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Molly Maloof, MD

Director of Clinical Content
@DoctorBase

Tooth 30 needs implant, tooth 13 is now an ER status cuz it broke apart yesterday, doc asked me not 2 go 2 ER. I had ASD heart surgery, Latex allergy, sister had MH, I do not, I have A.S. n take Humira, in major pain should I do all on 4 implants or not, I already have 6 crowns not going so well, about 3 more needed plus cavity issues. Help? Teeth always hurt with hot/cold? But this PAIN has taken it 2 a new level.

Full mouth implants or root canals that r going 2 most likely fail, I'm scared that it won't feel like teeth?
Poster
  • 42 years old
  • Ethnicity: Caucasian / White
  • Height: 5.6
  • Weight: 100lbs
  • Medications: Percocet, dilaudid, klonpin, 875 amoxicillin
  • Conditions: Yes
  • Hospitalizations: Yes

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Featured Answer

1 UpVoted this answer Brian L. Kirkwood, DDS, DDS Dentist, Greenfield
Elimination of your pain and infection needs to be the first priority! Sounds like you have complex treatment needs that may require a staged approach to treatment. Seek an expert consultation from a dental specialist; prosthodontist, periodontist and/or oral surgeon for an accurate diagnosis. All treatment plans should based on your diagnosis and clinical data base.
1 UpVoted this answer
I would suggest you research All-on-four option in detail, and ask your dentist to show you some before and afters of cases he/she has done. Also called teeth in a day although costly, it can be a alternative vs. saving several damaged/missing teeth, but it just all depends how badly your teeth are damaged, broken, and how much your bite has collapsed. With all on four you will have to remove all of your teeth, and you will go home with a temporary denture that attaches to 4 implants (2 implants right and 2 on left side of the arch) followed by a permanent denture in few months after healing. Keep in mind that you will not have "full mouth of implants" and its usually 4 implants per arch only (all-on-four)..
Michael Mazaheri
The story is heard often. Patients face multiple costly and painful dental appointments only to continue with tooth related problems, including tooth decay and restoration failure. With such problems implants are a serious consideration as an alternative. Your concern that they will not feel like teeth, while understandable, does not take into account that complete dentures (which many patients are on a course for despite "herodontic" attempts to preserve teeth) most definitely will not "feel like teeth". Consider dental implants in the hands of a trained oral surgeon considering your health history. Most patients find implant supported teeth to be a fantastic option and a relief from the dental problems they had previously. But finally, not all patients are candidates for any one technique. Let your surgeon make the recommendations.
John R. Scuba
You, your Dentist, Oral Surgeon and MD need to work together soon. Most likely with your health situation implants should be your last concern. Get the infection and painful teeth out and maybe even partials or temp partials until you are stable. I am not sure if you are losing weight or that is your norm, but your low weight is as much a concern as the rest of your health.

Your Team approach will get you through with the results that are fitting for you.
Brian L. Kirkwood, DDS
If your teeth are in an end stage condition, it may be worth looking into an all-on-4 type of implant solution. You need to be clear that this would involve removal of your remaining teeth and a moderate amount of bone to accommodate the restoration. If your remaining teeth are not in such bad condition, I would recommend other options. If you choose to have the all-on-4 or similar procedure, you will need a medical work-up to make sure that you can tolerate it and the anesthesia. There is also some risk that implants could be less successful depending on your healing ability and immune status. There is also nothing wrong with other options such as extractions and partial dentures. If that doesn't go to well for you, you can always re-evaluate for implants. Good luck!
I am more concerned that your overall health is affecting what is going on in your mouth! I would recommend a full physical and make sure you are healthy enough to go through extensive dental surgery, that is, do you have diabetes, are your current medications making your mouth dry, etc! Furthermore, I would work really hard to get your mouth cavity and caries free by using a Sonicare faithfully twice a day and using Prevident or similar high fluoride toothpaste before proceeding with new crowns or implants! It is possible and I have many 40 year old patients and older who have never even had a cavity and enjoy healthy teeth and gums! You will have nice results with future dental treatment and no failures once your mouth is healthy and stable!
Michael L. Green
A complicated medical history with dental issues needs thorough evaluation and work up before any work is begun. You do not receive that in an ER setting. I totally agree with implants as a great solution. Your low weight leads me to wonder how much good bone there is, you will need a CT scan to evaluate your situation. I agree a prosthodontist is great resource if there is one in your area. They specialize in full mouth reconstruction.
Lisa M. Murray
That is a tough question....first and foremost your Med History needs to be evaluated and decided by your dentist and physician if and when further treatment can be performed. I am a big fan of implantology!!! In my practice I will not spend too much time and effort on compromised teeth knowing how well implants perform and work!!! They are proven to be better treatment than a root canal, build up , and crown on a compromised tooth in many circumstances. A Ct scan would be helpful in determining treatment options in addition a set of impressions to go through all options with you.
I would think that your medical history would contraindicate anymore implants.
J. Abe  Smith
Ok!! Let's start with a firm foundation by checking with your physician re- your health to get clearance. Then we should obtain periapical x-rays and a CT scan of both arches to determine, rule out and solve the existing discomfort prior to doing any more crowns, implants. Perhaps a second opinion or referrals to one or more of the specialties: for example an endodontist. Once the pain issue has been resolved through fillings, root canals, crowns or extractions, then we can move on to the next step.