Unless I’m on it Every Day, I Get Decay!
Q: I have always had a challenge with my teeth. Since I was a kid, then teenager and throughout my adult life. After fillings, came crowns then root canals then extraction and bridges. I’ve spent a fortune in time and money in the dentist’s office. I know part of it is my fault. I always resolve to clean better but then fall back. Unless I’m on it every day, I get decay! There are times I go a stretch, maybe two, three, four years when the hygienist says, “good job”. Then the next time I go I’ve got an abscess, decay under a crown or something that needs more dental work. I’ve been thinking about implants. My dentist doesn’t do them but he said they’re not necessarily the final solution. He said implants, though they never get decay, can have problems too. He said they’re great but you’ve got to take care of them just like teeth. He said if the doctor does everything right and the patient takes very good care then they will be a great service. I want that but can you tell me what that means? Are they hard to keep clean? What can go wrong? I just need more information.
A: It is important before implants are placed that your health habits, your dental habits, your chewing habits, your grinding and clenching habits, tobacco, marijuana and vaping use, the amount of calculous you lay down, your willingness to follow exact instructions before and after surgery, be explored. It’s a big list and sometimes not everything comes out before surgery. For example, strength of bite when someone wearing dentures is given implants. They now can bite into anything they want. Their bite strength returns to them so they put enormous force on their implants or, large deposits of calculous build up on the new teeth which may have been the reason for gum inflammation and infection that doomed their natural teeth. These are only a few but important patient assessments. Dentists must evaluate bite strength, bite or tooth arrangement and relationship of your teeth top and bottom to each other, bone volume and thickness, bone quality, tooth wear, potential for wear on the tooth/teeth that will be supported by the implants plus all the engineering of size, position, angulation, and needed grafting that may be necessary for the implant(s) placed. On top of that, protecting the implants through various means while healing is taking place must be assessed. These are a few of the considerations and each implant placement is unique so care and caution are always important. Having said all that do I advocate implants whole heartedly? Absolutely. Are there failures? Yes, a few but good care from both doctor and patient will ensure this to be a rare experience. Get all the information you can – once satisfied go for it.
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Based on actual patient cases
Calvin Ross Crapo