Dental Implants

optimal oral health_01 Dental implants are frequently the best treatment option for replacing missing teeth. Rather than resting on the gums like removable dentures, or using adjacent teeth as attachments like fixed bridges, dental implants are long-term replacements that are surgically placed in the jawbone.

Tooth loss occurs for many reasons. An accident, periodontal or gum disease, failed root canal therapy, or tooth decay causes almost 70% of the population to have lost at least one permanent tooth by the age of 44. By age 75 at least a quarter of Americans have lost all of their teeth.

Before 1985, these patients would have had no alternative but to have a fixed bridge or removable denture to restore their ability to eat, speak clearly and smile. Fixed bridges and removable dentures, however, are not the perfect solution and often bring with them a number of other problems. Removable dentures may slip or cause embarrassing clicking sounds while eating or speaking. Sores on the gums often result from denture mobility.

In order to place a fixed bridge, healthy adjacent teeth must be cut down and prepared to hold an abutment. Recurrent decay, periodontal (gum) disease and other factors often doom fixed bridgework to early failure as they must be flossed underneath where food can tend to lodge. Gums and bone tend to shrink because of the pressure that dentures exert upon them from chewing forces. For these reasons, fixed bridges and removable dentures usually need to be replaced every seven to 15 years.

before implant after implant
Before dental implant.After dental implant.

In 1955 Dr. Per Ingemar Branemark did pioneering research in dental implantology in Goteborg, Sweden. He placed small titanium "fixtures" which is what he then termed implants and they were followed in scientifically controlled studies for 30 years. In 1985 after much scrutiny by the American FDA, both the device (the implant) and the technique (the surgical procedure) were approved for use in the United States.

Dr. Strahs has been placing implants since 1985.

Composed of titanium metal that "fuses" with the jawbone through a process called "osseointegration," dental implants never slip or make embarrassing noises that advertise the fact that you have "false teeth," and never decay like teeth anchoring fixed bridges. Because dental implants fuse with the jawbone, bone loss is generally not a problem.

The recipients of those early dental implants are still satisfied they made the right choice. If properly cared for, dental implants can last a lifetime.

Anatomy of a Dental Implant

after implant A dental implant designed to replace a single tooth is composed of three parts: the titanium implant that fuses with the jawbone; the abutment, which fits over the portion of the implant that protrudes from the gum line; and the crown, which is created by a restorative dentist and fitted onto the abutment for a natural appearance. This crown is created of a ceramic material, which a laboratory custom fabricates for you, and matches the rest of your teeth in shape and shade.

Some people who are missing a single tooth opt for a fixed bridge because it may be covered in part by their dental insurance and they are thinking it is the cost effective choice. But a bridge may require the cutting down of healthy, adjacent teeth that may or may not need to be restored in the future. Then there is the additional cost of possibly having to replace the bridge once, twice or more over the course of a lifetime. Similarly, a removable partial denture may contribute to the loss of adjacent teeth. Studies show that within five to seven years there is a failure rate of up to 30% in teeth located next to a fixed bridge or removable partial denture. Also, a point to consider is that if an implant not placed when a tooth is lost, it may be considerably more difficult, because of bone shrinkage with time, to replace it in the future.

fixed bridge
Fixed bridges (above) may require the shaping
or cutting down of adjacent healthy teeth.
before implant
(a) Bone is maintained by the presence of natural
teeth or implants.
(b) Bone loss occurs with the loss of teeth.

Because of pressure on the jawbone through the gum tissue, conventional dentures may contribute to the loss of bone in the area where a group of teeth are missing. As illustration (a) indicates, the presence of natural teeth preserves the jawbone. When a tooth is missing, as in illustration (b), the bone may erode and weaken until it may be necessary for Dr. Strahs to graft bone to the area to strengthen and broaden it for placement of a dental implant. (Please see our discussion of bone grafting.)

With an overall success rate of about 95% and 50 years of clinical research to back them up, both here in America and abroad, dental implants are frequently the best treatment option for replacing missing teeth.

Dental Implants vs. Conventional Dentures

(a) An implant can be used to replace one missing tooth so that the replacement looks and feels natural.
(b) Two or more implants can serve as a stable support for a complete denture to lock into to prevent mobility.

Often, even if you are missing all the teeth in either the upper or the lower jaw, you can receive 6 or more implants and have a fixed bridge which is not removable and functions as natural teeth, to replace a denture that you may have been wearing for years.

Many patients who have selected dental implants describe a quality of life that is much more comfortable and secure than the lifestyle endured by those with removable conventional dentures. Dentures often make a person feel and look older than they are, cause embarrassment in social situations when they slip and click, and restrict the everyday pleasure of eating comfortably.

When they count the benefits they enjoy as a result of their dental implants, patients say their implants eliminate the day-to-day frustrations and discomfort of ill-fitting dentures. They allow people to enjoy a healthy and varied diet without the restrictions many denture wearers face. With a sense of renewed self-confidence, many people rediscover the excitement of an active lifestyle shared with family and friends and the chance to speak clearly and comfortably with co-workers. For all these reasons, people with dental implants often say they feel better... they look better... they live better.

Are You a Candidate for Dental Implants?

Whether you are a young, middle-aged or older adult; whether you need to replace one tooth, several teeth, or all your teeth, there is a dental implant solution for you. With the exception of growing children, dental implants are the solution of choice for people of all ages, even those with the following health concerns:

Existing Medical Conditions. If you can have routine dental treatment, you can generally have an implant placed. While precautions are advisable for certain conditions, patients with such chronic diseases as high blood pressure and diabetes are usually successful candidates for dental implant treatment.

Gum Disease or Problem Teeth. Almost all implants placed in patients who have lost their teeth to periodontal disease or decay have been successful.

Currently Wearing Partials or Dentures. Implants can replace removable bridges or dentures, or they can be used to stabilize and secure the denture, making it much more comfortable.

Smokers. Although smoking lowers the success rate of implants, it doesn't eliminate the possibility of getting them.

Bone Loss. Bone loss is not uncommon for people who have lost teeth or had periodontal disease. Oral and maxillofacial surgeons are trained and experienced in grafting bone to safely and permanently secure the implant.

Implant tooth replacement in children is usually deferred until their jaw growth is complete. There are, however, some instances when a dental implant may be appropriate, such as when it is part of the child's orthodontic treatment plan. Your family dentist or orthodontist can guide you in this instance.