Posts

pic5

Frequently Asked Questions about Dental Implants

If you are missing a tooth and considering getting a dental implant, you may have a lot of questions. Below are some answers to the questions we get asked the most.

 

How does a dental implant work?

A dental implant is a small titanium screw that is inserted into your jaw bone. The implant will fully fuse with your jaw bone after a few months of healing and function like a tooth root. An abutment and implant crown (false tooth) will then be attached to the dental implant. It will look and function just like a real tooth, allowing you to eat regular foods. Additionally, because it functions like a tooth root, the dental implant will continue to stimulate your bone and prevent future bone loss. Other tooth replacement options, including bridges and dentures, do not offer this option.

 

What are other tooth replacement options?

If you are missing a tooth, you do have a few options and it is important to weigh the pros and cons before you determine the best way to move forward.

  1. You can choose to do nothing. This is obviously the least expensive option however it will have the biggest cost on your oral health. If you do not replace a missing tooth, eventually the teeth adjacent to it will start to move to the open space. This shifting can change how your other teeth come together when you bite down. Additionally, the bone where the tooth is missing is no longer stimulated and eventually starts to deteriorate.
  2. You can get a dental bridge. A bridge is when crowns are placed on the teeth adjacent to the missing tooth and a false tooth is attached in the middle. Aesthetically, a fixed bridge can give the appearance of a normal tooth however it can have limitations on the types of foods that can be eaten. While the initial investment may be cheaper than a dental implant, a bridge typically last about 5-10 years before it will need to be replaced.
  3. If you are missing all of your teeth, you can get dentures. Dentures are removable arches of false teeth that fit over your gums and need to be adhered daily. They need to be relined at the dentist’s office regularly to make sure they are fitting properly as your bone level continues to diminish. Dentures can impact the way you speak and severely restrict the types of foods you eat. Similar to bridges, dentures have a life span of 5 – 10 years before needing to be replaced.

 

How much do dental implants cost?

This is the question we receive most often and the answer is “it depends”. There are many factors that go into the total cost of a dental implant, including dental insurance contracted fees and how many additional services are needed.

While some offices may offer a “sale” discount price on dental implants, they may not be including the additional services that are also needed. Before moving forward, make sure to ask about what is all included in that price so you can fully understand what your total cost will be.

Below are potential services that may be needed when considering the cost of a dental implant.

  1. Extraction (removal) of the tooth
  2. Cone beam x-ray
  3. Placement of the actual dental implant
  4. Sinus lift and/or bone grafting (adding bone or bonelike material to your jaw if needed)
  5. Anesthesia
  6. Flipper (a retainer with a tooth attached to fill in the missing gap while the implant is healing)
  7. Implant crown and abutment (the false tooth that is attached to your implant once it is healed)

Dental implants alone are often in the $1,500 – $2,500 range, however when you add in the additional services (including the final implant crown) the cost will typically be in the $3,500 – $6,000 range. The good news is that many dental insurance policies offer some type of coverage for dental implants. Additionally, the costs can often be spread out over a few appointments. For example, the final implant crown and abutment won’t be needed until the implant is fully healed (approximately 3-6 months after placement). Various financing options are also available to those who qualify.

While the initial cost of a dental implant may be higher than the cost of a bridge, dentures or doing nothing at all, when you look at it over time dental implants can actually save you money in the long run. When taken care of properly, dental implants can last a lifetime. Bridges or dentures, on the other hand, only have a life expectancy up to about 5 – 10 years before they need to be replaced. Additionally, dental implants act like real teeth so they help stimulate your bone to help prevent future bone loss and the loss of other teeth.

Smoking and Dental Implants

As part of our In Depth series, Dr. Kylee Brightside discusses the impact that smoking can have on the success of dental implants.

Dental implants have a well-established history of high success rates.   Dental implants allow the patient to replace missing dentition to restore function and esthetics.  With proper maintenance, implants last for many years, however, one of the risk factors for implant failure is smoking.

Smoking has influence on the general health of the individual.  There is correlation between smoking and coronary disease, stroke risk, atherosclerosis, chronic obstructive pulmonary disease, pneumonia, low birth weight and cancers.  Smoking has its effects on oral health as well.  Smoking increases the risk of periodontal disease, oral cancer, root decay, delayed healing after surgery and implant failure.

The exact mechanism of how smoking compromises implants and healing is unknown.  However, studies have found smoking increases the expression of pro-inflammatory cytokines, which increases tissue damage and bone resorption.  Furthermore, nicotine has its own affect on the body.  Nicotine, a vasoconstrictor, has a negative impact on cellular protein synthesis and reduces the fibroblast’s ability to adhere thus directly interfering with wound healing.

There have been many studies showing the negative impact smoking has on implant success.  A retrospective multicenter study published in the European Journal of Oral Implantology, examined the 5-year success of implants comparing smokers vs nonsmokers.  They found smokers experienced almost twice as many implant failures compared to nonsmokers.  The complications such as significant marginal bone loss after implant placement, increased risk for developing deep mucosal pockets around implants, increased tissue inflammation and decreased success of bone grafts contribute to the failure rate.  Another study by Queiroz et al, examined salivary samples and determined smoking increases the salivary arginase activity, which may consequently increase the risk of bacterial infection and implant failures.

A study by Lindquist, found the quantity of smoking makes a difference in implant success.  The study found more marginal bone loss around the implants of heavy smokers (>14 cigarettes per day) than those with lower tobacco consumption.

Implants are not contraindicated in patients who smoke, as long as they understand the greater risk of failure and complication.  A recommended protocol for patients who smoke is to stop smoking at least one week prior to surgery to reduce some of the short-term effects from the nicotine.  Then the patient should avoid tobacco for at least 2 months after implant placement to reduce the risk.  After the implant is restored, it is imperative the patient maintain proper oral hygiene and recall appointments to monitor the implants.

References

  1. Bain CA. Smoking and implant failure- Benefits of a smoking cessation protocol. Int J Oral Maxillofac Implants. 1996; 11:756-9.
  2. Cavalcanti R, Oreglia, F., Manfredonia, MF., Gianserra, R., Esposito, M. The influence of smoking on the survival of dental implants: a 5-year pragmatic multicenter retrospective cohort study of 1727 patients. 2011; 4:39-45.
  3. Lambert PM, Morris HF, Ochi S. The influence of smoking on 3-year clinical success of osseoingrated dental implants. Ann Periodontol. 2000;5:79-89.
  4. Lindquist LW, Carlsson GE, Jemt T. Association between marginal bone loss around osseointergrated mandibular implants and smoking habits: A 10-yr follow up study. J Dent Res. 1997; 76:1667-74.
  5. Kasat, V., Ladda, R. Smoking and dental implants. J Int Soc prev Community Dent. 2012; 2:38-41.
  6. Queiroz DA, Cortelli JR, Holzhausen M, Rodrigues E, Aquino DR, Saad WA. Smoking increases salivary arginase activity in patients with dental implants. Clin Oral Investig. 2009; 13:263-7.

 

Source: willowcreekdds.com Blog