Dear Dr. Wada...

(as seen in Sacramento Magazine and The News and Review).

Dear Dr. Wada:

I am a 68-year-old woman and am missing several teeth.  I am interested in possibly replacing them with implants,  but I am concerned about my age.  I've looked on the Internet, but seem to get conflicting information.  Can you help?

Dear Reader:

At this time, we are living longer, more productive and healthier lives than ever before.  In 1860, half the population was 20 years old or younger, in 1994, half were age 39 or older.  By 2030, experts predict half the people on the planet will be 40 years or even older.  One eighth of our current population is 65 years or older.  Three in four people aged 65 to 75 consider themselves to be in excellent health, while 2 in 3 people aged 75  and older are still enjoying life to the fullest.  There is no question that the ability to smile, chew, and even kiss with confidence is critical to our health and quality of life.  We are now referring to healthy, active seniors as the "Young Old."  In this day and age, if you have a skilled dentist, almost all tooth loss can be prevented.  However, if you have already lost teeth, and are among the Young Old, implants can be an excellent option for replacing missing teeth, but there are several important things every patient should know and do before making a final decision:

1. Understand that where the implants will be placed is very important.  Different parts of the mouth are more predictably restored with implants than others.

2. The amount and quality of jaw bone present in the area implants are placed is also important.  If more bone is required, most of the time grafts can be placed, but this involves an additional surgery and expense.

3. Implants are a team effort between the surgeon who places the implants, and the specialty or highly-trained restorative dentist who builds the crowns or restorations (teeth) on top of the implants.  Make certain you are working with doctors who have additional education and years of experience with implants.  This is very important.  Implants can fail but if well-trained, highly-experienced dentists place and restore them, the failure rate is very small.

4. Make certain the rest of your mouth is stable, healthy, and your bite is balanced.  For implants to last, biting forces must be balanced and controlled.  Implants rest in bone, and do not have the natural shock absorbers teeth do.  If you bite incorrectly on implants, they can easily be rejected.

5. Understand that implants are vulnerable to gum disease, just as teeth are.  If you have a history of gum (periodontal) disease, make sure you are working with specialty dentists who  understand the problem and can manage it.

6. Think about what type of tooth replacement choices are available, and how many teeth will require replacement.  There are a wide variety of implant retained restorations.  Ask the dentist what types may be right for your mouth, and ask for pictures of them.  Also ask to speak with patients who have had implants, and get their feedback and suggestions.

Please feel free to contact me if I can be of service.