My Dental implant fell out and my dentist's receptionist won't book me

May 20, 2020 8:23 AM

She said since I'm not in pain it's not an emergency

I've had this implant for about 4 years now and my last dental check up said everything was fine. Yesterday I had the wise idea of raising the pressure of my waterpik a notch to level 4 (My waterpik goes from 1-5) and when I got to my implant, I heard a pop and the implant started to move. Then today I was chewing an apple and the whole thing came out (with a metal post underneath it). I now have a metal hole in my mouth where the implant was.

I called my regular dental office and they're only taking emergency patients because of Covid. The receptionist said mine wasn't an emergency because I wasn't in pain. I just said ok, if it's not an emergency I'll just leave it that way, but I now realize there is literally a metal hole in my gumline right now. It's going to be impossible to keep food out of it no matter how much I brush. I find it hard to believe this doesn't have to be addressed right away. Am I wrong?

posted by fantasticness to Health & Fitness (12 answers total)

I would call back and ask to speak to the dentist directly about this. The pain/no-pain test is probably a quick way to triage calls, but he may have a different opinion on it. At the very least, he ought to be able to advise on what to do next.
posted by jquinby at 8:28 AM on May 20, 2020 [16 favorites]

Yeah just tell them it hurts.
posted by bleep at 8:36 AM on May 20, 2020 [12 favorites]

Definitely call back and ask to talk to the dentist. But to me lying about whether it hurts seems pretty shitty - you're asking your dentist to make a decision that affects her and her staff's health and safety based on bad information. Because with dental work, they're mostly not worried about YOU getting COVID, they're worried about the dentists and hygienists getting COVID - they're right up in your mouth spraying things around and creating aerosols and it's very dangerous FOR THEM.
posted by mskyle at 8:41 AM on May 20, 2020 [7 favorites]

Guidelines here set down by the Dentists College is unless there is severe pain that can't be handled by drugs or infection they won't see you. Here if your case is determined to need immediate attention they book an appointment at the hospital where whatever needs to be done is handled by the hospital's dentist at the hospital where the aerosol risk can be properly handled.
posted by Mitheral at 9:04 AM on May 20, 2020 [1 favorite]

IANAD, but I have a dental implant. One thing to keep in mind is that your implant didn't come out - your crown/abutment came out. I make the distinction because the implant is the part that you really don't want to fail. Losing the crown sucks, but as I understand it, it doesn't threaten the integrity of your implant.

Definitely call them back and discuss your concern about keeping the implant clean and healthy until you can be seen in the office. If they don't feel it's safe for you to come in, perhaps they can provide cleaning advice in the meantime.
posted by toastedcheese at 9:07 AM on May 20, 2020 [9 favorites]

I’m in a similar position: a crown chipped a week into shelter in place and has since come off entirely. If it’s any consolation, my dentist gave me the same response as yours: unless it is a true emergency they can’t see me. So I don’t think your dentist or their office manager is giving you the run around. There is some relief in knowing they are following protocol to protect all of their patients’ health.

My approach was to ask my dentist for advice on how to care for the area to avoid further damage or infection. I imagine your dentist could give you similar advice until they are able to see you.
posted by scantee at 9:30 AM on May 20, 2020 [1 favorite]

I agree that you should call them again and try to have a more in depth encounter over this. Depending where you are, dentistry is beginning to re-open, and what you are describing is, IMO, a lower risk (to the dental team) situation. IAAD, but not your dentist, of course.

We have been doing more and more teledentistry. You could offer to take a picture of what is in your hand, so your dentist can evaluate what you have lost and what might be needed to get it back in.

Any reluctance on their part to see you is being guided, in part, by higher powers recommending what things should be done and not done, but in my area there is wiggle room for clinical judgement. Don't lie. If you are not in pain it's okay to thoroughly explain your situation and go from there. it is no small thing to lose an implant supported crown, and your dentist will realize this and not want things to deteriorate for you.
posted by OHenryPacey at 9:59 AM on May 20, 2020 [6 favorites]

If in fact your crown has come out, and the post is still intact, you may be able to use temporary dental cement to replace the crown and protect your investment. Please contact your dental office and ask specifically about this option.

Also, please be patient and kind with staff. They are dealing with a lot of scared and frustrated patients on a regular basis, and now those feelings among patients are heightened. Nearly everyone who calls a dental practice has picked up the phone because they are having a problem.
posted by bilabial at 11:57 AM on May 20, 2020 [1 favorite]

You can also try calling around for an implant specialist as they should understand. They should be able to place a temporary piece of metal - mine called it a “healing collar” in place of a tooth if they can’t get or make a crown yet. I still have it years later and it’s been fine (because Reason.)
posted by Crystalinne at 1:07 PM on May 20, 2020

Response by poster: So I took the advice here and it was a little touch and go because the receptionist seemed to have an attitude of exasperation when I told her again I wasn't in any pain, but I mentioned to her that, since I no longer have a nerve there (tooth is gone after all) that I wasn't going to feel any pain even if something was wrong. I'm not actually 100% sure if this is true, but that made her pause and give me an appointment for Monday. I asked her what I could do to keep any food from getting stuck and infected in the metal hole (it looks like a really deep hole that goes into my jaw bone). And she said to just rinse with water and salt. Unfortunately this doesn't seem to be helping in dislodging the food in there, but maybe it helps in some other way. I ate and tried to avoid that area, but everything seems to want to get stuck in there anyway. I guess I'll just have to deal with the bacteria awfulness that's going to reside in there until Monday. The waterpik on level 4 is too strong for an implant to handle I guess.
posted by fantasticness at 1:44 PM on May 20, 2020 [1 favorite]

Since you've got a water-pik already, just use it in the implant (that's the metal hole in your jaw) at whatever setting does the job without being uncomfortable. I would use an air/water spray to rinse it in my office, so there is little chance you will do it any harm.

The piece you have in your hand might look like it has threads that go down into the implant in your jaw. Sometimes these threads work loose and while they don't often come all the way out they get loose. its' pretty unlikely your last blast with the waterpik was the sole culprit, it was probably working loose, but then again that's just conjecture on my part. glad you got an appointment. hope it's an easy fix.
posted by OHenryPacey at 2:02 PM on May 20, 2020 [2 favorites]

I'd use the Waterpik to keep the orifice clean. Also, you probably want to chew carefully in that spot as, if you injure or traumatize the tissue in area around the post, you might cause a problem. Just be very gentle around it and try to stick with soft foods until you can have the top/crown replaced.
posted by bz at 5:27 PM on May 20, 2020 [1 favorite]