- Oral Health
My Experience of the Dental Implant Process
On the 18th June 2011 I was unfortunate enough to catch the heel of my shoe in a pothole, (resulting in a nasty fall), whilst walking home from a neighbour's retirement party (and no, I hadn't had much to drink). I was lucky in as much as it happened in the lane outside where my Husband and I live, but unlucky in the fact I landed badly and my upper right frontal incisor was immediately shattered as it made contact with the road surface, leaving the nerve exposed and me bleeding from my lips and mouth area. It was obvious that this was not a tooth that could be saved as a large part of it had sheered off vertically, so there was no possible way there would be enough tooth / root left for a crown to be an option. Even a quick glance in the mirror once I got back to the safety of our own bathroom told me I was going to need a dental implant.
The following day my Husband had the good sense to photograph the two potholes that were in the relevant part of the lane outside where we lived. We were still under the impression that the local traffic committee here in Guernsey (in the British Channel Islands), would be responsible for my dentist's bill, as surely it was their job to maintain the road in a good state of repair! My Husband contacted them on the Monday morning, and the gentleman he spoke to didn't seem to think this would be a problem and referred us to their insurance company. Within an hour of their conversation the same gentleman had been out and spray painted around the potholes with pink paint, and within 48 hours the potholes had all been filled in (it turned out there was also a third pothole on the other side of the lane further down). In the meantime I went to my dentist who took photos of the damage to my tooth, and then he initially removed the nerve and the majority of the tooth whilst a temporary denture could be made.
For the next week or so I had to cope with having just half a tooth left, which made me very uncomfortable about going out in public, but eventually the artificial denture was ready and I had another appointment to get it fitted. I should add that by now I had been X-rayed as well to make sure there was no underlying damage to the bone from the impact. The bill was creeping up, and the dentist I was using I later discovered is known for being very expensive compared to others on this island. Right now we were not too worried as our dentist seemed happy to wait for the insurance company to pay the bill.
I went in to my next appointment to have the remainder of the original tooth removed, and the temporary denture fitted. This proved to not be any consolation at all, as once my dentist put the temporary denture in my mouth, (and I went home and looked at it properly in the mirror), I realised the temporary tooth looked awful, it was way too long and did not look like it belonged in my mouth at all. This stressed me out completely, and I refused to wear it or to go out in it. Instead I emailed the dentist and complained to say I was not happy (especially as the temporary denture was £595 of the bill). He didn't answer the actual email, but at my next appointment he explained the denture is not meant to be cosmetically a good match, but that he would file it down somewhat so that it was a better length to match the tooth next to it. He did this, and also filled the chips on the other upper frontal incisor which helped the lengths to be a better match, but it was still uncomfortable to wear, and was impossible to eat with as it would just come loose in my mouth and end up churning around with the food like some kind of bizarre washing machine cycle. This became such a problem that I stopped eating out completely and only ate at home where I could remove the denture from my mouth to eat.
I was now becoming increasingly depressed, my self confidence was at rock bottom, and to coin a phrase, I felt like 'Janet Street Porter' or 'Esther Rantzen' (in other words like I had a mouth overly full of teeth). You can therefore imagine my distress when a letter came through from the insurance company used by the States of Guernsey, essentially saying they were 'sorry to hear about my accident, but as there was no 'Highways Act' in Guernsey, the States were not liable for my accident, therefore they hoped I would recover soon, but they would not be paying out for the dentist's bill'. I was horrified, and immediately got my Husband to phone the man he had spoken to originally. The response was not helpful, as he essentially said, 'oh well, that is all I can do, so tough luck', (only in more polite terms).
We then decided to try going to the States of Guernsey Social Security Department to see if they would cover my bill because I was unemployed at the time and on unemployment benefits. They initially said that yes, they would pay the bill, so again we breathed a sigh of relief. Our dentist faxed them through the bill so far, and applied discounts to it that they apparently offer when the States of Guernsey Social Security Department are covering a bill. At that point in time the bill was already at £1390+ and I hadn't even got as far as the implant process. Our relief was short lived when a couple of weeks later a senior manager in the same Social Security Department overruled the decision to pay my dental bill because he felt my Husband earned too much! Our dentist immediately removed all the discounts and we were left to scrape around in order to pay off the £1390+ the bill had reached.
Our second plan was to pay the dentist for the remainder of the process in installments of £100 per month, but we were becoming concerned by the length of time the whole process was taking, and the repeated appointments that seemed to achieve little, and that often lasted all of about five minutes. Meanwhile the bill continued to creep up and we were hearing rumours that this dentist whilst very good, was also very expensive compared to other equally good local dentists.
The last appointment I had with him was on the 18th October 2011, and he took another X-ray of my front upper mandible where the tooth had been, told me the bone had been preserved well (this was without even developing the X-ray), and that he would be away the following week, but would be writing to me the week after with a quote for the proposed work. Assuming I was happy with the quote I would need to sign and return an enclosed form so that we could proceed either late this year or early next year.
I went home feeling relieved there was at least some sign of this ending, but then a few days later I got a letter through from our local hospital for yet another dental X-ray, only this time it would be a full panorex of my entire teeth, and this was going to cost a further £50. My dentist had said nothing about this to me, and I was naturally concerned. I emailed the practice immediately to query this appointment, and said that I knew my dentist was away right now, but as the hospital X-ray was due the Friday of that week (before my dentist would return), could another dentist look at my records and let me know why this extra X-ray was necessary and if there was a problem that had shown up on the smaller X-ray carried out within the practice? I heard nothing back. Frustrated I emailed the practice again two days later saying I had not had a response yet, and had they received my email? Almost immediately I got a short curt email back saying they couldn't speak to Dr ****** until he returned on Monday. Now I was getting annoyed, and I emailed them again saying that I knew he was away, and I had stated this in my first email to them, and that Monday would be too late because my appointment was this Friday. They then phoned me, and said to me that they had looked at my records and this extra X-ray was normal procedure, but I could always cancel the appointment until I could discuss it with Dr ****** upon his return. I couldn't help wondering why their administration was so poor that they hadn't noted what I had said in my first email at all, or bothered to respond to it without my chasing it up, especially in light of their prices being so high.
I decided that rather than delay things any longer I would go for the X-ray at the hospital, and then see what happened when my dentist returned.
Meanwhile I had stopped claiming unemployment benefits voluntarily, so my Husband and I decided to approach our local Social Security Department again and see if they would now look at contributing to my dental implant. My Husband made contact with the dentist and asked for a quote for the final part of the process, and was told it would be about another £2500!!! This would have brought the bill for the entire process to about £3900, an exorbitant amount for one tooth. The Social Security Department apparently felt the same, as the person my Husband saw there informed him they felt the fees this dentist charged generally were 'greedy', and they would not even offer a contribution to the procedure if I used this dentist for the remainder of the process. What they did say was that if I used one of a couple of other dentists they suggested on the island, or if I went to the UK to have it done, then we could apply for a grant of up to £700 towards the costs. We had no choice but to agree, and to be honest I felt quite relieved that the decision was made to go elsewhere.
We opted to go to a South African dentist locally, and I was amazed when he said he could literally fit the implant whenever I wanted, and the crown a week later. Why had it all taken so long and been dragged out for over five and a half months by my previous dentist? Apparently three months would have been normal to allow for any damage to the bone to heal, but this had been nearly double that length of time. Even more amazing the new dentist only wanted £1500 to finish off the process, (which was £1000 less than the original dentist), and he didn't need to see any of the X-rays, including the most recent full panorex taken at the hospital.
I was all smiles at this news, especially as now instead of having to wait until January for a new tooth, I would have my dental implant completed in time for Christmas, ('All I want for Christmas is my Two Front Teeth' as the song goes!)
I went to the new dentist for the implant to be placed on the 7th December 2011. It took less than half an hour for the process to be completed. It wasn't painful, although perhaps a little uncomfortable in places, and both the dentist and his nurse were totally professional throughout, explaining step by step what they were doing and why. Having fitted the implant post, they adapted the temporary denture so that I could still wear it for the next week whilst the crown was made according to dental impressions they had taken of both my upper and lower teeth.
When I left the practice after the implant I was in mild pain for about eight hours, but as they had explained, this was due to the pressure on the bone now the implant was in place. I didn't need painkillers at all, and found a glass of red wine took away any ache.
The final appointment was for the crown to be fitted on the post / implant, and this was on the 15th December 2011.
We now have to submit the dental bill we have paid to the States of Guernsey Social Security Department and hope they pay the full £700 grant towards it. We are still disgusted that the local authorities cannot be held liable for the full bill as it was caused as a result of a pothole in their roads that residents pay taxes for them to maintain. There is no such thing as 'No Win No Fee' legal assistance in Guernsey, and we cannot afford to sue the States of Guernsey privately even if there was an actual law they were obviously in breach of. It is very frustrating, but as soon as we see any evidence that anyone else has successfully sued them for a similar occurrence, then we will seriously look at taking action ourselves one way or another (however we pay for it).
Meanwhile I hope this article has given anyone facing a dental implant a better idea of what to expect, and also made them aware that it is worth shopping around for quotes before you commit to the first dentist you happen to go to. I am now permanently changing to the South African dentist who completed my dental implant, not least because I like him, and that he was fair, not 'greedy' with his prices.
It is also worth mentioning that anyone who is on a very tight budget can save a small fortune by going to a country like Latvia or Thailand to get this kind of dental work done. They are incredibly professional and thorough, and probably would have done the work I needed doing for under £300, which is a lot less than the £2890+ it has cost having it done in Guernsey (and which nearly cost £3890).