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Dread dentures?
Implants are an option
By DAN SHINE
Knight Ridder Newspapers
Angell Villani,
Wilson Holsinger and Dan Easton don’t seem like the perfect spokespeople
for dental implants.
After all, who would want to hear tales of how Villani had eight screws
drilled into her jawbone to hold her implants? Or how Holsinger, 78, had
to have bone mined from his lower jaw to support his seven implanted upper
teeth? Or about how Easton, 60, had to have his jawbone sawed down not
once but twice before he could have his implants put in? Not exactly stories
to inspire implant candidates to beat a path to their nearest dentist.
But the three are such big believers in implant dentistry that they told
Dr. Patrick Sweeney, an Eastpointe, Mich., periodontist who did their
implants, that they will gladly talk to anyone interested in the procedure.
“Sounds awful, doesn’t it?” asked Villani of St. Clair
Shores, Mich., who has eight single tooth implants. “But it’s
not. And I’d do it again in a heartbeat.”
Said Holsinger with a laugh: “If people hear that there will be drilling
into their jaw, they think that they’ll be doing flips out of the
dentist’s chair. There is discomfort, but it’s not bad.”
Easton avoided doing flips by being sedated during his two jawbone-reducing
procedures. “I’m real satisfied by how it turned out,”
the retired Detroit police officer said.
The three are part of the growing popularity — especially among older
Americans — of dental implants instead of dentures and bridgework.
In 1998, a survey by the American Academy of Periodontology found that
its members were averaging about four implants per month. By 2000, that
number had jumped to 22 a month.
From 1998 to 2001, the dental implant market grew between 15 percent and
16 percent and is expected to continue at the same growth rate each year
through 2005, research suggests.
“There’s been more widespread acceptance the last five years,”
said Dr. Carl Misch, a Birmingham, Mich., dentist and one of the leading
implant specialists in the United States. “Implants were always seen
as an option, but not as the best option. More and more dentists are telling
patients that implants are the best alternative.”
There’s also an expected increase in implant dentistry because aging
baby boomers are becoming candidates for dentures. Having seen their parents
and grandparents struggle with dentures, boomers — with more disposable
income and a desire for better-looking and better-functioning teeth —
will opt for implants, implant specialists believe.
“Dentures slip and people didn’t eat sufficiently,” said
Sweeney, 47. “They didn’t eat out. Dentures are all aesthetics
and no function.”
Sweeney says implants “provide the biggest improvement in a person’s
life.”
With dentures, patients lose bone mass, which leads to their face changing
shape over time.
“Implants are used to maintain bone,” said Misch, 54. “It
can’t be maintained any other way.”
Traditionally, dentistry most often replaced a single tooth with a fixed
bridge. This is done by grinding down adjacent teeth, capping them and
joining them together with an artificial tooth. The cost for the procedure
is about $2,000.
“With a bridge, the adjacent teeth can be lost within 15 years,”
Misch said. “With an implant, adjacent teeth don’t decay and
no root canal is needed.”
For a single tooth implant, the failing tooth is removed. If there is
no bone loss, a screw with a post is placed in the jaw and covered for
six to eight months while the bone grows around it. The post is then uncovered,
and an artificial tooth — usually made by the patient’s dentist
— is cemented on.
The cost is about $3,000 to $5,000. If there is bone loss and a graft
is needed, the cost increases.
“If there is bone present, it’s a straightforward procedure,”
Sweeney said.
For a full set of teeth, the process is similar. Costs can start at $30,000
and go up from there. Villani spent $35,000 for her implants. Because
his implant procedure was more complicated, Easton spent $50,000.
Implants are not covered by insurance, while dentures — about $2,500-$3,000
for a full set — and bridges typically are paid for by insurance
companies.
“The major thing that holds implants back is that it isn’t covered
by insurance,” Misch says. “A lot of what doctors do is built
around what is covered by insurance. If it has coverage, that’s what
they do.”
Three-tooth bridges are a $10 billion-a-year business, while implants
pull in about $100 million annually, Misch says.
People from their early teens on up can be implant candidates. Misch has
done implants on patients in their teens and as old at 91. He says anyone
healthy enough to go through a tooth extraction is fine for an implant.
Misch says 30 million people in the United States only have teeth in one
jaw and 20 million people in the country don’t have any teeth.
“That’s why dental implants are not covered by insurance,”
he said. “So many people need it and can’t afford it.”
What also has slowed the growing implant business is that, up until only
recently, it was not even discussed in dental schools. Now all U.S. dental
schools give students an overview of implant dentistry and some clinical
experience.
“Every dental school must expose them to it,” Misch said. “Tell
them that it’s out there and is a good alternative.”
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