DENTAL CARE

Q: Why Can’t I Get Two implants?

A: We have touched on this topic before in passing during other discussions. Typically, patients want to reduce the number of implants they need or receive. The reduction of implants makes sense from many perspectives. If I place fewer implants, first and maybe foremost for many is a cost reduction. You don’t need one implant for each missing tooth, as implants are strong enough to hold multiple teeth when the procedures are designed correctly. Blending the body’s response to treatment with some good engineering sense allows me to reduce the number of needed implants.

The potential for problems, although small, is also reduced because we are doing less work. My rule of dental practice is that the least amount of dental work is always the best approach. My dentistry is good, but as I always say, the teeth you were given when you were born did not last forever, so how can my work last forever? This thought guides me to perform essential work and no more.

So why does my patient want more implants to fill a gap in their mouth? Let me share a little bit of history with you regarding her mouth. The area in question is cosmetic in her mouth. It is not right in the front but off to her left side. She sees a big gap when she talks and smiles, and the poor cosmetics brought her in to see me.

Over the years, she lost two teeth on her upper jaw. First, she lost the more posterior tooth, and it did not affect her smile. A few years later, she lost the more forward tooth and was devastated. As with many things in our lives, other activities and needs got in the way and took priority. Fast forward to today, and social events and life milestones are happening. She wants to be able to smile nicely for pictures. Now is the time for implants to come to the rescue and help restore function and cosmetics.

Two teeth lost equals two implants, and so she called me. One thing that she did not realize is that she lost space over the years. The tooth movement was subtle but still occurred. Let me explain what happens when we lose space. For implants to thrive, they need adequate support and blood supply in the jaw. Each implant needs a certain amount of healthy bone surrounding it for proper healing and stability. She no longer had that much bone in the area of concern.

A loss of space can create an opportunity for another dental option, namely a permanent bridge. When I create a bridge, I can adjust the sizes of all the teeth involved and make the missing teeth as large or as small as I need, keeping the looks aesthetically pleasing. The teeth anchoring the bridge must be healthy, which was true in this case.

Another alternative for her was a single implant in the most forward area, leaving a gap behind it. Doing it this way, I can mask her cosmetic concern and know we have a healthy implant. It is not my first choice; replacing the tooth behind it is important for overall health. I could even use the implant to connect to the back tooth, reducing the work that I have to do on natural teeth.

Choices are important in every aspect of life, and weighing all the pros and cons is paramount. The takeaway message is to replace a missing tooth as soon as possible and not wait too long. Teeth move and change over time, and your anticipated result may not be possible. If you lost a tooth several years ago, please call Nikki for a consultation. Our phone number is 440.951.7856, and as always, I look forward to meeting you.

Jeffrey Gross, DDS, FAGD, is an Ohio-licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile 34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Blvd) Eastlake, Ohio 44095

440-951-7856 Severance Medical Arts, Suite 603

5 Severance Center Cleveland Heights, OH 44118

216-371-2333 www.jeffreygrossdds.com