All is not lost as implants save our smiles
THEY ARE pricey, can take months to sort out and neither wealth nor patience can guarantee their availability to all who desire them. But despite the drawbacks, dental implants are the most exciting development in cosmetic dentistry since veneers in the quest for a perfect smile.
Think of them as permanent, bespoke false teeth — the opposite of old-fashioned dentures which have to be parked overnight in a glass. An implant is, at its most successful, a replacement tooth for life, consisting of a titanium support, screwed into the jaw to replace the root lost when a tooth has been extracted and topped with a custom-made porcelain crown.
It is not a solution for everyone; success depends on having enough bone to support the implant. And as not every dentist who fits them follows the same process, assessments by two or more practitioners could produce widely different recommendations.
Good general health is the first rule for eligibility — damage to the mouth caused by smoking and heavy drinking is so liable to compromise success that some dentists will not offer implants to smokers who cannot promise to cut down or give up. A history of gum disease can be a contra-indicator in nonsmokers too, given that it is associated with increased bone loss.
The more and better bone the dentist has to work with, the faster the procedure — but there are ways of improving the bone.
“Developments are moving rapidly,” says Dr Craig Parker, president of the Association of Dental Implantology, a registered charity whose aim is to educate and inform those thinking of implants. “Bone substitutes, which can be synthetic or from human or animal sources, can be grafted on to existing bone and left to integrate to build up the jaw. Three-dimensional scans of the jawbone allow grafts to be more perfectly matched, while computerassisted surgery allows implants to be placed more precisely when the bone is ready to receive them.”
The cost of implants is £2,000 to £4,000 a tooth but it is not always a case of one implant per tooth lost.
“Depending on the case, you can have two implants to replace three or four teeth and four to six implants per jaw to replace the whole set,” says Dr Zaki Kanaan, a dental implant surgeon and spokesperson for The Smile Clinic.
Implants can be used to create a bridge, says Parker: “Two implants could carry four teeth between them if the bone is strong enough,” he says.
The typical waiting time between tooth loss and implantation is six weeks to six months. Frustrating — but often necessary for a healing period after an extraction or to build up bone which is not sufficiently robust. Here again, technology is offering assistance: “In some cases now you can have a tooth removed and replaced all in the same day,” says Kanaan,
While payment plans are available, the high cost of implants has driven patients to eastern Europe, as Hungarian and Polish dentists offer cosmetic dentistry at lower prices, while cheap flights make multiple visits affordable. However, UK prices are likely to drop as uptake increases.
There is no UK register of dental implantation specialists, so for the moment the best way to choose may, appropriately, be word of mouth. “Ask for testimonials from previous patients,” says Parker, “and inquire whether [the practitioner] has followed an approved path of training in implants”. The more teeth there are to be replaced, the more crucial experience will be, he says. “If I was replacing a full set of teeth I’d want to know the dentist had done several hundred implants.”
It is not over once the implants are in place. Like real teeth they require scrupulous hygiene — and, like other kinds of crowns, the tops are liable to wear and tear. ‘“An implant becomes part of you and you must treat it as carefully as your other teeth,” says Kanaan.
Association of Dental Implantology: adi.org.uk