5 Impediments to Placing Dental Implants: A Guide for Dentists

19.02.2016
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Implants restore chewing and speaking functions as before without compromising the health of adjacent teeth. They can last a lifetime if they’re taken care of the right way, which is why they’re the preferred choice of patients and dentists alike.

Replacing missing teeth with dental implants can restore a patient’s confidence and lifestyle better than any other alternative. But not everyone is a candidate for implants. Certain conditions and habits can make it less likely that implants will succeed.
 
Benefits of Dental Implants
 
Getting dental implants is an excellent solution for people who have lost a single tooth or multiple teeth. Being made of materials compatible with human bone and tissue, implants help stop progressive bone loss and jawbone shrinkage.
 
Dental implants mimic the roots of natural teeth, thereby fitting securely and offering an advantage over conventional dentures and bridges. The latter can be uncomfortable and limit a person's ability to eat and speak normally due to clicks and slippages, making the wearer feel self-conscious most of the time.
 
Implants restore chewing and speaking functions as before without compromising the health of adjacent teeth. They can last a lifetime if they’re taken care of the right way, which is why they’re the preferred choice of patients and dentists alike. However, it is imperative for dentists to carry out a detailed dental examination and evaluation of a patient before starting the implant procedure.
 
The success of a dental implant depends largely on the general and oral health of the individual. As such, not all individuals are good candidates for a dental implants. There are conditions that can negatively affect the success rate of implants and even create contraindications, situations where implants can actually cause harm to the patient, some of which are discussed as follows.
 
Radiotherapy to the Jawbone, Head, and Neck
 
Surgical treatment of cancer in the head and neck can lead to defects that present challenges in using dental prosthetics like implants. Mucosal changes, dermatitis, radiation caries, scar tissue formation, and soft-tissue necrosis are just a few of the side-effects of head and neck radiation therapy.
 
Loss of teeth and jaw deviation due to muscle pull result in lack of support to dental prosthetics. Moreover, surgical intervention, as in the case of dental implants in Long Island and other places, can decrease healing and increase the potential for development of osteoradionecrosis.
 
Diabetes Mellitus
 
Diabetes mellitus is a chronic, lifelong condition characterized by an increase in blood glucose levels (hyperglycemia). Among several other complications, diabetes is associated with microvascular and macrovascular diseases, altered wound healing, and an increased susceptibility to infection.
 
Since diabetes increases the risk of complications after surgery, it is a major risk factor for dental implant surgery. Uncontrolled diabetes in particular, is a contraindication for a dental implant. Diabetes is also associated with increased levels of salivary glucose, xerostomia, caries, and swelling of the parotid gland.
 
Poor Oral Hygiene
 
Poor oral health is detrimental to the success of dental implants. Moreover, diseases like gingivitis and periodontal disease can be contraindications for dental implants. While a patient with vertical bone loss may respond well to regenerative therapy, horizontal bone loss is considered irreversible as there are no regenerative techniques developed as yet.
 
Dental implants won’t be a success if the bone has degenerated excessively. As such, it is imperative to examine a patient’s oral health when considering dental implants. It is also necessary to ensure that the patient is willing to take required care of his teeth and gums, and follow the advice of the dentist.
 
Smoking
 
Recent research shows that smoking is a significant factor in the failure of dental implants. While it is a known fact that smoking affects general as well as oral health, it also influences oral therapeutic procedures negatively.
 
Smoking increases the risk of periodontal disease, root caries, and cancerous lesions. It also causes delayed wound healing after orthognathic surgeries, periodontal procedures, and extractions due to cytotoxicity of nicotine, hydrogen cyanide, and carbon monoxide to cells involved in wound healing, decreased tissue perfusion, vasoconstriction, etc.
 
Increased use of tobacco is associated directly with increased implant failure. Furthermore, there is a higher risk of implant failure in areas where the trabecular bone is of poor quality.
 
Note that though smoking is a risk factor for dental implant failure, it cannot be considered an absolute contraindication for the procedure. It is possible to achieve success with dental implants depending on the oral health of the individual and his willingness to give up smoking before and after the implant.
 
Drug and Alcohol Abuse
 
Abusing drugs and alcohol irritates the soft tissue in the mouth and inhibits the production of saliva. Since saliva is the body’s defense against tooth decay, cavities can spread rapidly when a person has a dry mouth. Substance abuse also makes a person crave sugar and satisfying sugar cravings with sugary foods and drinks exacerbates tooth decay.
 
Moreover, teeth tend to degenerate due to grinding them repeatedly. Depending on drugs and alcohol can cause a person to neglect oral health too. All these factors combined can damage an individual’s teeth, gums, and the jaw bone, and increase the risk of failure of dental implants.
 
Do keep in mind that like smoking, drug and alcohol abuse cannot be considered absolute contraindications for a dental implant.
 
Conclusion
 
Dental implants can be a boon for people wearing uncomfortable dentures and having missing teeth. While they can improve the quality of life to a great extent, dentists need to assess each case carefully so as to ensure the success of dental implants.

Image copyright: Kevin Dooley, flickr, CC-BY

Article last time updated on 25.02.2016.

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