Dear Doctor Column, August 14, 2006
Dental Implants: Natural-Looking Replacements for Lost Teeth
Question:
Are dental implants a good alternative to fixed bridges? They are more expensive and I want to know if the extra cost offers any extra benefits.
Answer:
According to many experts, dental implants are the ideal replacement for anyone who has lost teeth to trauma, decay, or disease or for some reason, was born without a full complement of teeth. The devices also can replace cracked or diseased teeth. Dental implants, titanium screws or cylinders, are placed in the jawbone to form a stable anchor for custom-made artificial teeth, called crowns.
When implanted by an experienced oral and maxillofacial surgeon, the devices are indistinguishable from natural teeth, both in appearance and function. The titanium implants fuse with the jawbone through a process known as osseointegration, which eliminates the scarring that normally occurs when foreign devices are placed in the body. They are comfortable, do not decay, look and feel secure, and in fact, are more rigidly fixed in the jawbone than natural teeth.
Dental implants have been used for several decades, but modern technology has improved the devices and increased success rates, which are now higher than 90%. Because health care professionals have high confidence in modern implants, many will replace a failed implant at no cost. Excellent results are increasing popularity of the devices, and the American Dental Association reports a 49% rise in implant use between 1999 and 2002.
Dental implants offer benefits beyond their completely natural appearance. Fixed bridges, for example, require grinding down teeth next to the missing tooth or teeth, which weakens the structure of the remaining teeth and eventually can result in additional tooth loss. Bridges also have a limited life span and often must be replaced at least once during a person’s lifetime. Over time, implants are probably more cost-effective than bridges or other types of tooth replacement. They also produce better functional results that correct jaw mechanics, which are disrupted by missing teeth, improving speaking, eating and digestion, and self-esteem.
Implants also enhance bone health compared with other devices or not replacing missing teeth. Bone is a dynamic system that is constantly breaking down and rebuilding. When a tooth is lost, this process stops and the bone that once supported the tooth is gradually lost. Dentures and other devices constantly rub and erode bone, but implants stimulate bone growth and preserve its structure.
The initial cost of an implant is significantly higher than the initial cost of a fixed bridge or other types of tooth replacement. The cost, which is not covered by dental insurance, depends on the location of the missing tooth and other factors, but implants typically run between $1200 and $2500.
Getting implants is a multistep process that can take several months and sometimes longer. During the initial evaluation, the oral surgeon will examine your teeth and take X-rays or perform other imaging studies that provide information about missing structures. During the next appointment, the implant is placed into the jawbone and covered with gum tissue. This step usually is performed with local anesthetic or conscious sedation. You may experience swelling and tenderness for a few days after the procedure. Discomfort is usually treated with over-the-counter pain medications.
Once the initial healing process is complete, which can take up to 6 months for teeth in the upper jaw and 3 to 4 months for those in the lower jaw, your oral surgeon uncovers the implant and covers it with a cap. The gums seal and heal around this cap, and several weeks after it is positioned, a restorative dentist places an individually designed artificial tooth that blends seamlessly with the size, shape, and color of your other teeth.
Implants aren’t an option for everyone. Patients need to commit to rigorous oral hygiene and regular dental visits to keep their mouths healthy. They also need to be in relatively good health and have healthy gums and enough bone to support an implant. In many cases, however, a skilled oral surgeon can overcome gum disease and bone loss. Dealing with such issues increases the complexity and cost of the procedure.
The ideal time to consider implants is right after a tooth is lost. Experts point out replacing a lost tooth sooner rather than later decreases the amount of bone loss, which simplifies the implant process and lowers its cost. In addition, over time, teeth can drift into the space left by the missing tooth and cause long-term problems with oral function.
Oral surgeons, dentists, and some plastic surgeons perform dental implant procedures. Choosing an expert with sufficient experience produces the best outcomes. When selecting a health care professional, make sure to ask how many implants they have placed. More complex replacements require more experience and a broader range of skills. Your dentist can help you decide if dental implants are right for you, and if needed, refer you to an appropriate specialist.