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- As a Periodontists, Dr. Ross
Atkinson is specially-trained to treat gum disease, the number
one cause of adult tooth loss in the country. Additionally,
Dr. Atkinson is highly-trained in the replacement of teeth
through Dental Implants. Most of those he treats for gum
disease have lost or are at risk of losing natural teeth.
Replacing them to protect the quality of the patient's life is
a major concern for Dr. Atkinson.
It seems that a lot of people wear
dentures or partials. How prevalent is tooth loss in this
country?
Dr. Atkinson: Probably more than you realize. Ten percent of
the adult population in the United States are missing all of
their teeth. That alone accounts for 18 million people. Sadly,
a whopping 63 percent of adults are missing more than one
tooth. For those over the age of 65, this jumps to 98
percent.
From what you see on a day-to-day
basis, what do those who wear dentures need to know.
Dr. Atkinson: A far greater issue arises when tooth loss
occurs. It is the beginning of bone loss. The denture is like
an oral wig. It plumps up the face to fool the eye but does
nothing to maintain bone.
How would a denture contribute to
bone loss?
Dr. Atkinson: Once natural tooth roots are no longer present
in the bone, the bone begins to shrink. The pressure on the
gums over the bone from wearing a denture actually accelerates
bone loss. Eighty percent of denture wearers wear their
dentures day and night. Bone loss occurs more rapidly due to
this pressure.
How is bone loss detrimental?
Dr. Atkinson: Let's begin by looking at someone who has
recently lost their teeth and is now fully edentulous (without
teeth). One year after the extraction of teeth has occurred, a
denture wearer experiences a 25 percent bone loss. Three years
later, 60 percent of your bone is gone. The biting force with
teeth is 250 pounds. The denture wearer bites with 5 to 6
pounds.
Is biting strength the only problem?
Dr. Atkinson: Absolutely not. As the bone shrinks, facial
muscles detach and "jowls" start to form. The
thinning jaw bone also creates a "witches chin" and
deep wrinkling around the mouth. When the denture is in place,
it fills out the face somewhat but does nothing to maintain
bone. A person wearing dentures should look in the mirror
without their dentures for a realistic picture of what is
occurring under the skin.
Is bone loss the reason dentures
become loose when they once fit securely?
Dr. Atkinson: Precisely! On the average, when dentures are
first placed, the fit will last about ten years. However, once
bone loss begins, it continues so that the fit lasts at a
less-frequent interval each time.
If biting strength is effected,
doesn't that effect one's diet?
Dr. Atkinson: Definitely. It is a fact that people without
teeth die at an age that is ten years younger than those with
teeth. Typically, denture wearers take more drugs, have a poor
immune system, and have more gastrointestinal problems.
Are there other health repercussions
that denture wearers encounter?
Dr. Atkinson: You may be surprised to learn that denture
lawsuits are the number one reason for dental litigation in
this country. The denture wearer has many problems to face.
The psychological repercussions are equally as harmful. There
is a dramatic decrease in one's self-esteem, self-confidence,
and peace of mind when dentures take the place of natural
teeth. Denture wearers tend to unplug from society, don't look
at people in the face, smile and laugh less, don't leave home
often, wear no make-up, and eat out rarely.
It sounds devastating, but I know
happy denture wearers.
Dr. Atkinson: They seem that way because they are copying
people. Television ads for denture adhesives make
denture-wearing appear pleasant. Last year, the sales of
denture adhesives topped $148 million in the United States
alone. The manufacturers of these products are smiling, but
denture adhesives are
not being purchased by happy people. They are being purchased
by people trying to keep their denture in place so they can
speak without embarrassing slips and chew foods they enjoy.
Adhesives help, but merely lessen the degree of movement, not
eliminate it.
Let's talk about Dental Implants for
a few minutes. Aren't these fairly new to dentistry?
Dr. Atkinson: The oldest dental procedure is the removal of
teeth. The next oldest is Dental Implants. A 1,400 year-old
skull was recently discovered that had a single iron Dental
Implant embedded in the jaw! There have been continuous
strides for decades in dental implant technology.
How do Dental Implants prevent bone
loss when dentures contribute to it?
Dr. Atkinson: Bone loss occurs without the presence of tooth
roots. When the tooth root is replaced, the process is halted
and the strength of the bite is restored. When your jaw bone
serves as a foundation for teeth, rather than a denture that
balances on top of your gum, the function of natural teeth is
restored.
How successful are Dental Implants?
Dr. Atkinson: Better than a hip, knee, or any other implant
attached to the bone. The survival rate for implants of 7 to
10 years is 96%, but an implant placed properly can last a
lifetime. Actually, implants outlast crowns and natural teeth
by many years, on the average.
When implants are placed in the bone,
is the procedure painful?
Dr. Atkinson: Not according to our patients. Whenever any
surgery requires skin to be opened and then closed, there is
discomfort. We sedate our patients during the placement
process so they experience no discomfort. Post-surgical
tenderness is often handled with over-the-counter medications
although we
make prescription strength available to our patients. Most
claim they don't need them, however.
What happens after the implants are
placed?
Dr. Atkinson: Many of our patients are referred to us by their
general dentist, whether for implants or gum disease. For
dentists who refer implant patients, many are skilled at
affixing the teeth to them. We do the placement of the
implants and refer the patient back once the implant has been
secured by the bone which usually takes several months. This
integration process is similar to a rope tied around the
branch of a tree. Eventually, the tree grows around the rope.
This also occurs with implants placed in bone, although at a
much more rapid rate. A number of our implant patients come to
us on their own or from the recommendation of another patient
we've treated.
How much are implants?
Dr. Atkinson: Dental Implants are not sold by the handful. The
cost depends on the amount of remaining bone, since the more
bone that is present, the fewer implants that are required.
You see, an implant is not necessary for each missing tooth.
We often attach a bridge of several teeth, or can even attach
a full arch appliance to several implants that have been
strategically placed.
But these are definitely more
expensive than dentures, or even crowns, aren't they?
Dr. Atkinson: Yes and no. Let's consider the average life of a
Dental Implant versus a crown, for instance. If a $425 crown
is placed on a 22-year-old, by the time they reach age 75, he
or she has spent $12,000 in subsequent repair costs. This
includes repair of decay, periodontal bone loss, crown
replacement, and root canal work. Yet, a Dental Implant
experiences no decay, requires no root canals, and causes no
toothache. A well-placed implant that receives good care can
last a lifetime.
Yet, isn't the cost steep in most
cases?
Dr. Atkinson: It is often a great expense. Some cases cost as
much as a new car. Yet, I've never had a patient who felt the
cost of their Dental Implants was greater than the benefits
they received as a result. We are very much aware of the
financial commitment of this procedure for most. Quite
frankly, most of our patients are and always have been on a
fairly limited budget. What happens with most, however, is
they realize that they want a better quality of life more than
anything material. And, too, their life with dentures will
never improve. It will only get more frustrating.
What would you say to someone who is
considering Dental Implants?
Dr. Atkinson: Two things. First, look into the procedure as
soon as possible. As I stated before, the more bone you have,
the less implants that will be required. Then, select the
doctor who places your implants very carefully. There are many
intricate factors that must be taken into consideration when
diagnosing the type of implant best suited for an individual's
need. Because there are many types of
implants, your doctor should have extensive training in all
types to provide a successful result.
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