This is the second article in a 3-part series covering dental implants. This article will cover whether or not implants are the best option for your specific situation. Unfortunately, many individuals are faced with dental problems that lead to the loss of one or more teeth. This tooth loss can lead to many problems for individuals. It makes it difficult to chew properly. It also increases stress on the remaining teeth, increasing the risk of future tooth loss. If enough teeth are lost, it can place a strain on the facial muscles and temporomandibular joint leading to discomfort and joint problems. Tooth loss also leads to atrophy of the facial bones.
The most common problem that we see is individuals who lose a single tooth. If there are intact teeth on either side of the missing tooth, an individual has an option of a bridge or an implant. They both allow good function but are much different. A bridge can be completed slightly faster, and upfront costs are less. The downside is that the adjacent teeth need to be extensively modified to support the bridge. They are more difficult to clean which can lead to an increased risk of further tooth loss. Bridges usually require replacement every 10-15 years. So the initial upfront cost savings are lost due to ongoing replacement costs. The option of an implant for single tooth replacement does take longer, and the upfront cost can be more. One advantage is that the function of an implant-supported tooth is very similar to the original tooth and the implant tooth is, in fact, two times stronger than a natural tooth. Also, stress on the adjacent teeth is avoided and their health is improved by easier clean-ability. Implants are the preferred option when replacing missing front teeth because implants maintain the bone and tissue allowing for a more natural appearing tooth. These same concepts are applicable to individuals who are missing two or three teeth with the presence of healthy adjacent teeth.
Options for tooth replacement are different for individuals missing multiple teeth without healthy adjacent teeth. Looking at replacement options for these cases, there is a large functional disparity. Because of the difference in function and comfort, many individuals find implants a much more ideal replacement option. If an individual is interested in replacing teeth in these situations without the use of an implant, they are relegated to some sort of removable denture. Certainly, dentures are a more affordable option and do help spread function over more surface area; however, they present with many compromises. There are a number of foods that are difficult to eat. Dentures can cause soreness due to pressure on sensitive tissue. Food also gets caught below the prosthesis. Pressure from the denture causes destruction to underlying bone leading to poor fit. The denture is attached to the existing dentition to provide retention and support. This leads to strain on these teeth increasing the risk of further tooth loss.
To avoid these problems, a denture requires regular maintenance to assure a proper fit. This leads to chronic ongoing costs. Because of these compromises, many patients feel that implants are a better option. Functionally, implant-supported crowns perform as well as the original missing teeth. They help maintain the bone in the jaw and prevent stress on the remaining dentition. An individual has different options when replacing multiple teeth with implants. They can place one implant for each missing tooth with freestanding teeth, or fewer implants supporting implant-supported bridges. Either option is stable long-term. It is a question of the overall cost of care and ease of daily maintenance with the bridge requiring more work to clean. Certainly, the cost of placing multiple implants is more when compared with a removable denture.
The length of treatment time varies from site to site. Replacement of upper front teeth can be as quick as placing the implant at the same time of extraction with an immediate temporary crown placed. Treatment time varies from a few months up to nine months. In patients where there are bone defects requiring bone reconstruction, the treatment length is longer.
The level of discomfort following implant placement for the vast majority of people is minimal. In cases where the patient requires bone grafting, there is certainly increased discomfort for the first few days following surgery.
If you have any questions concerning whether or not you are a good candidate for implant placement, please talk with your general dentist or oral and maxillofacial surgeon.