Complex Dental Problems - Where to Even Start

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Sep 22, 2016
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I wanted to ask for some advice on where to even begin with this set of problems.

I have lost UR 4, 5 & 6, UL 6 & LL 6. The bone on the right side has begun to atrophy and this is resulting in slippage of the surrounding teeth. Debris and decay are beginning to set in on my front teeth and the molars behind the gap. On the left side, bone atrophy induced slippage has resulted in the decay of UL 5 requiring a root canal. This root canal work has now failed and there is a chronic infection at the apex (see below). To further compound things, the crown on that tooth has recently broken off, likely due to the slippage on that side. My general dentist has said that the crown itself cannot be salvaged but that at a cost of ~£1700, a post crown could perhaps be fitted, this is in addition to the risk of a re root canal on that tooth.

I have been told that I could have UL 5 extracted but that due to the infection and prior bone loss resulting from missing UL 6, I would require a vast amount of grafting to place an implant - indeed there was some question as to whether it would even be possible at all. Also as if that were not bad enough, I have been told that I will likely experience facial sinkage due to the bone loss around my cheek on one side and indeed later on on the other side i.e. I will end up with an asymmetric face!

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I have approached many dental practices about this situation. All have said that despite having a current CT I would need to sit in a room with a General Dentist (to determine if UL 5 can even be saved and the crown salvaged), an Endodontist (to make an attempt on the chronic infection) and an Implantologist (to place implants on both sides: ~x6 implants).

Obviously the work requires that the specialists actually communicate with each other and some of it is a case of 'chicken or the egg'. The first problem is that it is very hard to find a dental practice with all of the specialists in one place. Secondly those that do have the specialists have taken the fee and told me either that it's too complex or quoted some figure approaching 15K.

What should I do...
 
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