According to the user manual, a healthy adult has a full set of 32 teeth. 16 uppers and 16 lowers. Life being the way it is, though, there’s very often some attrition as the years go by. In fact, about 70% of American adults in the 35-44 age group have lost at least one tooth. Over the past 25 years, dental implants have become the preferred solution to this common problem. The materials and procedures get better and better all the time. In fact, many dentists would say that dental implants provide the biggest quality of life improvement of any procedure. Naturally, this kind of excellence comes at a price.
It’s not all that surprising our teeth go missing in action (MIA). After all, we ask an awful lot of them. We use them every day to slice, crush, grip, and grind. Mostly the food we eat. But who hasn’t used his teeth as a third hand, a wrench, or to open a package? Those improvised applications are not, generally, a good idea. We’re capable of applying tremendous forces with these teeth of ours. 200 lbs. is not uncommon. Human teeth are strong, but their strength is not unlimited. Moreover, they’re mounted, as it were, in bone sockets and in soft tissue, the gums.
We lose teeth to trauma, to decay, and most of all to gum disease. Sometimes the trauma is self-inflicted. Other times it’s just what this life dishes out to us. We get our teeth knocked out in sports, accidents, and sometimes even intentionally. We can limit our risk with lifestyle choices and with precautions such as mouth guards.
THE LIMITS OF PREVENTION
We cannot, though, eliminate trauma risk entirely. The same goes for decay and gum disease. Yes, the best-practices standard for self-care can help a lot. Brushing and flossing are the pillars. Regular checkups and professional cleanings complete the preventative mix. That said, perfection in anything is nearly impossible. Not only that, but some of us simply have genetic endowments that predispose us to decay and periodontal disease.
Thus, one way or another, about 10% of us in the 50-64 age range have no natural teeth left. Hence, the growing enthusiasm of dentists and patients alike for dental implants.
MISSING TEETH: THE PRICE WE PAY
Missing teeth surely do alter a person’s appearance. Depending on which tooth (or teeth) is MIA, the gaps can be more or less visible to others. Few would consider missing teeth a cosmetic upgrade. We can all agree it’s not an appealing look. So, there’s that. The downsides of missing teeth, however, go way beyond the matter of good looks.
For one thing, each one of our teeth acts as a place holder. When one goes missing, the others are not idle. The other teeth have a tendency to react to the new gap by moving. The speed and the amount of shifting depend on many factors. However, any shifting of an adult’s teeth is much more likely to be a bad thing than a benefit. It can, in fact, lead to a chain reaction of negatives. Upper and lower teeth not meshing properly. This, in turn, affects chewing. Maybe even speech. But there’s something else.
Bone loss. Normally, our upper and lower jawbones constantly “remodel” themselves to stay strong and fit. Our teeth provide the stimulation that drives the process. Everybody’s familiar with the idea that lifting weights keeps muscles big and strong. In a similar way, the pressures of teeth on the (alveolar) bone they’re set in stimulates the upkeep of bone mass. When a tooth goes missing, the effect on the underlying bone is quite dramatic. A loss of width up to 25% in the first year is common. And again, there’s a chain reaction. Once that alveolar bone socket is gone, the jaw bone itself begins to shrink.
WHAT ARE DENTAL IMPLANTS?
It should be pretty clear that a missing tooth should be replaced by an implant ASAP. Before the bone loss issue complicates things. Before the layout of the teeth shifts around. A dental implant is, simply put, a special screw that we sink into the jaw where a missing tooth used to be. We then put a connector called an abutment on top of the screw. Finally, we attach an artificial tooth, a crown, to the abutment. These crowns are custom-made for each patient. They look, feel, and function like natural teeth. Perfect natural teeth, that is.
ENDOSTEAL DENTAL IMPLANTS
The most commonly used type of dental implant is called the endosteal. The description above pretty well describes an endosteal implant. Titanium is the material of choice for the “screw”. It’s very strong, resists corrosion, and doesn’t irritate living tissues. Hence, titanium implants are so compatible with our jawbones that the two bond together over time. This bonding provides a strong, secure base that stands up nicely to those chewing forces we discussed.
Endosteal implants require a certain minimum bone mass. As mentioned earlier, bone loss progresses pretty fast after a tooth is lost. When a patient’s lost enough bone to rule out endosteal implants, one approach is to try to fix that deficit. We can use bone growth factors (GF) to stimulate added mass. These are natural or genetically engineered hormones. Normally, tooth pressure triggers our natural release of GF. When there’s no tooth, we can introduce GF from outside.
There are also surgical options available. Oral surgeons can graft bone matter from elsewhere in the patient’s body to the planned implant location.
SUBPERIOSTEAL DENTAL IMPLANTS
Efforts to restore lost bone mass aren’t suited to some patients. For these, there’s another type of dental implant called subperiosteal. The difference is that these implants don’t go into the bone. Rather, they implanted in the gum tissue, and rest on rather than in the underlying bone matter. You can probably already see the likely disadvantages, compared with endosteal implants. Since they’re not anchored in bone, subperiosteal implants can never be as sturdy. Moreover, they don’t provide the direct stimulation that promotes mass and strength in the bone. On the plus side, it’s an implant solution for patients who would otherwise have to go without. Subperiosteal implants look and feel as great as endosteal, and as a bonus, the treatment time is shorter. Patients just need to be more careful with them.
QUESTIONS ABOUT DENTAL IMPLANTS
The four questions patients ask most often are, of course:
- Will it hurt?
- How long will it take?
- How much do dental implants cost?
- Can I get dental implants near me?
Dentists nowadays are very, very good at managing the pain issue. Needless to say, any dental implant procedure will include effective anesthesia. We manage discomfort during the recovery process with appropriate medications. Antibiotics guard against infection. Patients themselves need to take part in the pain management program. It’s important to follow the dentist’s instructions about eating, drinking, and activity. Taking any prescribed medications per instructions is obviously essential.
How long will it take? By that, most patients are asking how long after the implant procedure is completed will their lives return to normal. Here, the unavoidable answer must be “it depends”. Does it ever! It depends mostly on the condition a patient comes in with. Severe bone loss, for example, can extend the total treatment time to months. It takes that long for a preparatory bone graft to heal up. At the other extreme, the simplest most basic single tooth implant procedure can be behind the patient in a few days. The important thing is that the dentist’s evaluation of a patient, including sophisticated imaging, sets reasonable expectations.
Cost? Dental implants are most likely going to involve significant out-of-pocket cash. How much depends on the patient’s condition, the type of implant and procedure, and more. A ballpark figure for the Palm Beach area is $2,000 for a basic, single-tooth endosteal.
The true cost of implants is actually less than it seems. Consider that an alternative such as a bridge will have to be replaced two or three times over a patient’s lifetime. So, three times the first outlay.
Implants, in contrast, are like diamonds: forever. One analysis, adjusting for inflation, indicates that the bridge solution ends up costing much more than an implant over the patient’s lifetime. Oh, and dental implants never decay, never get cavities.
The durability, functionality, and even the long-term economics of dental implants are unequaled. Your Royal Palm Beach dentist encourages interested patients to call and set up a consultation. Anderson Dental is conveniently located and yes, we do dental implants. There’s a lot to talk about. Sooner, too, is better than later.
“ I wish I’d waited another year before asking about dental implants!” –said no patient, ever.