It is widely known that bridges and dentures have been replaced by dental implants as the preferred treatment for missing teeth. Dental implants have a number of advantages over these traditional methods:

• Implant Supported Dentures preserve bone structure preventing that sunken in look of old age.
• An Implant Replacing a Single Tooth saves the surrounding teeth from the harm of attaching a bridge to them.
• Dental Implants look and feel like natural teeth.

Even though these benefits and more are well known the insurance companies, they have to protect their bottom dollar. So, don’t assume that dental implants are covered by your insurance. It is important to check before you pick and visit your implant dentist.

Recently, researchers examined 20 patients suffering from periodontal disease
and atherosclerosis (clogging of the blood vessels to the heart that can
eventually result in heart failure).  In 13 of the 20 patients, they found
that periodontal bacteria was present in the atherosclerotic plaque in the
coronary vessels.

Of the 20 patients examined, those with the more highly progressed and severe
periodontal disease were the most likely to have periodontal bacteria in these
vessels.  This supports the possibility that as periodontal disease
progresses deeper into the gum tissue, bacteria begins to enter the blood stream
and travel throughout the body.

Though more research is needed to prove that periodontal bacteria has a causal
role in the development of heart disease, periodontal disease is no longer
considered an exclusively dental/oral problem.

² Kerry Gutshall, What
Does Your Mouth Say About Your Heart?, (The American Academy of
Periodontology Press Release, February 13, 2007)

Crowns, bridges, and dentures are not the only options when replacing missing teeth. Dental implants offer the look and feel of natural teeth. Implants offer stability because they fuse to your bone. Integration of the implants into your jaw bone also helps the replacement teeth feel more natural and many people find this secure fit very comfortable.

Dental implants are an ideal option for people in good general oral health who have lost one or more teeth due to periodontal disease or an injury. Candidates for dental implants need to have healthy gums and adequate bone to support the implant. A thorough evaluation by your dentist will help determine whether dental implants are right for you.

Dental implants are actually more tooth-saving than traditional bridgework, since implants do not rely on neighboring teeth for support.  In a bridge, the teeth surrounding the site of the missing teeth must be shaved down and fitted with crowns.

Common Reasons for Implants

A common reason people consider implants is due to poor fit of their dentures, which causes difficulty in chewing and a fear of losing the dentures while talking or eating. The majority of patients treated with dental implants experience a significant improvement in their ability to chew food and they report that the implants are a far more comfortable alternative.

A good dental implant candidate should have the following:

• Over-all good health
• Healthy gums
• Enough bone to anchor the implants in the jaw – A dentist can evaluate the bone structure and recommend treatment options.
• Be committed to taking very good care of the implanted teeth and surrounding gums — Daily brushing and flossing are essential.
• Regular dental check-ups.

Common Reasons Implants May Not Work

Most adults can be candidates for dental implants. However, smokers and those with uncontrolled chronic diseases or systemic problems may not be good candidates for this procedure. Smoking impedes healing in the mouth and can reduce the likelihood that implants will be successful. People with poorly controlled diabetes may not be good candidates for implants as well, due to healing problems of the gum tissue that can arise.

The First Step

Making the initial dental appointment is the first step in evaluating if dental implants are right for you.  Usually a prosthodontist, periodontist or an oral surgeon are the dentists to look for. There are a few general dentists with specialized training qualified to place implants. Check with each doctor to make sure of their specialization or their certification with implantology.

On the first appointment a full mouth exam will be completed with a complete medical and dental history. You’ll receive X-rays and possibly a CT scan, which will give the dentist a good idea of your bone density and the shape of your jaw. Finally, you’ll discuss the options available to you and be educated by the dental staff about the whole implant procedure. They’ll discuss if you’d be a good candidate for a dental implant. You must also commit to a meticulous oral hygiene regime with regular dental visits.

Finding out if you’re a good candidate for dental implants begins with a simple step. With motivation, care and willingness, dental implants can give the confidence and security to last a lifetime.

Summary

Implants are the latest dental technology for replacing the roots of lost teeth. They are used to support crowns, bridges, and dentures. Implants offer stability, comfort and a sense of freedom for those who have missing teeth and want to regain their smile back.

Dental implant placement is not a dental specialty by itself. Many times it takes several dentists, working in different specialties, to provide the full treatment. From an oral surgeon to a prosthodontist to a periodontist, and even a general dentist, all of these specialists may aid in the placement or restoration of the dental implant. It also varies if you need a single replacement or a more extensive restoration.

One specialist may perform the surgery to actually place the dental implant, while another places the crown on top of the implant to complete the restoration (usually called "restorative implants”).

Typically, the implant surgery is performed by an oral surgeon or a periodontist, and the restorative crown is placed by a general dentist or prosthodontist. It’s important that all the specialists work together as a team for your dental implant treatment.

Why an Oral Maxillofacial Surgeon?

Oral maxillofacial surgeons are dentists specializing in surgery of the mouth, face and jaws. Oral surgeons receive an extra four to seven years of hospital-based surgical and medical training, after dental school. They prepare themselves to do a wide range of procedures including all types of surgery of the hard tissue (bones) and soft tissues of the face, mouth and neck.

Why a Periodontist?

A periodontist is a dental specialist with training in the diagnosing and treatment of the gum tissue and surrounding jawbone tissue. This specialist has an additional two years of extensive training after dental school. A periodontist devotes their time, energy, and skill to helping patients care for their gum tissue.

Why a Prosthodontist?

The prosthodontist examines and diagnoses disabilities caused by loss of teeth and supporting structures. They are specially trained to provide expertise in restorative treatment and they deliver smiles with high level function, maximum comfort and pristine esthetics. They are also known as "cosmetic dentists" and  often focus on the esthetic aspect of a smile to improve the appearance of your teeth with bleaching, bonding, veneers, reshaping, orthodontics, and implants.

Why a General Dentist?

Your general dentist knows your dental history and specific needs.  Most often, the general dentist will determine if you are a candidate for dental implants during your visits to their office.  They may then either proceed with surgery at their office, or they may refer you to a specialist and then later provide the crown restoration that accompanies your implant.

Things to Look For

In deciding whether to use your general dentist for all the treatment or using the ‘team’ of dental practitioners, the most important consideration is the qualification of each doctor involved and their ability to work well in a team to provide you with the best care possible.

The following are some useful questions to ask the dentist who will be placing your dental implants.

Key Questions to Ask

How much training have you had in this procedure?

How many implant patients have you treated successfully?

How long have you been working with dental implants?

Where did you receive your training for dental implant placement and restorative care?

Do you offer a book of testimonials or references from previous patients?

Once you have your answers you’ll be able to make an educated decision on which route would be best for your implant treatment. Don’t be afraid to ask any questions that come to mind: it’s your mouth and you have to live with it for the rest of your life. Get the most out of it, enjoy your smile and be proud of your dental treatment.

Summary

Dental implant placement is not a dental specialty. Many times it takes several dental practitioners working together to provide the full treatment.

It’s important to look for a qualified dentist/specialist to perform the procedure. Once you are comfortable with your choice, you are on your way to a brighter, healthier, more confident smile.

Recently, researchers at the University of Murcia in Spain discovered further evidence that smoking decreases the likelihood of dental implant surgical success. In a study of 66 patients over the course of 5 years, they found that 15.8% of dental implants failed in smokers whereas only 1.4% failed in non-smokers.

Smoking decreases blood flow to the tissues surrounding the dental implant posts, which inhibits bonding between the post and the tissue. When the post does not bond, the implant is not supported, has “failed,” and must either be replaced or removed altogether. Tobacco users are also at greater risk for post-surgical infection, which may cause them to heal more slowly than their smoke-free counterparts.

If you hope to retain your dental implants for life, a healthy smoke-free lifestyle is key.

1 Kerry Gutshall, Smoking Can Cause Dental Implants to Fail, (The American Academy of Periodontology Press Release, February 6, 2007)