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Yet another new health-related development has reared its ugly head.

Three years ago I had a dental implant for one of my eyeteeth that didn’t descend normally. A dental implant involves the implant itself, which is the screw mount that goes into your bone. After that heals for several months, they install an abutment that screws into the implant and provides a post for mounting a crown, and then once that settles in, the dentist puts in a crown. The procedures were expensive, not covered by insurance, and not my idea of fun. But it was over – or so I thought.

When I went in for my routine cleaning last week, the hygienist said, “your implant shouldn’t be wiggly.” Really? I never complained about it because it doesn’t hurt and I didn’t know implants are not supposed to move (like your natural teeth do). So this week I went in again so that the dentist could check on it. He confirmed the wiggliness but couldn’t tell what part of the whole apparatus was loose, so he sent me to the oral surgeon (who got me in the same day) to figure out whether the implant or the abutment was at fault.

Radiograph of the pre-crown implant 3 years ago. The areas circled in red are where the bone has since deteriorated.

It’s the implant. Apparently the bone that it mounts into has resorbed. The oral surgeon says he’s never seen anything like it before, but I’ve clearly lost a lot of bone around the implant and my jawbone has become thin in that area.

At least they can do something about it. First, the implant will be removed for a bone graft. They will fill up the hollow spot with (sterile) bone paste from cadavers because it provides structure and also signals the body to build new bone. They will also install a membrane to prevent my gums from healing over the location, which would be painful to correct. After 4-5 months (minimum) healing time, they will do a new implant all over again. So it will be about a year before my mouth is back to normal.

In the meantime, I have to get another flipper made so I don’t look like a toothless yokel or hockey player. It’s necessary since I’ll have no tooth for most of a year. Fortunately, the oral surgeon is doing the implant removal and graft at no charge (presumably the second implant too, I hope) and the dentist is making the flipper at no charge. I’m incredibly grateful to have such an awesome dental team, but can’t help wondering why that ethic of care so rarely transfers to mental health.

Unfortunately, I’ll probably need another crown. My lovely porcelain eyetooth will likely be destroyed in the process of removing the current implant; they tried to make it permanent, after all. The new implant will probably require a differently structured crown anyway. A crown like that costs about $1200, and I doubt the dentist will provide that one gratis.

But the price tag isn’t what has me cringing. Oral surgery is always painful. The lengthy healing times make it particularly irritating. Sutures in the gums are never fun. There are at least a half dozen or more appointments involved, and it seems like I already have more than my fair share of health-related appointments clogging up my days. The last thing I need in my life is another complication, but hopefully it’ll all go smoothly this time around. Hopefully.

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