Meeting Dr Drill - Getting a tooth implant in Thailand

[Rider]

It happened many years ago, an action of mis-spent youth and a skateboard resulting in a deadened tooth nerve and a world of hurt for a few days.
Years later it came loose and the tooth was pulled.

The result - A huge gap in my mouth and a lisp! Not what I exactly planned for in lifes rich tapestry.
However the all helpful doc wistfully made up a fake denture and in it went. This was back in Europe but I always felt the need to completly make up for the lost tooth with a full-on implant.
You know the ones, Liam Gallagher had one done when a brawl resulted in him loosing his front tooth, less than a week later he had a titanium implant drilled into his mouth and a shiny new tooth where it's unfortunate predeccessor was.

They are pretty established on the dental scene and most places have them, even in the provincial cities.

Well today I started on the road to getting my very own replacement tooth. Back home the cost would be in the region of 130,000 to 180,000 baht for an implant. But here in Thailand the price is a more reasonable 60,000 to 100,000 baht.

I took the plunge, spoke to the Doc, asked him a bunch of questions, settled on a (rough) price and got booked in.
I make sure I get assurances that if there are any major complications he'll fix them free of charge, just in case.
First came some X-rays, no big deal there, then came the nitty gritty a few days later.

Now getting an impant is no simple process like a filling, but not overly complex either. The (upper) jaw bone may or may not be sufficent to take the implant directly, in which case a bone graft will be required. This sounds pretty drastic but its typically only a small amount (a gram or so in weight). This will add a few thousand baht to the cost. The other factor is time.
Thats right you have to have plenty of time on your hands to get an impant, once the implant is in place the Dentist has to wait 6 months before inserting the replacement tooth into the implant. So the typical 2 weeker tourist will maybe struggle if they are gunning for an implant.
However, shorter courses of treatment are available, but this will cost you more as the Dentist has to use a different type of implant (more sophisticated I guess). For me I opted for the, get-it-done-in-four-months option. This added another few thousand baht to the price.

well today was D-Day for going under the knife and drill at the surgery. On walking in there the hospitality factor was laid on, water was brought out and after a short period it was into the surgery proper to meet Dr Drill!

Dr Drill was, as I expected, Chinese Thai. He looked professional and clean-cut and after brief formalities it was down to business.

First came this green cover-thing that obscured most of my vison, at first I didn't really like this but I suppose its psychological for the patient. Then came three injections, these didn't really hurt, except the last one in the roof of the mouth. I'm guessing they use ultra-fine needles that don't pierce the skin as much as the wider ones, or maybe I just got lucky?

The local anaesthetic took seconds to take hold, much faster than back home. After rinsing out the Dentist wasted no time, out came the knife and he started cutting back the gum to reveal the bone. This was the most disturbing part, for it took several deep cuts and was pretty crazy. I've had teeth drilled and root canal surgery done, but having the gum deliberately cut back and mildly feeling it was pretty new and radical for me. This was certainly going under the knife alright!
The anaesthetic (still working in) took care of 80% of the pain though and I only felt it a little bit. Dr Drill seems more Willy Wonka than sweeney todd and kept asking if I was alright, did it hurt etc etc.
After a minute of the knife treatment came the grinding part, which took an age. Then the bone graft was applied. This is important as there is a risk of the bone rejected it, hopefully not in my case though...

Then came the drilling for the implant. After a while I settled in, I was a bit apprehensive but not too worried. After this the Implant was inserted and the cut gum was stitched up and I was told to rinse out.

X-rays were taken and I got to take my first look at my new friend...



It looks pretty cool, in a bionic kind-of way I guess, but it is was it is and the titanium means it will anchor a new tooth in rock solid.

Several more appointments with Dr Drill were made to check up on the implants progress, although the implants enjoy a 95 - 97% success rate the implant still needs to be checked for the next 4 months. So its the waiting game now folks. My old denture tooth wouldn't fit in the recess due to the implant. No problem though as Dr Drill lived up to his name and ground the plastic denture down until it fit again!

As personal touch Dr Drill gives me his home phone number, the Willy Wonka treatment continues! Wondering if a golden ticket awaits on my next visit I take it, hoping I don't end up a screaming wreck when the pain-killers wear off or should the implant fail.



This is the cocktail of painkillers, anti-inflammiterys and anti-biotics I've got to take! Damn, they never mentioned this when I was making my decision to get the implant.

They also gave me the name of a powerful antibiotic (as they've run out) from the local pharmacy.

I paid half the 70,000 baht and left the clinic.

So I roll on down there, the numb effects causing a slight drool effect! Like after a filling but more so as he's injected me 3 times!

Shockingly, when i get to the pharmacy the extra antibiotics cost me 1,080 baht! I was a bit miffed but it's not like I can argue really.
But the next time I see Dr Drill I consider buzzing him on this and see if he can weave a discount, afterall, .

So now it's wait out the music to see what next week brings...

PS. The pain for the next 4 hours is nearly unbearable (mostly from the third injection) and the bleeding (from an injection, not the cutting!), while not bad, still is enough to annoy, but the extra painkillers I take help wonderfully though.

[Toy]

Thanks for the report, and congratulations to your new teeth, it keeps longer than all the others.

I've made crown and root treatment in Thailand, and I felt better about the treatment there than in Europe.

I am afraid of the dentist, but it disappeared with my treatment in Thailand

[cozza]

I had 5 (white) fillings done in Hua Hin earlier this year and paid 3000 baht.

I had to have old fillings that had half fallen out, taken out, which was painful without a needle.

I though the level of treatment was on par with here in Aus only way cheaper (even though I had no painkiller).

Can anyone suggest or recommend dentists that take foreigners or even share their experiences much like Rider has.

[crazy88]

I recently visited the smile corner clinic,the first time I had been to a dentist in 15 years .I fully expected them to find something they would need to do to my teeth whether required or not .I was wrong .They restored my teeth to the way they looked when I was a teenager for 700 baht I am considering having the laser whitening done as a result of renewed confidence in dentists .This one obviously did not study under Josef Mengles like my NHS one in the UK .Does anyone have experience of this treatment ?

Crazy 88

[cozza]

Crazy,

Not the same treatment, but I was told there was a machine that does the cleaning for you but it can push the gums back, way back.

I thought this sounded a bit strange and did not have the guts to try, so I do not know what it really is???

You heard of that?

[PeteC]

I knew an old Chinese gentlemen in HK years back who had all (and I mean all) of his teeth crowned in gold. When he smiled it was s sight to see for sure. I guess if you did that here you would have a hedge against any economic downturn...just yank a tooth when funds needed....but the teenage thugs may tackle you as well and begin yanking them out. Pete

[margaretcarnes]

Good luck with the implant Rider. I've heard different statistics on success rates though. I asked my dentist here in the UK about having in implant done (either here or in Thailand) and he said the success rate is about 75%, but much less for smokers.
But I do think these days there is a huge difference in the standard of treatment between NHS and private dentists in England. NHS dentists provide the basics. For access to more advanced techniques and treatment now available you have to go private, and the two are worlds apart.
For example - an injection SHOULD work almost immediately. You don't get that horrible numb feeling like you did in the old days. Crowns, and partial crowns, CAN be done in one visit using CAD/CAM technology. Advanced gum treatment is also quick and painless. (And after gum treatment my dentist gave me his mobile number to call any time if there was a problem.)
OK - we pay - and in an ideal welfare state there should be equal treatment for all. I can understand Weserners going for treatment in Thailand and other countries. But I WOULD be concerned if my first meeting with Mr Drill was when he was ready to cut! I'm afraid that as a private patient that really wouldn't instill confidence.
BTW I did have a dentist in HH for 5 years, and every faith in her for small fillings and (very) good cleans. Him Indoors had 3 fillings and a clean done in HH 2 months ago for 2000 baht. Very good value. I just think that equally good treatment is available at home - OK at a cost, but with the obvious safety net if anything does happen to go wrong later.
Hopefully your treatment will allay my doubts Rider! Please post an update when its all finished

[PET]

Rider, from my experience of Dental Implants a sterile surgery was the most important.
I had the initial surgery at a private hospital in Cyprus, with no visible sterile procedures in place, and six months later at the check up an infection was discovered and the 'Anchor' had to be removed - not recommended!!
I went to UK and commenced the 12 month procedure again which was totally painless although expensive, but the sterile procedures were extensive.
Good luck

[margaretcarnes]

PET - pleased you have re-opened this topic and fully agree with you re. the hygeine. I'm a bit concerned that Rider hasn't posted again, and genuinely interested in the outcome of his surgery. Because thats what it is at the end of the day and, as you have found, fraught with risk.
My main concern these days with Brits having medical treatment abroad is the NHS attitude towards putting things right if it goes pearshaped. Because theres really no guarantee that it will.
I do appreciate that some Thai hospitals etc provide excellent treatment for some conditions, albeit at a cost, as some users of this forum have found. Others have had (and are still having) horrendous experiences in terms of both medical care and cost.
With dentistry I do think that there is a tendancy in LOS to do cosmetic work on demand, without looking at overall dental health, and the viability of the treatment. My own dentist in HH had a lovely clean looking surgery, but her poodle and pet rabbit were always allowed to run around in it. She wasn't licensed to give injections (probably the same reason that Cozza didn't get jabs at his HH dentist) but they don't tell you that before the drill starts!
Perhaps most worrying of all is the total absence of x rays, which are essential now in the UK before any treatment is undertaken.

Unfortunately the lack of NHS dentists in the UK, and the high cost of private treatment, is understandably driving many patients abroad. But having now experienced the standard of private treatment back home there's no way I would have anything more than a clean or simple filling done abroad.

[Rider]

We need some cool heads here.

The failure rate is much lower, according to Dr Drill he has had less than 5% failure, in which case the treatment gets corrected.

Where this NHS doctor gets 75% from is a mystery, also the smokers being more at risk sounds like hokum as well.
Unless he means they start puffing away within hours of surgery or something.

Anyway here's the latest on Dr Drill and Riders Implant.

UPDATE:

Just been for three more appointments with Dr Drill.

The first one was to get the stitches out. No problems.

2nd and 3rd times the ever helpful doc. took a look at the implant and is happy with its progress.
It's taken to the bone well, the graft is good and there's no pain either

All being well D-Day for the final showdown is in Mid-March time.

As I was leaving an elderly farang lady mooched about outside getting her footware off.
"Seven" said the receptionist chirped up cheekily.
Not quite understanding what she meant I asked her.
"She getting seven implants!" The receptionist giggled.
The pain of just one is enough, imagine seven of the suckers buzzing on in there :O
LOL.

As I know you all love some glory pics here's one of the implant!

Dr Drills Handywork



This image, for some reason, was pulled from photobucket (teeth phobic?) so I can't guarentee it'll stay online

All this buzz about sterile surgerys, guys, ALL Dentists have to have a sterile surgery this one included.
If they haven't got one then they are breaking the code of practice.
At the end of the day it's a question of trust.
If it's not sterile or there's an infection then that's the roll of the dice you gotta take
An infection in the implant is a risk, just as it is with root canal surgery etc.
But you mitigate that with the antibiotics and anti-inflammitories etc...

[margaretcarnes]

Thanks for the update Rider - I really hope it continues to go well. Certainly sounding fine. Yes they always seem to zap you with plenty of antibiotics as a precaution, which makes sense.
Nice pic! But SEVEN implants? Grief. The farang lady must be loaded as well as brave.

[PET]

'All this buzz' etc - of course all dentists/doctors surgerys should be and are expected to be sterile but how do you know?

I have experience of both amd have had three implants, one was a disaster because of infection into the bone.

My problem came at a highly respected private hospital in Cyprus, but there was no comparison to when I had it again in UK. The sterile conditions were extensive and very noticeabe.

As regards smoking - it inhibits natural healing. Smoking narrows the blood vessels leading to the surgical site thus reducing blood flow and increases risk of infection. Equally, the heat generated from cigarettes causes blood to flow to the surface to aid cooling. The increased blood flow may cause bleeding and possible infection. So it is not to be discounted as you appear to think.

I wish you well.

[margaretcarnes]

Thanks for that PET - I forgot to mention yesterday - in response to the OPs last point - as well as (and probably due to) the problems you rightly mention with smokers, smoking also increases risk of gum disease. Therefore presumably the gums/bone are less able to heal around a transplant?
It also occurs to me that even after extensive gum treatment/extractions UK dentists don't prescribe antibiotics. Clearly therefore the risk of infection is considered very low here.
Not that theres any harm taking them of course as a precaution.

[Rider]

Part 2 of the saga continues...

Ok, just went back for what I thought was the last appointment.

Went in, the first thing Dr Drill did was unscrew the implant.

Out it came.

Then a dummy implant with a fake tooth was fitted and impressions (top and bottom) were made.

This done the real implant was re-inserted. This hurt a bit as the gum had closed in a bit since it had been removed and was probably tender. After a minute or two the pain faded though.

Then came the colour matching. For this I had a panoply of plastic toothes with shades from whiter than white to dark tobbaco stains! Glad of not hammering the cigs and booze my teeth are a natural off-white colour.

Narrowing the colours down to one of two I got some light on the case in the halogen-lit corridor and finally made my choice.

Dr Drill took a comparison as a second opinion and readily agreed.

All that remains now is for the tooth to be made up and it to be inserted.

Which should be (all being well) in about 2 weeks.

[Rider]

The Final Appointment with Dr Drill

Well, the final day of reckoning for the elusive tooth was today and it was an interesting conclusion to the saga.

First thing was a glass of foul-tasting green flavoured water in reception.
Hoping this wasn't some attempt to sedate me I made my way into Dr Drills domain.

Firstly an allen key was unleashed to unscrew the implant cover plug/bolt.

This done a zirconium alloy rod bolt was screwed into its place where the threaded implant was.
This was unpleasant as the area was tender. The implant of course meant it was hollow but not at the edges, nor at the extreme depth of the thing either. Some gum had obviously been keen to re-explore and growth about the 'fringe-zone.'
So he had to root and twinge about somewhat. At first there wasn't enough 'gap' but he made some prods here and there and soon there was enough space for the rod to screw in 100%

Dr Drill was making several precision adjustments using a fine metal probe. Hooked like a scyle, pain images of Dustin Hoffman being put through his paces as the Marathon Man started to take form.
The pain irritation was annoying now, my eyes were glazing with tear-film but the worst was over.
A mini-torque wrench appeared and he manually torqued up the bolt. Giving it a last painless tightening-tweak the part was anchored in to a steel-like consistency.

Now the crown porcelain tooth was slotted over the rod bolt gently.
I was shown it in the mirror to see how it looked prior to afixing.
Colour match was near perfect and it looked good.
I quizzed Dr Drill about the tooth looking slightly angled compared to the real tooth next door but then was reminded the gum would grow to cover the angle up and all tooth looked like that in their natural state.
Inserting the tooth meant the marathon man tool had to be used again.
This wasn't hurtful though but aided the tooths insertion by 'tweezing' aside and away parts of the gum so the tooth could be slotted into place.
The tooth was then 'glued-in' using a plastic resin then, like a model airfix being assembled, Dr Drill held the tooth firmly onto the implant structure with both thumbs.
After a minute a new tool from Dr Drills arsenal was uncovered.
A ‘heat gun’ which used trigger-activated halogen light was buzzed around the tooth, nearly touching it, by the cute dental assistant.
It was bright too. A plastic orange clapper thing was held over it so not to blind or damage the eyes.
A senior assistant took charge after a while held it against the back of the tooth for 3 seconds, just to make sure I guess, I yelped as the heat of it shot up through the crown, rod and implant! Mind a-fizzing like a rocket she removed it quickly again. Obviously satisfying herself that the porcelain was rock steady in there and not going become unstuck.

This done I was told to bite down on this red plastic slide.
Clack!
Feels like I’ve suddenly grown one big tooth!

Dr Drill unleashed his trademark polishing drill. Whzzzzzzzzzzzzzzzzzz.
‘Bite down again’ he said.
'Ok' Clack! But still the bite pattern was uneven.
Whzzzzzzzzzzzzzz.
Third-time lucky I bite down. dam_n this implant feels mean man, like I could bite through a rubber air hose! Not quite jaws out of James Bond, but a level towards it
It was still uneven, but not by much.
I knew that if Dr Drill took off much more of the crown the tooth would stand uneven against the partnering one. Yet to get an even bite on the lower row it would have to be slightly off center otherwise the bite would be wrong.

Fourth time under the drill...
Whzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz.
Clack! The bite was good. Not perfect, but nor were both teeth out of level either. Overtime the fine bite margin would even out.

I asked him what the procedure was to remove the tooth if the impant needed removing. The process involved cracking the tooth and discarding it due to the nature of the resin. Then the rod bolt could be accessed. It was trivia I didn’t really need to know, unless the crown was cracked/damaged but I was curious.
It was then explained to me, that a normal tooth has soft tissue between the tooth and the jaw-bone, giving it the slightly 'springy' feeling.
An implant was much more solid with no soft tissues between it and the jawbone. Giving it the dense, inner-hardened feeling.
This was certainly true, it felt wierd, like a different entity to the other teeth; stronger, elitist and yet somehow with more feeling and sensation than I first expected.

Implant details:

Upper - Titanium.
Lower - Gold Alloy
Rod - Zirconium (I think that's how its spelt)
Made in Sweden. Length 14.5 mm

I asked him about polishing procedures. For polishing the crown he advised telling a dentist about the implant. That was he could use an appropriate device not to damage/wear it away.

Some pictures followed for their records including an X-Ray.
No infection, bone growth was present/healed and all that was left were some farewells and making the last payment of 35,000 baht for a job well done!
I took Dr Drills email address just in case of later problems from the implant.
With that done it was time to get used to having a ‘real’ tooth anchored into my mouth for the first time in 2 years

No more worrying about a denture for separate cleaning and food getting stuck behind it, awkward removal when eating tough foods etc
Here’s the story by pictures:

After the first implant stage 4 months ago.


Goodbye to the denture!


Hello to the new tooth!



I recommend Dr Drill and if anyone wants to know more PM me and I’ll give you more details on this.