The simple answer is ‘very‘.
If you type ‘missing teeth‘ into Google the dominant treatment mentioned on the first page of results is ‘implant‘.
Why is this?
Is it a better treatment for missing teeth than other options such as dentures and conventional bridges? In a Cochrane Review (which is an independent rigorous review of the quality and validity of healthcare research) the answer was a little disappointing for those of us expecting a clear cut answer. Their conclusion was:
“AUTHORS’ CONCLUSIONS: Based on trials meeting the inclusion criteria for this review, there is insufficient evidence to recommend a particular method of tooth replacement for partially edentulous patients.”
First, let’s look at the trend in published literature from Medline (the main database for medical research) and as we speak nine times more papers are published in 2015 on dental implants than any other main-stream clinical technique for dealing with missing teeth.
Currently,9 times more papers are published last year on dental implants than any other clinical technique for dealing with missing teeth. The biggest difference between old-school conventional dental treatments and implants is money. Unlike dentures and bridges implant treatment involves working in collaboration with the pharmaceutical/biotech industry who are capable of directly and indirectly sponsoring the research, and research is very expensive. This has been studied and been shown to potentially positively bias the result in about 30% of cases.
Combine this with direct and more importantly indirect marketing and it can appear to the lay person there is only one GOLD STANDARD treatment, implants. The alternative treatment options don’t get the same amount of exposure. For indirect marketing, the modern term is astroturfing summed up nicely in this TEDx talk by Sharyl Atkinsson.
TAKE HOME MESSAGE: Dental implants are very good but so are all the other major treatment options done correctly. They just dont get as much exposure. The important message in evidence-based dentistry is that the treatment option, be that implant, denture, bridge or nothing must match up with:
- The best research evidence
- The clinical expertise of the team both clinical and technical
- The patient’s expectations, preferences, ability to comply with the treatment, personal circumstances, finances both now and for future maintenance.
As an example implants might be the best option to restore a missing front tooth following a skiing accident where all the other teeth are perfect, a baby-boomer with lots of old failing fillings and crowns might benefit best from a new bridge and where there are many missing teeth a denture may still be the best treatment option.
Before you chose make sure you have discussed all the sensible options with your dentist and don’t be afraid to ask those awkward questions.