Indiscriminate Dental Implants can be a Toothache

When implants are done indiscriminately, these can be more of a toothache rather than an enhancement. The caveat is, not so many people are aware they need to be discriminate about practitioners who are indiscriminate about doing implants. These are practitioners who have not gone through proper dental implant training.

Dental implants are generally expensive with ballpark fees ranging from P70, 000 to P90,000 per tooth for a simple, straightforward case. In Cebu and elsewhere in the country, these are not covered by health insurance. Having an implant though has very little to do with costs or looks but rather it is a lifestyle.

Implants must be seen as a life changing experience that becomes part of a lifestyle. People who have missing teeth will want to have implants to prevent oral bone loss, make eating more enjoyable and because they know they feel good about it. Having implants is no whimsical or vain decision the way you would when going to a beauty parlor to have a change of hair color and cut. To have a dental implant is more about health care and what you want to do with your overall physical makeup, that is, including your teeth. When this is the goal, costs don’t count.

Not just doing metal.

By its very nature, dental implants are tooth replacements where a titanium screw is anchored into the jaw so these serve as foundation for a crown or a bridge. Dental implants are only done for missing teeth. Precisely why it is called implant  because the roots of missing teeth are replaced with the screw. The surgical part of putting in an implant can be finished in 30 to 45 minutes but it can bring a lifetime of change to dental health care.

The only Periodontist in the Visayas and Mindanao and being in the practice of Periodontology for almost 14 years, Dr. Andrea A. Arancillo said that people experience oral bone loss when they lose their teeth because the bone shrinks.

“The purpose of alveolar bone is to support teeth. A tooth, through its root, transmits forces to the bone which stimulates it and allows it to maintain its shape and density. Implants preserve the integrity, density, thickness and width of bone because implants act like a natural root, stimulating bone,” she said.

Dental implants “is not just putting in metal” considering that currently, there are two prevalent implant practices in Cebu. One practice is using a standard implant where you undergo a minor surgical procedure. The other is mini-implants. It is this mini-implant that may sometimes cause a heartache and a toothache. Unlike the standard surgical implant where gums are opened and the screw is implanted and made to integrate with bone, in mini-implants there is usually no surgery involved.

Punching a hole.

There is reportedly an epidemic of practitioners performing implants indiscriminately through non-surgical or mini-implant procedures. The dentist punches a hole in the gums and then screws the implant in. Mini implants, as the term implies, are smaller than average fixtures that don’t provide much surface area for bone to ‘hold on’ to. The drawback, therefore, is that these do not predictably integrate with bone. So dentists may put two or three screws to replace a single tooth, “hoping” that when one screw fails, there is a backup.

Dr. Arancillo wants to emphasize that there is nothing categorically wrong with mini-implants. They do serve a useful purpose. For example, they can be used as temporary anchorage devices (TAD) for people who need to undergo orthodontic tooth movement but do not have enough teeth present for anchorage. Being temporary, these are removed after ortho treatment is completed.

Since these are removed anyway, good Osseointegration is not vital. Trouble starts when these are marketed as long-term restorative options. These are not. Even if two or three screws are placed, since these do not integrate very well, these will fall off and in the long term, these implants will be uprooted. What happens is that there are so many failures and complications and instead of having an implant to feel good, you could end up feeling worse than when you had missing teeth.

There is an attraction to mini-implants – by its term mini, fees are lesser and sometimes 50 percent cheaper than surgical implants. Now how would you like to look like a vampire when the screws fall off all because you went for cheap implants?

Another precaution is that in choosing the facility where surgery is performed. All surgeries must be done in a clean, aseptic environment using the highest standards of infection control. Even minor things are important. For example; there must be a different suction for saliva and a different suction for the surgical field. You should not mix the two. If you see your dentist do this, you are at risk of contamination, complication and the implant could fail. In principle, the body does not reject titanium which is the material used for implants. Rather it is complications resulting from wrong treatment planning or the improper way of doing implants that causes implants to fail and literally, fall off.

Dentistry with a Conscience.

Said Dr. Arancillo, “Let us practice proper Dentistry. Dentistry with a conscience. Charge whatever you feel is reasonable and appropriate, but do proper work.”

“The misconception is you can’t do implants unless you are a specialist. That’s not true,” she said. “A general dentist can and should learn to do implants. In a few years, a patient asking for implants will be as commonplace as asking for a root canal or a crown. It is already happening in other countries. However, the dentist must undergo proper and comprehensive training to be able to provide this service to the patient. That means enrolling in a structured program and not just an over-the-weekend course.”

“You have to invest time and money to enroll in a quality course. Proper training is not a choice, it is a must! Implants may seem easy to put in but so many factors need to be evaluated and meticulously considered. When faced with complications or unexpected situations, that’s when good training makes a big difference,” she said.

Dr. Arancillo is inviting interested dentists for a lecture on Dental Implants on June 6 at the Casino Español. This lecture will be given by Dr. Henry Kwek, an International Speaker and Specialist. You may contact her for more information about this event.

In the meantime, those who are deeply rooted in implants for a lifestyle will have to fully understand what it takes, not what it costs.