Researching for the Right Dental Implant Doctor - Las Vegas, NV

So far I have had consultations with 4 dentists....

So far I have had consultations with 4 dentists. The one I am currently speaking with is Dr Golpa assistant Carlos. At each stage and consult I have learned more and more about the industry and procedures and some of the little things that are done. Currently after a few weeks of communicating with Carlos, I was going to make the appointment and fly from NY to Las Vegas to have it done. However I am one of those people who need to know the details of what I am spending so much money on and I requested a line item list. I was sent 2 paper which were identical except for the final prosthesis. One covered upper and lower PPMA for the final and the other covered upper and lower Zirconia which is the porcelin with the lifetime guarantee. When I went to verify the the final costs, it turned out that the paper had one thing but I was told that that price covers upper Zirconia and lower PMMA even though it did not say that. Now Im confused because you can buy upgrades to the upper and lower Zirconia and the all inclusive package had the upper and lower Zirconia but I was told " there may be a "clanking" of the teeth when talking with Zirconia/Zirconia". Does anyone experience this ??

Well we are moving forward with Dr Golpa

I spoke with Carlos on the phone and we went over my outstanding questions and I was very happy with the conversation. As well as being a likeable person, he brings a sense of calm to what for me has been an anxious process. We booked the dates and paid the downpayment. I asked Carlos how I could be sure that if I wasn't satisfied with the permanents would they be redone to my satisfaction. This is important to me because after going through the consultation with 3 other dentists, I never felt confident in the answers I received to this question. My appointment date in April 29th. Kind of excited, a little nervous but I am feeling confident after talking with Carlos and Amanda.

moving forward with Dr Golpa

Carlos assured me that all will be done to assure my satisfaction and the way he described Dr Golpa as a very talented and capable. I believe him. Amanda helped with the hotel reservations and was on top of making sure we are all on the same page as far as coordinating lodging and transportation. The two of them seem extremely capable and makes me feel good.

Paperwork

The office sent me the medical paperwork to fill out. Also in the email was a descriptive list of processes depending on any medical issues I have which I do. I am a controlled diabetic and have a cardiac stent from 10 years ago which I just received the go ahead from my Doctors , so I try to stay aware of the processes involved in any procedure and this list helped.

Paperwork

One of the things mentioned in the informative packet I was sent mentioned getting pictures so Dr Golpa has an idea of what you want the teeth to look like. This got me thinking, I used to have a very nice smile when I was younger and before time and fear of dentists took their toll. I started looking at pictures of me when I had that nice smile. Aside from a chipped front tooth courtesy of my brother, they were perfect and I thought that this is what I would like them to be again. The most recent dentist talked me into shaving down all my upper teeth and putting in a bridge that spans 6 teeth. There was only 1 missing there, an implant would have been the better suggestion but I went with the supposed professional and did it. well at the time it did not feel right and he said you just need to get used to it, I never did. It actually feels like it pulls to one side. And the worst thing of all, when I smile it is plain to see that it is crooked. Looking at the pictures, I am praying that Dr Golpa can return me to those days. I used to smile so much more then....

Using my pictures

The more time I spent looking for pictures, the more I realized how much of a disservice that my local Sayville dentist did to me. The bridge he put in changed the mechanics of my mouth so much and his response was always 'it takes time to get used to the teeth'. While viewing my pictures I started to remember how they fit together and how there was never a misalignment. I cannot believe I accepted this for 5 years. With the current bridge the teeth on the left side align well but the top starts separating from the bottom at the left lateral incisor and gaps away and returns at the right lateral incisor and are so far out in the front that I can't run my tongue along the front of my teeth. 2 more weeks and hopefully this nightmare will be a thing of the past. These are the pictures I am bringing to Dr Golpa and am hoping he can do it.

Trying to find the right look

After giving some more thought to supplying Dr Golpa with pictures, I realized that this is probably a very important step in making the process successful. As Dr Golpa is probably not a mind reader I started thinking of what would be the best way to convey my idea of my perfect smile to him.
I noticed as I was looking for pictures on the internet that I was focusing on the teeth themselves then it hit me. There are teeth size, teeth layout, teeth spacing, and most importantly for me , how they fit into the whole face when I smile. In some pictures people had big front teeth or the teeth overlapped the bottom teeth more etc. My whole strategy for showing Dr Golpa what I wanted changed. I started looking for pictures of just teeth to portray the sizing in relation to other teeth. Like some people have larger incisors or smaller canines. So I compiled a group of pictures that show those characteristics of my old smile. Then once that was done, I started looking for pictures of how I wanted the smile to look while within the picture a whole face. Finding similiar looking smiles in the context of the whole face would give Dr Golpa guidance in shaping the prosthesis with the final look I want in mind. Then when I meet Dr Golpa I will have all these pictures printed out and explain to him what I would want for extra clarification. This may help in all being on the same page. I will let you know, 7 more days until I leave for Las Vegas!

Leaving for Las Vegas and Dr Golpa tomorrow !

My medicines were called in to my local pharmacy. I picked them up and as per my instructions I started the mouth rinse twice a day to help prepare my gums. I will do that all the way through until the bottle is empty which I think they said is about a week after the surgery. I also received Ibuprofin , I take 1 before surgery and every 4 hours afterward (this is for swelling , would have been something else but I am diabetic and can not take the other med). I am supposed to start the antibiotics 2 days before the surgery and continue until the bottle is finished. And finally , Hydrocodone for pain as needed. Taking it one day at a time now, and I will video document everything so you all can see what my experience is like and most importantly, the outcome.
Wish me luck !

Finally Home !

We arrived home yesterday ! I have tons of notes and pictures. Will be posting my experiences this week. Amazing !!!

Day one The Consultation

We walked in to a very nice office and were greeted by very nice and good looking people who had the best smiles I have ever seen. Like walking into a whos who of beautiful people !
We met Amanda who I had communicated with several times and she was also the one that coordinated a lot of the travel and transport arrangements. Very pleasant. Then Carlos came to the front and said hi. Carlos took the brunt of my never ending questions before my arrival. He had a big smile and was very friendly and then went back to work. Amanda gave us the forms to fill out, as you would get in any office. Also included were papers that helped me in understanding the process and what to expect. After finishing the paperwork, I was brought into the back and met the Amanda2, one of Dr Golpa's assistants. Very nice, young and pretty. She proceeded to examine and document the current state of my teeth, then took xrays and pictures with state of the art equipment. Me being into technology, I was impressed with the advanced equipment and how expertly the people worked with it. Carlos then brought me to another room and took my CT scan and then we went back. Amanda2 explained so much and was so patient with my questions, and as she reviewed my file (I had sent lots of email and pictures) and we chose the color and style of what my dream teeth would be. And after so much more discussion and her extreme patience with me ( I am a high maintenance patient and I know it). Dr Golpa came in and we talked. It was obvious he had already reviewed my file. He talked about things specific to my case and how to deal with them (specifically I already had an implant that was put in 8 years ago that failed and needed to come out) He listened to every word I said, something I had never experienced in any of the many dental offices I had been in. We spoke about the choices of teeth and color, he looked over our choice thoughtfully and agreed on the color and style of the teeth. And that was it ! Now I have been to 4 consultations with dentists who advertise they do this advanced procedure and every one of them spent a portion of the consult telling me how good they were and how happy the patients were. Dr Golpa not once patted himself on the back, I felt his focus was on me and what I wanted. Amanda2 went over some additional prep stuff and that was it. The surgery was on for next day. When I left the office I remember being so impressed at how competent and proficient every one I met and interacted with in this office was. They all struck me as extrememly qualified and good at what they did. That helped with my anxiety.

Day 2 The surgery

We arrived at the office the next day at 11:15 AM. I met Dr Young , the anesthesiologist. Very pleasant, but very professional. He struck me as very confident, and capable. I felt in good hands which says a lot for the high anxiety dental patient I have been over the years. We went into the surgery office. Dr Young and Dr Golpa's assistants told me the process and what to expect. And then I woke up ! It was over !! Some vague memories, like a dream. No real pain. just a little tenderness and what seemed to be a team of people all focused on me. I guess being a bit groggy, I really didn't remember much. My wife filled me in later. Dr Golpa met with her right after the surgery, filled her in on the details and that was it ! We left the office around 6 PM. But to me it seemed like no time had passed.When I got back to the hotel, I looked in the mirror and saw the implants in. I was amazed. All I took was the Ibuprofen. Didn't really need anything else. Had a liquid dinner and slept. I was so amazed. And thankful for the people in that office.

Day 3 The temps

We arrived at the office on the 3rd day and Amanda and Dr Golpa put the temps in. The first few attachment screws went in with no problem, then there was a problem. Dr Golpa took over and had to apply a lot of pressure. I got worried and wondered what was going on. After several minutes and lots of pressure and pushing, the screw must have caught and the finished putting in the rest. The problem screw had made me a little anxious. But then when I looked in the mirror, I was so amazed at what Dr Golpa and his staff had accomplished. Even though I knew this journey will take months to see if the implants take, I felt so grateful to be looking at a smiling face I had thought I would never see again. I felt a wave of emotion come over me and at that moment in time it felt as if all was right in the world !

Closer view of the new teeth

At month 1 I am so grateful for this.

I cannot believe it has been a month already. Being a diabetic, my healing will take a little longer and for the first week or so the unusual dull pains and other types of pulling feelings I felt I attribute to that. Over the next 3 weeks they lessened significantly and now I only have a small area of tenderness in one small spot in my lower jaw. Nothing that I am concerned with. I am so much more confident and talk and smile sooo much more ! To say I am extremely pleased is an understatement. The shame I used to feel that made me not smile or talk to people as much is gone. Now when someone smiles at me as I am walking down the street or in a store, I just give them a big ol smile right back !!!!!

Month2

It is now 2 months since my procedure. The tenderness I had is gone. My gums have receded a little and now I feel what I can best describe as an occasional pinch in the spots where the implants are. I assume this is the healing and it is barely noticeable. And where I was just relieved to have my teeth back, now I am thinking more about how slight off center the prosthesis is. A friend who I met on this site who went through the same procedure told me to make sure I mention this and any other issues to Dr Golpa when I go in for my perms. I will and I feel very confident that this will be addressed as Dr Golpa is kind of like an artist who takes pride in what they do. Overall I am still very happy to have teeth back and there are times I find myself smiling naturally and then I realize that I forget I got new teeth and smiled without the self consciousness and it feels natural and good !

Month2 update

I was asked "When you say the gums have receded, is that a swelling issue, like the swelling is going down?" and thought I would take a picture to show what I meant. Before, the prosthesis covered the implants, now the implants can be seen. Not by anyone but me when I move my lip down. When I eat more food seems to get caught under the prosthesis . The water pic is getting plenty of use. I am hoping when the perms go in they will be fitted better to my gum line and the 2 front teeth will align better with the center of my nose. Even though I cannot imagine myself without them and am very grateful for them, I would like the perfect fit. Currently the upper and lower prosthesis in the back of the right side is about 1/2 inch from my wisdom teeth and on the other side, it is flush up against the wisdom teeth. Once these things are addressed, they will be perfect !
Las Vegas Cosmetic Dentist

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Hi James! I have enjoyed reading your review about your experience with Dr. Golpa. I am actually day five post op from my all on four procedure there and I had a few questions. I am still pretty swollen and it sounds like you didn't experience much swelling at all, correct? If so, how long did it last? Right now I feel like I look so weird that I haven't been able to enjoy my new teeth at all and I'm worried that they will never look right. Also did they give you a WaterPik? I was not even taught how to use one. I was also wondering if you had decided if you're going to get the zirconia or not I have done lots of research but I am still torn about what to do. any insight you could give would be much appreciated! I am so glad that you had such a positive experience. it gives me more hope that mine will turn out okay. thank you so much Alison
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Hi Alison, your right , I had almost no swelling at all. But I do remember I had to adjust to the feeling of having new teeth. It took me weeks to smile where it didn't feel weird of forced. My temps now feel very natural however they are off center a little but Carlos has assured me the perms will look perfect and so far they have delivered on all they have promised. Yes I did get a water pik and I am surprised they didn't show you how to use it. Amanda took it out and briefly explained the proper way to use it. I am going with the Zirconia but am happy with how the PMMA holds up so far. I chose the Zirconia for the lifetime guarantee. But I believe the PMMA comes with a 15 year guarantee. Also in my research there were a lot of people who said the Zirconia looks more like natural teeth but honestly the PMMA temps look unbelievable. So it is hard to imagine a more natural look. Keep in touch with the office and let them know if the swelling isn't going down. And all the best and I hope your as happy at the 2 month mark as I was. Jim
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Hi James! I have enjoyed reading your extensive review of Dr. Golpa and your experience at his office. I am actually day 5 post-op from my all on four procedure there and had a few questions. I'm pretty swollen still and it doesn't seem like you had much swelling, correct? If so, how long did it last? My face looks so weird right now I haven't even been able to enjoy my new teeth yet. I'm worried they won't look right. Also, did they give you a water pik? I wasn't even shown how to use one. And I wondered if you had decided on zirconia or not? I'm torn about that and would love your input/opinion on that. I'm glad to hear you've had a positive experience, it makes me have hope that mine will work out, thanks so much! Alison
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Wow. Can't believe this went so well.
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I was wondering how you made out but did not want to disturb you. So the temps are in and all went well. That is great. I am glad to hear that !
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My surgery went well, woke up in hotel to absolutely no pain or swelling. I am so surprised. Carlos just called and we batted around the idea of doing a temperary with the "bar" in it because of the distance between their office and my house I agreed. But so far so good. 15 teethe extracted and not an ounce of swelling? Crazy
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I know, they are great aren't they ? So glad it all went well.
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Thanks James. Just out of curiosity. What did you eat? I've drank some ensure and oatmeal but still hungry as a horse!!!
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They don't have a great selection at the hotel
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well the first day I ate eggs for breakfast but that was mostly because I was worried. By dinner it was a burger and then salads the next and Chicken the third. And so on.
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What hotel ? I stayed at TI and the coffee shop was good.
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I'm at TI also. Surgery was Tuesday. It's Thursday now and just heard from Carlos. Go in at 2 today for temps. Seems like forever in this room!! :-).
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Why did you have to wait 2 days for the temps ? I actually went and played craps with no teeth ! And then after I got my temps I could tell the dealers weren't sure what was different ! Very funny
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Haha. Yeah I went and played poker yesterday. But not sure why I'm being iced here in room , surgery at 9 am Tuesday it's now 11 Thursday. Not much room for fitting
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I know, but maybe it's taking longer because they are adding the bar. I know that my temps are off center a little and I keep biting the left side of my lip but I keep reminding myself that the perms are whats important. And the fact that the quality of the work work they all do because I am planning on having these for many many years !.
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Gum recession is not a good sign, especially when the implants are loaded. The gums look puffy, I would go to a local dentist and ask them to check it out to see if it does not cause the food to collects under the denture. You maybe allergic to titanium after all. BTW, I asked a dentist who regularly does all on 4 procedure like yours about doing plastic on one jaw and ceramic on the other to avoid "clanking" and here is what he replied: "I prefer the ceramic teeth over the acrylic. All the man made teeth have a different sound that natural teeth When teeth hit unintentionally there is a clank with either material. The advantage of the Zirconia is no chipping or staining. They often look better than the acrylic. Sound is usually a non issue." -- Dan Hagi Acrylic is cheaper than zirconia, that is why you may have been pushed to get it, don't! Read on what plastic does to your body and that would be ANY plastic!
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Vegas bound!!!
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Good for you Oky. Keep us posted.
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Because of James's story I booked with dr golpa today. I live in St. Louis My surgery is in two weeks. Amanda said to tell you hi James. I was literally in the waiting room at clear choice in St. Louis yesterday waiting to go to surgery when all the power went out in the building. Dr came out and told me that the oral surgeon had walked two weeks before and the guy they flew in had to catch a plane back to Florida and couldn't tell me when they were going to reschedule. I mean really. I wore my pajamas in public !!
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Well I know that as of this moment, there is no one besides Dr Golpa and his staff the I would pick, I hope your experience makes you as happy as mine has made me. Let us all know how it goes.
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Hi James - believe it or not - in the next few months your gums will shrink even more. Lots of food - even more than at this moment will pack in them. It's loads of fun at this stage - LOL. I actually forgot how much room I used to have under the gum and when I used the water pik how it irrigated straight through to rinse everything out. Yes - your perms will be 'tight' and snug around the healed gum so when a piece of a pepper flake slides under the gum - it feels like a rock. Oh the fun we have. It still beats having dentures. Smile - that's what it's all about!
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I agree it beats dentures. I watched my mom and older brother go through a lot of discomfort and heartache dealing with theirs. But once the permanent prosthesis is centered in my mouth I think it will feel more 'right' and the center teeth will then be aligned to the proper position. And I also hope the alleviates the whistle the happens when I am speaking. The snugness will be an added benefit and I actually like using the water pik !
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Thank you for the extra picture!  Is that an infection issue, if food is able to get in there?  And did the doctor suggest the waterpik?  Did the doctor warn you that this recession might become an issue and how you should deal with it?  I some others in the community who have healing implants have removable dentures.  I didn't realize that before.  Do you think the prosthetic is better for you?
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I do not think it is an infection issue, and yes they actually gave the water pik to me and showed me the proper usage and also told me the recession would occur as others had also told me. However seeing that much of the implant through me off. The prosthetic for me is by far the better solution. It is like having natural teeth and once you adjust to it, others have told me you dont even notice them. This is still the best solution in my opinion and worth it in every way !
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