Replacing All my Teeth. London, GB

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Booked in to have all on 4 treatment for both...

Booked in to have all on 4 treatment for both upper and lower arches in less than 2 weeks from now. As the surgery date draws closer I am getting more nervous about the actual process, how I will feel afterwards and the end result -- is it going to feel really weird and unnatural? Like many people on this site I have had a big fear of dentists though not sure why as it is not even the needles that bother me particularly. I think it was more that I was didn't want to hear the bad news about my dental situation. I am still in my mid thirties just about still and have had aggressive perio disease which I left untreated until earlier this year when I was suffering from abbesses pretty much constantly and two teeth fell out within the space of 48 hours (though had lost quite a few before this and hadn't done anything). However, by the time I did go to the dentist, the first time in almost 15 years, it turned out just to be too far gone to save my natural teeth, those which hadn't already fallen out by the time I started this treatment, and the ones I do have left are all crooked and loose with major gum recession also. Basically not a pretty picture!

So I have spent the last 6 months or so getting use to the idea that I am going to lose my teeth and figuring out what I am going to do about it and how I might be able to pay for treatment. I have also attended many dental appointments during this time and more or less overcome my dental phobia thanks to some very kind and patient dental professionals. In terms of options, dentures were definitely something I wanted to avoid at my age as you hear lots of horror stories about them falling out and not being able to eat and speak properly. Full implants seemed like the way to go but the cost here in London, UK is so high so have thought about and looked into going abroad - Hungary being the most obvious choice but I am not the best traveller even under normal circumstances and my fear about what if something goes wrong during treatment definitely put me off this. Anyway, got some great advice from the guy who did the perio work and also did my own research and looked a few clinics in London and have found one that was recommended to me and seems very professional, offers a good guarantee and I feel comfortable with though certainly not the cheapest. At the same time, I figured out an affordable way of paying for the treatment, partly through re-mortgaging, as it so much money and I earn a very normal salary - not the kind of wage that can really afford cosmetic treatments.

Anyway, everything is now set up for treatment to go ahead I just need to turn up on the day and place myself in the hands of the surgeon and the rest of the team doing the work. It will be done under conscious sedation as well as local anaesthetic. Not had sedation before but hope this will help or at least make me not care about what is going on as last time I had just local anaesthetic for dental work I could still feel quite a bit of pain. I will be at the clinic all day and am told the actual surgery part will take about 3 hours. Well I am going to make the most of solid meals for the next week or so even though chewing with the amount of teeth I have left is not that easy as I will be on a very soft diet for a while after the surgery. I really hope it will all be worth it but I am optimistic that it will improve my quality of life and will start feeling confident to do all the normal things that people do again.

Anyway, I will post again after my surgery.

New teeth are in

Went for the 'all on 4 treatment yesterday and it all went really well. I think the actual surgery took about 4 hours maybe a bit longer but I lost all sense of time once they started pumping the sedation drugs into me. The only pain/discomfort I felt was towards the end when the surgeon bolted the prosthetic teeth into the implants and the rest was a bit of a blur -- the extractions, putting the implant screws in etc. and I was too out of it to feel anything much.

They gave me antibiotics, ibuprofen, co-codamol and steroids to take over the next few days. I felt a bit rubbish in the car one the way home and then slept a bit in the evening once I got back. I felt a bit nauseous at one point but the feeling passed after a few minutes thankfully. I have been using an ice pack fairly regularly also. I haven't eaten too much yet just some rice pudding and some very soft creamy desserts and drinking fruit smoothies. The lower part of my face has swollen up a little bit today and a my mouth feels a little bit sore but nothing too bad - nowhere near as painful as having an abscess.

Still feel a bit 'washed out' today, the day after but really happy I have got this done. My new temporary teeth look amazing and feel quite good generally. Beforehand, I was concerned if it would feel strange but it isn't that bad -- the lower one feel quite normal and with the upper ones it feels slightly odd where there is a bit of an acrylic ridge at the top that I can feel with my tongue. It feels a bit odd if I tap my teeth against each other, quite a different sound from my natural teeth - but not a big issue. My speech is not that badly effected though, I don't think I would want to give a presentation to a whole room of people or anything just yet but normal conversation is ok and in some ways slightly better than before as my natural teeth had drifted so much making speech somewhat difficult.

So far, I am really happy with the clinic where I have had the work done. It seems very well set up and all the staff have very dedicated roles including the administrative staff, the nurses, the dental technician, anaesthetist and the dentist of course who are all friendly, professional and most importantly highly competent in what they do. I think it is particularly good that there is a dedicated technician on site who works with you to provide teeth as you want them. I am also pleased I have chosen somewhere local as this is a complicated procedure that requires numerous appointments to get to the final result. I had three appointments prior to surgery, the surgery itself and now have seven further appointments planned over the next six or seven months.

Anyway that is about it for now. Will be taking it pretty easy for a few days as I expect the swelling to get worse possibly. Just happy that I have got the surgery out of the way and that my new teeth look great.

Recovering at home

My recovery seems to be going quite well. For the first couple of days I had quite a bit of blood in my saliva, felt pretty tired and my face swelled a little so I looked a bit like a chipmunk and my skin was really dry. Using the icepack pretty regularly for the first 3 days but not any more. Thankfully not too much pain though still taking ibuprofen to help keep the swelling down and using lots of moisturiser on my face and chap stick on my lips also. I have developed a bit of bruise on my right jaw and my face stills feels a little bit stiff and awkward so I can't wait for this to settle down to so I know how my new teeth really feel and my face looks with a mouth full of teeth once more.

Finished taking the steroids yesterday and just over half way through my course of antibiotics. I have just about been able to eat some normal food as long as it is really soft such as spaghetti bolognaise yesterday and tonight I'm going to try some chicken and vegetables but with lots of gravy to soften it up so I can mush it up and slurp it down hopefully. I've ventured out a couple of times now and day after tomorrow I return to work so getting back to normal. I just feel very grateful I was in a position to get this procedure done as it is very distressing when your teeth start failing especially when it all happens so quickly.

Two week review

Had my first post surgery appointment, just a very quick check and all is healing well, bite is ok and no numbness or other problems. Asked about the slight throbbing/pulsating feeling I get in the upper front implants and was reassured that it should stop after a month or so. Unfortunately, the stitch that I find irritating at the bottom couldn't be taken out so will need to live with it for now until it dissolves or wait till the next time I go back in about 6 weeks time when the bridge is removed to check underneath.

I was also shown how to use and provided with water pik. I am now ok to clean my teeth which I did as soon as I got home (twice) as my nice new teeth were not feeling so nice and new after 2 weeks of not brushing but grey and pretty disgusting. They are now white again and I used the water pik for the first time today, just on a low setting for now, which is a bit fiddly at first but feels good and cleans out between the bridge and gum line but I just need to remember to switch it off before I remove it from my mouth.

Just glad I have got to this stage now, my teeth are white again and speech is getting back to normal as I was finding it bit of a struggle for the first few days when I first went back to work. I think my face is fuller and much more like it used to be before teeth started falling out.

Family visit

Off to see my family today for the first time since I've had my teeth replaced. Little bit apprehensive but hopefully they will all like the change. Just wish the gum stiches would hurry up and dissolve as driving me slightly crazy.

Time to floss?

Freaked out a bit today. Was cleaning my teeth and noticed quite a lot of calculus had built up between gum line and teeth was a bit shocked by this as only just over 6 weeks in and been very thorough with brushing and using the waterpik. So I used a dental scaler to remove as much as I could but didn't want to get too close to the actual implants and possibly damage them. Rushed out to the chemist and bought some special dental floss the type with a pointy end so can thread under the teeth - used this to clean more around the implants but my gums did bleed a bit. Is this normal or am I a bit too soon after surgery to be flossing yet? I have a check-up in a little over 2 weeks and originally planned to ask about flossing then but didn't want till wait until then. I guess I am quite prone to plaque build up - hence loosing my teeth to gum disease which makes me nervous about my implants and developing problems such as peri-implantitis which I definitely aim to avoid. Any thoughts or opinions on flossing technique and frequency etc. or other methods of keeping gumline clean with all-on-4 would be welcome?

Minor set back

Went for 2 month check up today. The teeth were removed - upper ones first and each of the 5 implants were tapped to check they were integrating with the bone and all fine. Then the lower ones were removed and tap test repeated on the 4 implants there but the right hand one at the front made a distinctly different sound to the others and there was a bit of movement with it also apparently. Xrays were also taken of it and thankfully no infection and I have had no pain with it other than a bit of soreness initially after surgery. I was more concerned about the upper ones prior to the check-up than lower myself.

Anyway, plan is to go back in - hopefully Monday (just need to check I can get the time off work) and get the troublesome implant replaced. Surgeon said if left it might integrate but would rather replace it than risk waiting and seeing which is fine by me. It will set the whole process back a bit whilst the replacement integrates. I don't think there is any obvious reason why it hasn't worked first time that I'm aware of - just bad luck perhaps as surgeon has had very few instances of this in 20 years of placing implants.

Definitely glad the clinic is local and I can get implant replaced without a major hassle.

Not a failure

Went to get failed implant replaced earlier but it turned out to be a false alarm as it was a dodgy abutment instead of a problem with the implant after all. Relief all round I think! Pretty glad really as I know I would have spent the next 2 months worrying if the replacement would integrate ok. Anyway, the abutment was replaced and I can relax about it all for a couple of months as no futher appointments until April now. I think I have had at least one dental appointment a month for nearly the last year so will be good to have a bit of time off - fingers crossed no issues!

4 month review

Had my 4 month last Friday. X-rays and impressions were taken and all going well permanent teeth should be ready in about a month. I had broken my temporary upper bridge, without even realising, but this was fixed whilst I waited.

The technician asked about any changes I wanted for my perms but I hadn't given it enough thought. Anyway, thought about it a bit more over the weekend and requested they make my lower teeth slightly less perfect than on the temps just to make it look more natural but otherwise very happy with the shade etc of my temps. Hopefully, I won't regret this.

Otherwise life is going very well and recently got a new job which I am due to start just before my perms are due to arrive. I feel so much more confident since having this done and couldn't have imagined going through a recruitment process before having this done and this whole process has really taught me not to worry about things so much and embrace life more. So generally feel pretty positive about things.

Permanent Teeth

Yesterday I had my perms fitted which is about 6 and 1/2 months since surgery. Prior to this I had 3 wax try-ins. The first of these the upper teeth were way too long and just didn't work, second time was far better but after discussions with the dental tech it was decided to make the upper teeth smaller to suit my face better. My natural teeth had been quite large which I was never that keen on so made sense to reduce the size which was done for the third try in. All went well on this occasion so time to go a-head and make the perms. I requested the lower teeth to be made slightly crooked to enhance a more natural look.

The fitting of the final teeth was quite painful. The dental tech said many people say it is worse than the surgery and now I can see why! Apparently it has something to with realigning the gums with the titanium reinforced prosthesis. I also wonder if they are torqued to higher setting as just felt as though it was getting so tight that something must surely give. Thankfully, it didn't and most of the pain went away fairly quickly apart from one of the upper right implants which still feels quite sore now but this implant has always felt more tender than the others.

After the fitting, the dental tech spent a while checking the bite and making adjustments I.e. grinding bits off the teeth to get them just right. I need to see how I get on over the next week or so and if I have any problems with chewing or anything can go back for further adjustments. If no issues, I go back anyway in early August for a final check with the surgeon. I will ask again about the slightly tender implant if still an issue by then. It has been checked a few times now and no apparent problems with it but it does feel slightly sore at times still.

Once it was all done and I was about to leave there was a heavy shower so as I was cycling home I decided to wait until it finished. The rain stopped after 10 mins so I left, unlocked my bike and set off, turned the corner onto the main road and a lorry stopped in front of me, so I hit my brakes also but the brakes weren't working properly and I wasn't stopping. I had visions of me smashing up my newly fitted teeth straight away. Fortunately, I managed to steer my bike through the narrow gap around the side of the lorry and put my foot down to slow me down and gradually came to a stop without any teeth crushing impact - phew! Anyway, jumped off my bike and fixed the brakes before proceeding any further. Note to self - must always check brakes before cycling from now on.

I think I am happy with the new teeth and definitely worth going for all the try-ins and glad the dental tech spent the time and effort to get them right. I like the fact they don't look perfect but will probably take while to get used to them completely. Each tooth feels more defined than the temps did. They are much closer fitting to my gums and when I eat I can crunch down on food now which I couldn't do with the temps though not tried anything too hard/cruchy/chewy yet. I did take a pain killer last night as the upper right side was still quite painfull. Hopefully this will go soon and I can start enjoying my new teeth to the full.

All done

Went for my final check today with thevimplant surgeon. X-rays taken, teeth removed so gums and implants could be checked. All is fine so teeth refited, screws back in and more permanent coverings were placed over the screw holes in the teeth. I mentioned the upper implant that is still ever so slightly tender so this was checked and no problems found. I trust they know what they are doing so not particularly concerned by this.
So that's it for now. I go for a cleaning in December and should stick to a schedule if hygenist appoinments once every 6 months I think they said and a yearly check on the implants. Apparently my home cleaning is very good so they reckon I will only need the teeth removed once a year if I keep up the good work.
It is relief to get to the end point and l'm very happy with my final teeth. It is great to eat normally again; to crunch down on raw carrot or eating corn on the cob is a great feeling when you haven't been able to do so for years. I was speaking to the patient communication manager at the clinic and she asked if the teeth feel like mine and 'yes, they certainly do' I have really got used to them and because I can eat normally now and the perms feel a bit less bulky than the temps I don't think about them too much now. More importantly, I can get on with life without feeling self conscious about my teeth and going through the pain of abscesses constantly.
The clinic has been outstanding every step of the way and l have now updated my review to 'worth it'. The only slight downside was the general receptionist for the whole building (there are a number of different practices all based at the same location) had a bit of a go at my partner when he couldn't remember the name of the clinic I was using and I was running slightly late for my appointment - l found it quite funny though. I still prefer not to name the clinic as I didn't really write this to be a review of the dentist/clinic as such but more just to document my experience throughout this process. If anyone wants to know because you are looking to get this procedure in London just get in touch and I will tell you privately. I remember how scared I was before I started this but it has been so much easier than I ever thought it would be

why upper all on 4 teeth can feel bulky

I have had people ask me and seen disscusions about bulky teeth. Although my upper teeth feel ok to me, I thought I would add a pic of my temp upper teeth to try and show why they can feel a bit bulky. As the pic shows, there is an acrlyic ridge behind the teeth which the implant screws attatch to the implants. I guess it has to be this way, with the front most implants, as the the teeth are way too fine for the screws to go through. The rear implants go through the wider molar teeth. I got used to the slightly bulky feeling within a couple of weeks. It is a matter of retraining where to place your tongue when speaking. My permanent teeth, the ones in my mouth now, are titanium reinforced and feel slightly less bulky but there is still a ridge for the screws.
Everything still going well with me, one year down the line, and just pleased to be able to live and eat very normally again. I have my first hygiene appointment next week. Hopefully I will get a good report and all still ok with cleaning etc.
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