Alll-on-Four - ClearChoice at San Antonio, TX

I've been battling the periodontal disease since 2003 when I found blood on the bread of a sandwich I had bitten into. I was diagnosed and went through a tortuous full mouth Scaling & Root Planing and flap surgery--horrid experience being awake, being cut and sewn back up in one's mouth. It was a new start and my hygiene was much better going forward than before but not enough.

A few years later I noticed my gums sore and teeth shifting, a sign the periodontal disease continued to get worse. The dentist tried to stop the problem by using some yellow plugs injected inside the gums where the deep pockets were at and this also did not work. Doctor's next recommendation was to go through flap surgery again which I promised myself would never happen again.

I asked my doctor if he could perform a dental implant as I had lost one of my front incisors due to teeth shifting and pushing. He explained to me that the flap surgery was absolutely necessary *first* before doing so as he wanted the entire mouth removed of the disease before putting the gums over the stress of an implant. To determine if an implant was possible it was necessary to pay for some 3D scan. To sweeten the deal, if an implant was possible, the cost of the 3D scan would apply to the implant procedure.

The results of the 3D imaging proved a huge amount of bone loss mouth wide yet my immediate attention was my embarrassing missing front tooth. In the end, I couldn't convince my dentist to perform the implant before the gum flap surgery so I looked for alternatives.

When I visited Clear Choice in San Antonio, the intention was to look for someone to simply perform the single tooth implant. They did a free 3D scan just as my dentist had done two years previously and recognized the abysmal results of the bone loss. There was an initial shock that Clear Choice only does full upper or lower implants. In my situation, it would be necessary for full mouth implants at $40k. It wasn't what I was looking for or expecting and but I knew the progress of the Periodontal disease would be a train wreck over a long period of time no matter what.

It wasn't necessary to be sold on the idea, I sold myself and came up with a list of pros and cons before the salesperson could. It boiled down to the price. Single implants can cost up to $2500. I already had one missing tooth, three unstable (slightly loose) teeth and one good tooth (stable but holding well) in-between two bad ones (read, future problem), and enormous bone loss and deep pockets everywhere.
This wasn't new information really as my dentist had already gone over my bone loss. This would amount to approx $15k for the immediate issue and wouldn't address the problem as a whole. That is where $40k started to make sense, it would address the problem mouth-wide, would allow consistent structure, cheaper in the long run and could be done all in one day!

I did just like any other reasonable person investing $40k would do, research heavily on the Internet. There were good and bad reviews, mostly good. While there are other options for All-on-four implants what sold me the most on Clear Choice is that everything is in one place--no driving from one office to another. Clear Choice gave me the quick tour of their facilities, met some of the staff and felt very comfortable--none of that eery feeling like when you go into a dentist's office. I ended up making the commitment that day, setting the day which was approx two months out.

So, before posting my first-day experience, I'd like to point out I am 42 years old, diabetic and under control (my most recent A1C after my initial testing hasn't come back yet), hypertension and also under control, have circulatory issues being addressed with my primary doctor and overweight. Hoping this info can encourage those with similar health issues to look further into this procedure if they feel it is necessary.

My follow up consultation was two or three months back where they took molds of my teeth. The consultant went over the entire procedure and answered any questions I had. They also took various pictures of my mouth from different angles which we reviewed. I realize no one is born with perfect teeth yet my teeth in the pictures looked nothing close to a mold I had seen as a teenager (for braces). The procedure to perform the mold made me very nervous as I had two teeth slightly loose and didn't want that tooth sucked up from the pressure of the molding. They assured me they would apply a jelly to make sure that wouldn't happen which they did. In the end, I have further assured myself this procedure was necessary as my teeth looked like a train wreck, deep pockets, with twisted teeth.

My surgery visit was just 6/20/2017. Just shortly before my visit, my gums became slightly sore and my teeth shifting again which reminded me this was the right move. I was prescribed antibiotics for the day before. Out of my series of meds, was only allowed to take my hypertensive drug with a sip of water. I arrived at 6 am and could hardly believe this was going to happen, losing *all* my natural teeth! A part of me thought this was crazy. We (wife and myself) arrived and sent to our assigned and private waiting room which was very comfortable. The room included comfy recliner chairs, TV and small refrigerator with some goodies in it. One of the doctors walked in, went over the procedure in full and answered any questions my wife and I had. Shortly after, I was invited to the procedure room approx 7 am and that is when things got real.

I walked in the room where there was an initial staff of two people waiting for me. One of the things which had worried me previously about the procedure is whether I would fit properly in the operating chair as I am a big guy. This turned out to not be an issue at all and was comfortable. I didn't feel the IV once it was inserted which was a big plus for my comfort. The doctors/staff were very professional, there was a team about three or four, at least one of them being trained by a senior but did not appear to participate. The staff appeared to be very confident, regularly asked for my input and talked me through everything they did before doing it. This feedback made me feel very comfortable. The doctor joked he was giving me a little Margaritaville juice through the IV to help calm me down. Looking at the tube, it did have a lime color and that's when I go the joke and humor is always a good thing. I don't recall feeling drowsy or sleepy, the juice must have just hit me all at once.

Somewhere along the way during the surgery, I recall hearing the staff talk to each other and more importantly feel what was going on. There wasn't any pain and the staff noticed my moans and they answered me that I was doing great and they were almost done. Again, the feedback and acknowledgment were much appreciated. They also needed me to perform a certain bite which I don't think I was able to do properly with my jaw being so numb so they helped me. They finalized by doing some checks, told me everything was completed and went well. They were concerned with my blood pressure and administered something to help. I was able to comfortably walk back to my room as they escorted me over.

When I arrived at my private room, approx 11 am, my wife was waiting and asked how it the procedure was. My only negative is coming around during the procedure yet it was uncomfortable at worst--nothing painful and pretty sure they sedated me further. I sat down and experience no drowsiness, no headaches just enormous numbness on my gums and cheeks. My wife brought my own personal blood pressure monitor and it read 155/96 and the staff explained it should settle down soon as the doctor injected something to help. For the next few hours until 5 pm, my wife and I just talked, watched TV, dozed off or checking our phones.

Approx 5pm the first set of teeth (temporary) were ready and I was called to a different room. It was absolutely painless when they screwed out these white caps and place in the teeth. When my full set of teeth were installed, they performed some alignment tests to make sure my bite was proper--this took about four iterations and took very little time to do. I am surprised how well my temporary set felt and fit, they didn't feel too big or too small. Another one of my concerns is having less room for my tongue which they warned me about--that has not been an issue (so far). They called my wife to get her approval, unfortunately, I was unable to smile very well due to numbing so I did my best and it was met with her smile. They provided me a mirror and was very impressed! I have not seen my teeth look this good in years!

The remainder of the day was uneventful other than my BP going a little high so rested most of the day and that brought the numbers to acceptable levels yet still on the high side. I found that eating anything tasty isn't worth it without putting it in the blender--temporary set back. No brusing and no pain, just discomfort from the numbing. I have a funny lisp while talking that doesn't really bother me. I have no real complaints at this point.

Currently at the end of my day two and my BP is back to normal levels and happy about that. Food is a bit easier to eat with the numbing subsiding a bit. Sticking to easy to eat foods as anything else ends up just being swallowed (small pieces only). I still have no facial bruising, very little pain or discomfort. I've read the third day is the worst and hoping for the best as so far it has been great.

Will update at end of day three. If anyone has any questions, please let me know!