Dental Implants:THE FIVE QUESTIONSYou Must Ask Your Dental ProfessionalBy Dr. Helaine Smith and Dr. John L. Favaloro
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Table of Contents        Creative Commons...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Creative Commons License        Official ...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Introduction        As the “new” thing in...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Why You May Need a Dental Implant        ...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        If you smoke or have gum disease, your de...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        The Dental Implant Procedure Explained   ...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Placing the implant itself is fairly stra...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional         Why General Dentists aren’t Dental Impla...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Periodontists are now the recognized dent...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Any dentist can take a continuing educati...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional         The Five Questions You Must Ask Before G...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Question #1: Am I a dental implant candid...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Question #2: What is your training?      ...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Question #3: How many dental implant proc...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Question #4: Where will the CT scan be pe...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Question #5: Do you have pictures of prev...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Save $200 on Your Dental Implant Procedur...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        About Dr. Helaine Smith        Since grad...
DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional        Subscribe to Dr. Smith’s E-Newsletter    ...
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Dental Implants:

  1. 1. Dental Implants:THE FIVE QUESTIONSYou Must Ask Your Dental ProfessionalBy Dr. Helaine Smith and Dr. John L. Favaloro
  2. 2. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Table of Contents Creative Commons License 2 Introduction 3 Why You May Need a Dental Implant 4 The Dental Implant Procedure Explained 6 Why General Dentists aren’t Dental Implant Experts 8 The Five Questions You Must Ask Before Getting a Dental Implant 11 Question #1: Am I a dental implant candidate? 12 Question #2: What is your training? 13 Question #3: How many dental implant procedures have you performed? 14 Question #4: Where will the CT scan be performed? 15 Question #5: Do you have pictures of previous cases? 16 Save $200 on Your Dental Implant Procedure 17 About Dr. Helaine Smith and Dr. John L. Favaloro 18 Subscribe to Dr. Smith’s E-Newsletter 19© Dr. Helaine Smith All Rights Reserved. 1www.helainesmithdmd.com | 617.327.1350
  3. 3. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Creative Commons License Official disclosure: Although this e-book discusses medical and oral health conditions, in no way does it take the place of advice and care from your dental or medical professional. This work is licensed under the Creative Commons Attribution-No Derivative Works 3.0 United States License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nd/3.0/us/ or send a letter to Creative Commons, 171 Second Street, Suite 300, San Francisco, California, 94105, USA. You may post this e-book on your blog or email it to whomever you believe would benefit from reading it. Thank you!© Dr. Helaine Smith All Rights Reserved. 2www.helainesmithdmd.com | 617.327.1350
  4. 4. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Introduction As the “new” thing in dentistry, dental implants have received considerable press of late. And it’s no wonder. With implants, dentists can replace patients’ missing teeth with strong, stable devices that look and feel just like real teeth. As with any medical procedure, however, consumers really need to do their homework before agreeing to have a dentist perform a dental implant – otherwise, complications can result that can jeopardize your health. In an effort to educate you, we’ve developed this e-book about dental implants and what you need to know before you let anyone work on your mouth. We hope you find it helpful. Helaine Smith, DMD John Favaloro, DDS Board Certified Periodontist April 2010© Dr. Helaine Smith All Rights Reserved. 3www.helainesmithdmd.com | 617.327.1350
  5. 5. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Why You May Need a Dental Implant In simple terms, a dental implant is simply a hollow titanium pin that is surgically placed into your jaw. An “abutment” or piece of metal is screwed into the pin once healing is complete. Your dentist then places the “tooth” or crown on this abutment — giving you a very natural looking tooth. Dentists often use implants instead of bridges because implants last longer and are much stronger – in fact, they look and feel just like a real tooth. According to the Consumer Dentistry Website, studies have shown a five-year success rate of 95% for lower jaw implants and 90% for upper jaw implants. (The lower success rate is because the upper jaw, especially the posterior section, is less dense than the lower jaw, making successful implantation potentially more difficult to achieve.) Typically, your dentist will suggest the implant procedure if you’re missing a tooth or teeth (yes, you can have multiple implants placed into your mouth). Dentists can also use standard-sized implants or mini-dental implants to support dentures – often referred to as “implant-supported dentures.” Basic implants cost anywhere from $1,250 to $3,000 each, according to DentalResources.com, but the total cost can escalate to $15,000 to $30,000 depending on location, complexity and the need for bone or gum restoration work. Many dentists provide financing because most insurance providers don’t cover implants (although they should, as a missing tooth or teeth can adversely affect your health, but that’s another topic). Nobel Biocare Implants and Abutment © Nobel Biocare© Dr. Helaine Smith All Rights Reserved. 4www.helainesmithdmd.com | 617.327.1350
  6. 6. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional If you smoke or have gum disease, your dentist may advise you to either stop smoking or undergo treatment for periodontal disease before performing the implant procedure. Although dental implants aren’t susceptible to tooth decay, the gum tissue around the implant can become infected due to poor oral hygiene. Hence, it’s very important that you brush and floss your implant or implants – just as you would your natural teeth. It’s also important that you have regular cleanings to protect your investment. Reasons Dental Implants Fail • Lack of osseointegration – the process where the bone grows around the implant. • The implant was poorly placed or should not have been placed at all. • Infection due to smoking or poor oral hygiene. • The abutment comes loose, causing the tooth to break or fall out. • Undiagnosed or underlying medical problems.© Dr. Helaine Smith All Rights Reserved. 5www.helainesmithdmd.com | 617.327.1350
  7. 7. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional The Dental Implant Procedure Explained The first step in getting your implant is to determine that you are in fact a candidate for the procedure. If, for example, you’ve been missing a tooth or teeth for years, the bone beneath the gum tissue may have receded too much, making it difficult to properly place an implant. To rectify this, advanced procedures may be required, including bone grafting. Most general dentists can perform basic bone grafting procedures, but as with anything, you’ll want to ask how often your dentist performs this type of procedure, how often his/her skills are updated through continuing education, etc. Bone grafting will also add considerably to the cost. Next, your dentist will do a CT (Computerized Tomography) scan of the head and jaw in order to determine proper placement of the implant. Because CT scanning instruments are quite expensive, many solo practitioners don’t do scans in office. Instead, you’ll be referred out. (At our Boston office, for example we use XPresscan, a company located right in our neighborhood.) From this scan, the dentist can locate nerves and arteries; determine the shape and size of the jaw and position of existing teeth; note any potential issues or challenges; and plan for the exact placement of your implants. What is a General Dentist? • Holds degree from accredited dental school. • Must pass written examinations to receive license. • Trained to advise and treat issues relating to the mouth and teeth. • Licensed to write prescriptions.© Dr. Helaine Smith All Rights Reserved. 6www.helainesmithdmd.com | 617.327.1350
  8. 8. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Placing the implant itself is fairly straight-forward once specific pre-planning is complete. The dentist places a hollow titanium post into the jaw bone. After the post is placed, a healing cap is placed into the top of the post to protect the inner threads while the gum tissue heals and the bone begins to adhere to the implant. This healing process can take 2 to 6 months. Once the healing process is complete, the dentist then removes the protective cover and places the abutment (an extension) into the implant and tightens it using a special torque wrench. This process actually requires real skill to know how much torque to apply to ensure the abutment is screwed into the implant so that it doesn’t come loose. The first time Dr. Smith saw Dr. Favaloro place an abutment, she was surprised to learn that placing an abutment is technique sensitive in order to keep the abutment tight and in place for years. This is where a periodontist’s specialized training really comes into play (more on this in the few pages). Once your abutment is placed, your dentist then makes the new crown which covers the abutment. The beauty of a dental implant is that it doesn’t shift over time (the way a crown and bridge will) because it’s placed directly into your bone. (The crown that covers the abutment may need to replaced in about 10 - 20 years, depending on wear.) For implant-supported dentures, the dentist places either standard-sized implants or “mini” implants into the bone and the dentures are then “snapped” onto them. Implant-supported dentures give you the support and confidence you’ve always wanted as they don’t move around like ordinary dentures. Even better, implant-supported dentures eliminate the need for goopy dental creams and adhesives.© Dr. Helaine Smith All Rights Reserved. 7www.helainesmithdmd.com | 617.327.1350
  9. 9. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Why General Dentists aren’t Dental Implant Experts Although the implant procedure itself sounds relatively straightforward, here is the scary secret most consumers do not know: General dentists do not receive much training in dental school on how to perform the implant procedure – nor do they receive surgical training! Although Dr. Smith has advanced cosmetic training, she does not perform dental implant surgery nor would she even consider having another general dentist place an implant in her mouth. Because general dentists lack surgical training, having one perform your dental implant surgery is akin to having your family doctor replace your knee! Ouch! Because placing a dental implant does require oral surgery, anything can go wrong, including: • Hitting (or severing) cranial-facial nerves. • Drilling into the sinus cavity. • Severing the mandibular artery, which can cause death. • Life-threatening infection.© Dr. Helaine Smith All Rights Reserved. 8www.helainesmithdmd.com | 617.327.1350
  10. 10. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Periodontists are now the recognized dental implant experts Periodontists receive an additional three years of training – which includes one full year of dental implant training – on top of their general dentistry training. Peridontists are trained to conserve gum tissue and bone and can also perform all types of reconstructive surgeries such as sinus lifts and bone grafting. They know the facial and cranial bone structure inside and out and know how to consider the entire structure of the cranium and jaw when placing an implant. These considerations include: surrounding teeth and roots, nerves, the sinus, shape of the jaw, and blood vessels. In short, placing a dental implant is a very complex procedure — which is one reason Dr. Smith relies on Dr. Favaloro, her board-certified in-house periodontist. A “board certified” periodonist is one who passed a rigorous examination. Not all periodontists are board-certified. What is a Periodontist? • Three extra years of specialized training. • One full year of dental implant training. • Trained to conserve gum tissue and bone. • Performs all types of reconstructive surgeries.© Dr. Helaine Smith All Rights Reserved. 9www.helainesmithdmd.com | 617.327.1350
  11. 11. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Any dentist can take a continuing education course but . . . General dentists, oral surgeons, and endodontists can all take continuing education courses in order to learn how to do implants. The quality of these courses varies, however. You can take months of coursework from the Las Vegas Institute of Advanced Cosmetic Training, which is the gold standard as far as advanced dental training goes. Or, dentists can take what we refer to as “mill” courses — those two-day weekend courses that allow a dentist to then hang a “certificate” on the wall announcing he/she is now a Implant-supported dentures "snap" into place “dental implant expert.” and are much more secure than traditional dentures. So, how do you tell the qualified implant specialist from the bad and the ugly? If you’re considering a dental implant, you really need to do your homework and ask the questions we’ve outlined in this book. If your dentist refuses to answer or gives you vague answers, leave the office – fast! What is an Oral Surgeon? • Performs oral and facial surgery, including biopsies and implants. • Extracts teeth, including wisdom teeth. • Has four years of hospital-based training versus “chair-side” training.© Dr. Helaine Smith All Rights Reserved. 10www.helainesmithdmd.com | 617.327.1350
  12. 12. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional The Five Questions You Must Ask Before Getting a Dental Implant It can seem somewhat intimidating to ask any medial or health professional questions about his/her qualifications and training. You don’t want to insult the person by asking questions, and you do want to trust the person who will be performing a procedure on you – whether it’s teeth whitening or complex surgery! So it can be easy to forego your due diligence – it removes any discomfort you feel. Unfortunately, unethical health professionals do exist, as seen by the stories you see in the media about people dying from “simple” procedures such as liposuction. To paraphrase Bill O’Reilly, no one is looking out for you – so it’s very important that you ask your dentist the following questions before agreeing to a dental implant procedure. Any dentist worth his or her salt will be glad you asked these questions – and will take all the time you need to answer them.© Dr. Helaine Smith All Rights Reserved. 11www.helainesmithdmd.com | 617.327.1350
  13. 13. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Question #1: Am I a dental implant candidate? If your dentist recommends that you receive an implant (versus a bridge and crown), ask him or her to explain how he or she arrived at the diagnosis. Your dentist should be able to explain in plain English why an implant is being recommended as well as how the procedure will take place. Don’t be afraid to ask to see your X-rays and other supporting pictures / information. If you’re seeing a periodontist, he or she will look at your entire facial structure, the health of your teeth and gums, and the surrounding gum tissue and bone in order to discern if you’re a candidate for dental implants. WARNING Not everyone is a candidate for dental implants, especially if the jaw bone has receded or if you have other medical issues. If you’re scheduled for open heart surgery, for example, Dr. Favaloro or Dr. Helaine Smith would advise you to hold off on your implant surgery until after you receive the “okay” from your physician as the medications you take pre-heart surgery can cause serious complications during your implant surgery. It’s also wise to tell your periodontist or dentist if you’re planning to have open-heart surgery (or any surgery!) or about any pre-existing medical condition, such as diabetes. For this patient, implants were placed in order to secure dentures.© Dr. Helaine Smith All Rights Reserved. 12www.helainesmithdmd.com | 617.327.1350
  14. 14. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Question #2: What is your training? Now that you know general dentists don’t receive implant training in dental school, it’s imperative that you ask your dentist point blank where he or she learned how to do dental implants. Other questions to ask include: • When did you receive your training? How often to you update it? • How many course hours do you have with regard to dental implants? • May I see your course certificate? • Are you certified with the Academy of General Dentistry or the American Academy of Cosmetic Dentistry? If the dentist took a weekend continuing education course, you can research this course online to see whether it’s accredited. For example, the Misch International Implant Institute, which is an independent teaching institute similar to the Las Vegas Institute for Advanced Dental Training, offers exceptional ongoing training for dentists. WARNING Be very wary of the dentist who brushes off your training question. Surgery is serious stuff. You don’t want someone who doesn’t know what he/she is doing drilling around in your jaw bone — trust us.© Dr. Helaine Smith All Rights Reserved. 13www.helainesmithdmd.com | 617.327.1350
  15. 15. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Question #3: How many dental implant procedures have you performed? A dentist can tell you he or she is “certified” to perform implant procedures but what if he or she took a weekend course 18 months ago and hasn’t performed one implant since then? Scary! WARNING You simply *cannot* assume that a framed diploma or certificate hanging on the wall equals a competent health professional. Hence, it pays to ask *any* dental professional (periodontists included) the following questions: • How many dental implant procedures have you performed? • When was the last time you did an implant case? • What were the outcomes for the last three implant cases you did? • Are you taking additional coursework in implantology? Where are you taking it and why? • If a patient has an adverse reaction or complication, what is your procedure for dealing with this? • Are you available after-hours if I have questions or concerns?© Dr. Helaine Smith All Rights Reserved. 14www.helainesmithdmd.com | 617.327.1350
  16. 16. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Question #4: Where will the CT scan be performed? Comprehensive dental imaging, including CT scans and X-rays, is a key part of preparing for implant procedures. As a dental implant candidate, your dentist will either schedule your CT scan at a local hospital or other imaging facility or will perform it in-house. WARNING If your dentist tells you he/she doesn’t need a CT scan in order to perform the surgery, be sure to ask why, then call another dentist for a second opinion! CT scans portray highly accurate images of your jaw alignment and facial structure – including the sinuses and nerves – enabling the dental professional to create precision dental implants tailored to each individual.© Dr. Helaine Smith All Rights Reserved. 15www.helainesmithdmd.com | 617.327.1350
  17. 17. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Question #5: Do you have pictures of previous cases? In addition to asking your dentist about the dental implant cases he or she has performed, ask to see photographs – and not just photos of a person’s mouth, but the photos of the actual person. (In Dr. Smith’s lobby, for example, she has a photo album which displays the “before and after” photos of her cases, and in addition to the close-up photos of the mouth and teeth, she also has photographs of patients – often with them standing next to her. Dr. Smith’s patients comment that it’s this photo album that often “sells” them on having their treatment done at her office.) You can also do a bit of detective work on your own: do a search for the dentist online and see if he/she has any negative reviews as well as calling the Better Business Bureau. Before: Photo of patient with dental implant. After: The crown, which looks just like a Look carefully -- youll see the implant cover. natural tooth, has been placed over the implant abutment. WARNING Don’t rely solely on the information you find on review sites. Review sites such as Yelp can give you lots of great information about a dentist, but it’s also pretty easy to pay people to write positive reviews. Likewise, one disgruntled patient can wreck havoc with a dentist who is otherwise exceptional. The bottom line with choosing the right dental professional to perform your implant procedure is this: if you feel uncomfortable in any way, get a second opinion. Ensuring that you feel safe and confident with any medical professional is your right . . . and your responsibility.© Dr. Helaine Smith All Rights Reserved. 16www.helainesmithdmd.com | 617.327.1350
  18. 18. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Save $200 on Your Dental Implant Procedure Take the first step toward a beautiful new you – call Dr. Smith’s office today at 617-327-1350 to schedule your free consultation. If you’re a candidate for dental implants and decide to have Dr. Smith and Dr. Favaloro perform your procedure, we’ll reduce the cost of your procedure by $200. The Dr. Smith / Dr. Favaloro advantage: • Board-certified periodontist in-house – You won’t have to travel to another specialist for your surgery then back to your dentist for the crown. • Immediate answers – If either Dr. Smith or Dr. Favaloro has a question for the other, it’s answered immediately, saving you time by eliminating the need for referring out. • Impeccable cosmetic work – In addition to ensuring the crown for your implant is indistinguishable from your natural teeth, Dr. Smith can also help restore surrounding teeth that may have gaps or be discolored, broken, or chipped. You’ll walk away with a gorgeous new smile and increased confidence. • Pain-free dentistry – Both Dr. Smith and Dr. Favaloro are trained and certified in advanced sedation dentistry procedures, ensuring you feel no pain during your dental implant procedure.© Dr. Helaine Smith All Rights Reserved. 17www.helainesmithdmd.com | 617.327.1350
  19. 19. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional About Dr. Helaine Smith Since graduating from dental school in 1991, Dr. Helaine Smith has been driven to provide the very best in dental care and advanced cosmetic dentistry procedures. Not satisfied with providing general dentistry, Dr. Smith sought advanced dental training at the Las Vegas Institute for Advanced Dental Studies. She is now one of two percent of dentists in the United States who provides full mouth reconstruction. In addition, Dr. Smith is a Fellow in the Academy of General Dentistry – an award granted to dentists who have more than 500 practice hours and have passed a comprehensive 400-question examination. To book Dr. Smith to speak about dental marketing or cosmetic dentistry, please contact her at www.helainesmithdmd.com. You can also check out her blog at www.helainesmithdmd.com/blog. About Dr. John L. Favaloro A Board Certified Diplomate of the American Academy of Periodontology and a Fellow of the Academy of General Dentistry, Dr. Favaloro combines expertise in periodontics, implants and oral medicine. Dr. Favaloro holds certifications in implantology from Noble Biocare, 3i Implant Innovations, CoreVent (Dentsply,) INI, and Interpore IMZ and is licensed to practice in Massachusetts, Florida, and California. After obtaining his DDS from Georgetown University, Dr. Favaloro continued his training in the U.S. Navy and at Boston University’s School of Dentistry where he specialized in periodontics and dental implants.© Dr. Helaine Smith All Rights Reserved. 18www.helainesmithdmd.com | 617.327.1350
  20. 20. DENTAL IMPLANTS: The Five Questions You Must Ask Your Dental Proffesional Subscribe to Dr. Smith’s E-Newsletter If you enjoyed this e-book, then you’ll enjoy Dr. Smith’s bi-monthly e-newsletter, “Successful Smiles.” Based on her real-life experience drawn from working with hundreds of Boston cosmetic dentistry patients over the last twelve years, "Successful Smiles" is a cosmetic dentistry newsletter featuring lively articles about the transforming power of cosmetic dentistry and great dental care. Subscribe today at: www.helainesmithdmd.com/e-newsletter/© Dr. Helaine Smith All Rights Reserved. 19www.helainesmithdmd.com | 617.327.1350

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