Health

What are your options when your teeth have gone?

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Complete Dentures

COMPLETE DENTURES

  • Relatively straightforward to make
  • Almost everbody can have one
  • Inexpensive
  • A starting point for first time denture wearers
  • All the shortcomings of artificial removable dentures : psychological distress, sore mouth, risk of not getting used to them.
  • Maintenance is lifelong

IMPLANT SUPPORTED OVERDENTURES

  • Stability, retention and aesthetic problems are readily rectified
  • A “cure” for patients who can’t get used to dentures without the disadvantages of the fixed approach
  • Simplified surgical demands
  • Professional fees are not significantly higher than cost of complete dentures
  • Maintenance requirements do not appear to be demanding
  • Exhibit minor movement during function and likely to accumulate food debris under the dentures’ fitting surface
  • Size teeth available to chew on can be maximised

IMPLANT-SUPPORTED FIXED TEETH

  • Conceptually brilliant and supported by compelling research data
  • Limited in use, not everyone is suitable
  • Relatively complex to undertake both restoratively and surgically due to increased number of implants.
  • Very expensive
  • Enormous psychological and functional benefits
  • A “cure” form patients who can’t get used to dentures
  • Aesthetic outcomes may be difficult and unpredictable
  • Maintenance not always easy and may be expensive
  • Size of teeth available to chew on has to be reduced

How much do dental implants cost ?

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The number one question on Google Trends reference dental implants is cost. After a few seconds of searching around it is quite easy to see why. I found a ten fold variance in estimated cost from £320 to £3000.

I will not get involved in how good or bad these implants are. I am sure there are some fantastically good inexpensive implants out there and some expensive disasters. All I want to do is clear up some of the cost issues and clarify some information on the websites out there is cyberspace.

1. “Not all implants/dentists/patients are the same”.

2.The premium priced implants will usually belong to the large companies such as Astra, Straumann and NobelBiocare etc. these companies pioneered almost all the research and development of implants and have excellent global support and after-care. The less expensive systems can involve generic copies and clones specific to only certain countries. Product quality and customer support for these products can be variable and some would be illegal to use in the EU.

3.Beware of overstated claims of success that exceed the published research. As a rule of thumb in an ideal world 10 year success should be around the 90% mark at best.

4. You will need to differentiate between a clinic that does implants and a dentist who does implants. How long has the dentist worked at that practice and how many days a month are they there to deal with any problems. There is a running joke in the profession which goes ” If you want super high success rates and no complications then move your practice every 18 months. Success improves even more if you move country”. There are a lot of advantages in seeking out a stable practice enviroment because implants throw up a lot of complications  especially after 5 years in place, you don’t want to find your dentist has moved on.

5. It’s not how many implants you can place in a patient’s mouth but how few will get the job done well. I have seen patients with 11 implants where 2 would have done an equally good job. Make sure all sensible alternatives to implants have been discussed and potential complications and additional expenses covered.

6.Make sure  you treatment plan makes sense and get a second or third opinion and research the subject very carefully.

7. A polo pony breeder once told me ” A polo pony is expensive and a bad polo

Continue reading →

How well do different treatments perform?

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How successful are your treatment options

I have compiled a short list of risk relating to advanced dental treatment. Most marketing material relating to dentistry tends to only show success and how they will improve you health, well being and looks. What they don’t mention is the how long that treatment is going to last and the risk of it not working. It is extremely important that the patient can make an educated decision with their dentist as to the amount of risk they are prepared to accept before staring any advanced dental treatments

The figures are given in terms of Success

Implant placement (after 5 years)

Implant retained crown/bridge 96 in 100 at 5 years

Conventional crown and bridge

Back teeth 95 in 100 at 5 years

Front teeth 86 in100 at 5 years

Resin bonded bridge 87 in 100 at 5 years

Post retained 80 in 100 at 5 years

Treatment to resolve gum disease

Non surgical gum treatment 90 in 100 at 5 years

Surgical gum treatment 80 in 100 at 5 years

Root fillings

Root fill + crown (back tooth) 93 in 100 at 5 years

Root fill only (back teeth) 75 in 100 at 5 years

If you want to read further follow this link to Evidence Based Dentisty

Click to access 6400565a.pdf

EAO Conference 2010