Sunday, August 13, 2017

Dumbing Down Dental Implants


So, you went for your 6 month ( or year...or first-visit-in-a-while ) check-up at your dentist's office...and they tell you that your tooth is bad. SHIT! Now what?

Hopefully for you, it's not a visible one. Then, at least you won't have to worry about "walking around with a missing tooth" ( there is a temporary fix for that, though, that I will go over briefly ) But it does happen. Heredity, hygiene techniques and diet have a lot to do with how our teeth behave for us. And unfortunately, sometimes that really sucks.

My last two jobs focused on dental implants in their practices. So what I'm going to do today is answer some of the questions people may have about dental implants and what they are. And, as always, comments and questions are welcomed if I don't cover something that you've wanted to know.  

So what IS a dental implant?

If you take a look at the picture above that I found on another dental office's page, you will see 2 images. The first image is what we specialize in--the dental implant. A dental implant is a titanium "root" that is placed to replace a tooth that has been previously extracted. What you see sticking just slightly out of the gum tissue is called a healing abutment, which has the sole purpose of keeping the gum from growing into the implant.

You see, a dental implant is hollow on the inside about halfway down the post--this is because there are interchangeable parts to the implant from placement to full restoration, so we need to keep that "hole" safe from tissue overgrowth, schmutz and food particles.  

A good amount of people ask me, "Will I leave the office with a tooth?" and the answer is no. The process of dental implants from start to finish takes numerous months and 2-3 "stages". The very last stage is permanent restoration which is pictured in the second image. That is the stage where your general dentist will cement on a permanent crown which then cannot be removed. Unfortunately, you will NOT leave ( our office, at least ) with a full tooth that day. 

Dental implants are a good idea for many different cases:

Agenesis, or hypodontia, is when a patient doesn't develop certain teeth. With the help of orthodontics ( braces ), space can be made in the mouth to place an implant where a tooth never developed.

A tooth has abscessed ( became infected ) and needs to be removed, but you do not want to live without said tooth.

Sometimes patients find it a better option to have a tooth pulled rather than go through the headache of having a large cavity filled/a crown placed/root canal therapy/trying to fix a tooth that they can't guarantee will last them much longer. 

Implants are also used for edentulous ( no teeth ) patients as stabilizers for dentures. That way, instead of having to use pastes and constantly worry about loose dentures, they snap on to implants as to stay in place.

Now I'm going to go through a quick run-down of the process of dental implants from the surgical end--please also be aware that these our the steps in OUR office, so opinions are not of ALL oral surgery offices!:

Stage 1 is where we extract the tooth and place a bone-grafting material in the socket. No, we don't take bone from a donor source on your own body; it's sterilized materials from a bank. Grafting is done mostly to larger teeth like your molar areas due to the fact that once a tooth is extracted from that area, well, you have a big hole. And you can't successfully fill a big hole with a little implant. So the grafting is done to promote your body to grow bone in that hole; without it, the hole will begin to kinda "cave in" on itself, thus leaving nothing good to put an implant in to. Do we graft the other teeth? Sometimes. Do we have to ALL the time? No. Everything is done on a case-by-case basis.

...but if we do place grafting material, we allow it to heal for at least 3 months before moving forward.

Sometimes we can get away with doing what is called an "immediate implant". This means that once the tooth is extracted, everything else looks good around the hole and the hole is small enough to place an implant right away. We usually still put a little bit of the bone graft around the implant to fill in the space, but when we are able to do it this way it shaves 3 months off of healing time and gets you a crown a lot faster. This is not a valid option in all cases, though...

But if an immediately placement is not an option for you, once the graft heals and an xray determines that we have adequate bone, we move to stage 2: placing the implant.

Whether asleep or awake, the gum area is numbed where the implant will be placed. The tissue is reopened to expose the bone we just grew. A "pilot hole" is then made in the bone with the handpiece and, with the use of X-Guide Navigation, the implant is drilled and placed. It's kinda like laparoscopic surgery but for implants, is how I explain it. Once the implant is placed, we put on that healing abutment and you usually get a few stitches. And that's that.

When people hear the words "dental implant" they automatically assume it's a lot of pain; but actually, dental implants usually hurt a lot less than an extraction of a tooth!

Once the implant is placed, we allow THAT to heal an additional 3 months--thus making the process ( on OUR end ) about 6 months long. Of course, each person heals differently so it can be slightly longer, but usually 6 months is adequate. And if the tooth is a tooth you're worried about not having for 6 months, your general dentist can make you what is called a flipper, which is a temporary "partial denture" to mimic a tooth while the area is healing. Each office will charge a different fee for a flipper, but it's usually a few hundred dollars...

When the implant has healed the 3 months, we do a quick test by torquing the healing abutment to make sure the implant does not move. This shows that the jaw bone has integrated with the implant and is ready to be restored. 

The reason we wait to have your general dentist make a crown for your implant until this final check is because each crown is made SPECIFIC for that case. Even with technology, if something is redone even a millimeter different, the crown will not fit...thus leaving you to have to purchase a whole new crown! We want to make sure everything is as it should be before you begin the process of restoration.

If everything looks good at the final check, we give the OK to go see your dentist and they will go through the process of getting a crown put on your implant for you.

I know that this is a lot of info and it's probably not "dumbed down" as much as I'd planned ( it's hard to do that when you understand the process, apparently... ) but that's why I strongly advise you to educate yourself, have consultations/second opinions if necessary, and research all your options. Each office operates differently, charges different fees and, well, has a different "feel" to them. If you speak to a doctor and don't like their vibe, go elsewhere. Price shop. Look at their reviews on Google and Facebook. And please!...never go to a "same day" dental implant office! It may sound better, but it's not. 

There's a process for a reason. And you get gut feelings for a reason, too. Go with both of them when it comes to your body and your health ❤