Biting the Bullet

I'm a 61-year-old woman who has had periodontal problems since my early 20s--several full-mouth gum surgeries, etc. Back 2001 I had extensive dental work (orthodontia, perio treatment, a few implants) done at the U. of Pennsylvania Dental Clinic. While they did a fantastic job, and for an unbeatable price, I was all "dentisted-out" when it was over and I did not maintain my teeth properly. In the last few years I've lost some teeth to extractions, broke one off at gumline, and although my implants have been fine, my other teeth have shifted and perio problems returned.
After the last broken tooth, I was considering going back to Penn, but realized it would probably take more than two years to have the necessary work done. I'm in better financial shape now, so I did my research and made an appointment with Dr. Alan Meltzer in Voorhees, NJ, who is a professor at Penn and an expert on implant dentistry. Dr. Meltzer created a treatment plan for me, and I just completed phase one--the extraction of all my lower teeth and placement of a temporary set of teeth on six implants. In a few weeks I should be able to begin the same process with my upper teeth. Dr. Meltzer's reviews were outstanding, and my own experience was consistent with those reviews. The office staff are terrific, the doctor is personable and inspires confidence by explaining everything very, very clearly. I'm about four days out from the surgery, and apart from some remaining swelling and a huge bruise on my chin, I feel great. I opted for IV sedation, which I would highly recommend for a procedure this lengthy (5 hours) and involved. I was awakened a few times for repositioning (which I vaguely remember), but had no pain. On the ride home I had some pain as the local anesthetic started to wear off, but it was easily controlled with ibuprofen. My one mistake was not using the ice packs as regularly as I should have--the morning after surgery I looked pretty horrifying from the standpoint of swelling. I'll know better next time!I'm very pleased with how the first round has gone, and look forward to getting going with the upper teeth. The sooner I start, the sooner I'll be able to graduate to the finished product. I was sort of depressed at first when I realized my teeth could not be saved, but once I reached the point of acceptance, I started to get excited about being able to smile again and to eat with less caution about how I chew. I took out a low-interest personal loan (the doctor has financing options but this worked better for me). And just to reduce the financial pain a bit, I put all payments on my rewards card and will have enough points to pay for my overseas vacation this fall. Plus I can deduct the cost on my tax return and should get a nice refund. The cost above is the cost for the entire treatment plan (upper and lower), plus the cost of IV sedation (approx. $3000 per procedure).

I had the extraction/implant procedure for the upper jaw yesterday. This was a bit less daunting than the previous procedure--in part, I think, because I already had a few missing teeth, as well as a couple of implants that could be used for the full arch. So there were four new implants placed, and abutments put on the two that Dr. Meltzer decided he could use. I was more conscientious about using ice this time.

I still look rather chipmunk-like, with swelling around my nose and upper lip, about up to the bottom of my cheekbones, but so far it isn't extreme, nor do I have any bruising (yet!). This surgery was later in the day, too--all afternoon rather than all morning--so I woke up once last night with pain but took an ibuprofen and ate some ice cream, and went back to sleep without difficulty.

The upper teeth are more aesthetically pleasing than the lower ones, but they are still pretty artificial-looking. They still look better than my own teeth, though, and feel solid and sturdy in my mouth. I'm eating soft food till I go for my follow-up a week from Monday. After that, it's just a matter of letting everything heal and integrate for three months or so before we can start working on the final teeth.

I'm still very pleased with Dr. Meltzer and his office--they have been great to deal with. So far, the worst part of the whole deal has been the IV anesthesia--my veins are tricky to get, and the anesthesiologist stuck me multiple times (fewer this time than last time--last time I felt like a pin cushion!). I did wake up a couple of times when I don't think I was supposed to, but as soon as I let them know I was awake they knocked me out again (to my relief).

In a few days, after the swelling goes down, I'll post some before/after shots. Honestly, even with these temporary teeth, it's a HUGE improvement over my stained/crooked/missing teeth.

My swelling after the last procedure is finally down enough to take a decent photo. This "after" picture is about four days post-surgery on the upper jaw--the lower was done about a month ago.

And I'm including the "before" pictures--it was too depressing to post those until I had some happy "afters" to go with! I think these temporary teeth look rather artificial (too even across the bottom of the top teeth, for one thing), but they look a heck of a lot better than my own teeth did, and I'm confident the final ones will look just the way I want them to.