Crash - Fractured jaw and missing teeth

That sucks! I hope the little guy isn't feeling too bad. Tough injury.

Goodness. I hope he gets better soon. That would be so painful. I started riding with a mouth guard to try to avoid more concussions. I don't know if this would have helped him or not... That's awful... Hoping his surgeries have little complications and he heals quickly.

Since he is young and if you want the most normal function. Implants all the way will look the most natural and feel the most natural. Bridges etc will break and have to be redone and in the end you'll wished you went with implants.

I broke teeth out/fractured skull in a skatepark comp. Implants are best but make sure you get a very good oral surgeon with a proper plan. Good luck.

My ex old lady had a bridge come out while chewing on some Milk Duds, ended up swallowing it. She sifted shit for three days. Never found it.

Oh damn man , I haven't had to deal with that , but still wanted to give out my sympathy for your boy. He probably aint feeling to good , but I wish him a speedy recovery. Long time ago I knew a guy pretty well , did the same thing. They wired his jaw shut for about 6 weeks if I remember right. He ate breakfast , lunch and dinner through a straw during that time. He had a hell of a time getting his stomach to digest whole foods right after , so maybe ask the doctors on what may help that if he has some issues at first. They have made quite a few advancements I'm sure in the past 25 years or so when the dude I knew did it.

What a bummer man, I hope the little dude is able to keep his spirits high. I've always enjoyed your posts. It's nice to see not all mini dads are nuts.

Everybody I know that's used a flipper has ended up going the implant route eventually. Maybe you can do that to help spread out the financial blow.

Thanks for the reply's.

My son was actually with a good friend and his son. I had to stay back in TN and work. His son over jumped a wall jump and compressed his back. So he has both kids and 2 Service K-9 shepards in the Emergency Room. Crazy couple of days!

He is no pain really and the we had checkup's with the oral surgeon and orthos doc's on Friday. Everything is looking good but it's just a waiting game. His Ortho Doc is a former Mx'er and surfer. He actually rides a skateboard through the office. My sons braces were due to come off next month and I ask since everything will take longer how much extra $$$ will the cost be? He said you already paid for braces so do not worry about it because you will have enough to pay for.

I have been talking with my friend and former factory Suzuki rider Steve Childress II who is a dentist. He recommended the implants if they will do them at 15 years old. It depends on how mature his bone structure is.

I was just trying to get some ideas or suggestions from people who have went through this. I feel like crap it happened. It sucks in so many ways because he was riding so well and had so much confidence. He has made it clear he doesn't want to quit but we may need to take a hiatus for a year or so to pay bills.

project racer wrote:

My ex old lady had a bridge come out while chewing on some Milk Duds, ended up swallowing it. She sifted shit for three days. Never found it.

Too funny!

Part of the game. Best of luck with his recovery.

I glanced at the thread title and it read "JLaw seen with missing teeth"

I cased a triple at a pro supercross back in the 90's and broke my jaw in several places and lost some teeth. One option was bone graft but it was too expensive . Insurance considered it dental not medical and my dental coverage was not that great, nor was the AMA's medical coverage that came with the event. I went with a bridge and it has given me no trouble the last twenty years. I hope all turns out well.

brocsdad wrote:

Over the holiday break my son was ridding at WW Ranch in the Florida and crashed over a high speed double. He knocked 4 teeth out and fractured his jaw which required emergency surgery. They saved 3 teeth but they could not save 1 tooth due to the bone loss in the jaw.

He is doing ok and we go back to take the plates out next month. After that he will go back to his orthodontist to have his braces re-attached.

The oral surgeon said he will need a bone graft to have an implant. We didn't get into cost at this point but the bone grafting and implant will be very expensive.

The 2nd option would be a flipper tooth which is help by a clip. Though from what I have read they are a pain and no one likes them.

The 3rd option would be a Maryland Bridge that is adhered by a wings to adjacent teeth.

The implant seems to be the better option but it will be very costly with 2 or 3 surgeries involved.

Has anyone experienced anything like this? If so what did you have done?

Thanks!

Cam the kid golf?

Been there.... got the post card.

I broke my mandible all the way through, and shattered both joints by my ears when I was 15 (out jumped a decent size downhill and took a protaper oversized bar mount to the face under the helmet). I was wired shut, got a plate and 6 screws...the whole 9 yards.

When that happened, multiple teeth chipped and were broken. Luckily none were knocked out, and were fixed with that magic putty the dentist has. My front top tooth did crack the nerve, and die though. Over time it became grey and I looked like a god damn hillbilly.

I had it bleached, but it wasn’t perfect... and have been self conscious about it since then. I would get a few other opinions, and see if anyone has other options. They have screws that’s go down in the bone and anchor fake teeth. I would personally do everything to get kid all his teeth back. It rough growing up with a jacked up grill.... trust me.

Here is a picture of my face a while after the surgeries to get all sorted out. Sorry for the bad quality.

Sorry to hear about your son. I broke my jaw on a PW50 when I was 5 and it has messed my teeth up significantly. Had braces for 4 years til I was 18 and multiple extractions and root canals since my roots and teeth were still developing. My teeth are okay now and I’ve made it this far with 3 extractions of teeth that aren’t too important and my smile looks fine. I just hate the dentist now.

My girlfriend had an implant on her front tooth from being knocked out at a skate park and it looks very very natural. You couldn’t tell unless you looked at it closely. She had tried the flipper tooth which is basically a denture for one tooth. She hated it because she had to take it out to eat and lost it.

Can’t speak for the last option, but I wouldn’t recommend it for any of the front teeth if thats where he needs it.

The implant was covered partially by insurance and her dad paid I think $10,000 for it. Worth it imo and it’s been 10 years since it was done. Her first “one” fell out a couple times and they had to reshape it and tighten it down more, but it hasn’t come loose again. Overall happy with it.

I would look into insurance if your’s doesn’t cover it, and if not, try to see if some insurance will cover it retroactively. Worst case scenario, there are types of credit for dental work exclusively and you could probably knock it down paying out of pocket instead of insurance. Insurance prices are always higher.

I wish you the best of luck and hope his smile comes out fine. Breaking my jaw and having it wired shut for a month sucked and I would NOT want to do it again. Although watching the life flight land was always cool.

brocsdad wrote:

Over the holiday break my son was ridding at WW Ranch in the Florida and crashed over a high speed double. He knocked 4 teeth out and fractured his jaw which required emergency surgery. They saved 3 teeth but they could not save 1 tooth due to the bone loss in the jaw.

He is doing ok and we go back to take the plates out next month. After that he will go back to his orthodontist to have his braces re-attached.

The oral surgeon said he will need a bone graft to have an implant. We didn't get into cost at this point but the bone grafting and implant will be very expensive.

The 2nd option would be a flipper tooth which is help by a clip. Though from what I have read they are a pain and no one likes them.

The 3rd option would be a Maryland Bridge that is adhered by a wings to adjacent teeth.

The implant seems to be the better option but it will be very costly with 2 or 3 surgeries involved.

Has anyone experienced anything like this? If so what did you have done?

Thanks!

Hey Brocsdad, (Warning long post)

Sorry to hear about your son. I am a long time reader of these forums, but have never registered much less posted. However, after reading your post I felt I had to register and respond. I am a dentist and have worked in Urgent Care clinics before as well as been the director of a public health dental clinic. So suffice it to say that I have seen my fair share of dental trauma.

I have a long list of questions I would need before I could give specific answers to your son's case. However, with the assumption that you son is in his teens or is a pre-teen, I can give you some general guidance.

First off, Implants are the best option hands down for tooth replacement. However, these shouldn't be placed in young kids that have not yet completely finished growing. I.e. anyone younger than 18 should not get a dental implant. Implants are great because they preserve the bone where the former tooth used to be and they can be treated just like a natural tooth (brushed and flossed with no extensive maintenance required) unlike a maryland bridge or a partial denture aka a flipper. maryland bridges are bad because 90% of the time to create a maryland bridge, or any bridge for that matter, requires that you remove healthy tooth structure from the adjacent teeth. Keep in mind that any time you remove healthy tooth structure it is forever gone and that tooth is now set in motion to its ultimate demise if you live long enough. So try not to modify teeth if you don't have too. Yes, Implants are a very expensive option, but they pay for themselves 10 fold in the long run not only financially, but biologically as well. They should be considered an investment in your son's overall health and not just as an expense for a "tooth." studies show that there is direct correlation with systemic health problems (diabetes, heart disease, obesity, etc) with number of teeth missing in a person's mouth that are not replaced. Reason is simple, without teeth you cannot effectively chew good healthy foods and you rely more heavily on processed foods that are lacking in nutrients needed for good overall health.

If your son is young the recommended course of action would be to most likely bone graft the area and let him wear a flipper until he is over 18 years old and then let him get an implant. If the tooth is missing from the front (top or bottom) it is very important to get this bone grafting asap. Without it he will lose significant amount of bone and because of that him gums will follow suit making it virtually impossible to get a good cosmetic result without having to have more extensive and costly surgeries in the future (bone grafts, gum grafts, etc). Flippers are great, but they are not long-term solutions and are easily broken. Think of a retainer that a kid wears after braces. Same thing only with a tooth in it this time. Pets love to eat them and they will get worn out too. So plan on having to replace the flipper several times if he is quite young. Flippers can range from $250-600 depending where you are located and the doctor you see. Also, insurance companies really don't think flippers are necessary. so plan on paying for that out of pocket.

Implants are costly ($2,500-$5,000) depending on the same circumstances as listed above, but as i stated, will pay themselves off several times over in the future by not having to replace it or really truly deal with it.

The good news is that your son is young and young kids have a good track record of healing very well from major fractures of this nature. However, the bad news is that the other three teeth will most likely require more treatment needs in the future (root canals, crowns, or extraction and implant) depending on how the teeth respond to the replanting back into the bone assuming they came out of the bone. Some times teeth that sustain a large amount of trauma like this can cause them to become what we call ankylosed. Basically the tooth and the bone become fused together and as the patient grows the tooth doesn't move along with the other teeth and appears to "sink" into the patient's gums. Ultimately, if this happens the only solution is to extract and place an implant. However, only time will tell for this scenario.

So in summary: Implants are costly, but the best option. get the bone graft asap. Don't do a maryland bridge or any other type of bridge if the teeth adjacent to the missing tooth are in remotely good shape. Young kids heal really well. He may be dealing with this problem for a very long time as new things start to develop as he ages.

Oh finally, one last thing, look into things such as Care Credit or other forms of "health" credit cards/financing programs. These can make expensive treatment more cost effective with monthly payments. Warning is that most of them will retro activate interests if the balance isn't paid in full by the end of the term. Just a FYI.

Hope this helps.

Sev3ns

How’s your ability to get health insurance ? Factor that in. Wait for Major surgery until you can enroll in a GREAT plan even if plan itself is costly. I’d go with sevens advice. Kid ain’t done growing. Bone graft probably best bet if oral surgeons think so. Sev3ns makes a great point. Aaaaaaand...you Always can get Major restorative later when he’s done growing. A physician will clearly say it isn’t cosmetic in nature and could use it getting fixed. Also pre-existing conditions usually don’t matter with employer related healthcare plans. If you or your wife could take a job that has good benefits for the time being until after the surgery might save you a ton....

Really though I know cost might hurt, but don’t jip your kid over cost. Do everything in your power to get it fixed. I’m sure are doing everything in your power. But shop around so to speak. Social workers can aid you in seeing if you qualify for discounted rates or coverages no matter your income. Get multiple opinions from highly accredited professionals in oral surgery Etc. everything will work out. Good luck.

brocsdad wrote:

Over the holiday break my son was ridding at WW Ranch in the Florida and crashed over a high speed double. He knocked 4 teeth out and fractured his jaw which required emergency surgery. They saved 3 teeth but they could not save 1 tooth due to the bone loss in the jaw.

He is doing ok and we go back to take the plates out next month. After that he will go back to his orthodontist to have his braces re-attached.

The oral surgeon said he will need a bone graft to have an implant. We didn't get into cost at this point but the bone grafting and implant will be very expensive.

The 2nd option would be a flipper tooth which is help by a clip. Though from what I have read they are a pain and no one likes them.

The 3rd option would be a Maryland Bridge that is adhered by a wings to adjacent teeth.

The implant seems to be the better option but it will be very costly with 2 or 3 surgeries involved.

Has anyone experienced anything like this? If so what did you have done?

Thanks!

Sev3ns wrote:

Hey Brocsdad, (Warning long post)

Sorry to hear about your son. I am a long time reader of these forums, but have never registered much less posted. However, after reading your post I felt I had to register and respond. I am a dentist and have worked in Urgent Care clinics before as well as been the director of a public health dental clinic. So suffice it to say that I have seen my fair share of dental trauma.

I have a long list of questions I would need before I could give specific answers to your son's case. However, with the assumption that you son is in his teens or is a pre-teen, I can give you some general guidance.

First off, Implants are the best option hands down for tooth replacement. However, these shouldn't be placed in young kids that have not yet completely finished growing. I.e. anyone younger than 18 should not get a dental implant. Implants are great because they preserve the bone where the former tooth used to be and they can be treated just like a natural tooth (brushed and flossed with no extensive maintenance required) unlike a maryland bridge or a partial denture aka a flipper. maryland bridges are bad because 90% of the time to create a maryland bridge, or any bridge for that matter, requires that you remove healthy tooth structure from the adjacent teeth. Keep in mind that any time you remove healthy tooth structure it is forever gone and that tooth is now set in motion to its ultimate demise if you live long enough. So try not to modify teeth if you don't have too. Yes, Implants are a very expensive option, but they pay for themselves 10 fold in the long run not only financially, but biologically as well. They should be considered an investment in your son's overall health and not just as an expense for a "tooth." studies show that there is direct correlation with systemic health problems (diabetes, heart disease, obesity, etc) with number of teeth missing in a person's mouth that are not replaced. Reason is simple, without teeth you cannot effectively chew good healthy foods and you rely more heavily on processed foods that are lacking in nutrients needed for good overall health.

If your son is young the recommended course of action would be to most likely bone graft the area and let him wear a flipper until he is over 18 years old and then let him get an implant. If the tooth is missing from the front (top or bottom) it is very important to get this bone grafting asap. Without it he will lose significant amount of bone and because of that him gums will follow suit making it virtually impossible to get a good cosmetic result without having to have more extensive and costly surgeries in the future (bone grafts, gum grafts, etc). Flippers are great, but they are not long-term solutions and are easily broken. Think of a retainer that a kid wears after braces. Same thing only with a tooth in it this time. Pets love to eat them and they will get worn out too. So plan on having to replace the flipper several times if he is quite young. Flippers can range from $250-600 depending where you are located and the doctor you see. Also, insurance companies really don't think flippers are necessary. so plan on paying for that out of pocket.

Implants are costly ($2,500-$5,000) depending on the same circumstances as listed above, but as i stated, will pay themselves off several times over in the future by not having to replace it or really truly deal with it.

The good news is that your son is young and young kids have a good track record of healing very well from major fractures of this nature. However, the bad news is that the other three teeth will most likely require more treatment needs in the future (root canals, crowns, or extraction and implant) depending on how the teeth respond to the replanting back into the bone assuming they came out of the bone. Some times teeth that sustain a large amount of trauma like this can cause them to become what we call ankylosed. Basically the tooth and the bone become fused together and as the patient grows the tooth doesn't move along with the other teeth and appears to "sink" into the patient's gums. Ultimately, if this happens the only solution is to extract and place an implant. However, only time will tell for this scenario.

So in summary: Implants are costly, but the best option. get the bone graft asap. Don't do a maryland bridge or any other type of bridge if the teeth adjacent to the missing tooth are in remotely good shape. Young kids heal really well. He may be dealing with this problem for a very long time as new things start to develop as he ages.

Oh finally, one last thing, look into things such as Care Credit or other forms of "health" credit cards/financing programs. These can make expensive treatment more cost effective with monthly payments. Warning is that most of them will retro activate interests if the balance isn't paid in full by the end of the term. Just a FYI.

Hope this helps.

Sev3ns

Hey Sev3ns,

Thanks for the reply!

My son just turned 15.

The doc who performed the surgery at the ER in Florida mentioned waiting until he was 18 for the implant but the local surgeon I took him to for the follow-up mentioned we may be able to move forward with the implant. He seemed concerned about bone loss if we waited too long. I guess they will evaluate everything after the jaw heals. Both the oral surgeon and my Dentist friend have performed implants on kids as young as 14 with no issues.

My son will need to wear the braces for a few more months until the ortho gives us the green light to remove them.

I already have a Care Credit Card but I may need to increase the limit?.

I have pics of the injury and MRI/X-rays if you have an email address I can send to.

Thanks again!

GeorgiePorgie wrote:

How’s your ability to get health insurance ? Factor that in. Wait for Major surgery until you can enroll in a GREAT plan even if plan itself is costly. I’d go with sevens advice. Kid ain’t done growing. Bone graft probably best bet if oral surgeons think so. Sev3ns makes a great point. Aaaaaaand...you Always can get Major restorative later when he’s done growing. A physician will clearly say it isn’t cosmetic in nature and could use it getting fixed. Also pre-existing conditions usually don’t matter with employer related healthcare plans. If you or your wife could take a job that has good benefits for the time being until after the surgery might save you a ton....

Really though I know cost might hurt, but don’t jip your kid over cost. Do everything in your power to get it fixed. I’m sure are doing everything in your power. But shop around so to speak. Social workers can aid you in seeing if you qualify for discounted rates or coverages no matter your income. Get multiple opinions from highly accredited professionals in oral surgery Etc. everything will work out. Good luck.

I have insurance and the ER visit and follow up will be covered under Medical since it was an accident.

As far as the implant or any type of fake tooth will be considered cosmetic so that will fall back on me.

I will figure out a way to pay for it but I’m a single dad with a kid who like MX. So needless to say I’m on a budget.

I don't have experience with this exact issue. But my advice to you, pick the best option and worry about cost later.

brocsdad wrote:

Over the holiday break my son was ridding at WW Ranch in the Florida and crashed over a high speed double. He knocked 4 teeth out and fractured his jaw which required emergency surgery. They saved 3 teeth but they could not save 1 tooth due to the bone loss in the jaw.

He is doing ok and we go back to take the plates out next month. After that he will go back to his orthodontist to have his braces re-attached.

The oral surgeon said he will need a bone graft to have an implant. We didn't get into cost at this point but the bone grafting and implant will be very expensive.

The 2nd option would be a flipper tooth which is help by a clip. Though from what I have read they are a pain and no one likes them.

The 3rd option would be a Maryland Bridge that is adhered by a wings to adjacent teeth.

The implant seems to be the better option but it will be very costly with 2 or 3 surgeries involved.

Has anyone experienced anything like this? If so what did you have done?

Thanks!

Knocked two teeth out years ago. Had them put back in. They were fine for a few years but started getting noticeably darker than my other teeth. Had them capped and have had no issues since. Flipper teeth aren't bad at all. Two of my friends have them and you would never know until the mess around with them. Plus when he gets older they make for some hilarious pranks and bar bets...

lessthanbob wrote:

I don't have experience with this exact issue. But my advice to you, pick the best option and worry about cost later.

Well the cost will have to be addressed on the front end. I still have my portion of the ER visit to pay and I have no idea what that will be. I’m thinking we will sale the bike and take an extended break.

brocsdad wrote:

Over the holiday break my son was ridding at WW Ranch in the Florida and crashed over a high speed double. He knocked 4 teeth out and fractured his jaw which required emergency surgery. They saved 3 teeth but they could not save 1 tooth due to the bone loss in the jaw.

He is doing ok and we go back to take the plates out next month. After that he will go back to his orthodontist to have his braces re-attached.

The oral surgeon said he will need a bone graft to have an implant. We didn't get into cost at this point but the bone grafting and implant will be very expensive.

The 2nd option would be a flipper tooth which is help by a clip. Though from what I have read they are a pain and no one likes them.

The 3rd option would be a Maryland Bridge that is adhered by a wings to adjacent teeth.

The implant seems to be the better option but it will be very costly with 2 or 3 surgeries involved.

Has anyone experienced anything like this? If so what did you have done?

Thanks!

BobPA wrote:

Knocked two teeth out years ago. Had them put back in. They were fine for a few years but started getting noticeably darker than my other teeth. Had them capped and have had no issues since. Flipper teeth aren't bad at all. Two of my friends have them and you would never know until the mess around with them. Plus when he gets older they make for some hilarious pranks and bar bets...

I don’t anything he can take out or loose. Plus most people say you cannot eat with them.

i had a dental quote in australia for a few implants, almost $65,000.. i flew to Bali for 3 weeks and had the procedure done there.. ended up costing me less than $10,000 with flights and accommodation included.. before i got there i was a little worried about standards of hygiene etc but found it to be better than any australian dentist i had been to in the past

i had plates before the implants.. implants are so much better

Good info from Sev3ns!

brocsdad wrote:

Over the holiday break my son was ridding at WW Ranch in the Florida and crashed over a high speed double. He knocked 4 teeth out and fractured his jaw which required emergency surgery. They saved 3 teeth but they could not save 1 tooth due to the bone loss in the jaw.

He is doing ok and we go back to take the plates out next month. After that he will go back to his orthodontist to have his braces re-attached.

The oral surgeon said he will need a bone graft to have an implant. We didn't get into cost at this point but the bone grafting and implant will be very expensive.

The 2nd option would be a flipper tooth which is help by a clip. Though from what I have read they are a pain and no one likes them.

The 3rd option would be a Maryland Bridge that is adhered by a wings to adjacent teeth.

The implant seems to be the better option but it will be very costly with 2 or 3 surgeries involved.

Has anyone experienced anything like this? If so what did you have done?

Thanks!

Was just at the Oral surgeon today reviewing the Titanium implant to make sure everything is good. Had to do he bone graft as well. Since it is "only" 1 tooth I would 100% go with this. Even though I don't have a cap on my TI tooth, it feels 100000% better than it did a year ago. I paid the extra $200 to be put under and would recommend you do the same. I had minimal pain, and never once touched the bottle of oxy I was prescribed...serious I was back in the gym the next day. Get the implant.

Coincidentally, I broke out one of my upper front teeth and cracked a few others while I had braces on, similar to your son.

The dentist was pretty pumped that I had braces at the time of the crash because the braces apparently spared my teeth from some additional destruction. At the time, none of my teeth were completely broken out, just cracked at the roots and knocked crooked in my mouth. Because of the braces functioning just as braces are supposed to, the teeth were gradually straightened back out over the the next week-or so. Besides being weak, my front tooth, as well as some others, were otherwise fine.

However, at college the following year after my braces had been removed, I was involved in a bit of fisticuffs that resulted in my front tooth finally being broken all of the way out. Due to how the tooth broke out, cadaver chips were required to be stuffed up into the roof of my mouth to form a more solid structure before an implant could be added.

Between the time when the cadaver bones were packed into my gum, and the time when the implant was eventually installed, I had two "placeholders." The first placeholder involved the dentist literally gluing my front tooth into my mouth, attaching it to the two teeth around it. This was a decent temporary solution except that, if you examined the front teeth closely it looked kind of goofy, and it eventually broke out while eating... The second and last-resort placeholder was a "flipper."

To try and fix my grill after the glued in tooth had broken out, I first tried the flipper, but I literally couldn't talk because the retainer was so large and cumbersome in my mouth. To solve the problem of the broken out glued in tooth, and a flipper that wouldn't allow me to speak properly, I purchased myself a Dremil tool to reshape the tooth and literally superglue it back in. This was a solution that would last for about a day, and then it would bust out and I'd have to again re-glue the tooth back in my head (literally "rinse and repeat"). It got to the point where I would carry super glue with me at all times, and I had a Dremil living on the bathroom counter next to my toothbrush.

Also, during this same time period, I was working as a "hasher" (see: dishwasher") at a girl's sorority house. It was an INCREDIBLE gig with some ridiculous fringe benefits. However, juggling that particular job, while at the same time making sure my tooth was glued into my face each night before work, was kind of a challenge.

After farting around performing cosmetic dental surgery on myself most mornings, I decided to try my hand at Dremil shaping the flipper to allow it to fit more properly. After I did some significant grinding on the structure, I was able to learn to speak around the thing, and the modified flipper became the final solution before the implant could be fully installed. The added benefit of using a flipper is that I could randomly pop it out mid conversation and jack with people, and I could take awesome pictures. Check out my license photo from that time:



Eventually, the cadaver bone chips heald, and the implant was installed. No huge complaints with the implant and it's been over a decade. The only issue I have is that my gum line isn't exactly straight above my top teeth. Fortunately I don't have a "gummy" smile so this isn't really noticeable.


Best of luck to you and your son! This was a challenging ordeal for me but in hindsight (and because I've had no further problems with my implant) it really wasn't that big of deal at all. It was a financial hit for sure, but none of us got involved in this sport because it was cheap (or safe).

brocsdad wrote:

Over the holiday break my son was ridding at WW Ranch in the Florida and crashed over a high speed double. He knocked 4 teeth out and fractured his jaw which required emergency surgery. They saved 3 teeth but they could not save 1 tooth due to the bone loss in the jaw.

He is doing ok and we go back to take the plates out next month. After that he will go back to his orthodontist to have his braces re-attached.

The oral surgeon said he will need a bone graft to have an implant. We didn't get into cost at this point but the bone grafting and implant will be very expensive.

The 2nd option would be a flipper tooth which is help by a clip. Though from what I have read they are a pain and no one likes them.

The 3rd option would be a Maryland Bridge that is adhered by a wings to adjacent teeth.

The implant seems to be the better option but it will be very costly with 2 or 3 surgeries involved.

Has anyone experienced anything like this? If so what did you have done?

Thanks!

Sev3ns wrote:

Hey Brocsdad, (Warning long post)

Sorry to hear about your son. I am a long time reader of these forums, but have never registered much less posted. However, after reading your post I felt I had to register and respond. I am a dentist and have worked in Urgent Care clinics before as well as been the director of a public health dental clinic. So suffice it to say that I have seen my fair share of dental trauma.

I have a long list of questions I would need before I could give specific answers to your son's case. However, with the assumption that you son is in his teens or is a pre-teen, I can give you some general guidance.

First off, Implants are the best option hands down for tooth replacement. However, these shouldn't be placed in young kids that have not yet completely finished growing. I.e. anyone younger than 18 should not get a dental implant. Implants are great because they preserve the bone where the former tooth used to be and they can be treated just like a natural tooth (brushed and flossed with no extensive maintenance required) unlike a maryland bridge or a partial denture aka a flipper. maryland bridges are bad because 90% of the time to create a maryland bridge, or any bridge for that matter, requires that you remove healthy tooth structure from the adjacent teeth. Keep in mind that any time you remove healthy tooth structure it is forever gone and that tooth is now set in motion to its ultimate demise if you live long enough. So try not to modify teeth if you don't have too. Yes, Implants are a very expensive option, but they pay for themselves 10 fold in the long run not only financially, but biologically as well. They should be considered an investment in your son's overall health and not just as an expense for a "tooth." studies show that there is direct correlation with systemic health problems (diabetes, heart disease, obesity, etc) with number of teeth missing in a person's mouth that are not replaced. Reason is simple, without teeth you cannot effectively chew good healthy foods and you rely more heavily on processed foods that are lacking in nutrients needed for good overall health.

If your son is young the recommended course of action would be to most likely bone graft the area and let him wear a flipper until he is over 18 years old and then let him get an implant. If the tooth is missing from the front (top or bottom) it is very important to get this bone grafting asap. Without it he will lose significant amount of bone and because of that him gums will follow suit making it virtually impossible to get a good cosmetic result without having to have more extensive and costly surgeries in the future (bone grafts, gum grafts, etc). Flippers are great, but they are not long-term solutions and are easily broken. Think of a retainer that a kid wears after braces. Same thing only with a tooth in it this time. Pets love to eat them and they will get worn out too. So plan on having to replace the flipper several times if he is quite young. Flippers can range from $250-600 depending where you are located and the doctor you see. Also, insurance companies really don't think flippers are necessary. so plan on paying for that out of pocket.

Implants are costly ($2,500-$5,000) depending on the same circumstances as listed above, but as i stated, will pay themselves off several times over in the future by not having to replace it or really truly deal with it.

The good news is that your son is young and young kids have a good track record of healing very well from major fractures of this nature. However, the bad news is that the other three teeth will most likely require more treatment needs in the future (root canals, crowns, or extraction and implant) depending on how the teeth respond to the replanting back into the bone assuming they came out of the bone. Some times teeth that sustain a large amount of trauma like this can cause them to become what we call ankylosed. Basically the tooth and the bone become fused together and as the patient grows the tooth doesn't move along with the other teeth and appears to "sink" into the patient's gums. Ultimately, if this happens the only solution is to extract and place an implant. However, only time will tell for this scenario.

So in summary: Implants are costly, but the best option. get the bone graft asap. Don't do a maryland bridge or any other type of bridge if the teeth adjacent to the missing tooth are in remotely good shape. Young kids heal really well. He may be dealing with this problem for a very long time as new things start to develop as he ages.

Oh finally, one last thing, look into things such as Care Credit or other forms of "health" credit cards/financing programs. These can make expensive treatment more cost effective with monthly payments. Warning is that most of them will retro activate interests if the balance isn't paid in full by the end of the term. Just a FYI.

Hope this helps.

Sev3ns

brocsdad wrote:

Hey Sev3ns,

Thanks for the reply!

My son just turned 15.

The doc who performed the surgery at the ER in Florida mentioned waiting until he was 18 for the implant but the local surgeon I took him to for the follow-up mentioned we may be able to move forward with the implant. He seemed concerned about bone loss if we waited too long. I guess they will evaluate everything after the jaw heals. Both the oral surgeon and my Dentist friend have performed implants on kids as young as 14 with no issues.

My son will need to wear the braces for a few more months until the ortho gives us the green light to remove them.

I already have a Care Credit Card but I may need to increase the limit?.

I have pics of the injury and MRI/X-rays if you have an email address I can send to.

Thanks again!

Brocsdad,

My disclaimer is that I do not place implants. I simply restore them. Aka put the tooth on the implant and make it look good. as far as my comment about waiting until 18 to have implant placed that is from what I have studied and read up on. Maybe the surgeon and your dentist friend are privy to some literature reviews that I have not read. I am by no means a daily expert on when to place implants. So with that said you can take their word for it or seek out a second/third opinion.

As far as the bone loss goes, from my experience if they graft the area now the "defect" in the bone when he turns 18 will be far smaller than if they did not graft the sight. Again, i'm not the surgeon. Just the person that knows what the final product will look like when everything is said and done. You may want to get a second opinion for the grafting and the implant from a Periodontist. They usually have the end cosmetic product in mind when managing the bone, gums, and implant placement. Some times oral surgeons can miss this critical step. keyword there being "SOME". In no way am I suggesting that your surgeon and dentist buddy are that way. Simply just giving you some insight and food for thought.

That is good that he has a few more months in ortho. That way you have some time to think about it and get some opinions/consults. What does his orthodontist say about the injury?

CareCredit will usually let you increase your limit by calling them and seeing what they can give you.

You don't have to send pics or MRI/X-rays. If I saw them I would be tempted to try and diagnose and treatment plan for him and I would rather refrain from doing so having never actually seen him in person and not knowing his full medical/dental history. Just a fellow motocross lover trying to help another out with some information.

Too bad you don't live in East TN I have a great buddy who is a phenomenal Oral Surgeon over in Kingsport. The work he does is flat out amazing!

Sincerely,

Sev3ns

Thanks for the replies!

I will do what’s best for my son and hopefully we will be back on the track sometime this year. I feel he will be fine but the financial part will hit my disposable income for a while.

I just reviewed the first 5 claims from the ER and so far the total is $39K. I’m hoping this is all coded under the ER visit and just have to pay the ER deductible of $250. I hate fighting with the insurance company.