(Dentistry) Dental implant being contested - advice needed

Peddeh

Hi,


I hope this is the right place - I don't know where to go.


I had 4 single tooth dental implants placed with a very reputable implantalogist (at least if I was to go off of word of mouth and ratings online) back in June - I went with this dentist/implantologist because my own regular dentist recommended this person (he was still in the early stages of placing implants and didn't feel confident performing it himself).


To cut a long story short, everything went fine during the treatment (though I don't remember much of it because I went under conscious sedation) but it wasn't until a recent appointment I had to expose the implants to test them and take impressions that I became concerned with one of the implants. With it now poking out of the gum line, I noticed my lower molar implant seemed to be positioned within touching distance of another molar. I spoke to the implantologist about this and he dismissed my concerns, advising that it would be fine and that it was in the best place it could be.


I brushed this off and tried to forget about it until I went back to my original dentist for a oral health check up, who then brought it up as a concern, with him suggesting that he felt it may be positioned too close, suggesting that once it's crowned it may produce unneccessary pressure on the crown.



Following this, I booked another appointment with another implant dentist a bit further out of town, who agreed to see me for a second opinion and unfortunately he's agreed with my original dentist, in that the positioning of this implant is odd. His recommendation (sadly) was to start over.


However, I've took these concerns back to the implantologist and mentioned what I've been advised but my concerns have again been dismissed and I've been told to wait for my appointment to place my crowns so I can see for myself that it's a non issue.


I don't know how to proceed. Does anyone have any advice?

Toothsmith

I can't quite get my head round whats happening here, as it doesn't seem to fit together properly.

You've been to an implant dentist recommended by your own dentist, and by word of mouth from others? (I don't count online reviews as anyone can make those up or even pay for it to be done)

The implants have been placed, and you've now had them exposed and the healing caps put on and impressions taken?

Healing caps are usually put on a few weeks before impressions are then taken, but if impressions have been taken - then you usually only have a couple of weeks before the final restorations are fitted? I cant see how you've had time to go back to the implantologist, go back to your own dentist, and also seek out and see a different implant dentist?

When the healing caps are put on the actual implants, they do have quite a big 'footprint' on the surface of the gum, so can look big, and can look like they are too close to other structures to the casual observer.

Without taking further x-rays - and preferably 3D scans of the jawbone, though, no other dentist looking at it would know for sure exactly what the placing dentist had to work with in terms of the quality and quantity of bone available - so unless a thorough examination was done - anything they say cannot be considered as an equal opinion to the dentist who is planning and carrying out the treatment. It is the dentist doing it who is putting his a&se on the line here as well as his (apparently good?) reputation. It's not like some dentist abroad in a far flung destination who knows that if trouble strikes, it won't come back to haunt him. Your treatment is being carried out in a country which highly (over) regulates dental practices in a climate where making complaints is easy. I really find it hard to believe a dentist with a good reputation will be doing something obviously wrong. It might not be 'ideal' but I'm sure there will be some factor within your bone or bite that has meant it should be designed as he has.

What I really don't like the sound of (Assuming it's been correctly reported) is the responses from your own general dentist and the second specialist.

After referring you to someone he recommends because of reputation, and presumably seeing other cases from the same person done well, he then completely destroys your confidence in that person.

He referred you because he felt your case was a bit more complex than he could handle - and yet he feels qualified to criticise how the other dentist has approached it.

What he should have done, if he had concerns was to tell you he didn't really understand the planning well enough to make comment - then ring up or email the dentist to find out why it was done that way, and then maybe explain to you later why it was like that.

The second implant dentist you've been to strikes me as completely unprofessional. He has the same attitude as a dodgy railway arch garage owner who sucks air through his teeth and says "ohhhhh - this is gonna cost ya mate"

For one thing, it's a bit suspicious that he was able to get you in so quickly, and unless he did a proper full case assessment to see just what the first dentist had to work with, he is not sufficiently informed to make any such judgement.

I think maybe you have cut your story a bit too short. It doesn't really make much sense to me. But out of all of it - it is the behaviour of your own dentist, and the second opinion dentist that I like least.

Undervalued

Toothsmith wrote: »

He referred you because he felt your case was a bit more complex than he could handle - and yet he feels qualified to criticise how the other dentist has approached it.

Being able to do it better yourself is not always a prerequisite of knowing what is wrong with something. Roger Federer's coach won't be able to play tennis as well as RF. Few if any restaurant critics can cook to Michelin star standards themselves......

Maybe this chap was being over cautious and is rightly disappointed by what the so called expert he recommended has done?

Or not, who knows?

Toothsmith

Quite agree - but the 'professional' way to handle that would be to speak to the dentist who did it and ask for an explanation. Not just tell the patient he didn't think it had been done right.

If the dentist was not happy with the explanation given - then that's the time to raise concerns. Not before he knows the whole story.