Q. Why is it important to replace missing teeth?
A. Each one of our teeth has a blood supply and is fixed to our jaws via the periodontal ligament. Teeth are living tissue, and an increasing number of studies have linked our oral health to our overall systemic health.
When you are missing even one tooth, change can occur in the jaw and opposing teeth. In the absence of teeth, the jawbone is not stimulated during mastication (chewing) and can atrophy. With no counterforce, the opposing tooth will often erupt (project out), sometimes becoming loose and possibly leading to more tooth loss.
Although this “domino effect” can occur, the most common factor leading to complete tooth loss is a genetic condition called periodontal disease. The more teeth that are lost, the more bone atrophy one typically experiences. The results can eventually change the look of the face, leading to a drawn out and aged appearance.
Q. What are my options?
A. There are three primary options to replace missing teeth, and three clinical considerations.
Options:
As with most alternatives, pros and cons exist for each option. For most people, the ideal option is a fixed solution that functions and looks like a natural teeth.
The most common complaints of denture wearers are loose fit, messy adhesives and the gagging and lack of sensation of food that is associated with the palatal cover of an upper denture.
Studies have shown that the denture wearer experiences both a lower quality of life and a lower nutritional state [Link]. Additionally, just like with a missing tooth, the denture does not stimulate the underlying bone. Atrophy occurs, altering the shape of the jawbone, which results in a loose fitting denture that must be relined.
Like dentures, dental bridges have been utilized for centuries in an effort to restore the function of missing teeth. Unfortunately, the use of a bridge requires the destruction of good teeth in order to suspend the bridge. While sometimes indicated, in most cases a dental implant would provide a more optimal solution while preserving the adjacent teeth.
Dental implants have several advantages over dentures and bridges that can contribute to overall health and an improved quality of life. Implants permanently fixate to the jaw, so people who receive them can eat virtually whatever they want. There is no palate cover, so you can enjoy the taste and sensation of the food you eat, and the issues of loose fit and messy adhesives are completely avoided.
Advances in dental implant therapy have led to faster and minimally invasive treatment options, so the lengthy, involved procedures of the past can be avoided. With success rates of greater than 97% routinely being reported in the literature, dental implantology has transitioned from a focus on function to a focus on cosmetic results. The primary difference between caregivers today is less related to function, and much more related to the cosmetic outcome – and the standard should be no less than does the replacement teeth look like the originals!
Q. Are Dental Implants, the optimal choice for missing teeth?
A. The age of contemporary dental implants began with the placement of the first Brånemark System implant in Sweden in 1965. Professor P.I. Brånemark discovered in his research that bone naturally integrates to titanium, a process called osseointegration.
Dental implants have several advantages over dentures and bridges that can contribute to overall health and an improved quality of life. Implants permanently fixate to the jaw, so people who receive them can eat virtually whatever they want. There is no palate cover, so you can enjoy the taste and sensation of the food you eat, and the issues of loose fit and messy adhesives are completely avoided.
Advances in dental implant therapy have led to faster and minimally invasive treatment options, so the lengthy, involved procedures of the past can be avoided. With success rates of greater than 97% routinely being reported in the literature, dental implantology has transitioned from a focus on function to a focus on cosmetic results. The primary difference between caregivers today is less related to function, and much more related to the cosmetic outcome – and the standard should be no less than does the replacement teeth look like the originals!
Q. My dentures fit pretty well when they were made. Now they just do not seem to fit as well, even though they have been refined several times. Why?
A. Bone resorbs or begins to shrink immediately after the teeth have been extracted due to the lack of stimulation that was provided by the presence of the teeth within the surrounding bone. Several systemic disorders and nutritional deficiencies can also contribute to this shrinking process, in additions to excessive pressure exerted on the bone and soft tissues by the wearing of full or partial dentures. As this continual shrinkage of bone and gum tissue occurs, less bone remains to retain the denture and it becomes loose. This resorption of the underlying bone can cause premature aging by causing the collapse of the facial musculature.
Q. How can implants help?
A. Unlike dentures, implants are supported by the bone, not the gum tissues. This makes the implant’s replacement teeth (prosthesis) able to distribute chewing forces throughout the bone. With the bone being stimulated, shrinkage is slowed or stopped. Implants functioning with their replacement teeth may be able to restore 90 percent of the chewing force of natural teeth.
Q. What other advantages do implants have?
A. Stable dental implants and their replacement teeth can enhance the quality of life and offer solutions for the patient who cannot function with conventional dentures. Implants can help the patient who has lost teeth and desires a crown or a bridge rather than a conventional removable replacement. For most patients their appearance, comfort, speech and the ability to chew and enjoy food is greatly improved.
The increase chewing efficiency provided by an implant supported prosthesis (replacement teeth) aids in digestion, which numerous studies have shown can increase life spans. The psychological benefits can be very rewarding when people feel better about themselves, can chew properly again, are able to enjoy long ‘forbidden foods’, and are no longer embarrassed by falling or slipping false teeth.
Q. Will people know that I have implants?
A. Not unless you tell them. Since the prosthesis (replacement teeth) covers the implant posts, no one will know you have implants. However, many patients tell everyone they know that they have dental implants. Thousands of implant patients who had suffered for years trying to wear removable dentures exclaim: ‘My implants have changed my life and they have given me new confidence.’
Q. Are there any patients who should not have dental implants?
A. Yes, but in general, anyone healthy enough to undergo routine dental extractions or oral surgery can be considered for an implant procedure.
Q. Can any dentist perform implants?
A. Legally yes, however only a small percentage of the nation’s dentists have the unique special training and the extensive experience necessary for the diagnosis and treatment planning necessary with each individual implant case. In addition to the surgical placement of numerous dental implant systems, these trained implant dentists construct or supervise the construction of the implants’ replacement teeth. The replacement teeth on dental implants are very important as they must fit correctly and function well with the implants and any natural teeth for long term success. This complex and unique field of dentistry requires special advanced training and extensive experience in surgery and prosthetics.
Q. Must I be hospitalized to have implants inserted?
A. Hospitalization is the exception, not the rule. Most implant procedures are done under local anesthesia in the dental office. Many offices also use pre-medication or sedation to control apprehension. When the patient’s general health is compromised or the surgical procedures are very complex, a short hospital stay may be necessary.
Q. What are the chances of rejection or infection?
A. Dental implants are made from biocompatible materials – that is, materials that the body does not consider foreign and therefore no rejection response occurs. The possibility of an infection occurring around healed dental implants is the same as that for natural teeth. As with natural teeth, good oral hygiene must be practiced to keep the tissues healthy and the implants and replacement prosthesis must be professionally maintained.