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Alan L. Stott, DDS

Dental Implants

What is a dental implant?

A dental implant is a titanium cylinder surgically placed into the jawbone of the upper and lower ridges of the mouth. The bone will fuse to the implant in 4-6 months. On top of the implant are placed posts, crowns, attachments, and dentures to restore the mouth. The term “dental implant” can refer to just the cylinder that is placed into the jawbone or it can refer to the cylinder and the restorative parts (crowns or dentures) placed on top of the cylinder.

How much do dental implants cost? Why do they cost so much?

The cost for dental implants depends with how many implants are placed, what type of restorations are placed on the implants, and how complicated are the surgical and restorative phases of the implant work. Often the oral surgeon who places the dental implant into the jawbone must first place some bone graft to build up the ridge. For a single tooth implant, the cost may be $4500 to $5200 depending on if bone graft is placed or not. A dental implant bridge with all its parts may cost around $8000-9000. A denture attached to 2 implants may cost about $7000. A full arch implant bridge (top or bottom) may cost $30,000-60,000. Yes, they can get expensive. The cost is based on the need for bone grafting by the oral surgeon, the placement of the implants by the oral surgeon, the price of the parts and materials, the lab costs, the costs to place the posts, crowns, attachments, and dentures that go on the implants, and the time involved. Each patient has to consider the options such as leaving the space in the mouth, having a dental bridge, or having a full or partial denture.

Does my insurance cover dental implants?

It depends on each dental insurance plan. Some plans do not cover dental implants at all. Some cover 50% of the costs up to the annual maximum (which is often only $2000). Some plans will cover 70% of the cost up to the annual maximum.

How much time does it take to finish all the dental implant work?

This will depend on the complexity of the case. Let’s look at a one tooth dental implant. First, there needs to be adequate height and width of the jawbone at the site of the desired implant. If there is not enough bone in the area, the oral surgeon must add bone graft material. Also, when a tooth is extracted, and we want to place an implant, bone graft is often added to the extraction site. The bone graft may need 3-4 months of healing before the implant is placed. When the implant site is ready, the implant cylinder is placed in the jawbone. This stage of the process may take about 4-6 months for the bone to fuse to the implant. If we proceed too soon with the implant crown, the whole implant may fail. After the bone is fully fused to the implant cylinder, the post and crown are placed on top. This stage of the process may take only 2-3 weeks. So, the total time for a single tooth implant may be 8-9 months.

How long will dental implants last?

Dental implants can last many years. Most of the well-placed implants I see have been in the mouth 10 plus years. However, dental implants can also fail. Some implants fail to have the bone fuse to them and they are lost after a few months. Implants can break and get gum disease, leading to the loss of the implants.

What are the options when we have a missing tooth? What are the pros and cons of the options?

There are four options:

1) You can leave the space alone. The pros are this is the simplest and least expensive option (basically no additional cost after the extraction). The cons are it be harder to chew food, and the teeth on the sides and above the space may start drifting into the space.

2) You can have a bridge. The pros are that the making of a dental bridge will take about two weeks and it is about in the middle as far as price. The cons are you may have to grind on the adjacent teeth that may not really need dental crowns. If these teeth are in need of dental crowns, the dental bridge option is an easier one to make. Approximate cost: about $3000-$6000, depending on the number of teeth replaced.

3) You can have a partial denture made. The pros are that this is relatively inexpensive and is quick to make. The cons are that partial denture may feel bulky to the patient, may have metal clasps that show, and may trap food more than the bridge option. Approximate cost: about $1500-$2200.

4) You can place a dental implant. The pros are that the dentist does not have to grind on the adjacent teeth like with a dental bridge and it will not feel bulky like a partial denture. The cons are that it is the most expensive option per tooth and it may take about 8-9 months to complete due to the need for bone grafting, the need for the jaw bone to fuse to the implant, and the time needed to fabricate the final dental crown. Approximate cost for a single implant: about $4500-$5200.

When is a dental implant a good option for the patient?

A dental implant is a good option for the patient when we need to fill the space of a missing tooth, we have enough bone, we don’t want to grind on the teeth adjacent to the space to make a bridge, the patient does not want a partial denture, the patient is willing to wait the necessary time for the implant work, and the patient is willing to pay the price of a dental implant.

When is a dental implant not a good option for the patient?

A dental implant is not a good option for the patient if there is not enough bone width and height to place the implant cylinder in the jawbone, the options of a bridge or partial are preferred by the patient, the patient is unwilling to pay the cost of the implant, and the patient does not want to wait months for the work to be completed. Patients must brush and floss well and avoid smoking.

What are the pros and cons of dental implants? What are their advantages?

Dental implants can look and feel very natural when completed. The implant work does not require the grinding down of the adjacent teeth as we have to do with a dental bridge. The dental implants will not feel bulky like a partial denture. Dentures can be attached to dental implants for more support and retention. Dental implants will not move or pop out like a full denture can. The cons are that they will cost more than other dental procedures, they take several months to complete, they can fail, and they require a lot of maintenance and no smoking.

I see cheap implants offered online. How can they do them for so much less? Why not go with those?

When you see the offer, “Dental implants for $399”, you need to look at the details. We know what it costs to place the dental implant in the jawbone and restore the dental implant with the posts, crowns, attachments, and dentures. There is no way the total costs of a single dental implant, post, and crown can be $399. What they are not telling you is that this is the charge to only place the implant cylinder in the jawbone. Then they charge you a marked-up price for each of the parts used in the placement of the implant. For our implants, the price includes the cost of these parts. The $399 special does not include the cost of the post, crown, attachments, and dentures that go on top of the implant. In order to get the $399 special for the implant placement in the jawbone, you have to get the rest of the implant procedures done in their office, at very inflated prices. The other way you can get cheap implants is by having the surgical and restorative work done by foreign dentists using cheap implant parts and low quality dental labs.

Why not go to a foreign country and have a real inexpensive implant placed?

Dental Implant

Sure, there are some good implant dentists in foreign countries. But we have seen a lot of very poor dental implants made in these other countries. They often use lower quality parts that are hard to replace or fix if needed. If you have dental implant work done in a foreign country and need some repair work done to that implant, are you going to fly back to that country to have it done? They do not have quality control in those countries like we have in the U.S.

Are all dental implants the same?

There are about 50 manufacturers of dental implant parts. Most are of high quality. We like to stick with the companies that make high quality parts, have great success rates, and have good customer service. We can say it is similar to what we would look for when we are buying a new car.

What is the process of doing a dental implant from start to finish?

First, you need to have a full exam by the general dentist with a complete set of x-rays. In our office we will send you to our oral surgeon to take a cat-scan x-ray and see if you have enough height and width of bone for the implant placement. The oral surgeon may need to add bone graft to build up the ridge before implant placement. This may take 3-4 months to heal. Then the oral surgeon places the dental implant. It may take 4-6 months for the jawbone to fuse to the implant. The surgeon will then test the implant to see if it is stable. You will then go back to the general dentist. He will place a custom post on the dental implant cylinder that will stick out above the gum. On the post he will place the dental crown, which looks and feels like a natural tooth.  

Do I need to take time off work for my dental implant?

For the surgical placement of the dental implant, if you are having one to two implants placed, you may want to take 1-2 days off work. If you are having several implants placed and/or are being put to sleep, you may want to take 3-4 days off work. For the placement of the post and crown, you will only need to take time off work for your visit with us. There is usually no recovery time for this appointment.

Can I be put to sleep to have dental implants placed?

Consult with your oral surgeon. He can put you to sleep for any surgical work with dental implants.

I want to wait until my teeth are ready to fall out. Then I will get dental implants. What is wrong with this approach?

Even though dental implants are a good option to replace missing teeth, it is a lot better and less expensive to save your natural teeth. Natural teeth work a lot better than dental implants. If you take the approach of waiting until you lose all your teeth then go for dental implants, you may find that you have lost too much bone and you are now not a candidate for dental implants. You will also find that for full mouth implants, the costs will be very high. Your only other option may be full dentures.

Are dental implants as good as natural teeth?

Dental implants are never as good as natural, well maintained, healthy, natural teeth.

Can dental implants decay?

No. Dental implants cannot decay. One can say that is one advantage with a dental implant compared to a natural tooth. But, restoring and taking care of your natural teeth is so much easier and less costly than having all your teeth removed and dental implants placed.  

Can dental implants get gum disease?

Yes. Dental implants can get gum disease around them leading to their failure. You must brush and floss them properly in order for them to last a long time.

 Can dental implants fail? What is the success rate of dental implants?

Yes, dental implants can fail. The success rate for dental implants is about 95% for 5-10 years. However, this statistic can be misleading. If we look at a patient who has good healthy teeth and gums where there is no gum disease, a patient that brushes and flosses well and there is minimal amount of decay, a patient that gets his/her teeth fixed quickly when decay is found, the success rate is around 100% at 70 years. There are times when dental implants are placed, and the jawbone does not fuse to the implants. Then the implants have to be removed and new ones are placed. There are cases where dental implants do fine for several years and suddenly we see severe bone loss occur. Then the implants need to be removed and other dental treatment used. The best option always is to take good care of your natural teeth and make them last a lifetime.

Do I still have to brush and floss my dental implants like with my regular teeth?

Dental implants are a little harder to take care of compared to natural teeth. You need to use special brushing and flossing techniques to keep the gums healthy and avoid infections.

What if I don’t have enough bone for a dental implant?

To be placed dental implants require a certain height and width of jawbone. If there is not enough bone, bone grafts need to be placed. In some places of the mouth it is difficult to rebuild the jawbone such as in a severely resorbed lower jaw. See what the oral surgeon recommends.

Does smoking affect dental implants?

Smoking is terrible for dental implants. One of the main reasons the natural teeth are lost is due to the bad effects of smoking on the gums and jawbone. Smoking will increase the failure rate of dental implants by four times.

What are full arch dental implants?

Full arch dental implants are where the dentist places 4-8 implants in either the top or bottom arch or ridge, and attaches a large bridge or denture to this set of implants. This is called a fixed implant bridge if the bridge is screwed in place and the patient cannot remove it. It is called a removal implant denture when the patient can remove the appliance. The fixed implant bridge is much more expensive than the removal appliance.

What are single dental crown implants and dental bridge implants?

If one tooth is missing and the bone is good, we can place one dental implant into the bone and place a single post and crown on top of this. We do not have to attach crowns onto the adjacent teeth like we do with a dental bridge. A three-unit dental bridge is where there are three teeth missing and we place two implants on the sides next to the natural teeth and leave the middle space with no implant. An implant bridge is made by placing crowns on the two implant teeth and a false tooth (pontic) in between these two crowns. The bridge is cemented onto the implants.

What are implant supported dentures? Can dental implants help my denture problems?

An implant supported denture is where we attach a full denture to 2-6 implants. The implants provide retention, so the denture does not come loose.

Is it better to have a root canal done to try to save a tooth or have the tooth removed and a dental implant placed?

When there is no gum disease, the bone and tissue attachment to a natural tooth is excellent. It is very strong and long lasting. The bone and tissue attachment to a dental implant is good but is never as good as the attachment to a natural tooth. If a tooth with a good healthy attachment of tissue and bone needs root canal treatment, it is better to have the root canal treatment done rather than have the tooth extracted and an implant placed.  

Which dentists can place dental implants?

A general dentist or oral surgeon with the proper training can place dental implants. Some general dentists prefer to have the oral surgeon place the implants and the general dentists will make the crown or denture to attach to the implant.

If I need a tooth extracted and I would like a dental implant to replace it, what needs to be done first?

First, we have to decide what are the options to replace the missing tooth. You can either: leave the space open, place a dental bridge, place a partial denture, or have a dental implant made. It is best to start with the general dentist. He will review your options, take care of any other dental problems like decay and gum disease, get your mouth healthy, then refer you to the oral surgeon to place the implant. After the bone fuses to the implant, the patient will return to the general dentist for the crown placement.

What areas of the mouth are best and worst for dental implant placement?

Dental implants are more successful where there is thick dense bone like in the lower arch. Dental implants are less successful where there is thin bone like in the upper arch. Bone grafts may be needed where the jawbone is too narrow or not tall enough, or the sinus is too low, or there is not enough bone over the nerve in the lower jaw.

Can dentists who work on dental implants repair any type of implant?

No. A lot of general dentists have their favorite brand of dental implants. I usually stick with three brands of implants. That way I am very familiar with how their systems work and I can easily get the parts I need for repairs.

What are “All-On-4” dental implants?

All-On-4 refers to placing a fixed (not removable) implant bridge on 4 dental implants on the bottom. It is a nice option when a patient is missing all of his/her teeth, but it is very expensive. Not all general dentists make this type of dental implant appliance.

What are “Permament Teeth in a Day” dental implants?

This refers to taking out all the teeth in one arch, top or bottom, placing some dental implants, and attaching a dental bridge to these implants, all in the same day. This is a nice option but is very expensive. Also, there will be some questions about how well the bone will fuse to the dental implants with the “Permanent Teeth in a Day” technique. It requires 3-6 months for the jawbone to properly fuse to the implants. In order for the bone to properly fuse to the implants, the implants must not move. If the implants have movement too early, they will fail. That is why we do not attach the final crown, bridge, or denture to the implants for several months. With “Permanent Teeth in a Day”, the bridge is immediately attached to the implants, which may cause premature movement of the implants, leading to the loss of the implants.

I want to see if I am a good candidate for dental implants. Where do I start?

Give our office a call. We will review with you all the options to replacing missing teeth, not just the dental implant option. We will go over the pros and cons of each option and explain their costs. If you have a dental PPO plan, we can save you money since we are an in-network provider for most of the dental PPO plans. If you do not have dental insurance, we have an in-office plan to save you money. We look forward to meeting you.


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