|Dr. Kent Cohenour will be retiring from our practice effective June 30, 2017
Read Dr. Cohenour's Goodbye Letter
FAQ: Dental Implants
Why should I consider dental implants?Implants are a superior alternative for tooth replacement for a number of reasons. Implants preserve both the underlying bone and the structure of your face. They also look, feel and function like natural teeth and can improve both your nutrition and your digestion. They restore your mouth as closely as possible to its natural state, and you don’t have to worry about them coming loose or falling out. The comfort and natural appearance of dental implants can enhance your self-esteem and self-confidence.
One of the most important reasons to consider dental implants is that they provide a strong foundation for your teeth. In addition to replacing the crown of a tooth—the part that is visible in your mouth—dental implants also replace natural tooth roots where teeth are missing.
It is important to replace the tooth root as well as the visible part of the tooth (the crown) because natural tooth roots are embedded in bone, providing the stable foundation necessary to bite and chew normally.
While the bone holds tooth roots in place, the roots preserve the bone. When teeth are missing, the bone that supported those teeth deteriorates. Dentists call this process tooth resorption.
By replacing missing teeth with dental implants, the underlying bone is preserved. Since the bone forms a strong bond to the implants, they serve the same function as natural tooth roots—a strong foundation for biting, chewing, speaking, and appearance.
How can I benefit from implants?Here’s a more thorough explanation of how dental implants can benefit your life.
Am I a candidate for dental implants?Nearly everyone who is missing one or more teeth and is in good general health is a candidate for dental implant treatment. In conjunction with your primary care physician, we can optimize patients with diseases such as diabetes so that they are candidates for implants.
Usually, the quality and quantity of available bone is a more important factor in dental implant treatment. Even with significant bone loss, new procedures that add bone or create new bone allow people who would not otherwise have been candidates for dental implants to have successful implant treatment. Our surgeons are always the most up-to-date on new techniques and procedures to provide you with the best possible chance of implant success.
Is dental implant treatment painful?Most implant patients say that the implant procedure is not even as traumatic as having their tooth extracted. For patients who are nervous about the procedure, we are able to provide sedation, so don’t let the thought of a “surgical procedure” keep you from getting the best possible care. While everyone tolerates pain differently, most patients are comfortable simply taking Tylenol after the procedure.
Does each missing tooth require an implant?Each patient is different and should be evaluated by a dentist to determine the number of implants required to support the replacement teeth that will best fit the patient’s functional and aesthetic needs. It is usually possible, however, to replace all of the lower teeth with an overdenture supported by 2-4 implants. When you are missing back molars which take most of the brunt of chewing, some dentists prefer to replace missing posterior teeth with individual implants. Your dentist can assess your particular situation and recommend a course of treatment that’s right for you.
Is age a factor in implant treatment?Dental implants were developed in the 1950s specifically as a solution for older patients who were missing teeth. Overall health and a desire to improve your quality of life are more important than your age. In fact, many patients well into their 90s have dental implant treatment without any problems. Why not make the absolute most of your years?
Since implants preserve bone, why would a dentist recommend a tooth-supported bridge?Until the late 1980s, traditional tooth-supported bridges were considered the “gold standard” for replacing missing teeth. Advancements in technology have given dentists more options to offer to their patients, but bridges will sometimes still be the restoration of choice, especially when teeth already have large fillings and can benefit from the protection of crowns attached to traditional bridges. In these cases, particularly in the back of the mouth where bone melts away much more slowly when there are adjacent natural teeth, dentists may recommend a traditional bridge rather than implant treatment.
However, most dentists abhor the idea of grinding down perfect teeth to place a bridge, so they will recommend implant treatment for their patients when possible.
Would a dentist ever recommend extracting a tooth and replacing it with an implant?Sometimes natural teeth are failing or are about to fail. This can be caused by severe gum disease that has eroded the bone that supports the teeth. In these cases, it’s sometimes preferable to remove the tooth to eliminate the disease and infection and replace it with an implant.
Also, teeth that have had root canals are brittle and susceptible to fracture. In these cases, where the tooth needs to have another root canal and the prognosis is not favorable, it may be best to extract the tooth and replace it with an implant-supported crown. Teeth that are severely fractured are usually extracted and are excellent candidates for dental implant treatment.
How does the cost of implants compare to the alternatives?Though many people assume that implants are more expensive than traditional treatment, in many cases it is more cost efficient in the long run.
When replacing a single missing tooth, the two most common options are the tooth-supported bridge and an implant-supported crown. The bridge often costs less initially, but it will need to be replaced 5 to 10 years later. A bridge also requires grinding down adjacent teeth to cement it into place, which permanently compromises the long-term health of these teeth. Most importantly, a bridge does not prevent bone loss.
With a traditional bridge, additional procedures such as replacing the bridge, having to re-treat the teeth that were ground down, or repairing a defect in the bone, are definite future possibilities. This could increase the cost of treatment to more than $6,000 in a 10 to 15 year period. An implant, however, costs $2,500-4,000 depending on geographic location. Implants are better long-term alternatives from a financial and health standpoint. Visit www.idia.org for more details about the long-term savings patients have seen with dental implants.
How long do implants last?Once a dental implant has fused to the bone successfully and it is functional, it should last many years if cared for properly. Many implants have now been in place for more than 40 years.
Do implants ever fail?Dental implant treatment is one of the most successful procedures in the field of dentistry, with documented success rates of higher than 95 percent.
One of the reasons the success rate is so high is because implants are made of a safe biocompatible material called titanium, which also is used for hip and knee replacements.
Why do dentists prefer not to grind down perfectly good teeth to replace a missing tooth with a bridge?Until dental implants were developed, tooth-supported bridges were the preferred treatment for tooth replacement. Bridges are far superior to removable partial dentures, which accelerate bone resorption and weaken the adjacent tooth they hook onto, but they still have significant problems.
Basically, a bridge consists of two or more crowns with one or more false teeth fused together. The crowns on either end of the bridge are cemented onto teeth that serve as bridge abutments. The false tooth or teeth between these crowns replaces the tooth or teeth that are missing.
In order to cement the bridge into place, the teeth that support either end of the bridge must be ground down to pegs so that the crowns fit over them. In other words, a good deal of healthy, natural tooth structure has to be removed to allow the bridge to fit properly. Most dentists do not like to damage perfectly good teeth when there are other alternatives for treatment.
What are the problems with removing healthy tooth structure?If the teeth that will support the bridge are perfectly healthy, most dentists will not recommend a bridge, as it requires destroying healthy tooth structure that can never be replaced.
The tooth structure that is removed to support an abutment crown is enamel, the hard protective surface of the tooth. Enamel is far more resistant to decay than the layer beneath it, a softer, spongy material that decays more rapidly. When teeth are ground down to place a bridge, the tooth structure under the crown is more susceptible to decay, particularly since the cement that holds the bridge washes out over time and bacteria can leak under the crown.
A significant number of teeth under crowns and bridges will decay over time. These teeth may then require root canal therapy. Some dentists who specialize in root canals report that as many as 25 to 30 percent of the procedures they perform are on teeth under crowns and bridges.
How do dentures and partials accelerate the deterioration of facial structures?A denture is prosthesis, and like any other prosthesis, it is designed to replace missing body parts. Because the jaws deteriorate and the face collapses when all of the teeth are missing, dentures are designed to replace missing teeth and the facial structures that have deteriorated. To achieve this, they must be thick enough to compensate for the bone that has melted away. As the facial structures continue to collapse over time, dentures must be made thicker to compensate for additional bone loss.
Dentures accelerate the loss of bone because they press down on the gums and underlying bone when you eat, compressing the gums and bone. Unfortunately, if you wear a denture your bone will melt away faster and your facial structure will collapse more quickly than if you don’t wear a denture.
A partial denture is also a prosthesis, but it is designed to replace facial structures when only some teeth are missing. A partial has metal clasps that hook onto the adjacent teeth to hold it in place. A partial also accelerates bone loss as it presses down on the gums and underlying bone when functioning. The hooks put pressure on adjacent teeth as the partial rocks back and forth, so these teeth will eventually loosen and come out. New false teeth must then be added to the partial and the pressure from the hooks shifts to different teeth, which now become compromised. This process continues as long as the partial is worn.
Does the loss of one or a few teeth compromise facial structure?The bone in the front of your mouth is very thin, so if you lose a front tooth the bone usually melts away rather quickly. This will cause the bone and gums to cave in and be visible when smiling which makes many people self conscious about their appearance.
When a front tooth is replaced by a tooth-supported bridge, the teeth on either side look natural. Over time the gums and bone above the false tooth collapse, leaving the false tooth hanging and looking fake.
This problem is more obvious if a few teeth are lost in the front of the mouth, since the bony defect is much larger. As the bone deteriorates above the bridge, there is often a visible gap between the gums and the bridge.
How do dental implants preserve bone?Dental implants serve as substitute tooth roots, functioning as natural tooth roots by stimulating the bone and preserving it. Since the jawbone forms a bond with the implant, it provides a stable foundation for replacement teeth that look, feel, and function like natural teeth.
Replacing missing teeth with implants also prevents other problems associated with tooth loss, such as other teeth shifting into the spaces created by missing teeth and functional problems with the bite and jaw joints.
What do I do if my bone has already deteriorated?If you already have dentures or a partial, you may be concerned that your bone has deteriorated and it’s too late to consider implants. Fortunately, new technology makes it possible to grow new bone or to add bone to areas where the bone has melted away, allowing the placement of implants.
Bone grafting procedures make it possible to repair defects in the bone and place implants to improve appearance. Bone grafting makes it possible for people with significant bone loss to have implants that restore function and the integrity of their facial structures.
Sometimes it’s possible to graft bone and place implants at the same time; however, each person’s situation is unique, and not everyone is a candidate for bone grafting. Even if you wear dentures or a partial, you owe it to yourself to talk to a qualified, experienced surgeon to determine whether you qualify for bone grafting and implant treatment. These simple procedures can make you eat, look and feel better. Don’t wait. This one consultation appointment may change your life.