Implants vs. General Dentistry

Dental implants allow for the replacement of missing teeth without grinding on good teeth to make bridges. Many conventional dental procedures are still indicated today. However, with the advent of dental implants, many of those procedures are becoming outdated or contraindicated. For decades, the dental profession has advocated the preservation of natural teeth and natural tooth structure. This concept is certainly upheld when using dental implants for tooth replacement. The need for removal of healthy tooth structure (enamel) has been eliminated by dental implant treatment.

Dentists agree that a tooth often begins a downward spiral after being touched by a dental drill for the first time. Patients and practitioners alike have agonized over the decision to grind on healthy teeth. We, as practitioners, see conventional crown and bridgework fail prematurely. Several studies on crowns and bridges found an average 9-10 year life expectancy in the United States. Until about 1985 our choices for tooth replacement were poor, at best. Since implants have become the "standard of care" for tooth replacement our choices have improved dramatically.

The use of dental implants gives three more benefits rarely discussed:

1.) Dental implants strengthen the dentition (entire set of teeth). By adding a dental implant where a tooth is missing, we are replacing the root and the crown (top) which is missing, thereby potentially increasing the life expectancy of surrounding teeth. In some ways the implant is more solid than the tooth it is replacing. Bridges and partials weaken the dentition by forcing other teeth to carry the burden of the missing ones.

2.) Dental implants preserve the bone levels that are present when a tooth is lost. Without the implant the bone will slowly resorb (melt away) because there is no stimulus to keep it in place.

3.) Dental implants do not decay. By far, the most common reason for a crown or a bridge to fail is because decay starts at the margin where the crown meets the natural tooth. Titanium implants cannot decay.

Below we contrast implant dentistry with more traditional forms of dentistry:

One Missing Tooth

When a person is missing one tooth there are two options for replacement, a single tooth dental implant or a three-unit bridge.

 
Implant
Bridge
Cost Same as bridge Same as implant
Treatment time 3-9 months 2-5 weeks
Drill on other teeth No Yes
Life expectancy 10-30 years 5-15 years
Effect on dentition Strengthens Weakens
Chance for future decay No Yes


Removable partial dentures (RPD) have been used by dental patients to replace missing teeth for over a century. Simply by considering the phrase one can understand why they are really outdated treatment options; removable, by the patient several times per day. Partial denture indicates it is a denture on a smaller scale. Most people would choose to have "fixed" (cemented or screw retained) teeth if given the option. Fixed teeth on dental implants look, feel and function like natural teeth.

Several missing teeth

 
Implant bridge
R P D
Cost More than RPD Less than implant bridge
Treatment time 3-9 months 4-12 weeks
Drill on other teeth No Yes
Life expectancy 10-30 years 5-15 years
Effect on dentition Strengthens Weakens
Chance for future decay No Yes
Prosthesis stability Like natural teeth Moderate
Ease of cleaning Moderate Simple (outside mouth)
Comfort Like natural teeth Poor
Speech change None Improves with time
Palate covered No Yes
Preserves bone Yes No

Complete dentures have been a nemesis of mankind since they were invented. Though they do replace missing teeth and can be esthetically pleasing, there are few other accolades about dentures. Most dentures wearers admit that they would "do anything" to save their teeth if given the opportunity. Dentures are difficult to adapt to, uncomfortable to wear, painful to chew with and can cause public humiliation. Most denture wearers claim that dentures alter their lifestyle significantly.

Missing All Teeth

  Dental Implants Dentures
Cost Much more than dentures Much less than implants
Appearance Good Good
Treatment time 3-18 months 2-6 weeks
Life expectancy 10-30 years 3-10 years
Effect on chewing Like healthy natural teeth Poor
Prosthesis stability Like natural teeth Very poor
Ease of cleaning Moderate Simple (outside mouth)
Comfort Like natural teeth Very poor
Speech change Minimal Improves with time
Palate covered No Yes
Preserves bone Yes No-accelerates bone loss