Tuesday, September 26, 2006

Top 10 Things You Never Want to Hear the Periodontist Say

1. Hmmmm....let's figure out what to do.
2. I've never had to take out one of these that I put in.
3. I thought this would be much easier to do.
4. I think we need to leave the implant in.
5. I at least got the implant to move a bit.
6. I am going to call Dr. Mazur.
7. Oh, did that hurt?
8. This is going to take a while to heal.
9. Hmmmm...that's interesting.
10. If anyone ever had any doubt that bone integrates to the implant, here's proof.

Ok- so I had my appointment to have the implant removed yesterday. The suggested procedure was that they would go in, screw it out, fill it with bone graft, and stitch me up and send me on my merry little way. It sounded good to me...

So, I get in there... they get me numb (that's always fun). While I am waiting to be numb, Dr. Gomes says that he has never had to take an implant out before, or at least one that he has put in while he's been here. Says he has taken ones out before, but they were not well done. That's a great way to start the day. So anyway, he starts trying to unscrew the implant out, and it's not going anywhere. All I feel is intense pulling on my jawbone, all the way from my ear. So he stops for a bit, tries something else for a while and its still not coming out.

He tells me that he was at least able to get the implant to move a bit, so maybe the best thing is to leave it in, and pack some bone around it and then have Dr. Mazur use the angle abutment. He's afraid to do the other option for taking it out because that means drilling out the bone around the implant and then losing bone where there isn't much anyway. So, he says he's going to go call Dr. Mazur and see what he thinks. Now by this time, I am in pain from all the pulling, prodding, retracting, etc of course. Yeah, I'm numb, but nothing really numbs bone I don't think. And while I am waiting for him to come back from talking to Mazur, the song "Let It Be" comes on over the radio... and at that point, I am thinking that's pretty good advice! So, Gomes comes back in and says that Mazur wants him to take it out. So we will try to take it out. yay.

So at that point, he renumbs me and starts drilling around the implant but decides he's not going to go all the way up so he can try to save some bone. So after he drilled out enough to get a better grasp on the implant, he decided he was going to just try to loosen it up by wiggling it back and forth and right and left. And it actually works! It loosened up enough he could get it to screw out and then the implant was out. YAY. It's always interesting when your dentist is amazed by what he is seeing... there were still pieces of bone on the implant when he got it out and he was impressed by how the bone actually integrates with the implant. Fun times I tell you. But it was kind of cool to see. So the good news is that my body seems to integrate that cadaver bone pretty well! YAY!

So he packed me full of more bone grafting and stitched me up and sent me on my way. And then the fun began.

I did not have a good afternoon... it was worse than the first round when comparing initial pain. I think all the pounding, drilling, etc with the bone is a bit more traumatic to your body than just removing a tooth like they did the last time. Last time, they didn't mess with the initial structure much so it was not too bad. I think if you have ever had a broken bone, that's probably comparable to the pain from yesterday. But I am much better today. Still swollen a bit, and still tender, but not really in pain. A bit tired again today...but I took today off too, so I think I'll be good. I have been flipper free for 2 days- decided that was not a good idea to put it in after the surgery yesterday. I'll go back in a couple weeks for stitch removal (right before my sister's wedding! I thought she'd appreciate that. No stitches hanging out of my mouth for the wedding pics. :-) ) It will probably be a couple months before we go put the implant back in- got to give the bone enough time to heal. And at that time, Gomes will probably be in Indy... so we will have to wait and see how that plays out! Hopefully he will come back up here to do it for me!

I should know more in a couple weeks... try to pin him down to some dates when he takes the stitches out. I'll keep you posted...

Wednesday, September 20, 2006

Flipper #2

So today was the big day! Time to get the new flipper!!! Woo hoo! So I was anticipating going in for my 15 minute appointment, having them pop the new flipper in, and me being on my merry little way. How many of you actually think that happened? :) If you're the one optimist out there that thought "I do", then get real and read the former blog postings! Once again, I was there 4x's as long as my appointment was scheduled. (So just an hour.) Here's the story...

So they pull out the new flipper and I have to say it looked mighty impressive! They paid attention to detail on how it looked and some of the requests we made. So the part that fits in the roof of my mouth was a lot thinner and they did some extra molding to try to fill in the dark chasm with some pink filler so it looks like it blends right in. The tooth had some more shaping to it too and wasnt quite as flat as the previous one. However, the one detail they must not have paid attention to was how it fit in my mouth. "Comfortable" was the word that was the least descriptive of how it felt. I am not sure which set of my impressions they used to make this, but I think they found some from when I was 5 years old or something. But don't fret- Dr. Mazur is a stylistic genius!!!! He takes it back to the mystery room and starts making some corrections and shaving some stuff off of it... and after about 30 minutes of that.. I have something that I can live with. The good thing about teeth is that they move a bit. :) So in a day or 2 this should be feeling just fine. I have also found out that a nail file works pretty well to shave away some of the acrylic too- so don't tell Dr. Mazur, but I have already made a few corrections myself and I think we are almost there! I'm practically a dentist anyway- I have probably spent more time with them than they spent with patients in dental school! ;-)

On other notes... I got to see the wax up today. It was different than how I thought it would be. I envisioned it in living color, and it's just plain white. But it looks good. I will have a very wide looking I-tooth, but the freaky tooth will look like a normal tooth for the first time in my entire life!!! Woo hoo! The canine will not affect the aesthetic look of the overall smile, but it will just be a bit wider than it currently is.

So that's all for today... I leave for New Hampshire tomorrow morning and come back in time to have the implant yanked out and cadaver bone put in on Monday morning. I think will take my "spare flipper" with me on vacation, just in case flipper #2 doesn't behave itself. I just haven't decided how to explain to the security agents what's in the blue box if it sets off the security alarm. And for those of you who know me, I always get stopped going through security- I must be suspicious looking! That's a whole other blog though! :-)

Thanks for reading and I'll keep you posted....

Pictures

Ok... so this first picture is me with the first flipper. When looking at the pictures, it is the tooth that is on the right side of my mouth. You should notice some darkness around that tooth.

















Ok- so this is me before the flipper.. the tooth doesn't actually look that freaky here.. but trust me it was!
















Ok- this is Dr. Gomes. He's a cutie especially with his accent! He has a much better haircut now too and none of that facial hair!















And this isn't really a picture of Dr. Mazur, it's Rob Flynn, one of our college kids. But they look and act a lot alike.. so I thought i'd just try to put something up there for you! :)

Thursday, September 14, 2006

Freaky Tooth Blog Entry #5


Ok- so I had joked about actually creating a blog for this tooth...and now it is a reality!! It just seemed a lot easier to have all the information in one location for others to catch up on all the happenings and adventures of one little tooth! So without further ado, I present the Freaky Tooth Blog! Send it to your friends and family if you wish- it's hours of entertainment!!!

Flipper Fact of the Day- did you know they actually make the flipper using a real denture tooth? :)

The Update: Ok- so the good news- remember Dr. Hart? The Endodontist? Well, he is the one who referred me to Dr. Gomes. The good news is that I got a refund check in the mail from him last week to refund me some for a procedure that he did that ended up doing nothing for me in this whole process! YAY!

So last week, I began to realize that I had a check-up appt. coming up with Dr. Gomes and I wondered what the status was with the wax-up and if Mazur and Gomes were on the same page as to what was going to happen. So I called Mazur's office, and thus began the phone tag to the lab to find out what was going on. Also, I had wondered about getting the new flipper before my sister's wedding. So after a bit more phone tag, we got a time for me to come in and see Dr. Mazur. So I went to see him yesterday. I had to go for yet another set of impressions! You know, Halloween is approaching- so perhaps they needed more molds to make those funny teeth with for halloween costumes! But they said it was for a set of impressions so we can get my new flipper! YAY! And it should be here in a week! Woo hoo! I'll be looking spiffy for my vacation to New Hampshire next week! Now remember that wax-up they were doing the last time? So turns out it is about done... museum quality I am sure! I did find out they are not the same lab geniuses that made the flipper last time- this is a totally different lab somewhere on the west coast with a 3 hour time difference- so maybe they are geniuses! (the local lab is making the new flipper- keep your fingers crossed it turns out ok! ) So Mazur tells me he has tried calling Dr. Gomes to tell him that he's having this waxup done and that we should redo the implant, etc. However, Gomes has not called him back yet. Hmmm. That's a bit problematic because I have an appointment with him the very next day! So Mazur says that he will try calling Gomes again. Mazur suggests that we get a stent made with the waxup that will show him exactly where to put the implant when we redo it, but that it's Gomes's call on getting that make and cost to him too. So Mazur says I should just go in and say "we are getting the stent, right? " to Gomes and go from there. :) All I know is that we want it to look the best it can and I'm willing to do whatever it takes to get that done! So... I leave Mazur's office, with an appointment to get my flipper next Wednesday and knowing I have an appointment with Gomes today.

So... I go see Dr. Gomes today. He asks me what's the latest with Dr. Mazur. So I say, have you talked to him lately? He says a couple weeks ago. I say, but not this week? No, not yet. So he says he's going to call him, and then, one of the girls from the front desk comes in and says that Dr. Mazur is on the phone for him. :) It reminded me of that scene from Ferris Bueller's Day Off where the principal is trying to get in touch with Sloan's dad and then the friend calls in pretending to be the dad- it was just as if it was cued that way! So... I waited in the chair for about 10 minutes while they talked. Then Dr. Gomes comes back. He says that Mazur thinks we should redo the implant and he agrees! Woo hoo? Wants to do what's best for me, etc. I agree! He thinks Mazur thought he would be mad about it but he's not. (AND it's all for free!!!!!) Then he says, well, I'm glad your sitting down though. My only thought was 'um.. ok." And he says, because I need to tell you that I am leaving in a couple months! OH!!!! And he hasn't told any of his referring dentists yet, so Mazur doesn't know. Lovely. I am pretty sure this kind of stuff could only happen to me. But anyway... He's going to work in Indy since that is where he lives. But, he's committed to getting my case done. So he thinks he can even come up a time or 2 to finish things up if we need to. I told him I'd hunt him down if he didn't! ;-) So... I am scheduled to have the implant removed and more bone graft put in on Sept 25th. He wanted to do it this coming Wednesday, but I said I didn't really want to leave for vacation that next day not knowing what kind of state I was going to be in. So he was ok with that! So... now basically we do that, I wait 6 weeks for bone to graft, then we drill it up again and put the implant back in and hope for the best!

So do you see now why I am creating the blog? I think this tooth will have so many more adventures before this is all over! Fun times for sure!!! I'll keep you posted!!!

Wednesday, September 13, 2006

On a Side Note...

ok- so i don't really know what happened to entry #2... I couldn't seem to find it in my sent messages.. if i do, i'll repost it.

Freaky Tooth Blog Entry #4

Since entry #3, I have been back to visit Dr. Gomes. He concurred that the implant isn’t quite where it needs to be! BUT- good news.. they make something called an "angle abutment". Instead of hanging straight down, it hangs at an angle. Wow.. sounds like a great idea! Let's see what Mazur says.
So... Mazur calls... he doesn't like the angle abutment... it's all about physics and geometry, right. The force when biting on something needs to be centered over the tooth, not at an angle- especially when we had to grow bone for the implant to hook into. Sooo... Mazur says come on in.. I have an idea...
So I went back to Dr. Mazur today. He's the regular dentist. I am happy to report that this appointment was 3.25 hours less than my previous one with him! Woo hoo!
Today I went for impressions for what is called a 'wax up.' What that means is that with all the different things I have had done to me, I could start an awesome museum of dental oddities! Mind you, I have had plenty of impressions along the way during this whole procedure... not sure what really happens to the latex molds they make, but I'm pretty sure you're going to start seeing people in remote countries with false teeth that match my smile. Or maybe, they will start selling them as jello jiggler molds. How cool would that be? :) This is no less than the 5th set of impressions I have had during this whole ordeal. Where did the others go?????? Ok- so nevermind any of that- back to the wax-up.
So here is what is supposed to happen. The geniuses at the lab will create a wax model of my mouth. (yes, I do believe these to be the same geniuses that couldn’t even get my flipper to the right place the first time though). Then they will create a model of what Dr. Mazur thinks needs to be done. Dr. Mazur thinks we should put a veneer on the freaky tooth and the canine next to it and help even out the gap so the tooth isn’t so wide looking. We will take that model to Dr. Gomes and say this is what we are doing...look how pretty it can be- forgot that angle abutment! He will then say, how could I not have seen this option before and boy it sure does look good and I will redo the implant! And then when we are all one happy family and have the plan figured out, I will get a new flipper that looks better too! And the best part is, it's free! FREE FLIPPER!!!! I don't think dentistry gets much better than that! How many of you have ever gotten a free flipper? (it’s a $120 value! ) And then... I'll have one more thing to display in my museum.

Freaky Tooth Blog Entry #3

******* Mid-July Update**************
So I went in for a check up with the periodontist in mid-July. Essentially, at that point in time, he said that things looked good and were healing well. He asked how I was getting along with the flipper and said if I were doing well, we could just keep it in for another couple months and then do the permanent crown at that time. Wellll... I think most of you know how much I do not care for the flipper, so I asked what the alternative was if I didn't want to keep the flipper for 2 more months. He said that we could do "something temporary" in between that would not be the final product but would get the flipper out of there. So while I can tolerate the flipper... it was mildly irritating to still not be able to say the words "teacher" and "sheet" very well- especially when doing many workshops this summer with teachers and handing out worksheets. So I say, lets go temporary.
The perio says he will call the dentist to tell him to do this... the dentist should call me, etc. After a couple weeks of a game of 3-way phone tag, I finally had an appointment scheduled for yesterday afternoon at 5:00 with the dentist to do "something temporary."

*******Monday, July 31st Update*************
On Monday, I got a phone call from my periodontist telling me that he needs to talk to me. Hmmm. Ok. So I call him... and he says, well.. before they can do something temporary, we need to attach the abutment to your implant. (Essentially a metal post that hangs down and give you something to build a tooth around. ) So I was wondering if you could come in at 3:20 today (Monday) and if you would mind going without a tooth for a day until you seen the dentist tomorrow. Did you all catch that??? No tooth and a metal post sticking out.. um.. no. So I say...well Dr. Gomes... I wouldn't mind that so much if I weren't in the middle of a 3-day teacher workshop where I am presenting all day. So he says...well ok.. can you come pick up the parts and take them with you and maybe Dr. Mazur can put it in. SURE... I would love to do that. So I go pick up the parts Monday late afternoon.
When I get home Monday, there is a message from Dr. Mazur's office wanting to know if they can change the time of my appointment because they would like to induce Dr. Mazur's wife. No- please delay the birth of your child to do dental work for me. Well.. turns out, they only needed to move it back 30 minutes to 4:30 so we are still good to go!

******** Tuesday August 1st******************
So... I was so excited all day long that by early evening I should be flipper-free and able to regain normal speech patterns. I could hardly wait to go to the dentist.. you don't hear that one too often. But still a bit nervous about the whole "birth of his child" part of things and decided that was the first question I was going to ask before we started doing anything. So... it’s a bit after 4:30 when I get called back there. I have a recollection of this, because Oprah is still on TV. So... turns out, they are not inducing his wife until Thursday! So that was good news! The bad news was that it turns out that it seemed like I was there until Thursday. Have you ever spent 4 hours in a dentist chair??? People have heart surgery in that amount of time. Yes.. I really was at the dentist office until 8:30 pm last night. I think I watched more TV last night than I have in a few weeks combined. I went from Oprah to Rachael Ray to Jeopardy to Big Brother. Quite the evening of entertainment. But the question you all want to know is... WHY?
Well... it takes a bit of time for impressions to set up. I wish I could say it took 4 hours.. but really it takes about 20 minutes. Dr. Mazur told me he was going to cut up the flipper so it would be easier to make the impression and go from there. Sounds like a good idea. So basically he decides that maybe he should go ahead and put in the abutment before he does the tooth crafting in the lab.. I like that idea too. So turns out he can't get the healing cap off because there is too much tissue in the way... so what do we do.. we laser it away!

**** Gross Part****
That's right... laser trimming of tissue. I'll let your minds wonder a bit on laser burning of gum tissue. There are all sorts of sensory images that should go along with that. And did I mention he had to get me numb to do it too. I don't mind being numb... except when they work on a front tooth and they give you a shot that feels like it is going up your nose and one in the roof of your mouth. Not my favorite.

**** back to the story****
So we put the abutment in... and we have a problem. It heavily favors toward one side of the hole, while it should be centered in the hole... and it is a bit angular pointing toward another tooth. But- you must give Dr. Mazur some credit... he's adventurous. And creative. And spends 2.5-3 hours trying and retrying to craft something that will attach to the ill placed abutment and look semi-normal. It didn’t work.
So now I'm back to the flipper. Yeah... I thought he was going to cut it up in the lab too... But something told him not to do that - probably only by the grace of God did he not do that. So today I love my flipper. I don't care what words I can't say.

But the saga doesn’t end here... we are probably back to square one... which might mean lather, rinse, repeat. Yes, we might have to pull out the implant, grow some bone, and start all over again. There's a chance of a "better flipper" while we wait. And now I wait for the phone tag to take place again... Mazur to Gomes, Gomes to Me, me to Mazur. I'll keep you all posted!

Day 3 of ~ 120 Tooth Saga

*****Section one- tooth history and deciding a course of action************ I have a tooth I have affectionately called "my freaky tooth" for my entire life. It is one of my front teeth. It has it's own medical history and a variety of procedures performed on it over a life time (oral surgery at 10, root canal at 13, braces twice to hold it in place, etc.)
I started having trouble with the gum around it a few months back. After a few trial and error procedures, my dentist (Dr. Mazur) decided that he thought it might have a fracture in the tooth so he sent me to the endodontist (Dr. Hart) to determine that. Dr. Hart did a couple procedures (including drilling out a 20 year old root canal that they must have used concrete to seal since his drill bit kept getting caught in it) and trimmed away some gum tissue and still did not see a fracture. Hmmm. So he sent me to the periodontist (Dr. Gomes) so see what he suggested before Dr. Hart did any more. Well... he and Dr. Hart decided the best treatment would probably be to extract the tooth and do an implant, much to the dismay of my regular dentist, Dr. Mazur. After a long conversation and some 5 year guarantee of failure, Dr. Mazur was convinced that was the right course of action too.

******* OK- If you knew all that already... you can skip to here**********
Ok- so for aesthetic purposes they make something called a flipper that is basically like a retainer with a fake tooth attached so I don’t have to walk around with this huge hole in my head. I was supposed to go pick up my flipper from Dr. Mazur's office last Thursday so I would have it in hand when I went for my oral surgery this past Monday morning. Well... Dr. Mazur's office called and said they did not have the flipper yet, but they would have it directly delivered to Dr. Gomes office so not to worry about it, it would be there in time for my surgery Monday morning. So we get to the office at 8:15 Monday morning and my first question is- do you have my flipper. The appropriate retort was, no we thought you were bringing it with you. Nope... they said it wasn’t ready and it would be here for my surgery. So they sent out a search team to find it and Dr. Gomes says not to worry about it because he will "do something" if we don't find the flipper. Did I mention he's from Venezuela and has a fun accent? :) It's so much more fun to read that way. So when they take me back there, I ask him what the something is that we are going to do if we don’t' find the flipper. (OK- they aren't finding the flipper- did I mention that Dr. Mazur's office is closed this week so they can't check to see if it got delivered there instead? :) ) So here's what they do...
He took out the real tooth and he cut off the root of that tooth and then used resin to glue it to the 2 teeth next to it. Interesting concept and not such a bad idea since unlike the flipper, it would stay in. So he says we will leave this as long as it stays, but if it falls out then come right in and we will put the flipper in. Turns out there was a fracture in the tooth too..so it was the right thing to do... and now I have a titanium post in my jawbone that feels like it goes up into my nose. :)
So... I go home... bleed a lot... don't rest much.. eat soft foods. Tuesday, stay home from work, sleep most of the day... eat soft foods... feeling pretty good by Tuesday night. So I get up this morning, get in the shower... and feel a pop. Sure enough... one side of the resin had popped loose... so I went in this morning and now I have been flipperized afterall. It's a pain...literally.. pushing on the incision and hard to talk with it in. So its lots of fun. :) And it's only day 3 of approx 120 days of fun! Dr. Gomes said I will only have this for a few weeks and then we will, of course, "do something else" :) I can't wait...

The Moment You've All Been Waiting For

Ok- so I finally decided to do it. It's actually a blog about my tooth. I will post all the previous happenings so people can catch up if they are not up-to-date on the craziness and adventures of one little tooth! I hope you enjoy!