I have always been frightened of the dentist; not that one has ever hurt me.
It’s something about not being able to see what they’re doing. At one point, aged about twelve, I simply refused to open my mouth wide enough. So the dentist decided that I should have gas – and be completely unconscious – before he gave me a filling. I’ve managed to row back from that madness but over the intervening years, I’ve had the least amount of dental work possible and stored up all sorts of problems for the future – always hoping that the future would never arrive.
I was probably the last person in the country to hear about dental implants because if anybody talked about their teeth, I would either change the subject or put my fingers in my ears and go ‘la, la, la’. So when the news somehow filtered into my closed mind, I was both intrigued and appalled. On one hand, dental implants sounded like what I needed. On the other hand, it involved drilling into my jawbone – the stuff of my worst nightmares. In the meantime, my bridge over three teeth collapsed and was replaced by one over four teeth and a warning from my dentist: ‘This is only a temporary measure.’ In the meantime, I favoured the other side of my mouth and tried to shut out an overheard conversation in a pub about implants that failed and dentures which didn’t fit.
Last August, on holiday in Germany, the four tooth bridge broke for the second time. It was nothing very challenging just a humble bread roll. My choice was leaving a huge gap, having dentures or dealing with my dental problems for once and for all. I was veering towards the first option which is a shameful thing to admit – especially as a marital therapist (and author) I’m forever advising people to face up to their fears. Fortunately, I phoned a friend who’d had dental implants. He couldn’t praise them highly enough. His implants were not only stronger than his real teeth but he could eat anything he wanted.
‘What about the pain?’ I asked.
‘Nothing that a couple of paracetamol couldn’t fix.’
‘Really?’ I wanted to believe him but something was holding me back.
My friend gave me a recommendation and I googled the practice. I had only trusted two dentists in last twenty-five years but one of their team, Guy Barwell, was also a medical doctor and had read Psychology with a focus on reducing dental anxiety. I made an appointment.
My Assessment Appointment
I didn’t have to lie down in the chair and open my mouth but first talked face-to-face about my dental history. There was a full hour for him to explain the procedure and for me to ask questions.
Guy examined my mouth and his assistant took a 360 degree scan of my head (which would be sent onto my dentist, so I felt the treatment would be joined up). Perhaps most reassuringly, he told me I had good healthy gums and jaws. My problem was out-of-date dentistry which had simply worn out. A few days later, I had the costings in writing and a treatment plan.
After much thought, I opted for three implants and sedation – which cost three hundred pounds extra – partly because I’m a coward and mainly because Guy recommended it. (I think he wanted to be concentrating on placing the implant rather reassuring me.)
What’s it like having an implant?
During the week before, I began to obsess about all sorts of stupid things – like whether my blood pressure would be too high for sedation – and the night before I had my first ever panic attack. However on the day, Guy was calm, business like and I think relieved that I’d opted for the sedation. The last thing, I remember is the anaesthetist telling me to count backwards from ten.
When I came round from the sedation, my tongue immediately went to where the bridge had been and found two small buttons. Next, my tongue explored the other side – top at the middle – where I’d decided to have a poorly capped tooth removed and a implant in its place. Once again, there was a small button. They were like manhole covers protecting Guy’s work. Amazingly, my mouth didn’t feel anymore invaded than when I’d previously had a simple extraction.
Guy told me that he was very pleased with his work and he’d left instructions with the friend who’d been recruited to drive me home. I left the practise with a small carrier bag containing a weeks supply of paracetamol and a mouth wash to prevent any infections – so I didn’t have to stop off at a chemists. Another nice touch.
Because of the sedation, I only have brief patches of memory about the journey home but my next door neighbour reported that I had a big smile on my face when I came to collect the dog. I went to sleep for about an hour and woke up feeling more like myself. Although Guy had warned, there might be some bleeding – and not to worry – I had only a little blood in my saliva and a small stain on the pillow. In the evening, I ate risotto (no chewing) took my paracetamol and had an early night.
The next morning, I woke-up feeling something close to euphoria. No pain. No bleeding (just a little stain on the pillow again). I had a minor headache – probably the after effects of the sedation – which was quickly sorted by aspirin. My friend had been right. I was amazed. A week later, I returned and Guy took out the stitches. Up to that point, I hadn’t been away that there were any!
My failed bridge had been at the back of my mouth and because the gap didn’t show, I didn’t have dentures. Over the proceeding weeks, my gums had hardened, and with no pain from the buttons, I could chew most things on both sides of my mouth. About ten weeks later, for my next appointment which lasted only fifteen minutes. Basically, Guy wanted and was to check the implants were robust enough to take a tooth. This involved him putting a small screw driver into the button. There was a slight click in my head – which was really weird – and Guy took the buttons out. Next, he searched for any debris in the implant and screwed the buttons back in again. I already knew that the implants had taken: there’d been no bleeding, no swelling and they’d always felt like they belonged in my mouth. However, I was still pleased when Guy confirmed the procedure had been 100% successful.
While I waited in reception for my next appointment, with a dentist who specialised in fitting the teeth, I saw someone come out of the surgery and collect a small white carrier bag. As it was not a sedation day, she had obviously had her work with just the normal numbing. She looked a little fragile but definitely OK. I was contemplating whether I’d be capable of doing the same, if god forbid, I ever needed more work. At that point, I was called to get an impression of my jaw.
There’s still a way to go before I totally conquer my phobia, as I started worrying that the blue gloop used to model the position of my teeth might pull out my implants – even though they were beneath my gums! Fortunately, the Dentist, Tony Rose, listened patiently and reassured me that he would stop whenever I needed a break. He took the buttons out again – which Guy had left slightly loosened – and prepared the mould.
Once again my overactive imagination conjured up scenes of medieval torture; while reality was a kind man and all the comforts of modern technology. After Tony had finished, he screwed the buttons back and offered to show me the mould – but my curiosity had been sated.
Having my implants fitted
About two weeks after the impression, I returned to have the teeth fitted onto the implants. By this point, I’d stopped feeling nervous before I entered the offices and bizarrely enough I thought I might miss the buttons.
I had wondered how the teeth would be screwed into the implant – especially as at the top of my mouth the tooth could not be rotated into place. However at my previous visit, Tony had explained that the top of the tooth would be left open so he could insert a screwdriver.
First, I was given an injection – because the teeth can sometimes pinch the surrounding gum when they are screwed into place. Next, Tony started with the single tooth on the top of my mouth. It slotted into place quite easily – in fact too easily. I was a little confused because it seemed Tony fitted it not once but twice. I tried to concentrate on the radio playing in the background and forget about what was happening in my mouth.
It turned out that Tony was concerned that the technician had made the tooth too small and that food might be able to get down into the gap. ‘It’s always better if they make them slightly too tight,’ said Tony, ‘I can always polish away but I can’t build up.’ Although the new tooth had felt right to me, it was deeply reassuring that the team would only accept the best. ‘I’m going to have to send this one back,’ said Tony and he replaced my old friend the button.
Moving onto the two implants which had replaced my bridge, the first one slipped in without any problems. Unfortunately, there was a problem with the next one. Every time Tony tightened the tooth, his screwdriver would get stuck in the socket at the top of the tooth. I started to wriggle in the chair. Fortunately, Tony was 100% calm – I know because I’ve had dentists who sweat under pressure.
We stopped for a second. I took a couple of deep breaths and Tony decided to make a tiny adjustment to the top of the implant with his drill. As my mouth had been numbed by the injection, I wasn’t particularly worried and there wasn’t enough time for my imagination to go into overdrive. Before I knew it, the tooth had been fitted onto the implant. This time, Tony had no problems removing the screwdriver. The worst was over.
Finally, Tony put a small tab of tape over the top of the screws – so there would always be the option of removing the tooth – and filled in the top of the tooth.
The following week, I returned and the third tooth was fitted, this time without any problems, and I made an appointment for a final check-up in four weeks time.
Before I left, Tony stressed the importance to looking after my implants (and showed the proper way to floss). He also explained how the new teeth would feel a little strange at first. Obviously, my tongue had to get used to finding something where there had been a gap but it more profound than that.
Apparently our teeth respond to pressure and move ever so slightly as we bite down. Even if you have root canal work – and the tooth is completely dead – it still responds in the same way. By contrast, dental implants are fixed into the jaw and don’t move in the same way. It seemed strange to think that my new teeth were more secure than my old ones – but it chimed with that my friend had said when we’d first spoken.
The final check-up
It does take a while to a get used to eating with implants. With the new tooth on my top jaw, I was able to chew normally within twenty-four hours. Being one of the middle teeth, I think it gets away lightly – as it doesn’t have the biting down involved with, for example, eating an apple nor the heavy duty work of chewing. Basically, I’ve totally forgotten that I have an implant there.
In contrast, the two back teeth – which replace the bridge – see plenty of action and as Tony predicted feel a ‘bit dead’. Let me try and explain what he means, we are so used to the minute movements of our teeth that we are completely unaware of them. It is only when this action stops that we notice anything – like how we never hear the fridge motor until it stops…… and the kitchen feels eerily quiet.
The first week of eating with the lower implants, they did feel alien. Almost as if, they were too secure. However as time has gone on, I’ve got more and more used to the ‘dental silence’. By the second week, I would eat, for example, baked salmon with new potatoes and a crunchy green salad (and never thought once about the implants) but then I would have roast pork and chew first on the other side. It’s not that I thought the implants were going to break or couldn’t cope with the extra work of meat, just my brain needs time to adjust to a different sensation.
Many of Tony’s patients report, they are still getting used to their implants at six months but have completely forgotten that they are there at twelve months. In my experience, I would half or even quarter that time scale. By the time of my four week check up, I was only aware of the implants when eating muesli with brazil nuts. So I fully expect to have lost this sense of them being ‘ghost teeth’ that don’t react in the same way of my other teeth over the next few weeks.
The four week check-up was the end of the treatment programme. However the Implant Centre offers an insurance policy for implants which covers six monthly check-ups and the cost of any necessary treatment.
How having dental implants has changed me
I never thought I would write this, but I feel more confident. By trying to accommodate my fears, and having the least amount of dental work done, I’d made things worse rather than better.
Before going to for implants, my personal Room 101 would have contained a dentist ready to drill into my jaw bone. Facing the very worst and finding my fears were just shadows in my own head is incredibly liberating. The truth is that the only thing we have to fear is fear itself. I’ve always known this intellectually but its been harder to hold onto at 3am in the morning.
So next time, I start worrying I will remember the euphoria of waking up the morning after the implants. It is much better to look your demons in the face, work out what can be done to fix a problem and then take the first step (like I did when I picked up the phone and made my first appointment.) So I will always be grateful to Guy, Tony and the team for making this truly a painless experience and emptying my Room 101.
Psychologically having dental implants, rather than dentures, keeps me firmly in the ranks of the middle aged – rather than the elderly. I’m fifty and therefore far too young to put my teeth in a glass by my bed. Strangely enough, I feel like I’ve been given a second chance. I remember, as a child, the dentist telling me to look after my adult teeth because, unlike after milk teeth, I wouldn’t get another set.
Fortunately, I only needed three implants but they have given me a new lease of dental life. I don’t have to worry when eating a steak or a granary roll. I can look down the menu and chose what I’d like rather than what’s easy to eat. It feels good.
How to decide if dental implants are for you
Before I had my implants, I did not discuss the procedure with most friends or acquaintances – partly to try and forget about it and mainly to avoid having their fears piled onto mine. Since completing the work, I’ve told a couple of people and seen the same look of fear and curiosity. So would I recommend it? Most definitely yes. It is expensive – much more than I initially expected – but the joy of being able to eat what I want is greater than I imagined.
This posting was originally written seven years ago, as I’m now fifty-seven, and I’ve had no problems with my implants since and still stand by ever word I wrote.
Thanks so much for posting this. I had to get my own dental implants and knowing what to expect from a patient’s point of view helped calm my fears.