More dental implant procedures

I was back with the Implant dentist yesterday. First off he asked if I wanted a local anaesthetic. I thought about it for a moment and said no. Last time he unscrewed the healing caps it smarted only a little bit and the anaesthetic would have hurt far more. I also hate the numb face that lasts for hours afterwards. I’d rather no anaesthetic if I can help it.

He told me he would be fitting in the metal frame, to make sure everything fits before making up the final bridge (I have two implants next to my canines which will hold a bridge of four teeth). The metal thing was a sort of square U shaped piece of metal, each end screwing into the implant. Unscrewing the healing caps was practically painless, then he started to screw this thing in and it stung a bit, then it felt tight and then (with further tightening) it hurt, then it REALLY hurt, then I squeezed my eyes shut because it was hurting so much and my face flushed. Then my lower back lifted off the chair I started to sweat a little. I put my hand up and said “I think I’d like the anaesthetic”.

He had the needle ready and it went in and OH MY GOODNESS that hurt so much. I’ve had more than my fair share of injections in the mouth but this was a ridiculous amount of pain for what it was. I had expected the jab to hurt less than what he was doing but it was about the same.

He added a second and proceeded to screw in the frame deeper. It wouldn’t fit and he was pushing and pushing. With so much force being applied I was worried he might break my implants. They’re made of titanium, sure, but I know my bone is mere millimetres thick. I don’t want metal things snapping out of my head. I don’t want to hear a loud crunch and have been through all this for nothing (or worse! to go through it all again). Despite the anaesthetic at the front, I could still feel the tightening and pulling at the gum behind the area but it was acceptable pain, better than another jab, anyway.

He kept going away to modify this U shaped bit of metal, pushing it in, modifying it, pushing again. The thing wouldn’t fit and when his colleague came in they spoke about the limitations of the impression they send to the lab, hence this frame not quite fitting correctly. Clearly this was not part of the plan.

He modified it a little further and asked if I mind he make tiny incision at the gum. I was quivering by now, still shaken from the earlier experiences, but said “yeah, go ahead” (I was numb, so what does it matter?) and so another injection where the gum had felt tight earlier. God that jab hurt a lot, too. I must have been too tense or something – they do smart but not usually that much.

After the incision, it fit a lot better and I was to bite onto some quick-hardening goo (to show exactly where my bottom teeth will be, to prevent them bashing the bridge, I assume).

Once that impression was taken I was done and with wobbly knees I went off the find reception to have a further £800 removed from my personal finances. I’ve got another final installment to pay and then it’s complete. I’d pay anything to have this over and done with.

Once suitably poorer and after having plashed my face with cool water, I wibbled to the train station, wibbled to the right platform and nearly got on the wrong train, so wibbly was I. Once I’d got on the right train, I phoned Landlord and welled up a bit (I’m such a pansy!) and instead of going back to work I decided to go home (my mouth was still bleeding) and so I worked from home. But hey, it’s my last day on Tuesday – what can they do? fire me? and I think I got more done than I would if I’d been at the office anyway.

I go back in a fortnight and go through it all again but this time but with the final bridge rather than the metal try-ins. More jabs, more cuts (he said two) and for the first time I really don’t want to go. At least I know to say YES to anaesthetics next time.

I hope this is worth it. I’m so scared I’ll be disappointed with the results.

UPDATE:

to all those reading this as part of research into dental implants, I want to assure you that my teeth turned out absolutely brilliant. No Janet Street Porter but beautiful, natural looking teeth. Much better than I expected and I can eat whatever the hell I like. Case in point: today I had corn on the cob. An impossibility before with four front teeth on dentures. If you want info on the whole procedure and what it was like (not just the implant-placing bit) just leave a note in the comments.

trauma over

What a lovely weekend. Alan and I had a picnic at the beach and I read my textbook while he listened to the cricket. All very relaxing. We had ice cream, strawberries and a pic-n-mix. (see image below)

As for my healing – well the swelling has gone right down and I have almost complete use of my top lip again and look a LOT less snouty and mouse-like. I still have some bruising but the black eyes are fading now. Some of the bruises are turning yellow which will make me look unwell but they aren’t painful. Some areas of my face are still not touchable (too sensitive) and the area inside my nose is still constricted from the swelling but it’s a lot more comfortable than it was.  Before, it felt like someone was pushing something solid against my nose and pushing my top lip up and that I was in a permanent grimace.

At least I now look less like a domestic abuse victim (turns out this made The Sous Chef a little self-conscious when we were out, especially when I couldn’t smile at all and just looked permanently glum and covered in bruises).

However most importantly, psychologically I feel like myself again. I still don’t know why I reacted so badly to it all. I really did becomea bit of a wreck - fragile, depressed, tearful, agoraphobic, no appetite. Alan’s theory is it was my period. He blames everything on that (if I’m feeling cold, tired, unhappy, achey, sleepy, hungry, bloaty, sneezy bashful and doc… hold on, that’s not right… )

Actually, thinking about it now, I think he’s right (but don’t tell him). The antiobiotics I’m on interfere with my contraceptive, which will have sent my hormones all over the place, I suppose that makes him technically right but I can still shoot him vicious looks whenever he blames my menstrual cycle for what are normal life events.

anyway, I feel a whole lot better now. The old me is back, albeit still toofless and lisping like a good’un. Imagine the indiginity of playing a game of trivial pursuits and having to answer a question with “Saskatchewan”. Suddenly “I don’t know” seems the preferable answer.

My partial denture from before does not fit anymore. When I wear it and speak ok but I can’t eat with it and it’s constantly in imminent danger of coming out and I’m to wear it as little as possible. It also pushes against the stitches, so for practical reasons,  I’m working from home this week. This is not as nice as it could be because I have LOAAADS to do and would much rather be sitting in the garden like everyone will be assuming I am doing.  Bah!

Wednesday I have the stitches removed and hopefully a modified denture so I don’t look like I’m wearing one of these

(as in the pic-n-mix Alan bought) 

post op – Day 3

 

Finally – today is the first day I don’t feel like bursting into tears and I feel a bit more like my old self again. I don’t yet look quite like myself but I do feel a bit more like the old me.

The face continues to heal. I am still swollen around the cheeks and top lip and more bruising is revealing itself, such as some new faint blue patches under both eyes and at each side of the mouth. I still feel like I have a snout rather than a mouth and the stitches/swelling make speaking difficult but I feel more like me. At the cinema last night I felt extremely small and timid. I felt like my mouth had been sewn shut and I could only look about with large, scared eyes. Maybe it’s having been couped up at home for 48 hours, too. I was actually slightly agoraphobic – the world looked terrifying.

Not being able to pull any facial expressions might be contributing to how I’ve been feeling. If you can’t smile you end up looking glum all the time, which makes you feel glum. And the world seemed so alive and vibrant and big but inside me I seemed so small, so timid, so fragile.

Thank God I’m getting the old me back now. It’s almost certainly because the swelling is reducing and I am getting some of my movement back. I can now flare my nostrils, I can pucker up a little - not enough to whistle or even kiss but nearly there. I still can’t laugh but I’m getting good at chuckling.  

Speaking and eating remain difficult and so I guess it’s no surprise I’ve lost almost a kilo since the op. And why I’m still a bit low, moodwise. I can eat strawberries if they are cut up. Good job they’re in season. Strawberries cheer me up.

To cheer me up further (and because we can’t go off cycling anywhere) Landlord and I will be spending tomorrow afternoon having a picnic on the beach. I might make a cake  – that should bring the kilo back. 

To be honest, I am totally surprised by how I’ve reacted to the operation. I expected to be swollen, bruised and want some tlc for a few days. I did NOT expect to turn into this fragile little creature that cries at the dropof a hat. I did not expect to have any emotional response other than perhaps relief. 

The bruising and swelling is no big deal – it’s not that I think I look hideously disfigured (the swelling is actually less than I expected and I reckon I got off quite lightly with the bruising – all in all I don’t look that bad) it’s been how I feel.

I don’t know. I can’t explain it.

Day 1 post op

 

It’s the day after the op and I look funny. I seem to have someone else’s mouth. All the bone and membrane that sits right under my nose is pushing my top lip forward and my bottom lip disappears beneath it all. I feel I look like a mouse. It’s definitely a snouty look. It also feel incredibly tight and is still a bit numb.

I cannot smile. The best I can manage is to pull the sides of my mouth a little and do a Mona Lisa impression. I also cannot laugh. I can chuckle but that’s it. Sneering is totally out. In other words, facial expressions are extremely limited and consequently I don’t quite feel like myself at the moment. Not being able to laugh at all is what I miss the most.

There is slight bruising but a lot less than I was expecting. I wasn’t expecting to lose my mouth, though. Even speaking is difficult as I’m trying use muscles that seem to be unavailable at present and my lips are not where my body thought it had left them. Ps and Fs are especially difficult.

I’m really not liking the looking like someone else. You get so used to what your own mouth looks and feels like and in the mirror it’s like someone else is staring back. Someone altogether more stupid looking. I hope it’s just swelling (temporary) and not the bone implants (permanent) but the dentist did say it would gradually reduce in size as the bone is absorbed – a 4 month process.

Anyway, because I can’t wear my teeth without some discomfort (and it would interfere with the healing) I’ve asked to work from home this week. Unfortunately this does not mean sitting in the garden with a tequila sunrise in each hand, as I have rather a lot of stuff to get on with. Tons, in fact.

I don’t know why but every time I write or talk about this I start to cry. Stupid huh? I don’t even know what it is I am crying about. It’s all over, right? Why the wussiness now?

Gory details. Read later if you’re having lunch

I finally did it. My Big Challenge ™. I had a clear idea in my mind how bad the dental surgery was going to be and that clear idea was truly awful. Now, often you work yourself up about how bad it’s all going to be and when it’s over you have to grudgingly admit it was a big fuss over nothing.

I was definitely being a baby about the impending procedure and I’ll admit it (on my blog, anyway). The guys at work all know about my op and someone asked what I was having done. “something horrendous” I said (not wanting to go into detail). “oh wisdom teeth is it?” he asked, naively. “no, worse than that” and his forehead scrunched as he tried to imagine what could possibly be worse than having your wisdom teeth out. In the end, having nothing to go on but their imagination’s limit of wisdom tooth extraction,  they gave me the sort of advice you give to someone who is having wisdom teeth out and told me it’s not as bad as I’m expecting. I know what having teeth out is like, I’ve been through that four times and it really is nothing too bad. It’s a few jabs with a needle, some pushing and shoving and then some bleeding. This really WILL be worse.  Or will it? Am I not working myself up for a big anti-climax?

Well ladies and gentlemen, this was EVERY BIT as bad as I expected and maybe even a little bit worse. Wisdom teeth do not take nearly two hours, nor is there scraping, nor three types of drilling, some wrenching, some hammering, some more drilling, more hammering, some screwing in, some packing in, some sewing up and an A4 sheet of paper detailing what you can, can’t, must and must not do for the next few weeks and more pills than I’ve ever taken in my life.

I got there early and felt rather calm. When I sat in the chair I was nervous but still relatively calm and my beloved sweetie who’d insisted on coming with me made a great difference. He was positive and supportive and being a real gem.  We chatted and joked until I kissed him goodbye and stepped into the surgery.

First task was to swallow about six pills. The dentist took me through what each was for (paracetamol, codein, some antibiotics etc). I took the cup, chucked the lot into the back of my mouth and took a big swig of water. One gulp and gone. No problem. It’s a practiced skill. Read that as you will.

The anaesthetic is the first necesary evil. The first jab was painless, the second less so, the third smarted a bit, the fourth brought tears to my eyes and I started to get much less calm. I’m always a little bit scared the anaesthetic won’t quite cover some parts they’re about to work on and I’ll do a vertical take-off from the dentist chair. This has never happened yet but y’know. It might. And maybe this time.

So after about 6 injections I started to get that very familiar elephant-man feeling around my face. I was given some solution to swill around to get the bitter taste of local aneasthetic out of my mouth. This was when I noticed how much my hands were shaking. I threw some water down my front and then managed to get some into my mouth. Or thought I had. I’d by now lost all sensation in my top lip now and dribbled all down myself. Fortunately the dentist and nurse were busy gowning up and didn’t notice the dribbling idiot in the chair.

After a short time to allow the aneasthetic to work and for me to start shaking more and sweating a little, they put some easy music on and I started my task of staring most intently at the one light in the ceiling that was off. Over the next two hours I got to know every detail of that light fitting. I reckon I could pick it out of a line up if I had to.

The dentist prodded and pushed about and there was that strange sensation of not feeling any pain but still knowing exactly what is happening. I tried to treat this as though he was working on a piece of wood I’m holding in my teeth rather than actually on the bone in my skull. It worked mostly – I spent the next few minutes concentrating on the sensation in an almost zen like way. It was painless but fascinating. I felt oddly calm now, even without any sedation.

The first part involved cutting the gum and peeling it back from the bone. Nice, huh? With some people (he cheerfully told me) it falls away easily but in my case it was stuck pretty fast. My gum is like superglued carpet that some bodger had glued to the floor. He seemed pleased it was this tough (“very healthy tissue”) but found it hard going. As did I. The lightfitting was failing to hold my attention, the fascination was still there but I still wished I were somewhere else.

This scraping and cutting seemed to take ages and was more cringeworthy than uncomfortable. I’m not sure how long it took but I’d guess 5- 10 minutes. He then warned me about the drill. It whined the way dentist drills always whine. It’s more psychological than anything else, though.

He made pilot holes on each side, next to my canines and that was about as awful as having a filling. “okay, this is fine. I can deal with this” so I relaxed, listened to the music and pondered whether this was going to be an anticlimax after all. Now let’s see if I can make out the writing on that lightfitting…

He drilled a bit further and then  switched to another drill. He’d warned me about this one, too. It vibrates and is to make the drilled hole a bit wider. I didn’t know what to expect but I didn’t expect it to feel like someone was trying to tune a radio with my head. The varying pitches of white noise were deafening. I was expecting radio Luxembourg at any moment. 

 While it drilled, it also sprayed copious amounts of water everywere including over me. With the fine spray was a lot of dust. The dusty bits must be bone. My bone. I’m swallowing my own bone. It tastes funny. Maybe that’s the water. How many other people have tasted their own bone?  The drilling continued and the vibration made my eyes go funny and I lost that lightfitting in the blur. It wasn’t painful, but I still wanted it to stop. 

 Again I tried to take myself back to the ‘they are working on a piece of wood resting against my teeth’ image but frankly, with the drilling getting deeper into my head (figurately and literally) that was harder to do.

Is he going to fit the implants now? No. Now comes the tapping. One screw and one small metal hammer and he’s tapping it into my head. tap tap tap Tap Tap Tap TAP TAP TAP (wiggle tapped thing about to make hole wider) tap tap TAP TAP TAP TAP (wiggle thing about again, pull it out) tap tap tap TAP TAP TAP (wiggle thing once more) At least seven or eight times this went on. He apologised and said that some people’s bone is like balsa wood and all it takes is a little push. Some people’s bone is like marble. Guess which I had.

So while Michaelangelo continued hammering into my head, I closed my eyes and pondered the almighty headache I was going to be having later. It also very much put any hangover into perspective. No more claiming it’s like someone used to my head as an anvil. Hangovers don’t even come close.

As he turned away to pick up the next drill in his arsenal, I noticed that one of my canines was throbbing. “Is it meant to throb, d’you think? when under anaesthetic I mean. Does this mean I’m getting sensation back now? Is this going to hurt?” I thought.

He came back with a different drill and it was a little bit hurty. Not much, just a bit stingy, like when you’ve eaten something too cold. I put it down to my imagination and stayed quiet. Then he pushed with the drill and it hurt a bit too much. He commented I was being a perfect patient. They always say that, don’t they? All I have to do is lie here with my gob open and move as little as possible. It’s not exactly difficult.

He switched back to the hammer oh no, please not the hammer, that’s the worst part!and after just a few taps with that I  realised: “no, this is hurting. I ain’t numb” so with a raised hand and reasonably well articulated “ung, a’ uh a ‘ih” he stopped, noted that the anaesthetic must wearing off and went for the needle again. It went in painlessly on one spot and wincingly in another (yeah, thought I wasn’t numb enough) and a few more that weren’t too sharp and work continued.

 Now that I was numb again I could go back to looking at that lightfitting. It was halogen and set into the ceiling. All the others were on, but not this one.  That is why I was looking at this one. I could see the details, it’s edges frilled out in a pleasing pattern but I really couldn’t make out the writing around its edge. Nice light though. Almost like it’s keeping me company. Looking back down on me.

I glanced up to the dentist and saw the implant. Hooray, the main event, the headline act, the one we’ve all been waiting for!

It has a thread so needs drilling but after all that tapping the drilling’s pretty harmless. I can take the whine or the white noise but hold on… what’s this? This sounds like a home drill and someone is screwing a piece of furniture together. I’m the furniture. It’s coarse and growly and it’s going straight into my head!

and in it went…ngrrrreeerrrreerreeeeeyaaaaa [stop]  (oh thank god). Then there was this little ratchet thing, like you’ve got in your toolbox. I love those. I like the clicky noise it makes. Unless it’s doing it in my head. That I like less much.

Everyone then breathed a sigh of relief, including the dentist who’d played the “ok, everything looks fantastic and it’s all going smoothly” part very well.  The nurse asked how I was and with a numb lip and no front teeth my replies were somewhat limited so I said: “harp way!” and made a thumbs up gesture.

I was relieved. Relieved that I’d got this far though I know I was about to go through the same thing all over again on the other side. Also, mental note: if anything throbs, say so.

The next implant was easier. More bone to work with. For this reason the whole thing went a lot quicker (or maybe it just seemed to). The tapping was awful. The drilling was unpleasant. The vibrating made my eyeballs shake about in ways that I no longer found so distressing and the lightfitting did its part to take my mind off things. When the dentist got in the way of me and my lightftitting I moved my attention to the brick wall I could see through the window. I could count 32 bricks from here. The bottom two row of bricks were slightly different. The colours varied enormously but worked well as a whole. Nice bricks. Bricks – let me introduce you to – the lightfitting. You’ve not met I believe.

The next implant went in. I could feel it’s form being drilled into my head. There it goes. Good job I can’t feel a thi…. oh eck, why does it sting there? why can I feel the suctiony thing over there?

He packed some bovine bone into the gap, kinda giving the ossification a kickstart and I guess cow bone is easer to harvest than my own. My hobbies now include Cycling, Dancing and chewing the cud. Haha that’s funny. I must remember to blog that.

Over this goes a membrane to keep it all neat and together and I’m just about done. Stitches next. Still that stinginess but surely I don’t need a top up this late in the game. But after about the fourth stitch it really was a bit too sore. I made a series of vowel noises to get the dentist’s attention and it worked, so more anaesthetic was added. It stung, too. Dammit, why didn’t I inarticulate sooner so the needle wouldn’t hurt again? There were far more stitches than I’d expected so just as well as I didn’t hang on.

I sat upright, was offered some water to rinse my mouth but I remembered my attempts with that last time and declined. My top lip felt about 3 inches thick and numb. It’s kinda funny to be so numb. My bottom lip felt everything fine so it’s nerves were having a bit of a one way conversation with the top lip.

The surgery done, I walked to the front desk. The dentist and nurse asked if I was ok – not dizzy or anything. Fortunately no – I was well prepared for this and wasn’t going to go into shock again this time. I felt fine. Numb, swollen, a bit sore but fine.

Over the reception desk I handed over my debit card to have £2500 lifted from it.  When that transaction was processed you could almost hear my bank going into a dead faint. I don’t spend more than £30 on anything. The sum of money about to leave my bank account is more than I earn in two months.  This is quite the unusual transaction so once my bank had been administered a dose of smelling salts and come to, they needed me to verify some details to allow the transaction to go through.  I did and pondered that I’m spending 2.5 grand one something I wouldn’t wish on my worst enemy.

After an x-ray I was free to go so with my beloved’s arm around me we trundled to the station to catch the train home. On the train I regaled him with some (not all) the details of the procedure. All the other passengers will probably have been wincing and I had the swelling and small amount of blood in the corner of my mouth to verify my story.  What I didn’t know (since I was numb from the eyeballs, the cheeks down to the top lip) was that a small trail of snot was running out of my nose adn I was totally unaware. THIS is why it’s important to have your nearest and dearest with you.

We got home, I discovered that soup for dinner was a bad idea. How do you get soup from a spoon when you’ve lost all sensation and mobility in the top lip? Answer: you don’t. You end up eating bread and cheese instead – cut into chunks to pop into your mouth.

So now, here I am. Still numb, still swollen blogging about the worst surgery I’ve ever had and with a rumbly tummy. I’m about to go to bed and I’m worried I’m still numb. I also have to avoid wearing my teeth. This means I can not say anything with the letters S, SH, CH, J, T, V, F. This makes me a poor conversation partner and even worse on the phone. Thank god for text messages. I know have some titanium screwed into my head and in a few month’s time, I’ll have proper teeth, like you have. Look after yours, folks. Seriously.

Why can’t they just  unscrew my head and I’ll pick it up when they’re don?. That would be so much simpler.

can’t believe how fast the time has gone. It’s ‘the’ week. The one in which I have two dentists, decked out in sterilised green cutting my gums open, packing powdered bone into my skull, tapping holes into my bone and making the gap wider and then screwing in some titanium screws like I’m some wardrobe, before sewing me up again and sending me home. It sounds fun and exciting, right? It doesn’t at ALL make me want to run screaming from the room. Nuh uh.
Anyway, I’ve got my prescription for one mega-dose of antibiotics to take an hour before procedure to get from the pharmacy today. GL has transferred £1200 into my acount to help pay for this first part of the procedure (I’ll be putting in my PIN for a £2200 transaction on the day – gulp) which I’ll pay back to him once the insurance company have reimbursed me what they’ve agreed to contribute. My bills will by then have amounted to £2700 (which the insurance company’s contribution will cover). The rest is due in about 4 months time when the final stage of procedure is complete (once the implants have integrated with the bone and teeth can be attached). The amount for that is sat in an ISA in my name. It’s only through my beloved GL’s help (who pays all the bills, the mortgage and council tax for us both) that I could afford to save all this money. I’ve never had £5000 in my whole life, ever. Never even owned anything of that value never mind having it in cash.

Actually, right now all my assets are cash. I own no house (nor part of) no car, no TV, no computer, no electronic goods worth anything (specifically I am thinking of my stereo I inherited from a boyfriend when I was 18 and a basic mp3 player I bought off ebay 2 years ago) . In fact, the most valuable item I own is a second hand desk I bought for £75 a few weeks ago. (A lovely desk with a leather writing surface and drawers so deep you could put a bathroom in each and call them spacious studio apartments)

I don’t know whether I’m glad to be so uncluttered with possessions and how wonderfully zen all that is or sad that I’ve little to show for my 30 years on this planet.