So here’s the follow up to my last blog about fit and forget implants:

If you think that you might benefit from dental implants..

here’s a few questions to put to the dentist before you choose to go ahead:

Q. What guarantees do you offer on your dental implants?

Q. Will you replace an implant if it doesn’t take – free of charge?

Q. And in the long term – how will you ensure that I still have my implants in 10 years?

Q. What are the ongoing maintenance requirements for dental implants, and how much does that maintenance cost?

Q. Can I see some before and after photos of your work?

Q. Can I speak to any of your patients who have had implants placed by you? (Ask for testimonials)

Q. How long have you been placing dental implants?

Q. How many implants have you placed?

Q. How many of those implants have failed?

Q. Talk to me about peri-implantitis!

Q. I’m a smoker – am I still suitable for dental implants?

Q. I have had gum disease, this is how I lost my teeth (they got wobbly and fell out), will the same thing happen to my dental implants?

Its important to know everything before you choose, and of course, we’ll answer all these questions for you in the Free Consultation.  

I love talking my patients. They are my lifeline to the real world out there – you know the one where most people don’t spend all day every day think
This lady is one of my long standing dental implant patients – a few years ago we completely rebuilt her upper and lower jaws using custom porcelain bridges supported on titanium implants.ing about teeth (just ask my wife, it drives her potty!)

The thing is, they look as good today as the day we fitted them all that time ago. But this is no accident. Gill follows Laura’s (one of our lovely hygienists – yes they’re out there, honest!) advice to the letter. She cleans the bridges and implants twice a day, and visits us every 6 months for her Healthy Mouth Review to allow us to monitor the health of her mouth and implants, to clean those areas even she can’t get to, and to carry out our Oral Cancer Check.

This is routine at Winning Smiles.

Implants need as much – possibly more – upkeep than natural teeth…they are a great copy of the real thing (better than a chinese rolex) but even I don’t claim to have beaten mother nature at her own game!

So when Gill told me yesterday that she is coming across more and more people who are benefiting from this sort of dental treatment – but most of them can’t understand why she has to keep coming back to see us for what they see as ‘unnecessary maintenance’, I had to press her for further clarification! ‘Why.’ I said? And Gill went onto explain that these patients are popping into dental practices (yes,in the UK) and having implants placed ‘as if they are just expensive fillings’!

This is a worrying trend. Problems with dental implants rarely cause pain, so for a patient who has been advised in this way the first time they realise there is a problem with their dental implants might be the day they fall out! The fact that this may take 5-10 years is what is protecting both these dentists (and their patients – ignorance is bliss) for the time-being. But it’s a ticking time-bomb. These cheap ‘quick-fit’ (and forget) implants have been placed in the last couple of years as more and more of the profession learn about them – in response to greater and greater demand from patients….alas it is only a matter of time before the chickens come home to roost. And when they do, the only winners (as usual) will be the lawyers.

Leaving the cost issue aside, once implants fail it is not nearly as easy to do them a 2nd time. The bone around them disappears – which is why they fall out – so if they fall out, by definition there is often no bone left to put another one in….and this puts us right back to the 1970s: dentures for all.

Happy Easter. Lay off the eggs

Now I’m not one to decry something simply because its getting old – for example, I do love old cars (as friends will testify!), but how many of us would drive a 100 year old car as everyday transport? Wouldn’t that be uneconomic, wouldn’t it damage the environment?

Just like having dental bridges fitted, as it turns out.

The costs add up

The problem is, a bridge relies totally on the teeth either side for its support, and those teeth have to be drilled down to pegs would you believe.

So, installing the dental bridge actually weakens the adjoining teeth, and then to add insult to injury, the bridge leans on them for the rest of its life…..the dental bridge is ‘parasitic’. Bad for its environment.

The extra loads that that bridge imparts means those teeth are much more likely to fail in the long term……a single tooth loss leads to having 2 or 3 teeth missing…the long term costs go up.

Hardly an elegant modern solution

People should also know that with a bridge, the bone and gum underneath continues to shrink slowly over time.

At best this leaves a ‘dip’ in the gum above the bridge tooth and at worst a black hole (gap) appears so that everyone you smile at knows exactly where your false tooth is!

Dental Implants are the answer

The humble dental implant solves all these issues: It stands alone without interfering with its neighbours.

Over and above that, our bone loves the titanium surface of an implant tooth – and once an implant is inserted under the gum and into the bone, then the bone will not shrink like it does with a bridge.

The aesthetic and cost implications of implant teeth are just too good to ignore.

Let us retire the bridge, and give it the rest it deserves.

Just the other day I had a gentleman turn up at my surgery for the first time with one of his front teeth missing. When I asked the obvious ‘what’s happened’ he said that his own dentist extracted the tooth but forgot/didn’t bother to replace it with a temporary tooth at the extraction appointment!

I have to say both myself and Victoria my assistant looked at each other and were too shocked to speak! (not for long -ed)

Now, I’ve had plenty of patients walk into my office with front teeth missing over the years but

• most frequently the tooth has been knocked out in an accident
• they walk out with a tooth in place where there was none before.

I find it utterly amazing that in the developed world in 2008 someone can walk into a dental office with a tooth (albeit a wobbly one) in place – and walk out with no tooth at all!!

Suffice to say, despite there being no time in hand to sort this problem out – we had a ‘working’ lunch – we had a new tooth built from scratch and glued into place in less than an hour.

Once the gum has healed where the tooth was extracted we will be putting an dental implant tooth in as a permanent solution.

Had the patient come to Winning Smiles, it may well have been possible to put the implant tooth in at the same time as the extraction. Unfortunately a few days late is too late, as the gum grows down into the socket making immediate implant placement impossible.
OK Rant over!