Dental Implants

Why replace missing teeth? What is a dental implant? Why are dental implants better than bridges, partials and dentures? Will my new teeth look natural? Who is a candidate for dental implants? Is anyone considered too old for dental implants? How long does it take to complete treatment? Are dental implants painful? How many implants are necessary? How long do implants last? Do dental implants ever fail? Can implants be rejected? Can I get implants if I don’t have enough bone? Why would a dentist recommend a tooth supported bridge? What are the indications for tooth extraction and replacement with dental implant? What is involved with taking care of dental implants? What is the cost of implant treatment? Are dental implants covered by dental insurances? Does medical insurance cover dental implants? Are dental implants successful in smokers? Will dental implants set off alarms at airport security? What are dental implants made of? Why replace missing teeth?

The mouth is restored as closely as possible to its natural state. By replacing the entire tooth, including the root, it is possible to replicate the function of natural teeth, with a strong, stable foundation that allows comfortable biting and chewing. In addition, nothing in the mouth looks, or feels artificial.

Implants preserve the integrity of facial structures. By preventing the bone resorption that would normally occur with the loss of teeth, the facial structures remain intact. This is particularly important when all of the teeth are missing, as the lower one-third of the face collapses if implants are not placed to preserve the bone.

Your smile is improved when replacement teeth look more like natural teeth. Even when only one tooth is missing, long term esthetics are usually much better with an implant supported replacement tooth than with a traditional tooth supported bridge. This is particularly important in the front of your mouth, where preventing a visible bone defect is critical for natural appearance.

Adjacent teeth are not compromised to replace missing teeth. Tooth replacement with traditional tooth-supported bridges requires grinding down the teeth adjacent to the missing tooth/teeth, so that the bridge can be cemented onto them. This tooth structure can never be replaced and the long-term health of these teeth is compromised.    Partial dentures have clasps that hook onto adjacent teeth, putting pressure on them as the partial rocks back and forth. Eventually these teeth can loosen and come out as a result of this pressure. Replacing missing teeth with implant supported crowns/bridges does not involve the adjacent natural teeth, so they are not compromised, or damaged.

Overall quality of life is enhanced with replacement teeth that look, feel and function like natural teeth. With implant supported replacement teeth, the appearance of the smile is more natural and the teeth function more like natural teeth. The result is increased comfort and confidence when smiling, speaking, and eating. If dentures and partials are replaced with implant supported teeth, the overall enhancement in quality of life is even more significant, with an ability to eat all types of foods, elimination of messy adhesives, and improved speech, comfort and appearance.

Convenient oral hygiene. It is much easier to care for an implant supported crown, which can be cleaned like a natural tooth. In comparison, a tooth supported bridge requires the use of a floss threader for proper cleaning. It is also more convenient to clean a full set of implant supported replacement teeth than a traditional denture. Improved appearance. Since implants preserve bone, preventing deterioration of the facial structures, appearance is improved. Collapse of the lower one-third of the face caused by complete tooth loss can be visually corrected and the remaining bone preserved. The appearance of wrinkles around the mouth caused by posterior bite collapse, or complete facial structure collapse is virtually eliminated.

Restored self-esteem and renewed self-confidence. Many of the people who now enjoy the benefits of implant supported replacement teeth state that their self esteem and self confidence have been restored as a result of improved appearance, function, comfort, and health.

Improved ability to taste foods: Wearing an upper denture can prevent someone from really tasting food, as the roof of the mouth is covered. With implant supported replacement teeth, it is not necessary to cover the roof of the mouth, so it is possible to enjoy the taste of foods.

What is a dental implant? A dental implant is a substitute tooth root that serves the same function as a natural tooth root. It preserves bone and provides a stable foundation for a replacement tooth that looks feels and functions like a natural tooth. Dental implants are made of titanium, which is a biocompatible material used in orthopedic implants. Why are dental implants better than bridges, partials and dentures? Dental implants can last a lifetime, unlike bridges, partials and dentures that may need to be replaced several times. Since dental implants prevent the bone resorption that occurs when teeth are missing, the natural appearance of the smile is preserved. With implant treatment, there is no compromise to adjacent teeth; they are not cut down to place a bridge, or loosened by the hooks on removable partials. Dentures and partials have the added disadvantage of accelerating the bone resorption process, which causes the appearance of premature aging.
  • Dental implants clearly offer the best replacement option in today’s dentistry.  First consider the following documented studies:
  • Implants are generally 96%-98% successful for periods of up to 40+ years. The variations are a result of several factors, including the type of implant, age of the patient, health of the patient, whether or not the implant is placed in a “compromised” site (e.g. very little bone)
  • Recent research indicates that replacing a missing tooth with an implant-supported crown provides benefits for the adjacent natural teeth.
  • Success rates for implants do not decrease over time. Compare this to the success rate for bridges, which decreases steadily after 10 years. In fact at 15 years 1 in 3 bridges typically fail.
  • If more than one tooth is missing, the bridge “span” is longer – and will have an even lower success rate.
Will my new teeth look natural? Your new replacement teeth will look, feel and function like natural teeth. And since implant treatment is the only solution that prevents bone resorption, which can cause your smile to look unnatural, the long term esthetics will be superior to any other treatment option. Who is a candidate for dental implant Treatment? Nearly everyone who is missing one or more teeth and in general good health is a candidate for dental implant treatment.   There are a few medical conditions that can undermine the success of implant treatment, such as uncontrolled diabetes.   However, there are very few conditions that would keep someone from having implant treatment altogether. Quality and quantity of available bone for implant placement is more often a factor in qualifying for dental implants than medical conditions. However, even people who have lost a significant amount of bone can qualify for dental implant treatment with additional procedures to add bone or create new bone. Advances in this type of treatment have made it possible for most people who would not previously have been considered candidates to have successful implant treatment. Is anyone ever considered too old for dental implants? No. Dental implants are equally successful in older patients even in those with osteoporosis. Overall health and a desire to improve the quality of life are much more important considerations than age. When dental implants were first developed, back in the 1950’s, implant supported replacement teeth were originally designed as a solution for older patients who were missing all of their teeth. Since then, many patients well into their nineties have had dental implant treatment without a single problem. How long does it take to complete treatment? The length of treatment time depends on location of the implants, type of bone, and design of the prosthesis. Generally, implant heal in two to four months and ready for the final prosthesis. In patients with bone grafting, this may take closer to six months. The prosthetic aspect of the treatment may take from several days to several weeks to complete. In the smile zone, implants are usually temporized for three to four months before the final prosthesis. Are dental implants painful? Most implant patients report that the discomfort is far less than they expected, and is significantly less than a tooth extraction.  And although everyone is different with regard to pain tolerance, most patients are very comfortable simply taking Tylenol afterward. How many implants are necessary? In the back of the mouth, it is generally recommended to have one implant per missing tooth. In the front of the mouth, it is acceptable to place implants separated by crowns in between (bridge design). In denture users, two to four implants are adequate for support of a removable overdenture while six to eight implants are more appropriate for support of a fixed bridge.Each patient’s situation is unique and should be evaluated by Dr. Kazemi to determine the appropriate number of implants required to support the replacement teeth that will meet the patient’s functional and esthetic needs. How long do implants last? Documented clinical research demonstrates that implant supported replacement teeth have been successful for over 50 years. These were some of the first root-form implant cases ever completed and they have been closely monitored from the beginning. It is highly likely that these cases will be successful throughout the lifetime of those patients. Dental implants are designed to be permanent; however many factors contribute to the long term success of implant treatment, such as home care and regular maintenance visits to the dentist or dental specialist. By comparison, research demonstrates that the typical tooth supported bridge lasts from 7-10 years and that partials and dentures are functional for approximately 5 years. Insurance statistics indicate that bridges, partials and dentures last 5 years and they generally pay for replacements every 5 years.Dental implants can be a life-time solution to replacement of missing teeth providing the following important criteria are met: 1. Proper size and length of implants placed 2. Adequate bone foundation is present 3. Use of custom abutments and restoration (crown) that are well made with precision fit. 4. Restorations in harmony with surrounding gum tissue and also in a balanced bite. 5. Use of well researched and accepted dental implants (There are a lot of cheaper and less well known implants with unknown studies and materials). 6. Implant placed by experienced surgeon
. 7. Proper hygiene and regular follow up by your dentist
. 8. Individual’s health- Diabetes and any disorders affecting immune system can increase chances of inflammation or infection. 9. Smoking- Can be a factor in some people 10. Use of a good laboratory who fabricates the abutments and crowns.With these factors in mind, I do tell my patients that dental implants are for life. In-fact we guarantee them. There are no short cuts to great results. Following the best practices, techniques, materials, and knowledge by expert clinicians creates long lasting and successful results. Do dental implants ever fail? Dental implant treatment is one of the most successful procedures in the medical-dental field, with documented success rates over 98%. Although successful treatment is very predictable, there are rare occasions where the bone does not completely bond to the implants. When this occurs, new implants are placed, and the success rates for the replacement implants are even higher.Smoking or putting too much pressure on newly placed implants, as with excessive grinding of the teeth, can cause problems with the bone bonding to the implants and should be avoided. Can implants be rejected? No. Rejection does not occur with dental implants. The overall success rate for dental implants is 98 percent with almost 50 years of clinical research to back them up. Because implants are made of completely biologically compatible “bone-friendly” titanium material, they naturally heal and integrate with the surrounding tissues. Because titanium is accepted so well by the human body, it also used for orthopedic implants, such as hip and knee replacements. Can I get implants if I don’t have enough bone? The jaw bone undergoes signifiant shrinkage following third month after tooth loss, and can continue up to 12 months. If extraction site was not grafted at the time, there may be inadequate amount of bone for implant placement. Bone grafting is a highly successful and predictable treatment option to augment missing bone and build the proper foundation for the necessary implants. Why would a dentist recommend a tooth supported bridge? Naturally, since dental implants preserve bone, if a patient qualifies as a candidate, implant treatment is usually considered the treatment of choice. Now that implants are considered standard of care, it is much less common for dentists to recommend fixed bridges instead of implants. Some dentists recommend bridges for patients who are not candidates for implants, or when patients insist on having the lowest possible fee for tooth replacement.However, even in cases where the teeth adjacent to the missing tooth/teeth have restorations, many dentists do not want to grind these teeth down into peg shapes to fit a bridge, as this compromises the long term health of those teeth. And most dentists abhor the idea of grinding down perfect teeth without restorations to place a traditional bridge, and therefore, will almost always recommend dental implant treatment in these cases. What are the indications for tooth extraction and replacement with dental implant? There are many situations where natural teeth are either failing, or are about to fail. This includes severe periodontal disease (gum disease) that has eroded the bone that supports teeth. Sometimes in these cases, it is preferable to extract the teeth; eliminate the disease and infection and replace the teeth with implant supported crowns/bridges.There are also situations where a tooth has had a root canal (nerves have been removed from the tooth) leaving the tooth brittle and susceptible to fracture. In cases where the tooth needs to be retreated and the prognosis is not favorable, it is preferable to extract the tooth and replace it with an implant supported crown.Teeth with severe fractures are usually extracted and are ideal candidates for replacement with dental implant treatment. What is involved with taking care of dental implants? The home care recommended varies depending upon the type of implant supported replacement teeth. For example, a single implant supported crown is cleaned like a natural tooth, with regular brushing and flossing. Implant supported bridges that replace a few teeth are cleaned like tooth supported bridges, brushing and flossing with a floss threader.Home care is a little more complicated for people who are missing all of their teeth, in that special brushes and floss are often recommended. With overdentures, it is necessary to clean the implant attachments, as well as the overdenture.   Permanently fixed implant supported replacement teeth are cleaned like all other bridges.In all cases, it is recommended that patients see their regular dentist and hygienist at least twice each year unless they routinely see the periodontist, in which case they would continue to alternate visits. It is usually recommended that the patient see the surgical specialist who places the implant(s) at least once each year as well. These visits, combined with proper home care, are essential to the long term success of implant treatment. What is the cost of implant treatment? An investment in dental implant treatment is an investment in overall health, appearance and well being, as it involves preserving the integrity of facial structures, as well as replacing missing teeth.The actual cost of implant treatment is based on a number of factors, such as the number of missing teeth being replaced, the type of implant supported teeth (treatment option) recommended and whether additional procedures are necessary to achieve the proper esthetic and functional result.There is often a misconception that there is a set cost for each implant. The fees are calculated based on the amount of time the dental specialist anticipates spending to complete treatment (implant placement, other surgical procedures, fabrication of replacement teeth,…) as well as the estimated cost of implants, other components and materials necessary to complete treatment – and dental laboratory fees.The fee is usually comparable to other methods of tooth replacement; however, long-term, implant treatment is generally more cost effective than other options, such as bridges, partials and dentures that need to be replaced every 5-10 years.The only way to accurately estimate the cost for an individual patient is to have an examination and evaluation with a dental specialist. Are dental implant treatments covered by dental insurance? Insurance coverage of implant treatment depends on the individual policy.  However, it is rare to receive any substantial coverage. Since the benefit coverage is determined strictly by the amount the employer wants to spend on the policy, and the insurance companies want to build in their profit margins, there are major limitations on most dental insurance plans.   In reality, the plans are only designed to cover routine maintenance, emergencies and basic care.The insurance companies use statistical data to determine the most common procedures submitted on claims, and then they set their own “usual and customary fee” schedule for these procedures. They also determine the specific restrictions and limitations for each plan. Because the plans are only intended to cover the basics, there is an annual maximum allowable benefit of $1,000-$1,500 on most plans.Although most companies exclude implants as a covered benefit, many of the will pay the same benefit they would cover for the lowest cost alternative treatment option (partials and dentures) and some of the diagnostic records, if a specific request is made for “alternative benefits”. Even if an individual policy includes implants as a covered benefit, the amount of coverage is still limited to the annual maximum allowable. Does medical insurance cover implant treatment? There are a few cases where medical insurance is available for people who are missing all of their teeth, and as a result, have medical complications. This type of coverage depends solely on the individual policy. Other than these situations, medical coverage is very rare.Work related injuries and other types of accidents are the other cases that are sometimes covered by insurance. Medicare does not cover implant treatment. All in all, it is best to assume that there is no medical insurance coverage available. Are dental implants successful in smokers? There are some data to show increase rates of implant failure in smokers, however, it is not an absolute contraindication. In our experience, smoking can be more detrimental during the healing phase after implant placement (The initial 6- 8 weeks when the main integration process occurs). Following this period, it does not seem to have as much damaging effect. I have had successful outcomes in many patients who smoke, particularly when they ceased smoking during the healing phase.Having said that, our recommendation to every patient who smokes and wants implants is to stop smoking all together. It impacts both their overall health as well as decrease possible implant complications. Will dental implants set off alarms at airport security? No. Dental implants are made of pure titanium and therefore are not magnetic and do not set off alarms at airport security. What are dental implants made of? Dental implants are made of Titanium which is a bio-inert and bio-compatible material. It is accepted by the jaw bone and heals very predictably. Titanium implants have been in use for many years and are both safe and long-lasting. A newer type of dental implants made of Zirconia are also available. Zirconia dental implants, marketed as ‘meta-free’, are alternatives to Titanium implants, however there are no long term studies regarding their efficacy or success. We provide both types of dental implants, although over 99% are Titanium.