Questions and answers about dental implants
June 22nd, 2010
Q&A with our dentist
Dr Keith Cohen answers online readers’ implant related questions about the impact of smoking on dental implants, tooth loss, gaps between teeth, osteoporosis and ulcers.
Dental implants and smokers
Q: I have been told that I cannot get dental implants because I smoke. And even if I gave up smoking, it would be at least a year before I could get them. Is this true?
A: It is true that smoking reduces the success rate of implants and can even cause complications for surgical procedures. However, there are many factors that have to be considered like how much you smoke and over what time period, as well as general medical health and how straightforward the procedure will be. This depends on how much bone is there to place the implant in. If you insist on going ahead with the treatment and there is a dentist to carry it out, you must accept that there are chances of reduced success. This means that one or more implants might not integrate and will need removing or replacement.
Tooth loss and Implants
Q: I have lost most of my teeth because of chemotherapy and my dentures have gone loose as well. Is it possible to get implants and what would be the cost of this treatment?
A: Generally, it is possible to get dental implants after radiotherapy or chemotherapy. Success rates may be reduced as your bone healing might be affected. For further advice and referral, contact the specialists who previously treated you. Usually, with medical history like this, treatment can be carried out within the hospital service and often without charge.
Growing gap
Q: I am 57 years old and have undergone routine dental treatment all through my life. I have a gap between my two front teeth and with age, the gum is receding and increasing the gap. My gums seem a bit delicate, but my dentist says that I do not have any dental problems. Are there any cosmetic treatments that do not involve extractions for this problem?
A: It is natural for the gums to recede with age, but incorrect brushing and gum disease can make this worse. The simplest way of reducing the gap between the teeth would be by bonding composite restorations to the side of the teeth, if they are healthy. If your teeth are more heavily restored, you can reduce the gap with crowns or veneers. If there is a large space, partially closing it can improve the appearance.
Ulcers and Implants
Q: 12 years ago I had implants done in my lower jaw from a dental hospital. Ulcers have now developed around some of them and I am unable to return to the hospital because of ill health and because I moved to another area. Private treatment will cost £12,000, which is more than I can afford as I am a pensioner. NHS dentists will not touch my teeth. I live in a small town without facilities and cannot travel. Can you suggest anything I can do?
A: It is not easy to make a diagnosis without seeing you. Ulcers are not the only cause for concern. I think you need further advice and would suggest that you ask your dentist to refer you to a local dental hospital or private specialist for an opinion as to the cause and possible lines of treatment. (Initially, it may also be possible for your dentist to email pictures and X-ray images of your mouth to the specialist.)
Osteoporosis and dental implants
Q: I take alendronic acid tablets for osteoporosis. Does this mean I am unable to safely have a dental implant? What about Nonviva injections for the same condition?
A: Some medications used to treat osteoporosis have been associated with ‘osteonecrosis’ in a small percentage of patients. This means, with surgical dental treatment or extractions, areas of bone in the jaws become non-vital. There is more association with intravenous usage than when the medication is taken by mouth. If you need to have some form of surgical treatment, consult the doctor who has prescribed the medication and ask their advice on your particular case before undergoing treatment.
*Dentists may pick up on osteoporosis
Implant insurance
Q: Six years ago I had four implants and have not experienced any problems whatsoever. In fact, the bridge they support feels rock solid. Although the policy doesn’t cover wear/tear, I still insure the implants for £200 every year against treatment costs incurred through accidental damage. Do you think this is worthwhile or can I safely assume the implants are “part of me” now?
A: Unfortunately, there is no treatment which is 100% successful and as time passes there are more chances for problems. Implant treatments are usually very successful, but problems may occur with the implants, screws and even the structure on top which can fracture or chip. Your dentist should be able to check your mouth and give you an idea of whether or not any problems will occur later, so you can decide if it is worth continuing with the policy.
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