Planting a tooth

 The day of my operation arrived with some impatience and some nervousness. Getting something permanent into your body gives pause for thought. What if they do it incorrectly? It takes many months to go through the tooth implant process and I remind myself that it's a bit like pregnancy; once you start down that track you just have to cope with what happens 'til the end.

Loaded to the gills with antibiotics to protect my heart from  possible infection, I lay back in the chair. I was told to rinse my mouth very slowly with an antiseptic wash. There were several gowned nurses present. A table loaded with tools was placed across me and a screen so I couldn't see what was being done but I had a fair idea.

Anaesthetic: I was given 7 injections. The ones into the roof of my mouth were quite painful. It seemed the process went on and on. There was no effort to numb anything before this process went inexorably on. By the time my bum was about to exit the chair the anaesthesia was already starting to wear off. My suggestion to those of you undertaking the  procedure would be to take heaps of paracetamol in advance.

Extraction: Since my tooth had sheered off at gum level, the rest of the tooth needed to be pulled out. With all the tools at his disposal the surgeon seemed to effect this procedure quite easily, maybe because front teeth do not have double roots.

Drilling: Boys and their toys. There seemed to be endless changing of drills - different speeds and diametres. Check out the video link below for a better idea of what they get up to. It is not distressing but you do know what they are doing and you do hear and have a sensation of your jawbone crunching into crumbs. The screw was put in using various screwdrivers. It seemed there were as many screwdrivers used as drills. At the start of the procedure the surgeon uses a transparent guide made from a previous mouth impression, to make sure he gets the location and angle right.

Bone graft: It was at this point I was in for a surprise; the doctor said there was space between the socket and the newly installed screw so he would pack that with a combination of calcified cow bone and bits of my own jawbone he had harvested. Yes, I could feel the gritty mixture being packed in. There was enough bone density in my jaw for the screw and to support the implant in future but having extra space would not have encouraged the bone cells to migrate and fuse to the screw. So, I have cow DNA in my mouth? MOO!

Suturing: I discovered the anaesthesia coverage was becoming inadequate at this stage. I could often feel the needle going in. It made my eyes water. Later on I mentioned this to the surgeon. He replied that injecting me with more anaesthetic would have stung as much as the suturing. No warm fuzzies there.

After surgery I was driven home by a good friend. The pain probably could have distracted me from my driving though I was not sedated so it was great to have someone to get me home and spend some time distracting me by jamming with music. Make sure you have plenty of paracetamol. It takes the edge off the pain for the next few days.

Ten days after surgery I still had some localised swelling and discomfort. I was very careful not to get any food in the socket area as it hurts if you do. The wound remains tender. After 15 days I had the sutures removed. In three months there is a check up to check if bone integration is a success. Osteointegration is critical, otherwise the entire process has failed.

Unfortunately for me I developed a really violent and persistent cough. It was so violent it caused a 4-hour nose bleed from both nostrils and quite a bit of blood-loss. The worst was feeling what that cough was doing to my bone graft. I could feel 'something' being ripped away inside the socket. Each time that I coughed there was instant stinging. Three and a half weeks after the implant operation I have still a lot of painful swelling around the socket. I think this is the cough trauma to the bone graft but I can get no response from the surgeon's office.We are in lockdown and the timing couldn't be worse. I copied in a dentist who rang me after a couple of days to discuss. If the area does not become infected and if inflammation does not increase and if my persistent cough calms down a bit my bone graft should gradually sort itself out. Maybe the bone cells keep trying to regrow. I hope so as it is not painless after all these weeks and it should be. 

Hygiene: You need to brush the area with a softened baby's toothbrush after 2-3 weeks. I am doing that and it seems to be a good idea for simulating blood circulation. I have also never stopped flossing on either side of the socket. I sure hope the horrendous expense and some suffering is worth the result (whenever that is).

A detailed instructional video for surgeons and curious patients like me

https://www.youtube.com/watch?v=A7FYMRExufg&t=262s