Frequently Asked Questions About Dental Implants

VIDEO: Complications associated with tooth loss

VIDEO: Teeth replacement treatment options

VIDEO: Partially edentulous (partially missing teeth)

VIDEO: Complete edentulous (complete missing teeth)

Q) I have some missing teeth. My dentist told me that I could get a bridge. Is that a good option? Can I get an implant?

A) Bridge is a conventional approach for replacement of missing teeth. Although it restores the missing area, it has a few disadvantages: The adjacent teeth have to be prepared (cut down) for its support. This is very radical. Prepared teeth may become exposed to root canal procedures, suffer periodontal disease (loss of bone and recession) or may develop caries under the crowns. Also, hygiene is difficult as all units are connected. The ideal treatment option is replacement with a dental implant. This approach is conservative, easy, and highly predictable. There is no significant difference in cost between the two options. Dental implants allow replacement of the missing tooth without damaging the adjacent teeth.

Q) I have lost all of my teeth and have been using full dentures. Is this ok as a long-term solution? What are my other treatment options?

A) Prior to dental implants, complete dentures were the only solution available. However, it is well know that dentures have many disadvantages. They are very un-natural due to flange extension into the roof of the mouth, cheeks, and tongue space. Chewing and talking become very difficult. They also cause gradual resorption (shrinkage) of the underlying jawbone. As the bone shrinks, more material must be added to the denture to make up for it. As the result it becomes increasingly heavier and less adaptive. The dentures become gradually ill fitting and increasingly loose. The process continues until the bone has completely resorbed and patients become dentally crippled. Therefore, complete dentures are only indicated for short term as an interim or transitional prosthesis.

The current standard of care is to place dental implants for support of dentures (known as overdentures). This dramatically increases comfort and denture retention, allowing patients to enjoy their favorite foods. Dental implants also preserve the underlying jaw bone, as they help to absorb the forces of chewing. There are several options:

Removable Prosthesis Options

• Placement of two dental implants, one on each side of the jaw (either lower or upper) The denture will ‘snap’ on the implants providing great retention. This is the simplest design, yet very functional, and the most cost effective option. Patients have a dramatic improvement in their comfort and function.
• Placement of four dental implants, two on each side of the jaw. Because of the ‘tripod’ effect the denture now becomes stable and retentive 3-dimentionally. This is the preferred treatment option.

Fixed Prosthesis Options

(The prosthesis is fixed and completely supported by implants. There is no need for flange extension therefore creating the most natural feeling)

• Placement of 6 dental implants (Three on each side). In this case, it may be possible to place a hybrid prosthesis, which is fixed and cannot be removed by the patient. The prosthesis is completely supported by the implants. While the prosthesis is very stable, there is considerable increase in the overall cost (more implants and more laboratory cost)
• Placement of 8 dental implants (four on each side). This option allows placement of a fixed bridge, which is completely supported by the implants. The bridge is made of metal and porcelain with optimal strength and aesthetic values. This is an ideal option for those who do not want removable dentures or cannot tolerate them. This approach is more technically demanding and should be performed by an oral surgeon and a prosthodontist or a very experienced general dentist. While this option provides benefits most resembling the natural teeth, it can be costly.

Q) I want to get a dental implant, but my dentist has told me that I don’t have enough bone and therefore a poor candidate. Is this true? What are the treatment options?

A) implants need adequate bone for proper support and function. Following tooth loss, the bone undergoes some resorption, which occurs in various degrees in every individual as well in different areas of the mouth. This results in inadequate bone for proper implant support. However, bone can be easily augmented in virtually any area of the mouth using the bone regeneration and grafting techniques. These procedures are highly predictable and successful. Generally, 4-6 months of healing is required before a dental implant can be placed.

Q) I need a tooth extraction and I want to have an implant to replace it as soon as possible. What is the treatment scenario?

A) Treatment stages:

• extraction of the tooth by oral surgeon. If the tooth is in the smile area, a transitional prosthesis may be fabricated before the extraction and inserted on that day (may be removable or fixed). An immediate implant (placed at same time as the extraction) is an option and may be recommended if appropriate. However, in most situations the implant is placed in a delayed fashion in 6-8 weeks.
• Placement of the dental implant. This is allowed to heal for 2- 6 months depending on their location. During the time, the transitional prosthesis use is continued.
• Exposure of the implant and placement of a temporary extension (On occasion, this extension know as healing abutment is placed at the time of implant placement, therefore avoiding the exposure surgery). The gum tissue is allowed to heal for 6 weeks before taking the final impression. If the implant is in the smile area, an immediate fixed temporary tooth may be fabricated by restorative dentist and placed on or within a few days of exposure.
• Final impression by the restorative dentist and delivery of the final prosthesis.

On occasion, the surrounding bone of the tooth being extracted has been lost (infection, periodontal disease, etc). In this case, following the extraction, a minor bone grafting procedure may be indicated to rebuild the site and develop ideal bony architecture. In this case, the implant will be placed in 4-6 months when the bone has adequately been regenerated and healed.

Q) What is the cost of dental implants? What payment options are available?

A) While dental implants can be financially difficult to manage for some individuals, they become less costly in the long term. Many surveys have reported that patients spend more money on denture adhesives and new replacement dentures in just a few years than what they would spend on a couple of implants. These reports also show increased cost associated with potential root canal treatment and recurrent caries that occurs with conventional bridges. These reports support the cost efficiency of dental implants in the long term. This factor in addition, to its many other benefits, make it the optimal treatment option.

The implant cost can vary in different situations, but may be $1700-$2000 per implant. Bone grafting procedures may be necessary prior to placement of implants or occasionally at the same time. The cost of grafting is highly variable depending on the location and degree of grafting necessary. A current panoramic x-ray and pictures in lieu of consultation can be helpful to determine grafting needs and approximate costs. Insurances usually do not have benefits for these types of procedures. We have short and long term payment plans available to provide interest free payment plans for 3, 6, 12 months or longer if desired. Please call our office for information on these options. Please speak to our financial coordinator for assistance.

Q) I have had several consultations and have done some research and I’ve found a wide range of fees for implants and the prosthetic portions. Can you explain why?

The surgical and prosthetic costs are separate. The prosthetic cost, as discussed by your dentist can vary based on 1) your dentist’s background and experience (general dentist or prosthodontist); 2) laboratory use. implant dentistry is precision dentistry and optimal results require a great deal of careful planning and communication, skills, as well as an excellent laboratory. Our surgical fees include all phases of your treatment including consultations, necessary x-rays, conferencing and treatment coordination with your dentist, implant placement, implant exposure, and postoperative visits. It also includes our 'Life Time Guarantee'.

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