According to the American Association of Oral and Maxillofacial surgery, about 69% of adults between 35 and 44 have lost at least one permanent tooth due to an accident, gum disease, or other oral condition such as a failed root canal or tooth decay. Although people tend to be healthier and keep their teeth longer than they did in previous generations, about a quarter of adults have lost all of their permanent teeth by the time they reach age 74. Obviously, deciding how to replace a missing tooth is an issue many people encounter at some point in their lifetime. There are many good and reliable options that can be offered by a cosmetic dentist, but in many cases a dental implant may be the best choice – in fact, sometimes it is the only choice!
Traditionally, a missing tooth has been replaced by either afixed bridge or a removable denture. Unfortunately, neither of these options is a permanent solution and typically need to be replaced about every 5 -10 years. Furthermore, since most prosthetic replacements are not as good as what Mother Nature created, these replacement options come with potential problems – even well designed prosthetics affect the teeth around them upon which they rest. Fixed bridges require that a dentist cut down adjacent teeth to form an anchor for the replacement tooth; and removable “plates” made of metal or plastic can rub or wear on the nearby teeth which serve as anchors. When there is no healthy, stable tooth to form an anchor or if the anchor fails, sometimes the tooth cannot easily be replaced.
Even when bridges and dentures are beautifully and carefully made, some consequences are just unavoidable. Over time teeth adjacent to removable dentures and bridgework become more vulnerable to decay or gum problems simply because there is a foreign body the (replacement crown or metal plate) that collects plaque. After a tooth has been lost, the bone which once held the tooth in place in the jaw is no longer needed, so it begins to slowly dissolve away in the area where the tooth once was. This natural body process, called “resorption” leads to unnatural looking spaces under bridgework and changes in the fit of a denture which can cause slipping, soreness and chronic maintenance issues. Just a couple of decades ago, these undesirable side effects were considered the lesser of two evils, and the benefits of replacing a tooth outweighed the disadvantages. Today, dental implants all but eliminate these side effects and can even restore the smile of people who once had no options. What a wonderful option for a young person who has, perhaps, lost teeth due to an accident!
A dental implant is a titanium post that is embedded into the jaw bone by a cosmetic dentist or oral surgeon in the place where a tooth is missing. Over a period of several months, the postbonds with the jaw bone to create a stable foundation upon which a final restoration is placed to achieve a natural, cosmetically appealing result… the implant stands alone and does not affect the teeth around it. An amazing feature unique to dental implants is that the body actually interprets the titanium post the same as it would the root of a natural tooth, so no natural bone loss occurs over time.
People often wonder if this procedure is right for them, and that is a good question to ask. Dental implants can be the ideal solution to replace one or more individual teeth; or they can be used to create anchors which firmly hold a full denture in place without the progressive bone resorption that is otherwise inevitable. However, not everyone is a good candidate for the procedure: Several factors must be evaluated by the dentist before deciding to place an implant. Your dentist may have to order a specialized x-ray or CT scan that provides a three dimensional image of the existing bone, to ensure that there is enough to support the titanium post. This can be particularly important if the tooth to be replaced has been missing for a long time, or if you were born without it. An implant is more likely to fail in someone who smokes because the bone does not bond as well to the implant. People with poorly controlled diabetesdon’t heal as well and may require a medical evaluation to decide how best to proceed.
Everyone who considers a dental implant should be aware that good home care and plaque control are essential because gum and bone infections can -and do- develop around an implant just like they would around natural teeth that are not kept clean. This avoidable problem, known as peri-implantitis, is one of the most common causes of implant failure.
What about the cost? Obviously that is an important factor to consider in any investment. The good news is that the cost of creating and placing an implant is often similar to the cost of making a fixed bridge, and with good care and maintenance the titanium post will never need to be replaced. Occasionally the porcelain crown that is visible in the mouth may need replacement for cosmetic reasons, and this can be done relatively simply. The not-so-good news is that not every insurance company pays for dental implants at the same level that they might pay for a bridge or denture, so in some cases there can be a larger out of pocket cost. Don’t let that be a deal breaker… think of it as an investment and weigh the out of pocket cost of replacing a bridge one or more times, remaking and refitting a loose denture, or costly complications should adjacent teeth become involved.
At one time, dental implants were considered by many to be a luxury, and many insurance companies considered them to be an “experimental” procedure. Today, the procedure is common and state-of-the-art… not a luxury, but a worthwhile investment in your oral health. What are your thoughts about investing in dental implants as a tooth replacement option? Would you like to learn more about the procedure? Have you had a positive experience with implants? You might be surprised to discover that in the long run, the dental implant that costs a bit more up front is much more cost effective over the long haul, not only in terms of dollars but also in terms of your oral health and happiness.