With 21st Century technology, materials and procedures, gone are the days of dentures deposited in a glass by the bed. Today, when teeth are lost, the replacements are absolutely “not your grandmother’s false teeth.”
“Back in the Day,” it was generally accepted that people would lose at least some of their teeth as they aged, and full sets of removable “uppers” and lowers” were common. Today, however, with an aging population living longer and healthier lives, dental patients are becoming far less satisfied with traditional dentures that have to be removed at night, and are seeking better options.
Dr. Alex Planes has recently opened Planes Dental Arts Cosmetic and Implant Dentistry, taking over and expanding the A1A practice of Dr. Michael McCown. Implant dentistry began in the late 1980s early ’90s, Planes says, “but it has advanced more in the last five years than in the previous 30.”
Planes, who interned under top specialists in the field and recently received a mastership from the International Congress of Implantologists, says dental implants have literally changed the face of dentistry.
A dental implant is a titanium screw that serves as a replacement for the root of a tooth. Like the root, it is secured in the jawbone, invisible once surgically placed. The implants are used to secure the crowns (the parts above the gum line), bridgework or dentures.
Titanium is used, Planes explains, because it is lightweight, strong, biocompatible (not rejected by the body) and because of its ability to fuse with bone in a process known as osseointegration – the basis of dental implant success.
For patients who have lost one or more teeth, implants offers virtually the same look, feel, stability, strength and permanence of a natural tooth, without significantly altering chewing capabilities or sense of taste the way dentures often do.
As we age, the bones of the jaw continue to decrease in size. When teeth are lost, the bone that supported them begins to reabsorb. Even with traditional dentures, the bone continues to reabsorb, which can eventually compromise the jawbone’s shape and the facial configuration. The absence of teeth creates that “sunken in” look seen when dentures are removed. Additionally, bone loss increases the instability of dentures, and causes irritation. Medications, age and medical conditions can also adversely affect stability.
The dental implant stabilizes the bone, preventing its loss. Thus, along with replacing lost teeth, implants help maintain the jawbone’s shape and density, supporting the facial skeleton and, indirectly, the gums, cheeks and lips. Dental implants help a patient eat, chew, smile, talk and look completely natural. Another implant plus – should future dental work be needed, the implant is already there, no root extraction is required.
When a patient comes in needing a tooth or teeth replacement, the bone quality is evaluated to determine whether he or she is a candidate for an implant procedure. Women may have more fragile bones than men, because of calcium or vitamin deficiency. In addition to bone loss that occurs with age, Planes explained, bone loss also begins “the moment a tooth comes out. A patient will lose 1-2 millimeters of bone the first year.” Shifting of the remaining teeth also begins soon after tooth loss, which can cause tooth damage and necessitate realignment.
“The longer a patient waits the harder restorative work is,” Planes says.
Even when the bone is compromised, bone grafting can often be done to create the necessary support for an implant, in which case the implant dentist and an oral surgeon work as a team.
Once the bone quality has been evaluated and an implant procedure is recommended, the doctor and the patient will discuss a specific treatment plan. Patients are often pleasantly surprised at the menu of options available to them. Implant-retained choices include: partials; dentures (the whole jaw); bar retained dentures; crowns and fixed bridges.
When the best treatment has been determined, and the bone is determined to be stable, the implant(s) and the temporary crown(s) can be placed in one visit. If a root canal fails, the extraction, implant and temporary crown can usually be done in one visit, as well. The temporary crowns remain while the implant integrates with the bone. This process takes about 6-7 months for the upper jaw, and 3-4 months for the lower jaw. Then the permanent crowns are placed. The patient can continue to function normally during the integration period.
Sometimes, the body rejects the implant. This will usually happen within the first month, and is a rare occurrence. Dental implants have a 96 percent success rate, the highest among surgical implant procedures.
Patients “of a certain age” will remember, with distaste, the uncomfortable and bulky stuffed-in-your-mouth X-ray apparatus that accompanied many a visit to the dentist. Now, Planes and others in his field have far more high-tech, patient-friendly diagnostic equipment.
A “great diagnostic tool,” the panoramic camera produces a series of dimensional images as it circles the patient, who stands with chin comfortably on a pad. Another clever tool, the intra-oral camera, allows the patient and doctor to see exactly what’s going on – “all the anatomical landmarks” – far more clearly than an X-ray image.
As with most health care issues, the main goal, says Planes, “Is prevention. Get regular check-ups. When there’s a problem, don’t wait. And,” he emphasizes, “We want to get rid of the fear factor.”
As one first-time implant patient commented, “I was a bit apprehensive. I didn’t know what to expect. But my implants give me a whole new level of confidence.”
Dr. Planes’ office is at 4755 A1A, Vero Beach: 772-231-6004,
