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What's Going on with Dental Implants?
excerpted from an article by Mary Kay Richter

Since George Washington wore dentures, perhaps nothing has changed dental treatment options more than dental implants. While most of us consider implants to represent the very latest in technology for those children who may have missing teeth, viable variations have been in place since the mid-1930's. Over time, a host of different implant products have been utilized, all with varying shapes, costs and effectiveness.

Today most folks who refer to implants are referring to those similar to the type designed by Swedish orthopedic surgeon Per I Branemark. Generally, these systems require the placement of tiny posts, which may be screw-like in appearance, into the jaw bone through a surgical procedure. After sufficient time has passed, generally 4-8 months, for existing bone to attach itself to the implant (called osseointegration), further steps are taken to enable the attachment of a single tooth, multiple teeth or a denture. About 6-12 months are necessary between the first surgical
procedure and the delivery of the final false tooth, bridge or denture.

Dental implants hold great promise for individuals who may need them. Chewing ability with implant-connected dentures is markedly better than that with regular dentures. Scientific data indicates that as much as 95% of normal biting force can be restored with successful implants. Likewise, appearance, speech and self-esteem can also be positively affected with implant therapy. But not all implants work in every situation and not every dentist may be able to provide every type of implant.

Before you become a purchaser of dental implants, there are several things you should consider:

1) Is the type of implant your dentist offers the type that is best for you? The various types of implants should be considered along with their advantages and disadvantages. What may be appropriate for one may not be appropriate for another. The success rate varies from brand to brand and type to type. Improve your chances for success by selecting the brand and type that is best for you. Ask your dentist for ALL your options. If you are unsure, seek a second opinion. Ask for scientific data.

2) What type of training and experience has the dentist or orthodontist had? A television program recently explored the lack of training for some individuals doing highly sophisticated dental procedures. Dental implants fall into that category and individuals with as little as three days of training are attempting to provide the service. However, some dentists have taken advanced graduate level training in implantology which would indicate a higher degree of training and experience. It is important to ask the dentist how many implants s/he has installed, the reasons for any failures, his/her success rates and the number of implants s/he has provided for children with clefting disorders. Although implants have been around for some years, much experimentation still takes place. Minimize your risks by being certain your dentist or surgeon is qualified and competent! It is also important to make sure that the person who makes your fake tooth, bridge or denture (who may be a specialist called a prosthodontist) is working closely with your dentist (usually an oral surgeon or periodontist - also specialiusys) putting the implants in surgically. Having implant surgery without such and arrangement would be like asking a contractor to build a house without a blueprint from the architect.

3) What are the risks associated with your dental implants? Just as with any type of medical procedure, there are risks associated with dental implants. Included are the usual risks associated with general or local anesthesia and oral and maxillofacial (dental) surgery. Complications may include infection, nerve injury, getting a hole in the sinus, failure of the bone to bond to the implant and structural failure of one or more of the components of the implant system. Implant failure may lead to physical discomfort, emotional distress and dissatisfaction with dental care.

4) What are the costs? Implants are often considered to be experimental by insurance companies, or other "third party" providers (HMO's, PPD's, Medicaid, etc.)and may not be covered by insurance benefits. It is important that you discern the position of your insurer prior to proceeding if you are dependent upon benefits for bill payment. Prices vary from something like $1,500 for a single tooth implant to $10,000 for an entire upper or lower jaw - give or take a few hundred dollars in either case. It would be good to ask the dentist who is responsible for the cost of an implant failure. Having to pay for the same procedure more than once may make it less attractive to you. Because of the associated costs - financial, physical and emotional - it is important that you know what fees to expect and that you have confidence in both the individuals providing care and the implant system to be used. Knowing all these things up front will not only enable you to make a good decision, but will maximize your chances for complete success.

----------------------Mary Kay Richter is the director of the National Foundation for Ectodermal Dysplasias. The NFED address is 219 East Main Street, Box 114, Mascoutah, IL 62258-0114. Their phone number is 618-566-4718. Our thanks also to Dr Kirt Simmons for his input in this article.

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