WARNING PG-13! There are some very graphic images in this blog.

I spent Friday morning in the office of an excellent local periodontist, Dr. Munib Derhalli, (http://www.periodontalconcepts.net/). We have worked together for many years and often meet to discuss how to get the best outcomes for our mutual patients.


But this meeting was different—I was the patient.


Dr. Derhalli skillfully removed one of my lower front teeth,


and immediately placed a titanium implant into the socket.


The procedure went smoothly with very little discomfort. In fact, I had no post-operative pain, even without pain medication!

But why would I need an implant for a front tooth anyways? It’s actually a long story that begins about 10 years ago when I discovered that I had obstructive sleep apnea (OSA.) This is a condition in which sleep is disrupted by low oxygen levels caused by the upper airway closing off. One treatment is to wear an appliance that holds the lower jaw forward and keeps the airway open. I wore such an appliance for several years before I realized that my lower jaw had permanently moved forward. My upper teeth no longer properly overlapped my lower teeth. Instead, they made contact edge to edge. At that point I switched to a continuous positive airway pressure device (CPAP) to control my sleep apnea and stopped using my oral appliance.

In the meantime, a process had begun that was slowly eating away at the roots from the outside. We don’t know all of the reasons why this occurs, but trauma is often a factor, and the way my teeth were meeting was creating trauma. By the time I discovered the problem, one of my teeth was hopeless and had to be removed. This left a space that could be closed with orthodontic therapy while also correcting the rest of my bite. I began treatment with a very skilled orthodontist from Happy Valley, Dr. Michael Brown. (http://www.sunnysideortho.com/).

IMG_0625Slowly the space closed and my teeth began to come together correctly. But as I studied the x-rays that I took during the course of treatment, it became apparent that the roots of two more teeth were dissolving. After two years my bite was normal again and the braces came off , but the two remaining teeth had gotten worse. As a result one of them was removed and replaced with an implant. The other one will remain until the implant can support two new teeth. At that time two new teeth that are connected together will be created by my lab. One of them will have a hole through it for a screw that will attach to the implant. When the remaining damaged tooth is removed, the restoration will be attached to the now healed implant.

I am very grateful for the technical advances in dentistry and for the skilled specialists that are part of my team, both of which were needed for this treatment option.

It is also important for you to know that when I recommend an implant to replace a tooth, there are a number of factors to consider. But rest assured, I have been through the procedure myself. I enjoy solving the sometimes complicated issues around optimal restorative dentistry and feel confident I can do so for you as well.