Here Is What She Learned
I was surprised to see Kathanga in my chair. Last time I saw her was at my Public Seminar that I threw where I talked about dental implants to a room of 10 people. Kathanga never came back to me since the cost of ZirTeeth, our implant product, was well above her budget. She was missing teeth and needed help.
So after 6 months, I was eager to find out why she came back.
“I am so embarrassed to face you Dr. Benjamin, but could not wait any longer,” said Kathanga. “Why?” I replied. And that’s when the story unraveled.
After we quoted her our fee, Kathanga went to Kenya for her mother’s memorial. There, her sister offered to “come and visit her Dentist who apparently knows how to do dental implants.”
He quoted her $10,000 for both arches and she jumped at the opportunity to start the next day.
What Kathanga does not know is that in 3 days the Dentist will be MIA and her brother will end up driving 300 miles (each way) to get antibiotics for her severe infection.
On the first day, the young Dentist treated her top arch.
On day two, he did her bottom arch.
Day three, she ended up in the hospital.
It turns out that on Day 3 the Dentist took a 2 week vacation, but Kathanga wasn’t told about this in the beginning. Fearing the worst, she goes to the Hospital where she will spend the next 30 days recovering.
Typically after surgery on day 3, most patients experience maximum swelling. But no one told this to Kathanga. So she panicked and rightfully so - to get antibiotics in Kenya it's not like here in the States where you go around the corner to CVS or Walgreens. Her brother had to travel 300 miles each way to get the pills. But it was not fast enough, the Hospital had to intervene.
At first, it was uncontrollable bleeding and then the intravenous delivery of antibiotic. Not understanding the full impact, the Hospital just stabilized her, but inside her mouth the gums were getting more swollen because the young Dentist never inserted the temporary teeth to control the inflammation.
As you can see in Kathanga's case, after a big surgery like that, it is crucial to place temporary teeth immediately to curtail gum swelling and bleeding. If this is not done in a timely manner, within 2 days, chances are high that potent will walk around without teeth for a long time since gums take time to shrink. This young Dentist did not know this. In fact, Kathanga was his third patient for this type of work!
Back in my chair, as I reviewed her X-rays, I noticed that the implants were placed too close to each other and that they are too short. This can affect their longevity, as well as quality of chewing. The latter depends on how far the implants are spread out for what is called AP spread or anterior posterior distance. The longer it is, the more teeth can be placed in the arch for better chewing. “But doctor, I cannot chew anything since I am missing my back teeth,” says Kathanga. As I look inside her mouth and at the X-rays, I am holding back on telling the truth about her teeth - the bridge was cemented onto implants. “Well, Doctor can you help me?”
I am thinking, “I have to cut off the metal framework that the young dentist cemented on to the implants and redo the entire case.” By the way, we never cement long dental bridges but screw them in for easier retreat. Obviously, I never said this to her and gave her a compassionate look with the following reply, “just get used to these teeth and wear the bite guard that I just made you to calm your bad bite.”
Other practices would charge $40,000 to redo Kathanga’s case. From this experience, Kathanga learned that cheaper services don't necessarily deliver better outcomes, on the contrary.
She got lucky that she did not die from this experience. We always put patients first and we will help Khatanga to overcome this situation, but it will take a long time to get it right.
Patients that are looking for full-mouth rehabilitation should always consider doing it near their home. Otherwise, if something breaks it will be difficult to travel, especially when Novo Coronavirus (COVID-19) presents a big risk.
By Dr. Ilya Benjamin, DMD
