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Dental Implants Success Rates Linked to Patient Health

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Implants Success Rates Linked to Patient Health

Dental Implants Success Rates Linked to Patient Health

April 03, 2006
By: Jean Johnson for Dental1

“Implants are a good solution to tooth loss because they look and feel like natural teeth,” said Kenton Ross, D.M.D., F.A.G.D. of the Academy of General Dentistry. “They can enhance a patient’s quality of life and self-image.”

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Unique Facts about Implants

Unlike bridges, dental implants help preserve existing teeth.

A dental implant provides an anchor for missing tooth restoration. As a result, adjacent teeth do not have to be cut down for a bridge.

Scientists at McGill University School of Dentistry determined that implant treatment costs 2.5 times that of dentures initially, but that over the span of a lifetime, dental implants were only slightly more expensive than dentures.

Dental implants are composed largely of metals such as titanium, a material to which bone fuses. Consequently, according to a Loyola University Health System report, since implants “have never been living tissue, there is no likelihood of causing an antigen-antibody response which could cause rejection similar to that which sometimes occurs with heart and kidney transplants.”


That’s an understatement. For those who are good candidates, dental implants are best thing to come around since women discovered comfortable shoes. That said, the “good candidates” part can’t be under-estimated.

Periodontitis, a disease that affects the gums and bones of the mouth, is a risk factor for the failure of dental implants. A mid-2005 study linked inflammation of the gums, or periodontitis, to inflammation of the cardiovascular system connected to atherosclerosis.

But, vice versa was the conclusion of researchers in a newer study published at the end of 2005. Not only does heart health affect the success and longevity of dental implants, patients’ overall health and habits play a critical role in how well their implants will be received.

As an American Dental Association survey, which revealed an increase in dental implants over a five-year period from 1995 to 2000, concluded; implants are not an option for everyone. Not only must patients be in good health for the actual surgical implantation procedure and afterward, they must also have adequate bone to support the implant, and be “committed to meticulous oral hygiene and regular dental visits.”

Bone Quality

“You must have good bone quality and a lack of periodontal disease for the implant to stay in place,” said Judith A Porter, D.D.S., M.A., Ed.D., lead author of the study that was published in the November/December 2005 issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry.

Porter explains that, “Patients are unaware that bone loss in their jaw will often follow the loss of a tooth. When that happens over time, bone loss can cause facial changes and diet changes.”

While oral surgeons and dental implant specialists can augment bone with grafts targeted to the precise areas that will contain the dental implants, there is little they can do for patients who have weak bones.

Excessive soda consumption, for example, can lead to bone problems that could hamper the successful implementation of dental implants.
“There are a number of ingredients in soda that have the potential to have negative effects on bone health,” said director of the University of Cincinnati Bone Health and Osteoporosis Center, Nelson Watts, M.D.

Watts explains that the caffeine in soda can both interfere with the absorption of calcium into the body as well as increase the amount of calcium the body expels. The physician targets carbonated beverages because unlike many coffee drinkers who unwittingly compensate by adding milk to their morning cup, pop drinkers tend to simply replace the milk and calcium-enriched juices they might otherwise drink with soft drinks.

A soda here and there is unlikely to create adverse effects, but Watts cautioned against those that tend toward extremes. “Two 2-liter bottles a day is a problem,” he said.

The acids in soda can also cause the body to get rid of more calcium than it should. “Soft drinks may contain as much as 500 milligrams of phosphoric acid,” said director of the Didactic Program in Dietetics at Harding University in Arkansas, Lisa Ritchie, Ph.D.

Ritchie says that the government’s maximum recommendation for daily intake of phosphoric acid is 4,000 milligrams, a figure easily surpassed by those who crack open their first bottle in the morning as a prelude to a day of dosing on the fizzy liquid.

“Too many soft drinks may result in excessive phosphorus in the diet, and that can result in low blood calcium levels. The body will respond by pulling calcium from the bone to increase the amount of calcium in the blood.”

Bones robbed of calcium. Precisely the thing patients considering dental implants do not want.

Grinding and Clenching Teeth

Grinding and clenching teeth, or bruxism, can also be a factor inhibiting the success of dental implants, although not an insurmountable one. Most people grind or clench their teeth once in a while, but the habit runs to excess for as much as 25 percent of the high strung American population.

Usually, it’s through no fault of our own, since people largely tend to grind their teeth in their sleep. Nonetheless, considerable damage can accrue from what goes unnoticed in the night.

According to Charles A. Babbush, D.D.S., M.Sc.D., “This nocturnal bruxism can apply astonishing levels of force to the teeth, gums and jaw joints – up to 10 times that amount generated by normal chewing. Upon a newly-placed implant, that kind of force can be catastrophic, making osseointegration impossible.”

Osseointegration, or the bone fusing with the implant, is necessary to provide a strong foundation for the implant. Still, the unwitting gang who tends to grind can wear night guards to both allow the bone to fuse with the implant in the months following surgery and to protect their other teeth from excessive wear.

Diabetes

When the metabolism does not function normally and patients are reduced to regulating their blood sugar by matching food intake to insulin levels, a wide range of consequences ensues – including many associated with oral health.

Patients with diabetes are prone to infection and thus have higher rates of gum disease. They also tend to have dry mouths which can lead to excessive tooth decay. More, their ability to heal is significantly compromised if they have trouble controlling their diabetes, as those known as “brittle diabetics” do. But diabetics who are able to manage their blood sugar levels so that their general health is not compromised can be candidates for dental implants.

“Diabetic patients have to commit to really watching their diets and practicing scrupulous oral hygiene in order to expect good outcomes from their dental implants,” said Portland, Oregon prosthodontist, Nader Rassouli, D.D.S., M.S. “But in that way, they are no different from non-diabetics who must also develop these good habits if they want their implants to last as long as they can. It’s really just the diabetic patients who have difficulty managing their disease that we have to carefully evaluate before we can place implants.”

Tobacco

Smokers are regularly identified as poor candidates by dentists who place implants. Both immediately after the implant surgery and over time, good blood supply to the bone and tissue surrounding the implant is necessary for the initial healing and longer term viability.

“Smoking a single cigarette reduces the speed at which blood flows to the fingers by more than 40 percent for up to an hour,” according to Charles Babbush. “The restricted blood flow impairs the body’s ability to heal. Smoking even as few as five cigarettes a day appears to have negative effects.”

Summary

Dental implants, then, are revolutionizing dentistry. The future is here. Patient demand for this restoration technique is soaring because implants that are well-executed by careful, conscientious clinicians function, feel, and look like natural teeth.

Into the bargain, though, goes the question of the patient’s overall health. Implant surgery requires good bone quality and quantity, as well as adequate circulation for healing. More, after placing implants, any existing bruxism needs to be controlled, along with tobacco use and systemic diseases, like diabetes, which can compromise oral health.

With these factors accounted for and managed, however, edentulous patients or those missing one or more teeth, can expect state-of-the-art dental treatment that will provide years of confidence and enjoyment.

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