" solution provided you choose a reputable, patient-focussed surgeon. Mine happened to be exceptionally good, explained what he was doing and how long each step of the procedure would take. However, they do take a fairly-unpleasant 20 minutes each (although the *thought* of what's going on has much more to do with things than actual discomfort) so I'd definitely recommend paying extra to be anaesthetised for 4 in one go. Should be a walk in the park. My jaw/gum was midly uncomfortable for a few days afterwards - paracetamol was strong enough to deal with that - and you're discharged with antibiotics, just to be on the safe side. Hope that helps and good luck!

Carbar profile image
Carbar in reply to Tigerlily4

Hi tigerlily4, thank you so much for your response. It is refreshing to hear you had good experience with yours. I am delighted you had a good surgeon. I have faith in the surgeon I have chosen, as he has done a lot of research in regards to my sjogrens, osteoporosis and what my rhemuy has planned for me over the next 5 years etc. I also have to get bone grafting. Having 4 implants carried out in one go sounds really invasive and I hope my system will be able for that. I will call my dental surgeon tomorrow to ask if it is nesscessary to have all completed under one procedure.

Why couldn't rhemuys tell us the importance of our oral hygenie. I mean tell us how our meds are going to impact our life over the years and guide us as to what we need to keep on top of. Hope you life is good for you. Thanks again.

Tigerlily4 profile image
Tigerlily4

PS. I also have Sjogrens.

Purpletop profile image
Purpletop

I've had about 16 teeth replaced by implants. Some were done before lupus, some after lupus started to make its presence known. The first went without problem, the latter wasn't as straightforward - although I wasn't on any drugs at the time, the implants failed to take on the first go, which meant infection at the root and 2 weeks of heavy antibiotics hoping I don't need it re-done (antibiotics that triggered a flare). After the 2 weeks the surgeon decided to re-do the op and the second time everything went ok. I am very happy with all my implants. They cost me a fortune but they look great and they feel natural.

The bottom line is: ensure you go to a respected Maxilofacial surgeon and that you tell him all about your drugs. He/she is likely to liaise directly with your other doctors about your drugs and decide what you should stop and when.

A tip - 2 weeks before the op take some arnica pills. They help with the face bruising, as the implant op is quite mechanical - like having B&Q tool kit applied to your mouth :). No pain though, just general anxiety.

Carbar profile image
Carbar in reply to Purpletop

Hi purpletop

Thank you so much for your reply. I am thrilled to read your experience. I know some was not straight forward for you but your end result sounds fantastic. As I said previously to barnclown the replys have been amazing to read. It is great to hear postitve feedback. Mine will not be that easy I think, as I have to get some bone grafting also. I have no bone really on my bottom jaw. The four are all carried out on lower jaw. The more I read the more I am thinking about going for it. To feel like having natural teeth again would be brilliant. I never heard of this number of implants carried out in one go before. I just hope my system will be able for it. It is going to cost me a fortune that's why I reached out to you guys for help on what would be best. That is a great tip must remember that before hand. thanks again, hope you are keeping well.

Purpletop profile image
Purpletop in reply to Carbar

I had bone graft too - the surgeon cut almost 1" off my right lower jaw and grafted it onto the other side where I needed it. It took 1 month for the missing 1" to re-grow (isn't that amazing??) during which I wasn't allowed to eat hard stuff like bread or even chocolate as there wasn't equal leverage in the jaw during the re-growth.

But there is artificial bone that can be used around a matrix, not only natural bone. If you do prefer natural bone and there isn't enough in the jaw, they can take off the hip, so don't worry, there are alternatives.

Another thing to consider is that once the implant is installed, the gum may recede a little. In that case tissue augmentation might be needed (I needed that too). And even after that, the gum might still not want to stay in place but the tooth can be made to appear as if there is gum at the top.

Really clever stuff.

Prepare for swelling of the face - you'll look like a chipmunk for a few days.

Pain is controlled with neurofen and paracetamol and you'll be given antibiotics . It is critical to apply ice to your face in the first day - I used a tubular bandage filled with a bag of ice and tied on top of my head. It helps immensely with the recovery.

If you have more than 2-3 to be done in one go, as I had, the surgeon might decide to do stuff in stages. Firstly remove the old roots (if appropriate), remove bone for grafting, graft bone then leave it for 3 months to heal. Then do the drilling for the implants and the installation. It is not a short process. Or at least my surgeon (who was working closely with my prosthodontist) took it slowly but surely. And with lupus I have to say that is a good idea. My view.

Once you have them in and the swelling is down, buy yourself a water flosser to ensure that the implants are kept free of plaque. It won't be easy to clean with the little tooth brushes or regular floss and it is a pity to go through the suffering and the expense, only for them to fail because of inappropriate cleaning. Although there are now air flossers that take no space at all in the bathroom, I still prefer one with a proper flow of water (as opposed to short bursts) as the plaque is really sticky.

I'm so excited for you!! Good luck.

Carbar profile image
Carbar in reply to Purpletop

Hi purpletop

Thanks again for your reply. Great tip by the way about the waterflosser. I did not even know their was one and the tip for ice packs on the face. I am nervous though about the bone grafting. The amount of bone that was removed from your jaw sounds a lot. I do not know much about bone grafting. May I ask after the bone graft did you find anything different in regards to the look of your jaw afterwards. Did the bone re growth fully come back. I would be worried about my bone re growth especially having osteoporosis. I did ask my surgeon about that and he was not worried at all. This topic is so interesting. I am delighted to discuss this with everyone. Thank you for your advice. It really means a lot to me and to have your support. I never realised how hard of a decision this could be. Every time I speak about it amount friends, new names of surgeons are brought to my attention and I don't think I could go for all consultation as it would be a disaster for me. Too many opinions. I have just one in mind.

Thanks again for everything x

Purpletop profile image
Purpletop in reply to Carbar

The jaw grew back as it was before, absolutely no problem. The bone graft took beautifully too, no change in face contour or anything like that. But you only have 4 to put in, you might be ok with artificial bone.

You need to go to a Maxilofacial-facial surgeon - he/she will decide how many to put in - you might not need all 4 if they are all one next to another, just 2 proper implants and the rest bridged - apparently it's enough to keep the bone healthy and not recede.

Have a list of questions for your surgeon - you wouldn't believe the questions I asked! My first question was - what happens if during this long process something happens to you (I.e. die)? I had visions of my being left toothless and penniless :). Poor guy, how he kept his composure I have no idea.

Carbar profile image
Carbar in reply to Purpletop

Hi purpletop,

Thanks again for your reply. I bet your questions were very "creative"I have to say you did make me smile about being left toothless and penniless if something happened to you 😂

Delighted to hear bone graft worked a treat and jaw grew back. Wonderful. Yes my implants are not all align side by side. I have two implants for lower back ie one either side of jaw and two at the lower front to place a bridge. That was what I was told. It sounds great but I am trying to figure out funds at the moment and if I can afford it. Ohh the joys!!!!! Thanks again for the advice, your a star 😀

Elizabeth42683 profile image
Elizabeth42683

Does anyone know how much it would cost to have the denture implant done? I would love to have the single implant but I wouldn't be able to afford them. I heard about the denture implant and got very interested :)

Carbar profile image
Carbar in reply to Elizabeth42683

Hi Elizabeth42683

Yes this topic is very interesting. When you get lupus no consultant will tell you how important it is to protect your teeth. I am doing a lot of research into this to make sure all the boxes are ticked, but to be honest speaking to all the guys here has helped and directed me. I Appreciate everyone's replys and advice. They have been amazing. The cost of single implant you would be talking rd £1,200 + all depending on the nature of your condition. It is a lot of money!!!

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