Does All on 4 or Full mouth dental implants hurt?

hey everyone how you doing my name is gus i'm a cosmetic and implant dentist based near london in the uk and today let's talk about all on four treatment and specifically does it hurt what to expect after having the treatment so usually when my patients come in and see me 99.99 of my patients especially on the day are somewhere between anxious and terrified okay nobody is calm at the beginning of this appointment and a lot of it is due to the perception that it's going to be extremely painful now all on four is probably one of the more extreme treatments which we carry out and therefore you would think that if you have found a filling painful in the past this is going to be a million times worse now it's not actually like that and in this in this video i'm going to show you a couple of different ways that um that we control the pain during treatment i'll give you an honest perception from all the patients who i see is it painful during the treatment okay and if i was gonna say it's not painful i would be lying and um and what to expect afterwards okay during normal healing and some of the complications which i've had in fact i had one literally this week so let's get back let's go straight into this for those of you who don't know all of four is a treatment where we are able to remove all of the bad teeth typically they're infected in some way and place dental implants so that our patients can have a fixed set of teeth on implants and it's all carried out in one main surgical appointment okay so that's the key selling point of this treatment now there's two aspects to it there's the surgical side and then there's what we call the prosthetic side the surgical side is what i describe as the the first cut to the last stitch okay so we do all the anaesthetics this is the stuff which would be painful if you weren't anesthetized and then the stitch is when it's all finished so typically this takes between one and two hours in in the in the vast majority of cases and after that when we move on to what we call the prosthetic side giving the teeth connecting the teeth to the implants this can take one to two hours as well so we normally book either a whole morning or a whole afternoon for uh for an all-on-four treatment and that's kind of how it splits up half of it is surgical and half of it is prosthetics and for the vast majority of our patients we do this under what we call local anesthetic so the same anesthetics which your dentist has been using to to do your fillings that's what we use for this full arch treatment and for the vast majority of cases it works absolutely fine obviously we give a lot more anaesthetic than you would have if you were just going in for a standard filling the types of injections which we give in certain areas are slightly different but it's just a specialized way of doing a normal dental anaesthetic for this more complicated treatment now things to know about anesthetic are they firstly they take about 10 to 15 minutes to really work so we always do all of our anesthetics get all the injections done as early as possible and then my nurses and i we set the room up so we do a full what we call an aseptic setup with all the there are drapes everywhere and that process takes us about 10-15 minutes by the time we finish that we're actually ready to start our treatment and um i think a common mistake that especially younger dentists do is they just start too early the anaesthetic hasn't really taken full effect it hasn't had the time to do it so things hurt so we always give it a bit of time let it work next there is a window of about two hours where the anesthetics work really well so we do need to speed things up we do keep things brisk once we start going we don't want to slow down because as soon as my patients start to feel something i know it's difficult to maintain that really high level of anesthetics okay so when i said some patients do find this uncomfortable you know at the beginning almost absolutely everyone is fine but there comes a point where sometimes it can start to people can start to feel stuff and this is where individual interpretation of pain comes in quite a lot so you see when when everyone anyone is subject to a painful stimulus some people will react more they will feel the pain more than other people okay and this is just a normal variation we're all different and those people who are unfortunate enough to you know experience more pain are are going to find this a much more difficult scenario to deal with and a couple of weeks ago i did have a gentleman who was like this you know we did the all on four weeks everything was going really well but the last 20 minutes he found very uncomfortable and we really had no choice we just had to battle through it and i don't like it it's difficult for me the patient doesn't like it it's painful and for this reason i'm actually starting to do more sedation or i would recommend sedation more for other patients so i'll i'll talk more about what sedation is in a minute let's very quickly talk about perception of pain you see when we're exposed to a stimulus whatever it is it doesn't really matter i don't mean to keep throwing scientific terms but you know if we have something painful done to us people react differently and this is related to their kind of their perception of pain and how nervous they are so when somebody comes to see us for all on four everybody is somewhere between quite anxious to terrified okay they're in that kind of ballpark nobody comes in for an all-on-four on the day of treatment and says here i'm completely relaxed okay nobody is so if you're already anxious and you you think that things are going to really be painful then you're probably right you know you're telling yourself that story it's almost like a self-fulfilling prophecy but what happens is your mind is already telling you that it's going to hurt any stimulus that you have any um any pressure or mild pain can be interpreted as a lot of pain and unfortunately some people don't really have much control over this themselves now we know this is the case and also surprisingly you may not know this there are some dentists who are really good at hypnosis i'm not one of these i really don't know much about the subject but i've been told that they're able to take out teeth on patients without any anesthetic okay so i assume this means that they have to have a patient who is responding well to hypnosis and obviously their skills need to be on on point as well but my reason for telling you this is there is a very large psychological component to the perception of pain and if you will find all on four painful which is why these days i'm kind of recommending sedation a little bit more so sedation is when we have a specialist sedationist who comes in they give a drug through the back of the hand the drug is dazzling plus other ones um these guys are specialists they've got access these are hospital sedationists usually so they've got access to a whole cocktail of drugs really and what it ultimately does it really relaxes the patient and it provides a period of amnesia where you can't remember the pres procedure itself and if that is done and we combine that with our normal dental anaesthetics then the treatment is actually a lot easier for the patient and therefore it's easier for the clinician as well so this is this is a really cool thing to have the problem is it does cost more money okay when we do this for our patients typically it's about seven eight hundred pounds plus to have this done okay so it's not cheap it adds cost to an already expensive treatment the other downside is that you can't drive for 24 hours afterwards so you need to bring someone with you who is able to basically take care of you for the next 24 hours while the medications just work their way out of your body now there are some situations where even those people who are really good with pain will find things uncomfortable and that is if there is really active infections um in the areas where we're looking to to treat you see you've all almost everyone has had a friend tell them a story about this root canal treatment which was really really painful now the thing is the funny thing is root canal treatment itself shouldn't actually cause any pain because the nerve is removed very early on in the process but the reason that everybody will say that root canal treatments are very painful is that the reason they need root canal treatment is that the nerve is inflamed to begin with okay so you've got this really acute infection okay which is what inflation and in inflammation is and this inflammation is all around the tooth dental anaesthetics don't work as well in really inflamed sites okay so you can have ongoing infections and these will numb up quite quite nicely but if you've got a really bad toothache trying to numb that up and remove the nerve is often quite painful which is why anyone who tells you a story about root canal treatment is painful that's why usually i haven't done root canal treatment in a long long time but root canal treatment is that treatment where our patients are likely to fall asleep it's very quiet it's painless okay so inflammation active infection in the area is going to make any treatment including all on four more painful so all being said what can you do about it what can you do to to make this experience less horrible so number one is consider sedation okay if your budget allows it i think this is a really really good thing to do especially if you're considering top and bottom okay and you know that you're not good at the dentist so consider sedation it's a really really good option hypnosis or self-hypnosis is a key area where i think i need to learn a bit more okay when my wife was pregnant with our first child she did all this hypno birthing and all this kind of stuff basically to get the mind in a much more relaxed situation you see a lot of people especially when it comes to going to the dentist is a very emotive place to be and it brings back all these horrible past experiences and it makes you on edge what you need to do is first of all almost forget about all of those problems and all that historic experiences that you've had and try and create a new positive association with going to the dentist and this is what we often do so i've got point number three here multiple visits and what that means is get to know your dentist go there a few times before having this treatment done it's important that you feel comfortable there and for our nervous patients we do try and see them several times i mean i've had patients who who there was one lady who i was treating last month and her her problems and all her dental anxieties stemmed from the fact that her uncle passed away in a dental chair now this is the first time i've i've heard of this but this is reasonable because a long time ago dentists used to provide general anesthetics in the dental chair now this is very dangerous and people died and which is why you know we don't do this anymore so getting over that is a matter of building trust and once you build trust you will be more open to having these kind of treatments done okay so trust is it takes time and you need to basically destroy that perception of the dentist causing pain and overlay it with actually you know what i'm going to this dental practice they're really nice there actually and you know they do take good care of me okay so find a dental practice which is like that where they do take time where you're not rushed in and out of the surgery because it's not doing your your anxiety any good now that's all the treatment you know that's what's happening in the room on the day okay what about afterwards afterwards you're probably going to feel tired even though you haven't actually done anything in fact you've pretty much been lying there for two three or four hours whatever it is um you will feel tired it's mentally draining and it's it's not the best place to be let's face it now you go home and when the anesthetic starts to wear off pain usually increases okay and this is a general soreness usually okay and we we give our patients ibuprofen if they're good with that we'll give them that or paracetamol any over-the-counter painkillers are really good you shouldn't really need many of these expect swelling and bruising okay these are two very common things which you're going to have for a few days afterwards um some people get black eyes if we do the the top arch and um usually the swelling if it happens or the bruising it will kind of just work its way way down okay it is a complex procedure and we're working near certain blood vessels bruising is very common usually if it looks bad it usually looks much worse than it feels okay pain afterwards isn't really something a lot of our patients complain about okay the swelling and the bruising yes pain not so much okay and also they all tell me that it's a lot easier to deal with pain if you're at home now last week or i saw for a review last week but maybe two or three weeks ago we treated a lady we didn't all run for at the bottom treatment went really well she had it with sedation she didn't really feel much my nurse called her up a few days later everything was fine but then pain started again and then two weeks later we like to see our patients after treatment and what we saw was that the stitch which goes all the way from left to right had come undone in one area and this is painful it's when a stitch comes undone you start to get a different type of healing it's not a problem at all but it does cause pain okay and it's not a very common thing that we see but i think it was it happened in this case because the the muscles of the chin so we were doing her lower arch the muscles of the chin attach very close to where we did our stitches so if she had just pulled her lip down at all it would have put a lot of tension on the stitches and basically tore them open but it happened i saw her yesterday for another review it feels perfect now and clinically it looks really good so these are things that which can happen if you're experiencing pain if you've had all them for recently and you're experiencing pain now it's not gonna feel right for two or three weeks okay that's number one sometimes the stitches themselves can be painful so as soon as you have the stitches removed then it should feel a lot more a lot more comfortable but if you're having all on full treatment done your dentist is going to want to know if you're experiencing a lot of pain or anything like that so just give them a call you know and um and they should be able to field your questions and see you for a review okay so i hope you got something out of this video okay um i i don't want to tell people that this is a completely painless and amazing process yes the end result is fantastic and it is life-changing but it's not easy for for most of my patients some of my patients just walk through it they're absolutely fine but i'd say about 60 to 70 percent there's um a kind of a road bump in the middle where you know it's not a nice pleasant experience but this is this is just the way it is at the moment okay so i hope you found it useful guys until next time take care

Channel: Dr Gurs Sehmi

Views: 4,329

Rating: 4.9652176 out of 5

Keywords: full mouth dental implants, dental implants, all on 4, all on 4 dental implants, all on four dental implants, all on 4 dentures, dental implant procedure, dental implant, oral surgery, dental implant surgery, implant dentures, all on 4 procedure, all on four, dental implants procedure, tooth implant, bone grafting, all-on-4, implantology, all on 6, all on 4 implants, smile transformation, all on 4 dental implants before and after, all on four dental, all on 6 dental implants

Id: ibytM-SLon4

Length: 17min 26sec (1046 seconds)

Published: Mon Apr 05 2021