Ronald Weaks DDS

Ask the Doctor

QUESTION: I am so tired of my lower dentures not fitting, but I need to know if all implants are successful?

ANSWER: No. There are many variables to be considered in placing implants. First, the patient must be healthy with adequate healing potential. For example, if the patient is an uncontrolled diabetic, inconsistent healing could complicate the procedure. If such a condition develops at a later date after an implant has been done, this, too, may complicate the future of the procedure. Second, a proper diagnosis must be made and the proper implant placement and procedure must be selected for the individual patient. Third, the implant(s) must be treated properly by the patient and the dentist. If either person is neglectful, there could be complications. Fourth, if the patient is a heavy smoker or uses excessive amounts of alcoholic beverages, the success of the implant(s) will be affected.

QUESTION: My sister-in-law has dental implants, and she keeps telling me I would be much happier with them since my lower denture fits so awful, but explain to me in simple terms just what an implant is.

ANSWER: A dental implant is a man-made replacement for the natural tooth root which allows a person to return to non-removable teeth or a more secure dental restoration. It is not a transplant which would be taken from another individual. There are several types of dental implants. The doctor will select the one best suited to your needs and general dental condition.

QUESTION: I am strongly considering dental implants, but I want to know if they are going to be rejected like other kinds of implants.

ANSWER: Dental implants are made of biologically compatible materials which have undergone extensive testing over a period of several years. Since these materials are largely metals, such as titanium, and Vitallium alloy, and have never been living tissue, there is no likelihood of causing an antigen-antibody response which could cause the type of rejection that sometimes occurs with heart and kidney transplants.

QUESTION: Will I be able to chew in the implant teeth with the same amount of force and pressure as I did with my former natural teeth? I can not do this with my dentures.

ANSWER: For purposes of comparison, let us assume that the patient with all their own natural teeth in a healthy, well-maintained, functionally accurate condition can chew at 100% efficiency. However, with every tooth lost, efficiency decreases. How much decrease is dependent upon whether or not the teeth are replaced and in what manner. Ultimately, if a person has no teeth and is using a proper fitting denture on an adequate bony ridge, a chewing efficiency of 15-18% may be achieved. If the ridges are not adequate, the percentage decreases. With implants and non-removable bridgework, or well supported tooth replacement methods, a person may get back to as high as 85% efficiency compared with their natural teeth (depending on the number of natural teeth present and their condition).

QUESTION: What happened to the bony ridge I used to have under my dentures?

ANSWER: Nature has provided tooth supporting bone during the years when there are teeth present in the mouth. When the teeth are lost, the tooth supporting bone is also lost. Nature takes away from you what you do not use! For example, the person who is confined to bed for a long period of time loses his muscle tone. The muscles get soft and literally wither away. In the mouth, the bone under the gums "shrinks", and dentures get loose. Notice in the mouth of a person who has lost half of his or her teeth, the bone is present around the teeth which remain. Where implants have been placed and properly maintained, the tendency is to preserve this bone because the bone is being used in much the same way it was when the natural teeth were present.

QUESTION: Is the implant procedure painful, and will there be swelling?

ANSWER: Just as with any surgery, there can be some discomfort. However, anesthetics and sedation virtually eliminate discomfort during the actual surgery. Post-operative discomfort will be similar to that of having teeth removed, and patients will be provided with medication to alleviate this discomfort; however, many patients do not require prescription pain medication following the implant procedure. Swelling can vary, but most patients experience only minimal swelling, and any that does occur usually ends within one or two days.

QUESTION: What type of dental implants do you place, and how are teeth attached to them?

ANSWER: Although there are many types of implants, the types can be divided into two basic groups: (1) Those that are inserted INTO the bone, and (2) Those that are placed OVER the bone. In both instances, the implants are placed UNDER the tissue and extend into the mouth. After osseointegration has occurred, a minor procedure is performed to expose the top of the implant and attach a small post. Then the new tooth or teeth are custom designed to fit precisely on top of the post.

QUESTION: I have three missing teeth in a row. Wouldn't a bridge work as well as implants to fill the gap?

ANSWER: When a tooth is lost, it is best to replace the tooth with a non-removable replacement as promptly as possible, and for the replacement of a single tooth, a non-removable bridge is often very satisfactory. However, in replacing a number of missing teeth, a considerable amount of root support is lost. Now that does make a difference. This can be compared with losing fence posts. The fence is not any shorter, but here are fewer posts supporting the fence. The fence is no longer as strong as it was earlier. In the case of the fence, it is obvious that fence posts need to be added so that support will be increased, and similarly these areas of the mouth need to be aided by replacing the missing tooth structure by means of implant(s).

QUESTION: My partial denture does not fit well anymore. This is my second one made. Maybe I should think of implants. What is your opinion?

ANSWER: Partial dentures are either tooth supported or tooth and gum supported. An entirely tooth-supported partial will fill the space, but the supporting teeth are more stressed than they were before. In areas where teeth are missing and have been filled in with gum-supported denture teeth, the gum tissue and bone structure beneath this denture will shrink gradually, and the partial denture will have to be replaced or relined periodically. If these areas are not relined, then space develops under the denture. It is not bearing its fair share of the chewing load, and the remaining natural teeth, which are doing all of the chewing, become overloaded. Under these conditions, the remaining teeth will undergo accelerated bone loss. These situations in the mouth can be greatly aided by implants.

QUESTION: My question involves the money part. Is it expensive, and does insurance pay for implants?

ANSWER: We have solved problems for as low as $200. But implant procedures, which vary in complexity and extent depending on the patient's dental condition and requirements, can involve a significant investment. A survey of 350 patients contacted after completion of their implant treatment revealed that not only was it worth the investment, but that they would happily do it again. Some dental procedures, implant surgeries, and portions of implants surgeries are covered by dental and medical insurance policies. Our office personnel will assist you in obtaining these benefits.

QUESTION: I am considering dental implants, what is the first thing that I should do?

ANSWER: You may come to our office for a complimentary consultation, but the absolute necessity is your medical history. We will provide you with a "Medical History Verification" form to take to your physician. He or she will verify your medical history and current general health, provide us with results of recent examination, records, including blood tests and urinalysis, and will make indications of drug allergies and/or alternative recommendations. We want to make sure you are healthy and that there is no reason why you should not heal properly. We also want your medical doctor to be informed of the treatment we will be providing you and the medications we may prescribe.

QUESTION: I am in my seventies, and am I too old for implants?

ANSWER: Age is not a deterrent. Health is the determining factor. Many people seventy and eighty years of age are a better surgical risk than someone years younger who has physical complications. Older individuals are more likely to need implants because they have lost more teeth, and have lost more supporting ridges. As long as you live and breathe and are important to someone, including yourself, you owe it to them to take the best care of yourself that you possibly can.

QUESTION: How long can I expect dental implants to last in my mouth? Will they last a lifetime?

ANSWER: Very few things do last a lifetime. There are some implants which have been in the mouth for as long as thirty years. In the final analysis, whether they last a lifetime depends on how long you live and at what age the implant(s) are placed. Every natural tooth in the mouth of every living person will have one of two possible fates: it will either last until we die, or it will be removed at sometime. The same thing applies to implant(s)

QUESTION: How would I look while my implants are healing and how long will it be until I get my replacement teeth?

ANSWER: The implants must be left undisturbed in the jawbone for 3 to 6 months for osseointegration to take place, and then your new teeth can be attached to the implants. To minimize any cosmetic or chewing inconvenience, a temporary denture will be made created from your current denture. Because the implants are covered by gum tissue, you will not be aware of them during the healing process.

QUESTION: Will my new teeth after implants feel natural?

ANSWER: Yes, your new teeth will look, feel, and function like your own. They will be comfortable and reliable. Without the worry of loose-fitting removable bridgework, or removable dentures, you'll regain confidence in your appearance. Eating will be enjoyable again. Most of our patients tell us that they have forgotten that their new teeth are not natural. With an improved appetite, your general health will also improve. Time and again we see that implants offer a positive, predictable outcome.

QUESTION: I have all of my lower teeth, but I have an upper partial that I cannot wear. I was told that I have lost too much bone in the back part of my upper jaw for implant? Can anything be done?

ANSWER: A complete exam will be necessary to determine that your remaining teeth are in good health. Then careful evaluations are made with x-rays to determine the size and position of the maxillary sinuses which progressively grow as the the skull matures. These sinuses are located immediately in the area which was once occupied by your upper back teeth. If you are considering replacing those upper back teeth with fixed teeth that stay in all the time, it may be necessasry to perform a sinus elevation procedure to allow room for placement of dental implants into the area to support those 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 a medium which causes the patient's own bone to grow back into the area. The sinus-elevation procedure could be all you need to allow room for the placement of implants in the back portion of your upper jaw so you can have fixed teeth once again.

QUESTION: I am missing most of my back teeth and do not wish to lose any of my remaining front teeth. I do not seem to be able to wear removable partials. I have heard that dental implants would help me have teeth that stay in all the time. Please explain.

ANSWER: Your situation is very common. A thorough evaluation must be made to determine if a tooth is healthy enough to keep or not. If we do work in other areas of the mouth, we do not want remaining unhealthy teeth to compromise the success of any new treatment. Providing you are a good candidate for implants, we must determine if bone substitutes will be necessary to help you grow back the bone you once had, or if simply just placing an implant is all that is necessary for support of fixed bridgework to replace those missing back teeth. If you have had problems with removable partials in the past, this form of treatment with the use of dental implants could be just what you wished for all along.

QUESTION: I have an upper denture, and it is fine. I have only two of my own lower teeth remaining, and they are very loose and have a lower removable partial plate which hooks on to these teeth. How do I know if I have enough bone structure for converting over to implants?

ANSWER: A thorough clinical examination will determine if there is enough bone structure remaining to place implants. We have seen people with natural teeth that have lost bone completely to the end of their root structure and still have enough bone structure for implants, but the key is not to wait too long for treatment because the longer you wait the more bone loss will occur with time.

QUESTION: I work with the public and do not want to be seen without my teeth, but I would like fixed teeth instead of my ill fitting lower denture. If I had dental implants, would I have to go to work without teeth?

ANSWER: If we determine that you are a good candidate for implants, then one of the first treatment procedures we would do is to take an impression for a temporary full lower denture, and then we will place the temporary denture before the implant surgery. After the surgery you will wear the temporary denture for a period of 4 to six months. Then we will show you how to care for these new teeth so you will avoid the same problems you had with your natural teeth. During this entire time you will not have to go without teeth.

QUESTION: I have a full set of dentures, and my uppers are fine, but my lowers are so bothersome when I try to eat. Can I have implants on the lower and keep my dentures on top?

ANSWER: Absolutely. Your situation is a common one. The full lower denture is the most unstable, unretentive, conventional prosthesis fabricated in routine dental practice. During function the average lower denture moves fives times more than an upper denture. The person with advanced bone loss has additional problems of poor muscle coordination, speech difficulties, inability to even keep denture adhesives in place, general failure, and adverse influences on a normal lifestyle. Dental implants can be the solution to all of these problems. Even in cases where a lot of bone loss has occurred, there still is a good chance something can be done. If you are happy with your upper denture now, we can usually design lower implant teeth to match, assuming your upper is in good condition.

QUESTION: Can wearing dentures affect a person psychologically? I'm wondering about my mother, who started wearing dentures recently.

ANSWER: The psychological need of the edentulous person takes many forms. For example, in the United States more than 90 million dollars are spend each year on denture adhesives. The person must be willing to accept the unpleasant tastes, the need for recurrent application, the inconsistent fit of the dentures, embarrassing circumstances, and the continues cost of items for securing their dentures. Only 80% of the edentulous population is able to wear both dentures all of the time. Some people wear only one denture, usually the upper, while others are able to wear them for short periods of time. 7% of the people who have dentures are not able to wear them at all. These people, unfortunately, become dental cripples. Therefore, implant supported teeth are seen as an integral part of one's own body, and the psychological benefits are many.

QUESTION: I have had dentures for several years and have lost a lot of jawbone, are dental implants an option for me?

ANSWER: In most cases with the wide variety of treatment options available today in the field of dental implantology some form of treatment can be done. We encourage people if they are already having some problems with their current situation to get help as soon as possible. People without teeth, or diseased teeth and gums have a life expectancy of 9.8 years less than those who have a healthy oral environment (Harvard Research Symposium)

QUESTION: What kind of credibility do dental implants have among the dental profession and what is the basis for this credibility?

ANSWER: Implants have been used for several years to replace a person's missing teeth. It was not until the use of the modern metal implants that the procedure has some predictability to it. The American Dental Association's recognition of implant dentistry comes after several years of close observation and evaluation of the materials, procedures, and results. In a statement issued in August 1988, the National Institues of Health went on to say patients prefer dental implants over conventional dentures. Psychologically, dental implants are important for those who cannot adjust to the idea of removable dentures. Implants are here to stay, and have reached the point where they can be considered predictable and are becoming a significant factor in dentistry today.

QUESTION: I constantly have sores in my mouth from my dentures, and even though I have had several relines, it doesn't help very long. Can implants help me?

ANSWER: With wearing dentures, the underlying supporting gums and bone is constantly shrinking and changing, thus the good initial fit with a denture usually does not last. Another reason for mouth sores is the instability that can occur with dentures when there has been severe bone loss. There is no stable base for the denture to rest on, and slight movement of the denture during chewing can rub the gums and produce these ulcers. Also with shrinkage of the support bone, there is a change in the position of the denture which produces a change in the occlusion of the bite, and this contributes to ulcers. Dental implants will provide a solid foundation for the teeth and get the biting forces off the gum tissues. The implants will also stimulate the bone structure and will reduce bone loss dramatically.