Tooth Extraction + Implant - Your Experience?

[Jax]

Ha! This will mess people up because I actually went to DAN first! AND read the other threads.

Issues:

• I want to know about other's experiences so I know what to expect.
• The local service is the doc coming into town one or two times a week, so time delay is a huge factor.
  
• I am going to Cayman Brack in mid-January so I am working on scheduling around this.

Background - long, well-attended battle with lucky #13 finally ended with a determination of extraction, and implant if desired. The extraction needs to happen PDQ as the tooth is draining. My note to DAN:

I have a tooth that has been 40 years with a root canal. The root canal was redone a year ago. The tooth is suspected of having a vertical crack and has developed an infection and will be pulled Fri. I haven't gotten a consult with the oral surgeon yet.

The bone still looks healthy. The doctor will put in an implant if possible. How long should I wait before diving?

NOTE: I am in tiny town, ARIZONA. Please do not advise me to find a diving doctor. However, if you can list someone to whom the report and x-rays can be sent, I would love that.

Answer from DAN:

Thank you for contacting Medical Services of Divers Alert Network, and for your inquiry. Your dentist / oral surgeon is the best resource for activity. He does not need to know diving, just dentistry. This is not an issue for a diving doctor, just a dentist.

Normally, following an uncomplicated dental extraction, four to six weeks is sufficient time to allow for resolution of any risk of infection. This is provided there has been good healing and gum tissue has begun to fill in the empty socket. The dentist will probably mentioned “dry socket” and the risks of infection. If proper healing is delayed, the open socket can be not only a route for infection, but also a route for air to be forced into the subcutaneous tissues, causing further injury. Pain medication can impair judgment underwater, and should have been discontinued prior to considering diving.

You did not specify which tooth is to be extracted, only “non-wisdom tooth”. Incisors are not typically a problem, but for teeth further back on the upper arch, especially molars, the tip of the root can abut the maxillary sinus floor, resulting in accidental oroantral (mouth to sinus) communication. This is not uncommon, and will further delay a return to the water. If there is sinus involvement, then the fistula (hole) should be closed and healed prior to consideration of diving.

An implant is a totally different matter than a simple extraction. When an implant is placed, whether at the time of the extraction or later, the implant needs time to osseointegrate into the surrounding bone. Micro-movement can cause the implant to fail. Some oral surgeons will recommend 6-12 months to allow complete healing prior to anything that can cause stress on the implant. If this is a tooth that would be impacted by the bite wings on your regulator mouthpiece, time to heal is even more critical.

Please have an open discussion with your oral surgeon regarding the implant and diving. He does not need to know anything about diving. Have the discussion as if you were chewing hard foods on that surface. The stress on the healing site will be similar.

 

[ibj40]

I had two implants performed, finishing the process about a year ago.

First process involved extraction by an oral surgeon, which discovered intertwined root into jaw bone, which required cadaver material to fill the void. From procedure to being cleared by the oral surgeon to go about daily activities was about 90 days to make sure nothing interfered with the assimilation of the cadaver material into my jaw bone.

Once that was completed, then the implants were installed by the oral surgeon, and he requested another 90 days to allow the incisions to heal (complicated somewhat because one of the implants was into the cadaver material). At that point, notwithstanding I was still without two teeth, I was free to do whatever I pleased.

When the dentist finally installed the new "teeth" over the implants, he asked that I defer strenuous activity (didn't specifically speak to diving) for about a month to 45 days to make sure the adhesive he used didn't get compromised (normal food consumption was okay - short of biting down on hard candy, etc.).

If it hadn't been for the cadaver material issue, I could have been diving within 45 days of either the extractions or the implants (prior to teeth being installed), which was the expected normal healing process for the disturbed gum area each time, so appears to be pretty consistent with what DAN is saying (just beware of complications like I experienced).

 

[Charles2]

I've had three or four implants. My dentist is also an avid scuba diver. I asked both the dentist and the oral surgeon prior to each procedure if they had any concern about diving. Their answer was "no". I don't remember if they had any concerns about waiting some prescribed time; but I don't think so. The new implants have never bothered me. My procedure was similar to ibj40's

 

[redacted]

You are going to love the pill.

I have had a couple done. As I recall, the extractions and implants were done in one sitting. A couple weeks for the surface to heal and then no special restrictions. The floppy they give you is not necessary unless you just want to look pretty. A other couple months before the implant ts are ready to be capped. I only remember a day or so of caution with the new caps. But they still don't want you to enjoy a Mary Jane or sugar daddy.

 

[gfaith]

@Jax Yours looks to be behind where mouth-piece and teeth contact, if I understand tooth #13 correctly. I had one on a front upper #9 as I recall and it does contact with my mouth-piece. I have no problems at all with it now in fact I forget which tooth it is.

Now as far as the cadaver or synthetic material attaching to your jaw bone only your surgical dentist can tell you how long you will have to wait. After extraction, they might even put off the implant procedure until you return from your trip. I don't know..

 

[Jax]

As my dentist and I have been tracking this tooth carefully, I am hoping there is no bone problem. But as you say, the oral surgeon will make that determination.

 

[Manneca]

I had a molar done years ago. I just had an incisor break. IIRC, I had the root dug out, flew out the next day to NC. The oral surgeon recommended a fairly long healing time. I then had the pin put in and flew out to go diving in the Seychelles and Mauritius. I never thought about mentioning diving or anything else. I would be going in to see him to make sure I'm fully healed before I get the replacement "tooth" but I'm off to Cuba to dive. I've had no issues. I took antibiotics after each procedure.

I love the implant I got a while back. My dentist recommended an implant because the neighboring teeth are strong and putting in a bridge or whatever could compromise them.

 

[flyingDiver75]

Started diving this summer in the final stages of getting a front upper tooth replaced with an implant / cap. Due to various circumstances, I needed a 'temporary' crown for multiple months. My dentist is also a diver and her only concern was stress on the temporary before I had my porcelain crown fitted.

IShe suggested putting a bit of dental wax around the temp and then molding a custom-fit mouthpiece such that the area around the tooth didn't 'grip'. Turns out, most modern mouthpieces don't grip on the front teeth in any case, so while I picked up a custom-fit to try, I haven't used it yet.

 

[Jax]

Thank you, everyone!

Tooth extracted this morning. He would have done the implant but the tooth infection had a cyst formed into the sinus. A short delay, and it will be done in plenty of time to dive Cayman Brac.

Thank you so very much for the feedback.

 

[gfaith]

Good deal Jax maybe the tooth fairy will visit you