Do Dental Implants Make Financial Sense?

Do Dental Implants Make Financial Sense?

by | Mar 5, 2017 | Bridge, Cavities, Cavity, Dentistry, Dentures, Implant, Periodontal Disease, Tooth Loss, Tooth Replacements

Because tooth-loss so often creates long-lasting and generally negative effects for personal health and, not infrequently, appearance – the entire array of tooth replacement options has long been an important subject in the dental field.  Dentists not infrequently discuss which options are best for their patients, given different circumstances.  And if there is any debate in the profession at all, you can be sure the public will also question which options make the most sense for them.

The truth is there is no one right answer.  Each person’s circumstances differ – whether the reasons are anatomic, functional, emotional, or financial.

But the question is still an important one to ask, because patients face new realities when they lose even one tooth.  These changes include (but are not limited to):

  • Difficulty chewing
  • Altered speech
  • Food impaction
  • Jaw pain
  • Drifting teeth

And, then there are the secondary effects:

  • Poor health resulting from a changing diet
  • Compromised appearance
  • Self-consciousness/embarrassment
  • An inability to wear dentures
  • Financial challenges created by the need to address these problems

It is this last point that I want to touch upon here, because I have observed a good deal of confusion surrounding dental implants.  As a dentist, I am obligated to review all options with an individual when discussing their tooth replacement options – regardless of affordability.  I can’t, and don’t, pre-judge anyone financially when discussing their choices.

Commonly, though, when I raise the subject of dental implants, I get an immediate reaction along the lines: “Oh, forget it. I could never afford that.  How about a bridge?”

Now, I’m not going to try to convince you that implants are cheap. Restore a full mouth with dental implants and it is likely to be costly.  Nevertheless, cheap is relative.  For some of my patients, even a small filling can be perceived as expensive.  For my wealthy patients, they might be prepared to spend any price for what they perceive will serve them best.  Lucky them.  Right?

What I hope to do here, however, is to show you when an implant may make the most sense for a person. And — at least, when when it comes to replacing a single tooth — a dental implant may just be the way to go.

But first, permit me to remind you again – there is no one right answer for everybody.  Your choices may be very different depending upon whether you are 25 or 85 years old, for example.

I’m sure you can fill-in still other reasons that affect your decision-making process.  But for now, let’s consider the following scenario:

A patient loses one tooth.

For the sake of argument, we’ll call it a lower right first molar.   Suddenly, the patient realizes this is annoying.  Their bite is changing; their gums are sore.  They feel the need to do something.  Now.

Here are a few options. I’m just going to list the main ones, but there are sub-sets to some of these:

  1. Do nothing anyway.
  2. A removable denture.
  3. A non-removable bridge,
  4. A dental implant.

For the purposes of this discussion, the patient has already decided that doing nothing isn’t working for them.

So, the next option is a removable denture.  I usually get “the face” on this one.

And with good reason.  Food gets caught around partial dentures every time you eat.  You will have to remove the appliance after EVERY meal and clean it separately from your own teeth.  Certain foods will also cause it to dislodge as you eat, allowing some of the food to get caught between the denture and your gums.  The cost – depending upon what kind of partial you have made – will typically range between $750 and $1,500.† The recommended replacement time: every 5 to 7 years.  The reality – people replace them roughly every 15 years.  Sometimes more.  The longer they put off the replacement though, the more issues they may face with the replacement.

Bottom line:  Removable dentures are potentially uncomfortable.  Average lifetime replacement cost if you are 25 years old, (based on an average life expectancy of about 79 years, and an average 10-year replacement rate – not adjusting for inflation) is going to be nearly $7,000.

Next, we’ll take up considering a “bridge.”  It’s called a bridge because it spans a gap (like a bridge spans a body of water) with a fake tooth, or teeth, in between the ones that are still there.  The trouble is that you must shave down the supporting teeth to little stubs so that the result will look natural and be strong enough to take the force of daily chewing.  For the most part, bridges look, and can often feel like, your natural teeth; but you do have to floss under the fake tooth after every meal.  Food will get caught under there, whether you perceive it or not.  If you don’t clean it regularly, the life expectancy of your bridge will be shorter.

Now, the cost on this option can really be widely variable, because some teeth need to have fillings replaced before they can be used as supports for the bridge.  In other cases, the teeth may end up with root canals if the process of shaving them down results in lingering sensitivity.  This doesn’t always happen, but it is a risk.  If the tooth needs that additional treatment it will cost you more.

The average cost to replace a single tooth with a bridge is about $3,500.  Again, that can be a little more, or less, depending upon what part of the country – or even what part of a city, you live in.

If, on the other hand, you also need to place or replace fillings on the teeth being used as supports, and you need to do root canals as well, it could be as much as $7,000.

Roughly, double.

The average lifetime replacement cost with the same parameters given above (25 years old with an average life expectancy of 79 years and a 10-year average replacement rate) is going to be: $31,500.  And that assumes that the underlying teeth will be strong enough to survive that many replacements.

That brings us to dental implants.

Here is the breakdown:  The average implant cost in many metropolitan areas is around $1,800 – $2,200.  If you end up needing a bone graft before the implant can be placed, though, add another $550.  (Basically, a graft is adding bone to your jaw when you don’t have enough for the implant.) So far, these costs are just for the implant.  It doesn’t include the cost of the crown.  Add about another $2,100 for the parts needed to make up what supports the crown above the gumline, and the crown itself.  If your tooth is short, and there isn’t enough tooth height to which your crown can be easily cemented, you might need something called a UCLA abutment — it lets your dentist screw down the crown instead of cementing it.  That could cost you more.  How much depends upon the lab your dentist uses, but $500 more wouldn’t be unusual.

On the low end, one implant may cost $3,900.  On the high end, let’s round up to $4,900.

So, what about the average lifetime cost?

$4,400.

That’s less than either partial dentures or bridges!

Why?

Because, unless you bite into a rock, grind your teeth uncontrollably, or have some serious illness that causes you to lose bone around the implant – any of which can happen to you with the other options as well – you will probably have your implant for life.  Still, no one can guarantee this because, sometimes, plain ol’ dumb luck will factor into any equation.

But, you can’t get a cavity on an implant.  On the other hand, you still can get a cavity on the teeth that support your partial denture, or bridge (and crowns, for that matter).

So, do the math.  Look at your circumstances, and decide what is right for you.  But when your dentist starts talking to you about dental implants, hear them out.  It just might be more cost effective than you realize.

† [Note: The prices mentioned here are just averages in US Dollars at the time of this writing.  Actual costs could be more, or less, depending upon where you live.]

Foods That Are Good For Your Teeth

Foods That Are Good For Your Teeth

by | Dec 28, 2011 | Cavities, Cavity, Dentistry, Tooth Decay

In a previous article, Foods That Are Bad For Your Teeth, I reviewed three broad categories of foods that can be detrimental to your dental health.  These were sugars and sweeteners, low fat foods, and foods that contain white, especially bleached, flour.

With this article I would like to spend some time talking about an area that I feel receives entirely too little attention – whether by patients, or dentists, for that matter.  Possibly, this comes about for the simple reason that by the time many patients arrive at the dentist they are looking for resolution of a specific problem.  In this sense, the market has conditioned both patients and doctors into focusing upon the end-game.

This has its place and fills a need.   Patients who are in pain do not generally want to hear about what they should be eating – they want to handle their pain.   Yet, knowing what foods can repair teeth may be a key element in establishing their future long-term dental stability.

In today’s economic climate, health care has undergone many challenges and the consumer has been faced with high medical and dental costs.  Consequently, health care is not infrequently reserved for the handling of emergencies.  This is actually counter-productive, as emergency dental care is also expensive.  Couple this with efforts by the patient to reduce costs, and the “treatment” may be a decision to remove the offending tooth.  Later, when the patient starts to regret his choice and seeks tooth replacements, he may find that replacement costs are many times more than had they handled the problem once discovered.

Economics can also influence the quality of the food we consume.  In an effort to save money many consumers will also select lowest cost items.  These are typically quite profitable for the producer but are usually highly processed and very unprofitable for your health.

So what do you need to know?

Let’s start with this simple concept:  If what you eat comes out of a box, a jar, a can, or a plastic wrapper, it has been processed.

Your diet is the single most important thing that you can control to create or maintain a healthy mouth.  When you eat too many processed foods – especially those that contain sugars and bleached flour – you create effects that may not be immediately noticed by you.  For example, the level of blood sugar can become elevated and with it a person can experience elevated cortisol.  Cortisol is a hormone produced by your adrenal gland and is responsible for raising blood sugar.   It also affects the flow of parotin (a salivary gland hormone) and, in so doing, can lead to cavities.  Cortisol also counteracts insulin which regulates carbohydrate and fat metabolism in the body, and it slows down bone formation.

The inability to metabolize fats, in turn, can keep you from benefiting from the healthy foods that can help you to repair your teeth.

So, you see, it is a little like the children’s song “The foot bone’s connected to the ankle bone.  And the ankle bone’s connected the leg bone.”  The bottom line: what we do – or don’t do – can have unseen and unwanted effects when it comes to our diet and teeth.

Maintaining healthy hormones is very important to your dental health as well as to your general health.  The relationship between demineralization and remineralization is balanced when hormones are healthy.  When unbalanced, calcium and phosphorus can be pulled out of the blood and create deficiencies in our bones as well as the teeth.  It can also create a condition wherein your body becomes excessively acidic. An acid environment is more receptive to the growth of bacteria and fungi.   If there is one take-home message that you take out of this article it should be that real food – namely unprocessed food, as nature intended that it be consumed – will not only support your general health, but will also support your teeth.

What foods, then, are good for your teeth?

  1.  Proteins:  Eat proteins in order to regulate blood sugar.  As mentioned above, blood sugar fluctuations are one of the key reasons that we lose minerals.  High quality proteins such as grass fed, or wild game are best.  While I realize that this may pose a problem for vegetarians, it doesn’t alter the fact that the most productive stores of minerals, protein, and fats are derived from meats.  Vegetarians must rely on eggs and cheese for their protein.
  2. Foods with phosphorus:  Possibly more important than calcium for your teeth, phosphorus can be obtained from milk and cheese.  Raw, unpasteurized milk is best.   Unless, strictly vegan, vegetarians should have no trouble getting their phosphorus from these sources.  Other good sources of phosphorus include organ meats of both land animals and those from the sea.  Muscle meats (most common meats consumed, i.e., not from organs such as liver or kidney, for example) are also a good source, as are beans and nuts.  Organ meats have more phosphorus than muscle meats.  Although present in some grains, the quantities can be insufficient or difficult to absorb, and this may not be the best choice for your teeth.
  3. Trace minerals are important:  In addition to phosphorus, the following deficiencies can also lead to problems with tooth decay – iron, copper, magnesium and manganese.  Foods with iron include shellfish and organ meats.  Copper is found in liver and mollusks.  Smaller amounts exist in mushrooms.  Magnesium can be found in fish, nuts, and spinach.  Manganese, also important in the regulation of blood sugar, occurs in liver, kidneys (organ meats), mussels, nuts, and pineapple, to name a few sources.  Other trace minerals may also play a role, but are too numerous to mention here.
  4. Healthy fats: These are a great source of energy, but are also important to help maintain hormonal function and balance.  Among the healthy fats are olive oil, butter, beef, chicken, pork and duck fat.  Avocado and coconut oil are also healthy fats, especially if from organic sources.  Vegetable fats do not generally contain the vitamins that help to re-build our teeth.
  5. Fat soluble vitamins D and A: Simply put, without adequate stores of these two vitamins, we can’t get the calcium and phosphorus into our bones or teeth.  People with tooth decay are typically lacking these two vitamins.  Seafood is an excellent source of Vitamin D.  If you don’t have easy access to seafood, or if you don’t like it, lard, or pork fat, will help. Suet, or beef fat appears to be more effective, however.  Another excellent (and relatively simple) way to get Vitamin D is with daily exposure to sunlight.  Consuming fermented cod liver oil is still another easy way to get Vitamin D into your diet.

Eating healthy is the single-most effective action you can take to protect your teeth – and your overall health.  It is also one thing that you can control.  Take the time to learn which foods can provide you with proteins, phosphorus, healthy fats, vitamins D and A, as well as trace minerals, and you will be well on your way to healthier teeth and gums!

 

Foods That Are Bad For Your Teeth

Foods That Are Bad For Your Teeth

by | Dec 19, 2011 | Cavities, Cavity, Dentistry, Tooth Decay

This is the first of a two-part series that discusses the effect of foods on our teeth.  Part One will review those foods considered harmful to the teeth, and Part Two will discuss foods that can actually help to rebuild them.

Generally, more attention is given to the former than the latter.  From a viewpoint of prevention, this has its value.  Nevertheless, a good understanding of which foods are beneficial to dental health is, in my opinion, of no lesser importance.  In actual fact, this understanding may hold the key to not only improving an individual’s dental health, but very possibly their general health as well.

While there are usually several components to any program that leads to improved dental health, of these, it is my opinion that diet is paramount.

Dentists generally spend the bulk of their time discussing the importance of hygiene.  I, too, have addressed this topic in several articles.  Nevertheless, over time, I have come to see the value of spending a great deal more time with patients reviewing and modifying their diets.  Truthfully, this is more challenging – and meets with greater resistance.  But it is vitally important.

I don’t think it is important to the exclusion of hygiene, however.  Yet, I have come across some opinions that promote diet only.  So let’s take another look at this area more broadly, just to put it into perspective.

Hygiene involves care of the entire body.  Naturally, that includes the mouth.  While good personal hygiene is generally something one should practice for themselves – it is also important to insist others maintain it as well.  Consider the following example:

Let’s say you have adopted a diet of fresh organic food and you are now on your way to your local butcher to purchase some fresh meat.  You arrive and are greeted by someone who smells as though he hasn’t bathed in a week.  His hair is greasy.  His hands are dirty and after he unceremoniously coughs into them, he wipes one hand on a dirty shirt.   Then he reaches over for your fresh cut of meat and holds it up for inspection.

You would have a right to refuse it.  Not because there is anything wrong with grass-fed, hormone free meat.  Rather, it would be because the person clearly practices poor hygiene and may infect you – and whoever else they come into contact with.  You wouldn’t be wrong to say something about it.

Similarly, good oral hygiene is simply a reflection of the total care of one’s body.  This also means getting sufficient rest and exercising regularly.

That having been said, let’s take a quick look at what types of food cause people dental problems.

These can be simplified into three broad categories.  As you will see, however, they comprise a very wide array of commonly consumed foods.

  1. Sugar and Sweeteners.  The first category I will mention is the one nearly everyone focuses upon and possibly falls into the category of “common knowledge.”  Despite this fact, you might be surprised by the quantities of sugars and sweeteners that are regularly consumed in a typical diet.  When the quantity of sugar in the blood rises it upsets the balance of calcium to phosphorus in the blood as well.  This has the effect of pulling calcium out of our teeth and bones.  Low phosphorus levels likewise affect the mineral content of dentin, which is the layer of tooth structure supporting tooth enamel.
  2. Low Fat Foods. This includes such items as skimmed or low-fat milk, which many individuals assume helps their teeth if they consume it in sufficient quantities.  Unfortunately, this is a fallacy that gets many people in trouble. Milk that is homogenized and pasteurized has been stripped of its nutritive value.  Pasteurization kills off the probiotic (good bacteria) quality of raw natural milk.  Paradoxically, this can allow pathogenic (bad) bacteria to grow more easily in pasteurized milk.  Also, the absence of healthy fat can affect hormonal function which, in turn, may affect mineral levels adversely.
  3. Bleached (White) Flour.  Products that contain white flour can also be damaging to teeth – especially when combined with sugars and in the absence of healthy animal fats.  If one stops to consider how many foods are made with white flour, this can create quite a dietary challenge.  Furthermore, if not removed after meals, these foods will create a thin sticky layer of what is basically a form of sugar.  Because this, in turn, can stick to the teeth for hours – and becomes acidic – it can accelerate that demineralization process that breaks down the outer layer of your teeth, resulting in tooth decay.  Also, the bleaching process typically adds chlorine dioxide or benzoyl peroxide to make the flour appear bright white.   You don’t need these in your diet.

In the next article, we will cover what foods are good for your teeth.  The positive side to this story is that there is good news and you can do something to remineralize or rebuild your teeth; however, knowing how foods come into the picture and which ones are detrimental to your teeth and gums is a critical element for taking control of your dental health.

Need A Job? Fix Your Teeth!

Need A Job? Fix Your Teeth!

by | Oct 30, 2011 | Cavities, Cavity, Dentistry

Bad teeth may not only have negative consequences for your health, they can cost you a job.

Many people with visibly unattractive teeth go through life avoiding eye contact with strangers for fear of having to smile back or even to make small talk.  Not infrequently, when such people do talk or feel compelled to smile, they cover their mouths with their hand.

Unfortunately, in a job interview, this will not go over well.  Yet, for the person with dental problems, to smile or talk would compel them to reveal something they are deeply embarrassed about – their teeth.  There is an old saying that you don’t get a second chance to make a first impression.  And first impressions are typically based upon appearance.  Your teeth, or even your breath, can either enhance or completely destroy your chances of landing that new position.

Teeth that are blackened by decay, are crooked, discolored, or even missing may not just be embarrassing – they may turn off prospective employers.  Also, hiding your smile during an interview can be one of the worst things you do.  A smile and a confident response project self-assurance and make a person appear likeable.

This is just one of many subtleties employers may take into account when interviewing a prospect.  Teeth that are stained by coffee, tea or cigarettes may distract the interviewer from what is really important – you and your qualifications.

Likewise, coffee and cigarettes leave a smell that can be easily detected.  Apart from not showing visible stains, a prospective job-seeker should also avoid certain other foods shortly before their interview.  The most obvious offenders are garlic, onions, anchovies or tuna.  But it is also prudent to steer clear of such lunch meats such as salami, pepperoni or pastrami before your interview.  Strong cheeses, such as Roquefort, Camembert, or Bleu cheese also leave persisting odors and, similarly, should be avoided.

Women are cautioned to avoid getting lipstick on their teeth.  Softer shades or lip gloss are preferable to bright red.   Lipstick on your teeth can give you the appearance of being careless or hurried – which may also sink your prospects the moment you open your mouth to speak.

In today’s economy, competition for work is fierce.  Applicants need every advantage they can get to land the job.  Applicants’ teeth need to be as good looking as the way they dress, comb their hair, or even shine their shoes, because employers can afford to be selective with so many qualified people looking for work.

Recent research conducted in the U.S. estimates that those prospects with well-maintained teeth experience as much as a 58% higher chance of finding a job than those whose teeth are perceived as unattractive.  It also seems that potential employees who have invested in dental treatment with cosmetic dentistry are regarded as more professional, congenial, and trustworthy.

Individuals seeking employment can increase their chances of getting work by taking several steps before their interview. These include getting a dental examination, completing unfinished restorative work and possibly even having cosmetic dentistry.  The number of job seekers getting their teeth whitened and getting porcelain veneers placed (as a way to increase their chances of hiring success) is increasing for these very reasons.  So what do you do if you can’t afford a Hollywood smile?  Don’t worry, there are affordable answers.

If you need a lot of work and it is out of your reach, temporary cosmetic solutions such as a Snap-On Smile® can make a dramatic change in your appearance – very often at less than one quarter the cost of a more permanent solution.  This is on the order of a functional, but temporary, smile design that snaps over your natural teeth.   Once you land the job and start making an income, you can consider something more permanent!