Dental Implants - 5 Things You Should Know About Dental Implants
Summary
TLDRIn this dental-focused video, Dr. Richard Stevenson and his guest, Dr. Juan P. Anfrance, discuss critical factors for successful dental implant procedures. They highlight the importance of controlling health conditions like diabetes and quitting smoking, as these can affect implant success rates. The conversation emphasizes the quality of implant materials, the significance of proper planning and imaging, and the necessity of rigorous training for dentists. Additionally, they clarify that implants are not identical to natural teeth, requiring different care and maintenance. The discussion serves as an informative guide for patients considering dental implants.
Takeaways
- 🦷 Over 36 million Americans have no teeth and 120 million are missing at least one tooth, highlighting the significant need for dental implants.
- 📈 The implant industry has grown into a billion-dollar market in the United States, surpassing other dental industries.
- 🚫 Smoking and diabetes are the top risk factors affecting implant success rates, with uncontrolled diabetes and smoking impacting wound healing and blood flow.
- 💡 Patients with diabetes and smoking habits can improve their implant success rates by managing their conditions and quitting smoking.
- 🌟 Dental implant quality varies by manufacturer, with some using higher-grade titanium; it's crucial to inquire about the materials used.
- 💰 Be cautious of extremely low-cost implant offers, as they may compromise on quality and use additional fees to compensate.
- 📈 Proper diagnosis, planning, and imaging are essential for successful implant placement, and patients should expect multiple visits before implantation.
- 💼 It's important to ask about a dentist's training and experience in implantology, as not all training programs provide the same level of expertise.
- 🦴 Implants are not like natural teeth; they lack sensory feedback and require diligent cleaning and maintenance to ensure long-term success.
- 🧼 Oral hygiene is critical for implant longevity, and patients with a history of poor dental care should be prepared to commit to a strict cleaning regimen.
Q & A
What is the current state of the dental implant industry in the United States?
-The dental implant industry in the United States has grown to over a billion-dollar industry, surpassing all other industries in dentistry. It has dramatically increased since the 1990s when only about one percent of people were performing implants.
How many Americans are affected by tooth loss?
-36 million Americans have no teeth, and 120 million Americans are missing at least one tooth, which is approximately one-third of the population.
What are the biggest risk factors for dental implant success?
-Smoking and diabetes are the biggest risk factors for dental implant success. They can bring down the success rate significantly due to their effects on wound healing, bone metabolism, and blood flow around the implant area.
What advice would you give to patients who are diabetic or smokers to improve their implant success rates?
-For diabetic patients, it's crucial to manage and control their diabetes. For smokers, quitting smoking prior to surgery is encouraged. Both habits can negatively impact the success of dental implants.
Is there a difference in implant quality among manufacturers?
-Yes, implant quality can vary among manufacturers. Some use the highest grade of titanium, while others might use lower grades, which can lead to more problems and lower success rates.
What should patients consider when choosing a dental implant provider?
-Patients should consider the provider's use of high-quality materials, their training, and the technology they use for planning and placing implants. It's also important to ask about the success rates of the brand of implants used.
How important is the planning phase before dental implant placement?
-Proper diagnosis, planning, and imaging are essential for the best results in implant dentistry. This includes the use of technologies like CBCT for 3D imaging and guides to ensure accurate implant placement.
What is the significance of a dentist's training in implant dentistry?
-A dentist's training is significant as it ensures they have the knowledge and skills to diagnose, plan, and execute implant procedures effectively. Patients should feel comfortable asking about their dentist's training and qualifications.
Are dental implants the same as natural teeth?
-Dental implants are not the same as natural teeth. They lack the periodontal ligament that provides sensory feedback, making them more susceptible to damage from excessive biting forces without the patient's awareness.
What are the maintenance requirements for dental implants?
-Dental implants require special attention for cleaning and maintenance. Patients need to spend considerable time daily cleaning around the implants, which can be more challenging than maintaining natural teeth.
Outlines
🦷 Introduction to Dental Implants
Dr. Richard Stevenson introduces the topic of dental implants, highlighting the range of dental topics covered on the channel, from endodontics to oral surgery. He welcomes Dr. Juan P. Anfrance, an expert implantologist, to discuss the growing prevalence of dental implants in the United States. The conversation touches on the staggering statistics of tooth loss among Americans, the booming implant industry, and the shift towards more general dentists performing implant procedures. Dr. Anfrance shares his extensive training and experience in implantology, emphasizing the importance of patient education and informed decision-making in dental care.
🚭 Impact of Habits on Implant Success
The discussion delves into the factors affecting implant success rates, with a focus on the detrimental effects of smoking and diabetes. Dr. Anfrance explains how these habits can significantly lower the success rate of dental implants due to their impact on wound healing and bone health. The conversation suggests that patients with these risk factors can improve their chances of successful implant integration by managing their conditions and modifying their habits. The dialogue also addresses the emerging concern of vaping, which, despite being marketed as a healthier alternative to smoking, contains high concentrations of nicotine that can be harmful to dental implants.
🔍 The Importance of Planning and Technology in Implant Dentistry
Dr. Stevenson and Dr. Anfrance emphasize the critical role of proper diagnosis, planning, and the use of advanced technology in achieving successful implant outcomes. They discuss the importance of conducting thorough medical history reviews, utilizing 3D imaging like CBCT, and employing computer-aided planning to virtually simulate implant placement. The dialogue underscores the significance of these steps in minimizing complications and optimizing the positioning and integration of implants. The conversation also touches on the potential for geographic success, where implants may appear successful in the short term but lack long-term data on their durability and functionality.
👩⚕️ The Role of Dentist Training in Implant Success
The conversation shifts to the importance of a dentist's training in implant dentistry. Dr. Anfrance stresses the value of comprehensive, long-term training programs that go beyond short courses or quick overseas certifications. He highlights the need for dentists to understand the intricacies of implant planning, execution, and management of complications. The dialogue encourages patients to inquire about their dentist's training and qualifications, advocating for transparency and informed decision-making in dental care.
🦾 Implants vs. Natural Teeth: Understanding the Differences
Dr. Stevenson and Dr. Anfrance discuss the differences between dental implants and natural teeth, highlighting that implants do not possess the sensory feedback mechanisms found in natural teeth. They explain that implants lack the periodontal ligament, which provides natural teeth with shock absorption and feedback during biting and chewing. The conversation points out the potential for patients to exert excessive force on implants without realizing it, leading to complications. The dialogue also addresses the importance of proper oral hygiene and maintenance for the long-term success of dental implants, emphasizing that implants require diligent care to prevent issues such as peri-implantitis.
Mindmap
Keywords
💡Dental Implants
💡Implant Success Rate
💡Diabetes
💡Smoking
💡Vaping
💡Implant Materials
💡Treatment Planning
💡Cone Beam Computed Tomography (CBCT)
💡Training
💡Implant Maintenance
Highlights
36 million Americans have no teeth, and 120 million are missing at least one tooth.
The implant industry has grown to over a billion-dollar industry in the United States.
One third of all implants are placed by general dentists, a change from historical trends.
Implant success rates can drop significantly due to medical conditions like diabetes and habits like smoking.
Proper diabetes management and quitting smoking can improve implant success rates.
Vaping, with its high nicotine concentration, is not a safe alternative to smoking for implant patients.
Implant quality varies by manufacturer, with some using higher grades of titanium than others.
Patients should inquire about the materials and success rates of the implant brands their dentist uses.
Some dental operations may cut corners on materials to offer lower prices, affecting implant quality.
Proper diagnosis, planning, and imaging are essential for the best implant results.
Cone Beam Computed Tomography (CBCT) allows for 3D imaging and virtual surgery planning for implants.
Training is crucial; patients should ask about their dentist's training in implant dentistry.
Short courses may not provide adequate training for complex implant procedures.
Implants do not behave like natural teeth and lack the sensory feedback of a periodontal ligament.
Implant maintenance and hygiene are critical for long-term success, even more so than with natural teeth.
Implants require special cleaning methods and are not maintenance-free, contrary to some advertisements.
Transcripts
hi everybody i'm dr richard stevenson and welcome to five things you should know about x and x
is dental topics we have demo topics ranging from endodontics oral surgery implantology veneers etc
and our channel is here to help patients make better decisions when you go to your dentist
i'm really pleased to have our guest today who is dr juan p anfrance hi juan good to see you
bud how are you we are old friends he's uh my surgeon for all my implant cases here at the
teaching center in san dimas and he is an expert implantologist and before we get into the topic
about implantology let's talk a little bit about what's happening with implants the united states
well first of all you may not know this but 36 million americans have no teeth 36 million
it's unbelievable it's it's striking yeah and 120 million americans are missing at least one single
tooth 120 million americans that's approximately one-third of americans are missing one tooth
the implant industry has grown to over a billion dollar industry in this country just implants
itself that's just mind-boggling it's basically surpassed all other industries in in dentistry
and it doesn't continue to slow down i mean when it started in about you know in the early
1990s actually it started in the 1980s late 80s mid to late 80s but in about the 1990s
only about one percent of people were were even performing implants and now it's grown
dramatically and that number is is much much much higher another interesting thing about
implants and it's a confusing thing particularly for patients is one third of all implants are
placed by general dentists and that did not always used to be the case and i wanted to uh
kind of delve into a little bit about some of the decision-making that you're going to want to make
before you get to the dentist to get the right implant for the right reason and our guest today
is dr juan p and friends he uh is originally from spain he was trained in new york in implantology
he came to ucla he went through an extensive implant training program there for many years
and uh actually became a faculty member at ucla he's trained under some of the greatest
implantologists in the world and he is an expert surgeon and serves all of our patients here in our
san dimas teaching center and also i'm pleased to say that john and i have taught many courses
together at ucla and now here at our teaching center so is there something i missed about your
amazing credentials you did pretty good thank you nice uh well it's really good to have you here so
i'm gonna i'm gonna go ahead and challenge you a little bit with some some questions and and these
are things i think that every every patient should really know right and the first one is
uh implant success is variable implant success is variable and
smoking and diabetes are the biggest risk factors is does that statement ring true to you
correct yeah generally speaking we can say the dental implants are about 96 to 98 successful
that's in normal healthy patients but there are certain medical conditions and habits
that can certainly bring down that success rate to almost too close to 10 points below
the normal standards and diabetes and smoking are probably two of the biggest one
two of the biggest reasons why dental implants could have some problems
diabetes has an effect on wound healing and bone metabolism and bone healing and so patients
that suffer from uncontrolled diabetes diabetes especially can certainly have a lower success rate
these are patients that are perhaps more prone to developing infections around dental implants
and smoking is the other big one smoking affects dental implants by affecting the blood flow around
the area both in the soft tissue and in bone and so these are two things that we always worry
about when dealing with patients is diabetes and smoking these are two probably two of the biggest
issues that we see in dental implants today yeah i was i was thinking
is there anything a patient can do if they are diabetic and they are a smoker to better their
their their healing rates and their chances of success in the world definitely especially
in diabetes we want to make sure that the diabetes is well managed and under control
um unfortunately we see a lot of patients that are what we call borderline diabetes which means that
they they go up and down they're not very well controlled their sugar levels uh spike and these
are patients that are very high risk of developing infections and problems around dental implants
on the other hand smoking we always encourage our smoker smoking patients
to try and quit smoking prior to surgery and we've actually been quite successful with uh with that
in some patients you know patients are going to make a significant investment both in time and
money and so for some patients that is a good reason to quit smoking and we've successfully
been able to do that in some patients um that's really helpful so a patient with that has both
diabetes and smoking or either one of those can improve their implant success rates just simply by
changing some of their habits and maybe some of their medications or their their
their eating habits and things like that uh but what about vaping i mean isn't that okay
yeah that's that's that's a big uh that's that's a big question right now vaping is
is seem to be considered as the healthy way of smoking and in fact what vaping does is it it has
high concentrations of nicotine which is one of the components in tobacco that is harmful
for dental implants and so in these e-cigarettes the the nicotine concentration is is exponentially
higher than in a cigarette um and there's a a lot of other chemicals that we don't even
know really what the effects are yet uh on on dental implants we do know that there's a
lot of research happening around e-cigarettes and and vaping especially at ucla and so we're always
following very closely that research to see if there's any new developments in that nice well
it's really helpful information that the patient can actually do something for the team if you will
by improving their success rates right a lot a lot of patients believe that it's all about
the doctor's ability and it's all about i went to a good doctor they took care of it for me
well and you are a great doctor that is important patient factors are extremely
right but i mean it's kind of cool that the patient actually can take some positive steps to
improve their chances of success which is really awesome you know there are a lot of you know i'm
driving on the la freeways and and if you're not from l.a that means something to los angeles it
means you're going to be on the freeways a lot and one of the signs i see one of these billboards is
implants for some some dollar 3.99 right 3.99 um can you so my next question is and this is
a statement i want you to just tell me if this makes sense uh implant quality is not the same
and manufacturers have different standards make sure you ask for the best materials
when you receive implants or at least know the success rate of the brand your dentist is using
how does that sound yeah i mean the way that i like to compare it is for example let's take
gold for example right you have 24 karat gold you could have 18 karat 14 characters different
levels of purity of of that material up to all the way down to gold plating for example
dental implants are made out of titanium and titanium has different grades as well
from one to five five being the highest uh the highest grade of titanium and so
most of the well-known reputable brands use the purest form of titanium which is uh grade five
uh but there are other smaller companies that perhaps don't have the funds to
you know do all the research and uh develop their their uh their products the the proper way and so
some of these companies they're cutting corners by utilizing uh titanium that is not perhaps
to the highest grade and that's what we see in the industry we have a lot of smaller companies that
are using products that are not necessarily the highest quality they're still dental implants they
can still integrate in bone but the quality of the material is not the same and that therefore can
lead to more problems so would it be safe to say that you get what you pay for to a certain extent
yeah i think you could say that um are there some dental operations that you think might be charging
really high fees for implants and they're cutting corners to try to improve their bottom line i mean
is it a good idea for patients to be aware of what they're getting yeah i've seen that happen
and these infomercials and and these billboards are very misleading um i know for a fact that some
of these places they'll offer an implant for 3.99 but what they don't tell you uh in the small print
is that then they'll charge you 3 dollars for a crown for example and so they're gonna they're
gonna make their fee up somehow right right right and typically these are the places that are using
materials that are not to the highest standards so that's that's really helpful i i i really
appreciate that because uh for me as a general dentist and doing a lot of restorative dentistry
materials are so critical to our success and we have to understand the materials
i mean to a certain extent i mean i think dentistry has to become like a material
scientist to be a really good dentist you have to understand all the chemistry and what have you
i wanted to move on to sort of planning and this whole idea about coming in to see a dentist
and having a workup done maybe that's a couple of x-rays or maybe there's a cbct
which is you can talk about and then they go immediately into implants almost the next day
is this kind of approach to care a great idea and here's my statement that you can you can
discuss or disagree with proper diagnosis planning imaging which means mainly x-rays different types
and guides are essential for the best results and recommending that patients should have
numerous visits in the planning phase before the implant is actually placed does that
make sense generally that's that's absolutely true i mean planning is is the key to success
uh not only planning but everything will start with the proper diagnosis and evaluation of the
patient review of the medical history review of the medications we know that there's a lot of a
lot of medications that can have an effect on bone metabolism bone healing wound healing in general
and so those are the first key steps that we cannot uh skip through good diagnosis good
review of the medical history and then planning the case adequately is absolutely a fundamental
thing in implant dentistry and we can do that today utilizing a lot of the technology that is
available to us like cbct three-dimensional x-rays the way hang on cbct that means
cone beam compu coming computerized tomography okay so this is a sort of like an x-ray that
will take it's a specialized we could say that it's a specialized three-dimensional x-ray that
makes slices on on the jawbones and then we can upload that information into a computer and we
actually have some computer planning softwares that can allow us to do a virtual surgery on
the computer before we even do the surgery on that's amazing that allows us to choose the right
size of implants the right components can give us an idea of any anatomical
variations or limitations that we could encounter in these cases yeah i was going to ask you if a
dentist has made the decision to utilize this digital technology to plan to to virtually place
the implant before they actually place the implant to have these plastic guides made that tell them
exactly where to drill does that guarantee success in the implants it does not guarantee success but
it can certainly improve the chances of success uh the the more you plan the better prepared you are
before proceeding with the case the more chances that you know the case will be
will be successful so certainly all of the computer uh technology that we have
available to us today really helps us in minimizing the complications that can arise
from implantation yeah i mean i was thinking about as a patient again what would i want to
see from my dentist as a if i were a patient and i'm thinking i'd want to see that implant
planned before it was actually placed in other words i'd like to see a three-dimensional model
either on a screen or on in somebody i can hand a hand handhold and see that the implant
is going in a certain location and here the doctor talked to me about uh how important
it is to get the right angles where the bone is things like that and i think that patients uh
really have a right to know that information i mean as a patient receiving an implant i would
want to know exactly how that was going to be done and what thought process went on your brain before
you decide to put something metal in my body that's going to hopefully last a lifetime correct
and as you know that's that's what we teach at ucla i mean that's right our students go
through extensive treatment planning sessions and they learn how to diagnose and utilize all the
computer techniques that's absolutely right and i'd like to say also plug plug that's what we do
here at stevens solutions we absolutely teach our dentist to be amazing uh which beautifully leads
into the next point which is training training is really important um would it be okay to ask
your dentist where they receive their training is that a fair question is that does it matter
it absolutely matters i i i think that patients should be able to ask where a practitioner has
completed their specialty training if any at all well wait a minute why don't i just go ahead and
go to uh i can take a four day course overseas sure and i can i can place 30 implants and i can
come back i mean i've got 30 implants on my belt come on am i not at the right level it's not about
quantity it's about quality okay so what does that mean well generally speaking these uh these
fast track courses right we'll just show you how to drill a hole and plug it and plug it with an
implant right they don't necessarily review things like diagnosis treatment planning proper surgical
technique what happens when there's complications how to manage complications how to properly
place the implant how do we plan an implant right so like if i if i'm there for a week and i place
a lot of implants and if something goes wrong with that implant i'm already home i got off the plane
yeah i don't even know if that's happened as far as you're concerned that implant was successful
we call that a geographic success right so i was thinking do you um do you have a kind of in your
mind an idea of what length of time what span of time would be appropriate for a dentist to
learn how to place it at the best you know at the highest level yeah implant dentistry has changed
a lot uh at the beginning when dental implants were first introduced it was only reserved for
oral surgeons they were the only people that were allowed to train how to play simple so
the manufacturers restricted that yeah exactly okay obviously now we're in different times
we have general dentist placing implants but there's really good training programs that you
could follow to make sure that you achieve the highest standards of training generally speaking
a two-year program in implant dentistry will give you good basic fundamental knowledge on how to
plan how to execute and how to follow up with your with your implants but we do see unfortunately a
lot of a lot of weekend courses a lot of um you know week or or or two-week courses abroad they
go right they take you to a tropical island and you place implants for about a week sounds fun
that sounds fun sounds like fun but it but you're not really getting much out of that interesting
yeah and i i i as a consumer uh you know you know patients should feel okay about asking
about the dentist training and don't feel that this is a taboo question and if your dentist
is offended by the question you might want to think about getting another opinion
because if a patient ever asks me about my training i am full disclosure and i think
everyone needs to know exactly what we are able to do and what we're not able to do um
you know uh i i hear this all the time in these radio commercials implants are just like your
normal teeth they're they're just the same and i heard once a really wise dentist said once to me
no implants are not replacements for teeth they're replacements for not having teeth in other words
right i mean can you talk about that a little bit i mean what can we expect about what should
a patient feel when they have implants in their mouth what are the differences what could what
do they need to be prepared for when things don't always work we need to understand that as you all
said implants do not behave uh like teeth we use them to replace missing teeth but it's a tooth
is very different than an implant well what's one of the ways is different well for example
a tooth has a natural shock absorber called the periodontal ligament and when we're biting when
we're chewing if we chew too hard it's gonna it's gonna give us feedback and say oh that would that
hurt i shouldn't do that dental implants don't have that uh that feedback and so a lot of times
we could see patients that uh will bite too hard or we can see the occlusion being too hard
on these implants and that can lead to problems so that's one of the biggest differences that we
don't have a sensory feedback from dental implants like we see with natural i heard someone say that
that if a tooth is exquisitely sensitive because it has a nerve it has a ligament
that gives you all this feedback but when you extract the tooth the nerve is gone the
ligament's gone and the bone heals and then the bone the bone is not really designed
to have a lot of nerve endings in it it's essentially not a lot of sense yeah there's
there's there's no feedback on it and so that's why we see you know sometimes patients like like i
mentioned earlier um we can have a lot of problems are derived from the biting forces being too harsh
on the implants because we have no way to know whether we're biting too hard or not and so
problems derive from heavy occlusion or too much biting forces or grinding forces on the implants
that's something that we see that we see commonly and we need to address yeah and i was thinking
about maintenance about hygiene you know okay let's say i've just done a really bad job keeping
keeping my teeth clean i've done a really miserable job i hate going to the dentist
i don't like to get work done and i find myself 25 30 years down the road having a lot of teeth
that need to be removed i mean it's embarrassing i feel really guilty about it it's kind of one
of those things that has always bothered me i have sleepless nights about my rotten teeth
and i go to the dentist and have them taken out and i get implants is it fair to say i
don't have to worry about my teeth anymore no absolutely not that's unfair quite quite the con
quite the contrary actually not implants are for life you said 98 they have they have the potential
to last a lifetime okay but they don't come without complications and hygiene hygiene is is an
extremely important aspect of implant dentistry in your scenario let's say that you know you we
we placed implants because you had rotten teeth that's because your oral hygiene probably wasn't
very good to begin with dlt is charged so what are the chances that that patient is going to be
good with this hygiene when dental implants are placed that's a good point yeah right so chances
are that they're probably not going to take care of their implants as well and patients should know
that it is much more difficult to clean around a dental implant compared to a natural tooth the
dental implant has a very intricate anatomy and the tools that we have available to us are not
really designed to clean around those implants and so you need to spend a considerable amount of time
every day cleaning around those implants and so if you were already not used to doing that when
you had teeth right chances are that you're not going to be able to do it when when implants go in
so that's something that we need to consider also when we're planning implants on patients because
am i going to take care of them well if i have a sense that you're not going to be able to take
care of them i may not want to place implants but we can talk maybe i can check we'll see it's
time for discussion all right very good first of all your health matters make sure you understand
the importance of controlling your diabetes and quitting smoking other health concerns are also
important make sure you ask your dentist how this impacts your success two not all implants are the
same there are various different manufacturers of implants some of them use the best materials
in the world others not entirely true make sure you know what you're having placed in your body
number three planning is key your dentist should be utilizing the most innovative up-to-date
technology possible including 3d imaging and guides that help the dentist place the implant
in the correct position four don't be afraid to ask your dentist about their training dentists
have various levels of understanding about the intricacies of implants to make them successful
they need to have gone through significant academic level training this can require years
and five implants are not like real teeth they don't have a ligament around them like a real
tooth they don't have the ability to absorb the types of forces in the same manner as real teeth
they also require special methods for cleaning them and maintaining their health well uh that
really concludes our faint five things you should know about x today x was implants and i really
want to thank dr juan p and friends you have that little name with the hyphen at the end of it i i
added the hype that's pretty cool um and uh i want to thank you for your expertise it's uh certainly
a pleasure to work with you as a colleague and as a friend and uh thanks for joining us today
thank you all right everyone uh next time we'll have a very exciting x topic for you
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