Frequently Asked Questions About Dental Implants

Dental Implants Frequently Asked Questions Q. What is Teeth-In-An-Hour all about?

A. Teeth-In-An-Hour is the trademarked name of the procedure that has been developed by Nobel-Biocare (the largest manufacturer of dental implants in the world). You may have seen NobelSmile advertisements on the television. This is truly an outgrowth of technology that amazes dentists and patients alike. It combines the power of a special and highly accurate Cone beam I-CAT CAT SCAN with Procera software to construct an exact model of all facial structures. With this data, dental implants and teeth can be constructed in the context of a 3D model of YOUR mouth. The implants are placed in your mouth using a customized surgical guide to direct the surgeon's hands so that the implants are anchored with precision. The customized teeth can then be set on the implanted roots and posts. There are no incisions. If you have the correct anatomy, this is a great way to get that smile you have always wanted in the shortest possible time. It actually takes less than one hour for the upper or lower jaw to be reconstructed. Currently, we have the technology for doing one jaw at a time, and it has worked remarkably well for every patient we have treated. If you would like to talk with one of these patients prior to your treatment, we have several who have said they would be glad to help other patients in making their decision.

Q. What is Teeth-In-A-Week?

A. Teeth-In-A-Week is the process of treatment that allows a patient to go from having teeth to being fully completed with their new teeth in a week or less (usually 3 days). A patient who is wearing dentures can also have this procedure done. Dr. Musser, Dr. Richards, and Dr. Kirkpatrick have treated hundreds of patients with this method. At this point, we also use the cat scan for diagnosis, but use less expensive and basic dental skills to get our patients to their final outcome--a beautiful smile. When we first started treatment with this method, years ago, the "in office" CAT scan was not even on the drawing board. The implants are placed and a conventional impression is made that is at the same level as or a higher level of accuracy than the one used in the Teeth-In-An-Hour method. The prosthetic teeth are made in the laboratory with a strong cast Vitalium infrastructure, and teeth that are preselected for color, size, and tooth position for optimum aesthetics and phonetics are attached in a pink wax base that can be attached temporarily in your mouth to verify all of these factors the second day. The completed teeth are attached to the Vitalium and secured to your implants the next day or at least within the week, as your schedule permits. You can eat right away. There are some other ways to do this as well. Sometimes we make a preliminary set of teeth all in acrylic. These teeth can be attached the same day, and you can wear the teeth for a while to make sure you are happy with them. If changes need to be made, the procedure is easy and inexpensive at this point. Some patients like to take a "test drive," and this is a great way to do it. If you just want a lighter shade, this can be done in the finished teeth that are made as described above with a strong Vitalium casting that will remain stable for years to come and give you the look and feel of your natural teeth. If you want to show a little more tooth when you smile, this aspect of your tooth structure can be changed as well. This option may be just right for you!

Q. What are dental implants?

A. A dental implant is the replacement for a missing tooth root. It is placed in the jaw where a tooth is missing, making it possible for a dentist to attach a natural-looking replacement tooth. The replacement tooth looks and feels just like a real tooth, with the normal color and contour that makes it blend with the other teeth in your mouth.

Q. What are some of the advantages of dental implants?

A. 1. More attractive appearance

2. Natural chewing ability

3. Greater comfort

4. Speech improvement

5. Better self-image

6. No decay or gum disease

7. Lasts a lifetime

8. Easy maintenance

Q. What is the success rate of dental implants?

A. 98% If you are a non-smoker, the success rate is closer to 100%.

Q. Which dental specialty places the most implants? I have looked at many sites, and I was just curious about the differences among dentists.

According to the latest survey of 3000 dentists published in the American Dental Association website (ADA.org), there has been a great increase in the number of dental implants placed as the procedure has become a part of everyday practice. This survey is a little old, comparing 1995 with 1999, but the trend is definitely up, and the popularity of implants seems to be increasing as of September 2008. The data indicates that oral and maxillofacial surgeons increased in their number of implants performed from an average of 42.5 implants in 1995 to 80.9 implants in 1999. Periodontists climbed to 70.8 implants per dentist from 43.4 implants per dentist in 1995. General dentists rose to 30.6 implants per dentist from 27.8 implants in the same period.

I think that you can infer from this data that oral and maxillofacial surgeons place the most implants of all the dental specialties. Some prosthodontists who have had additional training in surgery also place dental implants. In the survey, 10% of the prosthodontic specialists placed implants. Comparatively, only 8.1 % of general dentists placed their own implants. 67.9% of the periodontists placed implants. 89.6% of the surveyed oral and maxillofacial surgeons placed implants.

Q. Can I be sure the dental implant procedure is safe?

A. Our surgical facility is designed as an out-patient surgical facility with 10 operating rooms, one of which is a category 1 hospital suite where any major reconstructive surgery can be performed for reconstruction of the face with bone grafting from the hip or tibia if necessary. This would be done for severe defects from tumors or traumatic injury. Facial cosmetic procedures are also performed in the category 1 suite. Most dental implant procedures are considered to be minimally invasive, but the same monitoring procedures for anesthesia are performed with all patients who are having any type of intravenous anesthesia. Most patients are treated with intravenous sedation and local anesthesia as a supplement. The oral injections are given after you are comfortably under the effects of the intravenous anesthesia. As part of our evaluation of your case, we do a complete review of your past medical history, allergies, and current medications. Oral and maxillofacial surgeons have extensive medical and anesthesia training. All of these facts make the risks involved with surgery minimal.

Q. How long will the implants last?

A. Dental implants are designed to last a lifetime. They are fused with the actual jawbone by a process called osseous integration. Because all the implants we use are biocompatible titanium with enhanced "Tiunite" surfaces, they can usually be loaded immediately. Some of Dr. Musser's and Dr. Richards' patients have had root form titanium implants for 30 years, and the teeth are still performing as well as they did initially with little or no change, according to the x-ray used in their follow-up examinations. I think at this point, we can tell our patients that their dental implants placed when they are 30 will still be in function and supporting natural looking teeth when they are 90+.

Q. Are dental implants expensive?

A. They are slightly more expensive than repairing a natural tooth with a root canal and a crown, but they last much much longer.

Q. I consulted a dentist several years ago about using dental implants to replace my lower denture, but he told me that I did not have enough bone for implants. Are there any alternatives?

A. Yes, there are alternatives to implants that go into the bone. It is the rare person who cannot be helped by implants. If adequate bone is not available for the in-the-bone type of implants, an over-the-bone implant can be placed and teeth can be attached to the implants. Over-the-bone implants, or subperiosteal implants, have been used successfully in dentistry for over 60 years. Very short implants that are 3-5 mm in length work very well in minimal bone. This is because implants integrate or fuse with the bone and are MUCH more firmly attached than natural teeth.

Q. I am missing teeth on both sides of my upper jaw, but still have some natural teeth. The removable partial denture, which replaces the missing teeth, is uncomfortable and unsteady. Is there an alternative?

A. You can throw your partial away and replace the missing teeth using implants as the anchor for fixed teeth. It is very common for the back teeth to be missing and the front teeth to be healthy. The use of a removable partial denture is the old way of restoring the bite, but they don't work well, so many end up in the nightstand or medicine cabinet. Partials generally lead to the loss of more teeth because of the leverage the clasps place on the natural teeth. Through the placement of implants in the jaw behind the good natural teeth, the missing teeth can be replaced. In this situation, the posterior teeth are supported by implants alone while the good front teeth maintain their natural health.

Q. Are there risks of the body rejecting dental implants?

A. Rejection does not occur with dental implants. When people use the word "rejection" in connection with implants, they are usually describing rejection of transplanted organs such as a heart or liver. Dental implants fall into an entirely different category. They are made of biocompatible titanium that actually adheres to the bone more tightly than a natural tooth.

Q. I've heard people talk about how long it takes to complete the implant process, but then I heard that time frame wasn't right. What is the real truth?

A. CAT scans can be used inexpensively now to study the jaw anatomy so that implants can be placed without gum incisions and without stitches. Teeth can be attached immediately. This surgical procedure takes about one hour (TEETH-IN-AN-HOUR). This is a great advancement in implant dentistry and is very appealing to both patients and dentists. We have the special training and the imaging I-CAT scan available in our surgical center to make this process quick and affordable. The consultation includes an I-CAT scan and a personal meeting with the doctor to discuss options for treatment and cost. You will know exactly what is planned and what it costs before we start.

Q. How can I tell if I am healthy enough to have dental implants?

A. Placing dental implants is usually a very minor procedure. If you are considering dental implants and want to improve your life with stable teeth, you are healthy enough for dental implants. If you want to improve your diet and avoid denture embarrassment, then you are healthy enough for this procedure. Medical problems such as diabetes, high blood pressure, and heart disease need to be managed, but should not prevent you from having this in-office procedure. As a part of our consultation, we will discuss your general health issues and may consult with your physician if needed.

Q. Will I be without teeth or unable to eat for a long time?

A. Replacement teeth will be made before any teeth are removed. We want you to maintain your appearance and your nutrition. Your diet will temporarily change in consistency if you have several implants placed at once, but very soon you will be able to chew.

Q. How long does the implant process take?

A. The time depends on the extent of the treatment you need. If your anatomy is normal, the implants can be placed and the teeth attached the same day with the use of CAT-scan technology (TEETH-IN-AN-HOUR). Normal anatomy means that you have not had a lot of jaw atrophy that eventually follows the removal of teeth. A single tooth can be restored with a temporary tooth the same day. More complex procedures such as bone replacement will lengthen the time of treatment, but you will always have replacement teeth to wear while your mouth is healing. Your life does not stop during this process. You will always have teeth to wear. When your treatment is complete, you will realize it was worth your time!

Q. I lost my upper back teeth on one side and have gone for years without doing anything about it. My sinuses always seem to bother me more on that side than on the other side where I have back teeth. Could these problems be related to one another?

A. A phenomenon that occurs in many people who have had their upper back teeth missing for a long period of time is the increasing downward growth of the maxillary sinus. At birth it is the size of a pea, but it progressively grows as the face matures. This growth is at the expense of the surrounding bone. The average adult sinus can hold 15ml of liquid. If you are considering replacing those upper back teeth with fixed teeth that stay in all the time, it may be necessary to perform a sinus lift procedure to allow room for placement of dental implants into this area to support the teeth. This involves placement of bone and/or bone substitutes into an area which was previously occupied by the lower part of the maxillary sinus. These bone graft materials set up an environment which assists your own body in bone growth. This raises the floor of the sinus and allows for less sinus volume, less chance for fluids to accumulate, and fewer problems with sinus drainage difficulties. We treat our patients with only the intent of replacing their missing teeth through implant and implant related procedures, but it is very exciting if their sinus-related problems are improved also.

Q. I've had dentures for several years and have lost a lot of jawbone. My lower dentures are floaters, and I need help. Is there still hope for me?

A. With the options available today in the field of dental implants, anyone can improve their situation. We encourage people to see us for a consultation and an x-ray. You may have more bone than you think. The sooner the problems are corrected with dental implants, the better off you will be.

Q. I've heard that dental implants are expensive. How much do they cost?

A. Most of the good things in life that last a long time are expensive. The procedures can involve a significant investment. As of August 2007, we are charging $1600.00 for the surgical placement of a single implant. Most general dentists charge between $800.00 and $1500.00 for the replacement tooth that is attached to the implant. Teeth fixed in your mouth in one week or less will usually cost $12,000.00 for the lower teeth and around $15,000.00 for the upper (TEETH-IN-A-WEEK). Teeth placed at the same time as implant placement with CAT-scan technology cost slightly more (TEETH-IN-AN-HOUR).

The cost of delaying treatment can be considerably more expensive. Continual bone loss occurs from the wearing of dentures and partials. This progressive loss of bone can eventually cause nerve exposure and complete inability to function with regular dentures. Placing implants before the bone loss becomes severe not only saves money, but also halts the atrophy of the jaw and facial features. (Americans spend over $148 MILLION annually just on denture adhesives alone!)

Q. Is there one type of dental implant that is better than any other?

A. The majority of dental implants that are placed today (August 2007) are shaped like tooth roots and are made of titanium with a TiUnite surface that extends to the platform of the implant where the teeth are attached. They are hugely successful. In the past 30 years, we have used a number of different implant shapes and sizes, but these current ones are the best to date. They are manufactured by Nobel-Biocare, the largest implant manufacturer in the world. The surface etching of TiUnite increases the surface area. A special "groove" thread design also adds surface area for greater contact with the bone. These factors make implants particularly suited for immediate loading. Immediate loading is the placement of teeth at the same time as implant placement.

Q. I must have some teeth extracted and I intend to have implants placed to restore my ability to chew. Can a dental implant be placed at the same visit as the teeth are extracted?

A. Placing implants at the same time that teeth are removed is standard practice in 2007. Diseased teeth can be removed and implants placed at the same time. Initial prosthetic work can be completed immediately so you can be finished with all treatment in a few days (TEETH-IN-A-WEEK). Also, a single tooth can be removed and an implant and tooth placed at the same time. When you leave the office, your smile will be intact.

Q. I have heard that it takes a long time to complete dental implant treatment. Is that true?

Technology has advanced in the field of dental implantology to an amazing degree, so most procedures can be completed extraordinarily quickly. For example, if you have to have teeth removed, implants can be placed and the teeth attached the same day. You can walk out with new beautiful teeth the same day!

Q. Do dental implants require special care?

A. Brushing and flossing is all that is needed. This is just like natural teeth. Return for regular checkups, brush, and floss. That is it! Realize also that caring for the gums is the best way to care for your implant-supported teeth as well as your remaining natural teeth.

Q. I have been a denture wearer for many years now and use denture adhesives to hold my teeth in place, and I'm getting tired of the constant bad taste and mess in my mouth. Could dental implants eliminate my need for adhesives?

A. A common complaint is having to constantly add adhesives to secure dentures, especially after drinking a cup of coffee or eating a meal. This can really be a nuisance when eating out at a restaurant and having to excuse yourself from the table to go to the restroom because your dentures won't stay in. Laughing, sneezing, and coughing can also cause trouble for people who depend on adhesives to hold their teeth in place. It may be funny to see another person have a denture fall out, but it is not funny to the person who has to deal with these embarrassing situations on a daily basis. Denture wearers with problems such as these are not alone. There are 40 million people in the United States with no teeth, and 29% in this group chew only soft foods. Dental implants can give these people their lives back.

Q. I am missing all of my teeth and wear full upper and lower dentures. I can no longer tolerate my lowers. Will I need an implant for every tooth I am replacing on the lower?

A. Two implants can add tremendous retention for a lower denture if you still have some ridge left. This may be an economical option, since the majority of the denture is still supported by the gum. With four to six implants you can have teeth fixed in your mouth that have the look and feel of natural teeth. Many people rave that the implant-supported teeth feel like their natural teeth.

Q. My husband lost all of his teeth from gum disease. He refuses to wear "false teeth." Would implants give him the look and function of natural teeth?

A. Yes, we can give your husband back his natural look and the feel of natural teeth that stay in his mouth. They will be anchored by several dental implants in the upper and lower jaw. The ability to function socially and eat properly is the driving force behind the development of dental implants. The procedure will provide him with stable teeth, perhaps for the first time in years. Implants are a viable and functional way for improving one's quality of life and health.

Q. I have a full set of dentures. My uppers are fine, but my lowers are a constant juggling act when I try to eat. Can I have implants on the lower and keep a full denture on top?

A. Absolutely. Your situation is a common one. The full lower denture is the most unstable, unretentive, destructive, conventional prosthesis fabricated in routine dental practice. It is the technology of the last century. During function, the average lower denture moves five times more than an upper denture. The person with advanced bone loss has additional problems of poor muscle coordination, speech difficulties, and inability to keep denture adhesives in place, all of which adversely influence a normal lifestyle. Dental implants can be the solution to all of these problems. Life is too short to suffer with this very correctable dilemma. Please call us for a consultation.

Q. I have advanced periodontal disease and have been battling with my teeth for years. They are actually moving at this point. Can I still have implants and immediate teeth?

A. You are the perfect candidate for tooth removal with placement of implants and teeth the same day or in a week or less (Teeth-in-a-week). One of the reasons you have periodontal disease is because the root surfaces of your teeth are the best places for bacteria to grow. This type of bacteria is destructive, adhering on to the rough surface of the tooth root. It will grow, reproduce, and create destructive waste products. When the teeth are removed and the implants are placed, the pathogenic bacteria lose the type of environment that perpetuates their growth and their destructive process on the bone surrounding your teeth. If you have lost more than one half of the bone that once supported your teeth, then dental implants are the best, safest, and most cost-effective way to regain your smile and stop the drain of time and money in periodontal therapy. Dental implants are easy to maintain and are not susceptible to the same bacteria that affect natural teeth. They are made of titanium and will not decay.

Q. I am missing most of my back teeth and do not wish to lose any of my remaining front teeth. I've been through several sets of removable partials and could not wear any of them. Could I have teeth that stay in all the time to replace my teeth missing in back and keep my remaining teeth in front?

A. First of all, we will do everything possible to help you keep your remaining natural teeth as long as the gum and bone around the teeth are healthy. If you have had problems with removable partials in the past, dental implants may be just what you need. Dental implants will give you natural-looking teeth in your mouth that stay in all the time and function exactly like your natural teeth.

Q. Both of my parents have worn complete dentures for many years, as have my grandparents. Recently, I lost two of my teeth. Does this mean that I will eventually have to have dentures?

A. No..No..No....Your family's past history will not condemn you to the same denture plight. Here is how to avoid it:

1. See your dentist twice a year for cleaning and examination.

2. Avoid sugar.

3. Don't smoke.

4. Learn to brush and floss properly, daily, to remove plaque from all tooth surfaces. Ask for help from your dental hygienist.

5. Replace missing teeth with dental implants to preserve your facial bone. No other tooth replacement accomplishes this. Remember, it is less expensive to maintain your oral health than to correct it later.

Q. I have a very narrow bony ridge where my back teeth are missing, and I cannot comfortably wear a lower partial. What type of implant would work best for me?

A. A narrow ridge in the back of the lower jaw can be widened by moving bone from the side of the jaw or the chin to the ridge. This is called a bone graft. These living bone cells attach themselves in their new location in about four months. Once this is done, dental implants can be placed. There may be other less invasive procedures that can help you regain your ability to chew.

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