Below are some of the most frequently asked questions patients have about dentistry and oral health issues. If you have any other questions, or would like to schedule an appointment, we would love to hear from you.
Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. Dental implants also help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing. Dental implants have been extensively researched and used for 50 years.
The implants themselves are titanium posts that are surgically placed into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts called abutments that protrude through the gums are then attached to the implant. These posts provide stable anchors for artificial replacement teeth or implant crowns and bridges.
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.
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. Dental implant treatment does not affect adjacent natural teeth, so they will not be compromised or damaged.
Integrity of facial structures is preserved. 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.
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.
Increased stability and security of teeth. People who wear dentures often worry that their dentures will fall out when they laugh, sneeze and sometimes even when they eat. Since the bone bonds to the implants, replacement teeth have a stable foundation and are securely attached to the implants, so there is no fear that teeth will fall out.
Improved health due to improved nutrition and proper digestion. People with dentures usually have problems eating certain foods, such as fresh vegetables and fruits, which can compromise their nutrition. Additionally, since it is difficult to chew properly with dentures, digestion is often compromised.
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.
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, are virtually eliminated. Even when only one tooth is missing, long term esthetics are usually much better with implant-supported crown than with a traditional tooth-supported bridge. This is particularly important in the front of the mouth, where preventing a visible bone defect is critical for natural appearance.
Increased convenience of hygiene. It is much easier to care for an implant-supported crown, which can be cleaned like a natural tooth, as opposed to a tooth-supported bridge, which requires the use of a floss threader for proper cleaning. It is also easier to clean implant-supported replacement teeth than a removable partial.
Elimination of denture adhesives. Since implant-supported teeth are securely attached to the implants, there is no need for messy denture adhesives, which are often needed to keep dentures from falling out.
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.
Nearly everyone who is missing one or more teeth and is in general good health can be a candidate for dental implant treatment. There are a few medical conditions that can undermine the success of implant treatment, such as uncontrolled diabetes, compromised immunity and smoking. 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 bone grafting procedures. Advances in bone reconstruction procedures have made it possible for thousands of patients who previously would not have been considered candidates, to receive successful implant treatment.
Consultation. The first step is an examination and consultation to determine whether you are a candidate for dental implant treatment. This involves examination of x-rays and may include taking impressions for models of your teeth for fabrication of a surgical guide or stent. Additional diagnostic x-rays such as a CBCT or focused CT scan may also be necessary. We will refer you to a dedicated x-ray laboratory to obtain the scans.
During the examination, we will evaluate the areas of your mouth where teeth are missing, including the amount of bone available to support the placement of implants. We will also be evaluating the type of replacement teeth that will best meet your needs.
Implant Placement Procedure. The implants are placed in the jaw bone during a surgical procedure. Following implant placement the implants may be left undisturbed for a period of 3-9 months so that the bone can bond with the implants. In the meantime your dentist will usually provide you with temporary replacement teeth so that you do not go without teeth for that period of time.
Abutment Attachment Procedure. Following appropriate healing period, a small connector called an abutment, is attached to each implant by your dentist. The permanent replacement teeth will eventually be attached to the abutments.
Fabrication of Replacement Teeth. A series of appointments with your dentist will be needed to take impressions of your teeth and the implant abutments, to place temporary replacement teeth, to select the appropriate shade for your replacement teeth, and to try them for proper fit. In between these appointments, the laboratory technician will fabricate your replacement teeth and the underlying structures that will be attached to the implants.
Dental implant placement surgical procedure takes 1-1.5hrs and can be performed with local anesthetic only. It is painless and produces little or no post-operative discomfort. Additional adjunctive procedures such as bone reconstruction and removal of infected teeth are more often associated with post-operative swelling. We will answer your questions and describe in detail what to expect during your healing process after assessing your individual situation as part of your consultation visit.
Many dental implant patients report that they have been really surprised by lack of post-surgical swelling or pain. And although everyone is different with regard to pain tolerance, most patients are very comfortable taking Advil or similar medications after their surgical procedure.
Dental implants provide a long-term replacement for your missing teeth by integrating with your jawbone. In fact, most dental implants make a stronger bond with your bone than do roots of natural teeth because the implant connects directly with the bone, while teeth have a thin ligament interposed between the roots and surrounding bone. This is the reason teeth may exhibit some movement, while healthy implants do not move. It is important to understand that just like natural teeth, implant restorations require meticulous home and professional maintenance care. Without it, dental implants may develop infections similar to gum disease around natural teeth. However, one important difference between natural teeth and dental implants is that dental implants do not develop decay or caries, which is the primary reason conventional crowns and bridges need to be replaced.
Research demonstrates that conventional tooth-supported bridges last 7-10 years and that partial and complete dentures are functional for approximately 5 years. Insurance statistics also indicate that on average bridges, partials and dentures last 5-7 years, as insurance companies generally pay for new replacements every 5 years.
Dental implant treatment is one of the most successful procedures in the medical/dental field, with documented success rates over 95%. Although successful treatment is very predictable, there are occasions when the bone does not completely attach to the implants or is destroyed by bacteria found in periodontal (gum) disease, and the implant must be removed. When this occurs, in most occasions new implants are placed. However, certain medial conditions such as smoking, diabetes and compromised immunity are associated with as much as 30% decrease in dental implant treatment success rate. Putting too much pressure over implants similar to teeth grinding and clenching, can cause loss of implant integration with the surrounding bone and should be avoided. Your dentist may advise you to wear a nightguard if you are prone to grinding. And lastly, just like it is important to properly care for your teeth at home and keep up with professional cleanings, usually every 3-4 months, the same rule applies to keeping your implant restorations problem-free. Poor oral hygiene is associated with dental implant complications and failures.
The recommended home care 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 by brushing, flossing with a floss threader, and using interdental or proxy-brushes. Water flosser replaces the need for manual flossing and makes the home care a lot easier and more effective.
Home care is a little more complicated for people who are missing all of their teeth. Special brushes and water floss are often recommended. In all cases, it is recommended that patients see their regular dentist or periodontist at least twice a year. In most cases, patients will alternate their cleanings between a periodontist and their regular dentist every 3 months. If a surgical specialist placed the implants, it is usually recommended that the patient sees the specialist once a year as well. These visits, combined with proper home care, are essential to the long-term success of dental implant treatment.
The cost of replacing a single missing tooth with a 3-unit bridge is almost identical to that of a single dental implant. Yet, if you are a good candidate, dental implants are r superior to dental bridges, which adversely affect your adjacent teeth and need to be replaced, on average, every 7-10 years. The financial and emotional cost of replacing your bridges over the course of many years and many dentists' visits will almost certainly greatly exceed the cost of a single dental implant.
An investment in dental implant treatment is an investment in your overall health, your appearance and your peace of mind. The actual cost of implant treatment is based on a number of factors, such as the number and type of implant fixtures placed by a surgical specialist, the type of implant-supported restorations (crowns, bridges or other prosthetic appliances) recommended by a restorative dentist and whether additional procedures, such as extractions, bone reconstruction and gum grafting are necessary to achieve the proper esthetic and functional result. The only way to accurately estimate the cost of your dental implant treatment is to schedule your consultation with us.
Insurance coverage of dental implant treatment depends on the individual policy. However, it is rare to receive any substantial coverage. In reality, the plans are only designed to cover routine maintenance, emergencies and basic care.
Very few dental insurance companies allow benefits for dental implants. Many of them will provide coverage for the lowest cost alternative treatment option (such as a denture instead of dental implants). If an individual policy includes dental implants as a covered benefit, the amount of coverage is still limited to the overall annual maximum allowable (in most cases $1500 per year for all dental treatment). We will research your individual policy to determine if your company allows for dental implant coverage and help you maximize your benefits.
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 medical insurance. Medicare does not cover implant treatment. All in all, it is best to assume that there is no medical insurance coverage available.
A periodontist is a dental specialist with advanced education and expertise in the field of periodontics which is treatment of periodontal (gum) disease, removal of infected or severely compromised teeth, bone reconstruction, treatment of gum recession, esthetic rehabilitation and placement of dental implants. The American Dental Association, along with the American Academy of Periodontology, requires periodontists to complete at least 3 years of post-doctoral advanced specialty training from an accredited program after graduation from dental school. This type of surgical training is generally not part of education program for general dentists.
A general dentist can perform periodontal surgery and place dental implants, but cannot claim to be a specialist in the field, nor do they have the adequate training or expertise to perform more complicated procedures. Generally, non-specialist’s training consists of short courses, several day or weeks long, which cannot replace a 3-year academic program. Furthermore, most periodontists undergo hundreds of hours of continuing education in periodontal and dental implant related courses every year, and are well versed in latest scientific and clinical developments. This is what makes them experts and sought out specialists in the field of periodontal and dental implant surgery.
Recent study published in the Journal of American Dental Association in 2014 has demonstrated that dental implants placed by general dentists have significantly lower success rates and higher complication rates than those placed by surgical specialists such as periodontists and oral surgeons.
Not all dental implants are the same. Just like any manufactured product, some products are better than others. Low-end dental implants may be purchased for $50-70 per fixture, whereas dental implants produced by the industry leaders typically cost between $350 to $500.
Some patients are attracted by internet advertisements offering low cost dental implants (for as little as $1000 per implant) in countries such as Hungary, Russia, Brazil and Costa Rica. As tempting as these advertisings may be, please keep in mind that treatment in those countries will not include ongoing post-surgical care and you will have to fly back if something goes wrong with your treatment!
According to empirical observations, the rate of dental implant failure and complications is significantly higher for patients receiving low cost implant components. This is due to the limited amount of R&D spent by the low end manufacturers on implants design, as well as the fact that the established dental implant specialists will rarely (if ever) expose their patients to the risks of placing second-rate, under-researched dental implant components.
We offer Nobel Biocare dental implants to our patients.
While the total number of implant cases that a specialist has performed is important, the more important (especially in complex cases) is the number of previous cases that were similar to yours.
When evaluating the competence of your dental implant professional, keep in mind that single tooth replacement cases are a lot more common than full-mouth or full-arch teeth replacements.
Also, if sophisticated soft tissue or hard tissue augmentation procedures are necessary, you may need to consider whether your specialist is best qualified to perform those. For instance, in some cases a periodontist may be preferred to an oral & maxillofacial surgeon, while in others the exact opposite may be the case.
If upon placing an implant your surgeon elected to leave your implant covered by the gum, an implant uncovering procedure will be necessary to expose the implant platform and to proceed with implant restoration.
This second stage surgical procedure usually takes between 15-30 minutes for each implant fixture that had been placed. Some specialists have an additional fee for this procedure, whereas others do not. If you would like to know the total cost of your implant surgery remember to ask your surgical specialist whether there will be an additional charge for the second stage implant uncovering.
We do not charge additional fee for implant uncovering procedure if the dental implants have been placed at our office.
This is an important aspect of dental implant treatment which often gets overlooked during the initial consultation stage by both specialists/dentists and patients. This is because at the initial consultation stage more emphasis is usually placed on the discussion of how the "missing teeth can be replaced", rather than on "what new teeth would look like".
The esthetics of your final result is clearly more important if you are replacing your front (particularly upper) teeth. In those cases it is imperative that you examine "before and after" photographs of your specialist's previous implant cases that were similar to your situation.
The discussion of the esthetics of your case supported by before-and-after photos of prior cases should set a clear expectation for both yourself and your specialist as to the final appearance of your implant.
Please visit our Gallery for before-and-after photos of our actual patients.