Why Have Dental Implants?

Why have dental implants? Sound expensive? It’s not as expensive as it might sound. In fact, in the long run, dental implants may be the most cost effective solution for missing teeth.  For most people who lose teeth, implants are rapidly becoming the treatment of choice. More often than not, dental implants are the preferred option—because they tend to offer a permanent solution-- implants carry a success rate of around 98%.

Some of the older, more traditional options to replace missing teeth include bridges and dentures.  Let’s take a look at bridges and dentures, and still a third option that uses dental implants in combination with some form of dentures and bridges.  Finally, we will explore the dental implant procedure itself to show how it is rapidly replacing bridges and dentures as the most comfortable and long-term solution for maintaining a healthy mouth.

Implants vs. Bridges
If you only lose one tooth and choose a bridge as a solution, your dentist will grind down the two healthy adjacent teeth to create a support structure that will anchor a replacement tooth.  Over time, the two healthy adjacent teeth can become more vulnerable to decay and nerve damage because they have been ground down.  Eventually, a root canal may be needed or the bridge might fail and need to be replaced altogether.

When choosing a bridge over implants, here are some factors to consider. With a bridge, if one of the adjacent crowned teeth fractures or suffers from decay or nerve damage, then the bridge and its three, or sometimes more, crowns must be removed and replaced. Repeating this procedure over time results in the anchor teeth becoming weakened to the point that they can no longer support a bridge.  In terms of maintenance, many patients have difficulty flossing and properly cleaning under the bridge, which can result in serious periodontal infection and is another cause for bridge removal and replacement.  A bridge makes it hard for most people to keep their gums and underlying bone healthy.

So if you think that a bridge is an economical solution, think again.  While many dental insurers cover most of the cost associated with a bridge, studies have shown that over a five-year span the maintenance costs for patients with bridges were higher than for those who had dental implants. While bridges have an average life span of 10 to 12 years, dental implants can last a patient’s lifetime.

Implants vs. Dentures                                                                                               
Dentures are another, more traditional option for replacing missing teeth.  While many people wear dentures without too much difficulty, they are often ill-fitting and difficult to clean and maintain.  For most patients, implants do not require the same level of maintenance that is required for dentures. Implants, unlike dentures, do not wiggle, loosen or slip.

Implants are healthier for the surrounding gum tissue as well as for your bone structure. The screw in your jawbone will make your  body believe that you still have teeth and your bone will continue to grow and thrive. And who can argue that a permanent solution is preferable to having a temporary moveable part that is capable of slipping and causing embarrassment?

For all of the advantages of implants, the two main reasons why a patient would opt for dentures may be due to the cost of the procedure and the oral health and lifestyle of the patient who is considering treatment.  Dental implants are expensive and insurance coverage can be minimal.  Another reason not to have implants might be that the patient does not have the requisite amount of bone needed at the site of where the implant would be placed.  Implants aren’t a good solution for every patient, particularly those who smoke or who have already sustained significant bone loss.

Dental Implants + Bridges + Dentures                                                                   
For a single tooth replacement it is more cost effective over the long-term for the patient to get an implant.  In certain instances, however, when patients need to replace most or all of their teeth, getting dentures is clearly the cheaper alternative.  But since dentures have been known to slip and interfere with the patient’s enjoyment of life, the solution is not satisfactory.  Now patients have yet a third option: Dental implants can be used to support a number of dental prostheses, including crowns, and  implant-supported bridges or dentures. This method ensures greater support and stability and results in less slippage for the patient.  Practically speaking, the cost is not nearly as expensive as a full mouth restoration using only dental implants.

Here are some important details about dental implant procedures.                       
The implant procedure itself has been designed to create minimal discomfort for the patient. A titanium screw is surgically placed in the jaw bone. A prosthetic crown is then attached to the implant. The basic technique involves surgically inserting a titanium screw into the supporting bone, which can be done under local anesthesia in under  two hours, and attaching  an abutment, followed by the placement of a natural looking crown. Implants usually take about eight weeks for the screw to become firmly attached to bone and before the crown can be placed. The dental implant looks and feels very much like a natural tooth.

The implant procedure is not without risk that potentially includes damage to a nerve or sinus cavity, which is heightened if the dental practitioner lacks proper certification and adequate training. Depending on the patient’s pre-existing condition and overall oral health, an extra procedure such as a bone graft or sinus lift may need to be done. For dental implants to work, there must be enough bone in the jaw.  When there is not enough bone, more may need to be added with a bone graft procedure. Another predictor of success is that the natural teeth and supporting gum tissues near where the implant will be placed must be in good health--one more reason why smokers are often discouraged from having the procedure done. 

In most cases, both a surgeon and a dentist must work together to ensure the success of the procedure.  As a patient seeking a dental implant, you will need to make several office visits first for the initial surgery to place the abutment and then later to add the crown. Nowadays many implants are placed by Periodontists or Prosthodontists who are well trained and certified in the technique.  In most instances, dental implants used to replace lost teeth are by far the best long-term solution. Also, because they so closely mimic natural teeth and rarely need to be replaced, they are far more preferable than bridges or dentures. With a failure rate of  less than 5 percent, dental implants are a worthwhile investment that will last a lifetime.


Jim Janakievski D.D.S., M.S.D.

Jim Janakievski, DDS, MSD received his DDS from the University of Toronto, 1995, and completed a general-practiceresidency, at St. Clare’s Hospital, Schnectady, New York, in 1996. He completed his postgraduate training at the University of Washington, where he received a certificate in periodontology with an MSD degree and a fellowship in prosthodontics. He is a Diplomate of the American Board of Periodontology, serves as an affiliate assistant professor in the Department of Periodontology at the University of Washington, and maintains a private practice in Tacoma, Washington.

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