What is the difference between different implant treatment plans?
When shopping around different dentists or even going overseas for dental implant treatment, there is a marked difference in treatment plans and prices. Treatment depends on patient needs, patient’s wants, dentists experience and expertise. I recently had a patient who asked for a dental implant treatment to replace some missing back teeth on the left side. When asked, the patient was functioning fine, except for a sensitive spot on the right side. They wanted to restore teeth on the left to unload the right side. Upon treatment of the sensitive spot, the patient no longer required implant treatment. The patient wanted the implant treatment. The treatment was appropriate to restore the left teeth that were missing. The treatment could be carried out easily, but the treatment wasn’t needed, and would not have stopped the pain from the right side. The cost of the treatment that was provided was 95% less than the implant treatment was going to cost. The left side can still be restored, but the initiating pain has now gone without the need for further intervention.
So when we see a patient to discuss implant treatment, I want to know as the treating dentist what the reason the patient is seeking the treatment. I want to know what happened to the natural teeth, and what caused them to fail. I want to inspect the other teeth for decay, periodontal disease, and for wear. I want to look at the colour of the teeth, and how well the new teeth can be matched. I want to look at the gum line, and what is commonly referred to as “Pink Aesthetics”.
I find that if the whole patient is not taken into consideration, the treatment may not be the best long term option. Treatment needs to able to adapt to the changing patient. We want the implant restoration to not only deliver an appropriate restoration now, but to be able to be used in the future depending on the patient’s future needs. Having one implant placed and crowned now in a 20 year old patient should be able to be used as a bridge abutment in 20 to 30 years’ time if other teeth are lost in the vicinity.
Classic problems faced when this is not taken into consideration are cases of implant placed cheaply overseas. The implants I have seen that were placed overseas have been placed in poor positions to be easily restored, and are way too small to handle the load. The consequence of this is that the implant will likely fail in a short number of years. When they do fail, they will not be easily restored with a new implant as the overloading will have destroyed the bone. Retreatment will then require grafting, and time delays which will make future treatment unpredictable.
As I am a dentist whose practice is located at Caboolture, I typically see patients from North Brisbane through to Noosa, and do have regular patients who come from Fiji, Vanuatu, Hervey Bay, and Mackay. These patients understand that we aren’t here to place implants, but rather, to work out the intricacy of a treatment plan to restore the dentition. Patients who have destroyed their dentition due to bruxing are going to need a more substancial support structure than patients who have lost teeth due to decay. Patients with Periodontal problems may need alternative treatments such as full clearance as the periodontal problems will compromise the long term success of implants. Being both the surgeon, and the restorative dentist, the implants are planned, placed, and restored to a plan to achieve the best outcome.
