Dental needs Delayed!

[kantuckid]

In spite of the dental plan to maintain my good dental health and ability to chew real food, I've recently found that getting a simple extraction is a far off reality! Fillings and implants, crowns etc. are not the issue but an oral surgeon who does the extractions these days and also does the gum restorative process is a 4 month wait everyone I've checked with.
 That's the first look/see visit then throw in the wait for some live action on top of that! Guy I saw Wednesday tried to make me feel better by saying the stem cell restorative process jump started the implant but reality is it's a long wait overall. 
Also, I've never fully understood why our mouth, eyes and hearing get short end of the insurance stick when we all know what they mean to quality of life. Paying as much to get a tooth extracted as it costs to get many other medical services is beyond my thinking.
I normally use the U of KY Dental College for all dental work but seems that even a much higher costing street dentist or oral surgeon is also seen via the slow boat!  

[Ed_K]

 After my stem cell transplant the Dr. and oral surgeon both that I can't ever do implants. To easy to get infections. Dentist won't even talk to me about dentures.

[Magicman]

After having knee replacement surgery and then shoulder surgery, I had to take a round of antibiotics before I having my teeth cleaned or dental work done. 

I don't know how long that will last?  I have what I suppose will be my final knee surgeon visit on the 12th, so I will ask about future dental, etc. procedures.

[kantuckid]

After my hip replacements I was running into a variety of opinions on the antibiotic before a teeth cleaning and certain other procedures. At the U of KY Dental College you don't always have the same professor for your assigned student who you keep until they graduate. So I then asked my hip doc (whos also my knee doc now) for his guidance. He provided me with a syandardized letter that relates the orthopedic doctors stand on if a person should get and antibiotic every time their teeth are cleaned or a filling, so on. Generally speaking the answer is that unless you've got a rotten mouth due that reflect overall poor dental health, you don't need to do an antibiotic. 
I had one dental prof. that went zonkers on me but now it's in my file and no problems with taking something I do not need!
I'm confused by the gum regeneration reaction comments? It's the oral surgeon who does that to begin with! The oral surgeons nurse explained that they draw your own blood then run it in a centrifuge then inject it back into your tooths former location. I reacted by saying it sounded like a knee treatment using stem cells to which she said, "yes, it's very similar". The advantage is that you get your implant sooner with a better prognosis for success as well. 
The main thing you lose is what left your billfold... :D
Another thing I learned is that there are what they called regional implant brands that have minor differences and best to stay within a brand. My dental college doesn't use the brand the oral surgeon uses where I went this Wednesday, hoping to get served sooner. I am now reffered to another dentist who's closer to my home and in the same town as a different oral surgeon so they work in tandem. My oral surgeon felt he could get me in sooner given that he worked with them both for a year or so after his residency at U of KY where I met him first in Oral Maxillo Facial Surgery when I see my students dentist. That dept provides a watch on pre-cancer area in my gums. 25 years of dipping snuff has it's bad effects! If your a dipper look my way for good advice as it's not a free ride to dip. So far, so good in my case as my biopsies come back OK for the past 5-6 years I've been on this watch. 
FWIW the orthopedic doc I see is said to be one of the best in the world at his two specialties-knees & hips. IMO, you can go to the bank with his professional organizations stand that antibiotics are not needed for majority of people with joint replacements.

[kantuckid]

After my stem cell transplant the Dr. and oral surgeon both that I can't ever do implants. To easy to get infections. Dentist won't even talk to me about dentures.

This confuses the whole idea of an implant? Why would the very person who provides that service say you cannot use that service unless it's peculiar to your own health situation. Seems to be much about your dental health, etc. that's left unsaid here?
Dentures are not something I ever hope to see in my mouth. Implant technology has greatly advanced in recent years and not just regular size vs. mini-implants. I began going to the Dental college in 2009 when I was faced with a bunch of new crowns and old crown replacements as a means to save money. In the beginning they didn't do implants, then began but not the minis, now they do them all plus the regeneration. dental colleges are conservative until somethings been in the market awhile they hold off. otherwise they are at the leading edge of dental healthcare. it's not unusual for me to receive consults from multiple areas of dental care in one student visit, oral surgery, orthodontics and other stuff I forget the name, on and on. Services not found in moist street dentist offices w/o a multiple of new appointments to see a specialist/ At near 77, I'm from the pre-flouride generation and many of us had a mouth full of silver thats now full of crowns or dentures.
 I like my teeth as I also like to eat! 8) 

[Ianab]

Why would the very person who provides that service say you cannot use that service unless it's peculiar to your own health situatio

Compromised immune system? If they do the procedure and you get a deep seated infection in your jawbone afterwards guess who the insurance companies are going to blame. 

[Ed_K]

Compromised immune system?

 Because of the blood cancer, I have no immune system. They are like Ianab, said scared to death to do anything more than clean or fix a cavity. If I do need a bad tooth taken out I have to stop my cancer treatment for 6 weeks. The 2 I did have out I lucked out as it was between old treatment and a new one. I also have necrosis of the jaw where the jaw bone just decides to rot an poke out of the gum. 

[kantuckid]

Thanks for that explanation. My comment was toward the idea that it's best to not deter others from taking advantage of anything that improves their quality of life.
My immune system is weakened by age but is also not a basis for hesitating to get implants, teeth cleaned so on. I, for one e.g. am not any more prone to get a common cold than any other person I know of, or so it seems. 
 
I got my letter of orthopedic group think, as I'll call it, after one particular dental professor at the insisted I get an immediate dose of a very powerful antibiotic to get my teeth cleaned.  
I very much dislike using an antibiotic if it's not needed. After my discussion with my orthopedic  doc I felt much better about what's needed to maintain my dental health and not endanger me. 
 
It is interesting to see the difference in approach to dental procedures from the various specialties and professors. As one e.g., I've had several peridontist referrals at the dental college and a variety of opinions. Like many my age, my gums have receded, plus as a guy who dipped for 25 years they are abraded by dipping tobacco. A couple said I needed a tissue graft and the rest/most of them, said not important at all.  
 They use some young professors who are highly trained, very much up to date in variety of aspects in their field. A few others are old fogies and may have (seems to me!) archaic approaches to certain dental procedures when I compare what I hear. 
The students I get are all in their last two years of a doctoral program and as a retired educator I really enjoy the interaction with those sharp kids. They are also a very cosmopolitan group- I've had students from all over the world and the entire USA. All colors and cultures, many are female. I've had an Albania , Iranian, California, OH, GA and so on.
  

[gspren]

 My Implant story started in January 2019 and isn't quite over yet. In 1/19 I had the tooth pulled, upper right about 3 from the back, wait several months to let the bone heal then put in the implant, wait a few months then he said it didn't take so rip it out and wait 6 more months to put in implant number 2 and then wait more months till he said good to go now back to regular dentist for the crown, take impressions and last week when they were to put on the crown the dentist didn't like the fit so he sent it back and I now have another appointment for mid December. If it works this time it will be just under two years and more $$ than my first new truck cost back in 76. I have Medicare, BlueCross retired federal worker, and VA insurance which pays pretty much all my normal medical and my prescriptions are dirt cheap, the vision and hearing are covered by the VA but none of them do Dental >:(.

[realzed]

After having knee replacement surgery and then shoulder surgery, I had to take a round of antibiotics before I having my teeth cleaned or dental work done.  

I don't know how long that will last?  I have what I suppose will be my final knee surgeon visit on the 12th, so I will ask about future dental, etc. procedures.

After my knee surgery 9 years ago - I was told I would have to take antibiotics prior to every visit for dental care and/or work (if needed) for about 5 or 6 years afterwards.. 
Now after my recent surgery (hip - a couple of moths back) I was told now it would be a regime I would always have to follow, going forward for the rest of my days for such procedures, with no time limit on it.
Maybe the thinking has changed - or possibly there is increased risk because of double (soon to be triple) replacement surgeries, as my troublesome previous TKR is tentatively scheduled to be redone after Christmas..
At any rate I guess it is a small price to pay for healthy teeth and even general overall health if that is what it takes..  

[kantuckid]

My Implant story started in January 2019 and isn't quite over yet. In 1/19 I had the tooth pulled, upper right about 3 from the back, wait several months to let the bone heal then put in the implant, wait a few months then he said it didn't take so rip it out and wait 6 more months to put in implant number 2 and then wait more months till he said good to go now back to regular dentist for the crown, take impressions and last week when they were to put on the crown the dentist didn't like the fit so he sent it back and I now have another appointment for mid December. If it works this time it will be just under two years and more $$ than my first new truck cost back in 76. I have Medicare, BlueCross retired federal worker, and VA insurance which pays pretty much all my normal medical and my prescriptions are dirt cheap, the vision and hearing are covered by the VA but none of them do Dental >:(.

The same students I see at U of KY college of dentistry also serve as dentist right behind their own bldg at the VA on campus facility in LEX., KY. The ones assigned to the VA gig are often also vets who often have taken the military cash to pay for their schooling and will do some years active after they graduate. 
It's sad that the high cost for dental care out of pocket forces seniors like me to either do with out in some cases or be forced to spend off our savings. Eyes, ears and mouth are often not covered. Even when I worked for the state of KY the Delta Dental plans offered to us paid less than enough to justify the premiums-based on price points of local dentists we were seeing who were employees of a small local hospital operated by a Catholic group. Still that same story line too. 
Another dental story line I can tell is that when I ran a juvy treatment program I often got boys who had dire dental needs but couldn't meet them due to short time spans in treatment and dentist who wouldn't begin service since the kid would be gone before they could complete the job. Had one kid form Cinn with bad "buck teeth" that I tried hard and failed to get started on braces as an e.g..
I'm seeing my student dentist tomorrow at U of KY for a filling then nextt day a "street dentist" to get my two molars pulled. The street lady doesn't do the re-generation thing, just pulls them so I'm asking the U of KY lab doc if it's a wrong move on my part to follow through with the extractions on Friday? meaning to avoid your issue with an implant that doesn't take.
I will not do a bridge. My Mother once told/warned me that all her senior friends had bridges in their drawers unused. 
The college told me 3 months wait for healing which is the same time span they'd told me on my only present implant done some years back before they began doing the re-gen gum thing. Doesn't add up for me? 
FWIW, I'm a vet but prefer to go with the various docs I have based on several factors, two major aspects are my location from services and our own income level. 

[kantuckid]

After having knee replacement surgery and then shoulder surgery, I had to take a round of antibiotics before I having my teeth cleaned or dental work done.  

I don't know how long that will last?  I have what I suppose will be my final knee surgeon visit on the 12th, so I will ask about future dental, etc. procedures.

After my knee surgery 9 years ago - I was told I would have to take antibiotics prior to every visit for dental care and/or work (if needed) for about 5 or 6 years afterwards..
Now after my recent surgery (hip - a couple of moths back) I was told now it would be a regime I would always have to follow, going forward for the rest of my days for such procedures, with no time limit on it.
Maybe the thinking has changed - or possibly there is increased risk because of double (soon to be triple) replacement surgeries, as my troublesome previous TKR is tentatively scheduled to be redone after Christmas..
At any rate I guess it is a small price to pay for healthy teeth and even general overall health if that is what it takes..  

I have had both hips replaced by same doc. Interestingly, he belongs to a group of docs from around Lexington, KY and area who do THR's and knees and they have a required class taught by a registered nurse who works near my own ortho doc for persons getting their 1st hip joint replacement. She mentions the antibiotics in the class but says to ask your own doc when getting teeth cleaned for advice. As I mentioned already my ortho docs professional group only says do the antibiotics if the patients overall dental health is very poor-meaning in my own words-"ya got a rotten mouth"...
Anecdotal proof for me is that I'm here now to tell the story :D I'll add that dentists have gone from annual cleanings to whats is now commonly seen to get your teeth cleaned every 3 months! I told the dental college to put it in my charts that I'll do it once a year and no more! 
The college used to have the students do it to learn but now they use their dental hygentists employees and my theory is they need to cover their pay. 

[Ed_K]

@kantucid, does the college have the machines that make a crown right there in 15 mins? New dentist has one, it's like the 5 axis machining centers I used to run,pretty kool.

[Raider Bill]

I've been told by both my Dentist and the knee Surgeon that from this point forward anything done in my mouth I will need antibiotics prior to and after the procedure.
Went for a cleaning, when they asked me if anything medically had changed I told them about the knee replacement they said they could not do the cleaning or anything for that matter until I took antibiotics. This will be for life.

[trapper]

I had rods placed in my back 30 years ago  required antibiotics  before dental work.  The last few years they tell me I dont need them. 

[kantuckid]

The molar crowns that I'll get next will be non-cosmetic in that have no need for white surfaces based on my preference for less$$$. The students don't make them. Long time ago dental students often did sand casting of jewelery using lost wax method I learned in jewelry class in HS. Many years later I've had a few things cast for me by a dental lab but was quite some time since then too. U of KY sends them out far as I know based on delay and comments about "that lab". 

[Old saw fixer]

Because of my hip replacement, I am supposed to take antibiotics prior to dental work, but I don't.  My periodontist also had a hip replacement and he doesn't take the meds prior to his dental work.  He also says if the docs want you to take meds they should write the script.  Never had any flack from the dental folks, not that it would do any good.

[kantuckid]

The above discussion is called "dental antibiotic prophylaxis" and the American Dental Association no longer requires a pre treatment antibiotic dating from 2012. My orthopedic doc belongs to a professional group who agrees with that.
From what I 've read this change comes from the reality that our mouths are always full of bacteria to begin with so why overuse an antibiotic. Obviously from above comments some doc are on a different page than others. 
Meanwhile here I sit playing on the web cause my extraction dentist called in sick. 
FWIW, my local MD lady had her hip replaced by same doc as myself and she said the same thing as what I just typed above about no pre-antibiotics needed for most patients who get their teeth cleaned and have an appliance. 
I could type quite a bunch of varying opinions on dental concerns as I've heard from the many faculty dentist at the dental college over the years! Some perodontists would say i needed a tissue graft on my gums, most others said not and so on, ad infinitum...
Actually it's beneficial to hear a wide range of opinions and learn.