“Implants for replacing lost teeth have come a long way since I began my dental practice in 1986”, according to Dr. Ryne Johnson, prosthodontist with Newton Wellesley Dental Partners. “Better materials, computer diagnostic procedures, CAD/CAM technology and professional experience result in far fewer problems than occurred in the early years of implants”.
Critical to their success, however, is proper selection of both patients and practitioners — and, after the implant, a commitment to good oral hygiene. Dental implants must be treated like natural teeth: kept clean and free of plaque through proper brushing, flossing and periodic professional cleanings.
“Bridges are not the standard of care anymore,” For most people who lose teeth, implants are the treatment of choice” according to Dr. Johnson. “Implants do not decay, and adjacent healthy teeth do not require crowns to support them. And because it is easy to clean and floss between implants, the gum tissue and underlying bone are more likely to remain healthy”.
With a bridge, if one of the supporting crowned teeth breaks or develops decay or nerve damage, the bridge and its three or more crowns must be removed and replaced.
Implants can replace individual lost teeth or many teeth in a row. For those who have lost most of their teeth, implants can be used to anchor a full or partial denture. About half a million implants are placed each year in this country.
On average, the total cost of a dental implant to replace a single tooth is $5,000 to $7,000 (more if other procedures are required), or about one-third more than the cost of a bridge. But while bridges have an average life span of 10 years, an implant can last a lifetime.
Not a Quick Procedure
The basic technique involves surgically inserting a titanium screw — the implant — into the supporting bone, which can be done under local anesthesia in less than an hour, and attaching a small fake tooth called an abutment, followed by a crown. The resulting tooth looks and feels like a natural one.
Although there is an increasing trend toward ‘immediate loading” where computer design is implemented and dentistry is immediately placed on the, the conventional approach can be a lengthy one. Unlike a bridge, which can be completed in a few weeks, implants usually take about eight weeks for the screw to become firmly attached to bone before the final crown can be placed. “A patient’s health, not age, determines suitability for an implant,” Dr. Johnson reports. “I just did implants for a 88-year-old who needed them to support and ill-fitting denture. “If cases are chosen well, implants are very successful — 96 to 97 percent successful. And they rarely fail down the road.”
A most important element is having enough bone in the jaw to support the implant, although in some cases bone cells removed during drilling for the implant or taken from elsewhere in the
In some cases when a tooth must be pulled, an implant can be placed right after the extraction, with the advantage of limiting bone loss in the area. When bone is not being stimulated, it tends to break down. I consider myself lucky that although I’ve had this troublesome bridge for many decades, my underlying bone has remained healthy enough to support an implant.
Choosing a Doctor
Just as any physician can legally perform surgery, any dentist can legally do implants. Be sure to choose someone thoroughly trained in the technique. Taking a weekend course in implantology is rarely adequate. There are risks involved in placing implants, including damage to a nerve or sinus cavity, which are magnified when the practitioner lacks adequate training.
Dental Implants were once done mainly by oral and maxillofacial surgeons, most of whom operated independently of dentists. Now at least as many implants are placed by periodontists who are schooled in the technique and who coordinate their work closely with the patient’s dentist. Ideally, the periodontist should be board-certified.
Just as you might ask for referrals for a prospective attorney or financial planner, consider asking to speak with other patients of the practitioner before deciding to proceed with an implant. Though every case is different, at the least you can determine how well you are likely to be cared for.
For more information visit, www.NewtonWellesleyDentalPartners.org and remember to, “See a specialist…the difference will make you smile”.