Q: Dear Dr. Crapo: Four months ago I had two implants put in. I told the dentist that since I was getting implants, I wanted the best. I have friends who are getting their dentistry done in foreign countries for a greatly reduced price, but I thought with implants, I should get them done here. I was missing one tooth in the back and two in the front. He told me he could save me some money by using two implants instead of three. He said that in the front space where two teeth were missing, one implant could hold two crowns. He called it a cantilever. I’ve seen cantilevering used in buildings, so I assumed it would work – he’s the expert.
Two weeks ago he told me the implants were ready for the crowns. “When do you want to do them” I asked? He said “I’m strictly the surgeon; your general dentist can do the crowns”. Because my general dentist doesn’t do crowns on implants, I went shopping. I saw two dentists who would do them but their approach confused me so I saw a third fellow. He spent a lot of time asking questions; then looked at the x-rays and my bite. “The implants look good” he said. “Did anyone take molds of your teeth to study the forces of your bite”? “No”, I said.
Now, because of our discussion, I’m going back to get the analysis done to see if that very kind surgeon should have tried to save me money by placing two implants instead of three. I’m a little “bummed out” because I was already to get my front teeth. Now if I have to get another implant I’ve got several more months to wait. Got any advice?
A: This sounds more complicated than it is. Here are the ground rules. In all complex cases, (bad bite, multiple teeth missing, severe wear and breakdown, clicking joints, headaches etc.) there must be one person who oversees all the treatment. X-rays, tooth molds, joint imaging and testing etc., must be done and planning complete before any work begins.
It is human to want the “best for the least”. It is also quite human to capitulate in order to please. Your surgeon wanted to save you money and perhaps he has, but stick with the guy who plans carefully before crowning your implants. The idiom states “poor quality remains long after the sweetness of low price is forgotten”. Your surgeon did a good job – he just may not have done enough to make it a perfect job because “your friends were getting bargain dentistry”.