Something to chew on – Dental implants may not be for everyone

The impact of missing teeth extends far beyond mere aesthetics, as it profoundly affects an individual’s confidence, functionality, and, subsequently, their overall quality of life.

Beyond the physical aspects, the psychological toll of having gaps in one’s smile can be considerable. For quite some time, dental implants have been favoured as an optimal treatment solution for tooth replacement.

According to several studies published in the Journal of Prosthetic Dentistry, the success rate of dental implants for five to 10 years ranges approximately from 90 to 95 per cent. This preference for dental implants stems from their unique advantage over dental bridges, wherein adjacent teeth need not be sacrificed to support the missing tooth. While alternative options like dentures exist, they necessitate removal during sleep and possibly during activities like contact sports. This could significantly impede daily life and potentially diminish the overall quality of life for patients.

Dental implants are prosthetic tooth roots made of biocompatible materials such as titanium, that are surgically placed into the jawbone. With advancements in technology and techniques, dental implants have become a preferred choice for individuals seeking durable and natural-looking tooth replacements. However, the suitability of dental implants for each patient is multifactorial and requires careful evaluation by dental professionals. While the benefits of dental implants are numerous, including enhanced chewing ability, improved speech, and preservation of jawbone structure, their success relies heavily on various factors related to the patient’s oral health and overall wellbeing.

Patient’s general health plays a pivotal role in the success of dental implant therapy. Conditions such as uncontrolled diabetes, autoimmune disorders, and cardiovascular diseases can compromise the body’s ability to heal and integrate implants. Studies have shown that implants in diabetic patients showed a 77.7 per cent higher risk of failure than in non-diabetic patients. Therefore, a comprehensive medical history review and consultation with the patient’s medical practitioner and dental clinician are essential to identify any underlying health issues that may impact the treatment process.

Dental implants are well-known for their hefty price, with government specialist dental clinics offering implants with a price range of RM5,000 to RM7,000. In private settings, the cost is typically higher, varying between RM7,000 and RM10,000. Factors influencing the cost include treatment complexity, implant type, the necessity of bone grafting for implant support, and other considerations.

An important consideration in determining the suitability of dental implants is the patient’s bone density and volume which is crucial for the successful placement and stability of implants. Patients who have experienced bone loss due to periodontal disease, trauma, or prolonged periods without teeth may require bone grafting procedures to increase the bone volume before implant placement. Advanced imaging techniques such as cone beam computed tomography (CBCT) allow dentists to assess bone quality and quantity accurately, aiding in treatment planning and ensuring optimal treatment outcomes.

Osseointegration is a process where the implants and bone get integrated to provide a solid foundation for the survival of the prosthesis. This process typically takes about three to six months, and patients who do not have favourable bone quality may require a minimum of two surgical procedures. After implant placement, there will also be follow-up visits to review the implant condition, followed by the placement of a crown or bridge that is connected to the implant. Therefore, an implant may not be an ideal choice of treatment for patients who seek an immediate replacement of their missing teeth. Periodic visits for maintenance purposes are also mandated to ensure the long-term survival of the dental implant.

Additionally, factors such as oral hygiene habits, smoking status, and compliance with postoperative care instructions influence the long-term success of dental implants. Patients must maintain good oral hygiene practices and attend regular dental check-ups to prevent peri-implant diseases such as peri-implantitis, which can lead to implant failure if left untreated.

In conclusion, while dental implants offer an enticing solution for tooth replacement, their suitability for each individual hinges upon a multitude of factors. From the patient’s overall health and bone density to lifestyle habits and financial considerations, a comprehensive evaluation by dental professionals is essential. While dental implants boast impressive success rates and numerous benefits, including improved functionality and aesthetics, they may not be feasible or advisable for everyone.

It’s imperative to weigh all aspects carefully and work closely with your dental team to determine the most suitable treatment option tailored to your unique circumstances. Ultimately, the quest for optimal oral health and wellbeing requires a thoughtful and informed approach, ensuring that the chosen path aligns seamlessly with your individual needs and goals.

Dr Anas Hakimee Ahmad Ubaidillah and Dr Sofya Zulkiffli are Restorative Specialists at the Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya.