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Article: Dental Implant pros and cons DR. JERRY GORDON
Patients with certain diseases or who take medications that affect the immune system can have an increased risk of implant infection.

Dental implants are one of the most important advances in dental treatment over the last two decades. Discovered by a Swedish scientist and orthopedic surgeon, Dr. P.I. Br'emark, dental implants have led to a vastly improved quality of life for many people who suffer from the problems associated with missing teeth. Dental implants are titanium rods about a centimeter long that are placed inside the jawbone and serve the same purpose as the roots of teeth. Dental implants allow dentists to replace individual or multiple teeth, or create denture supports that are much more natural and better fitting than normal dentures. Dental implants can also have problems, including breakage, infection, and lack of esthetics. Dental implants are usually more expensive than most other types of dental care.

One potential problem with dental implants is breakage. There is a possibility that the implant within the jaw can break, as well as the crown (cap) that it supports. This can happen if the forces in the mouth are greater than the strength of the implant or its components. This is why it is imperative that the dentist be both highly trained and experienced before recommending dental implants. Errors in diagnosis are the most common reason that dental implants break. Fortunately, there are often warning signs before this occurs. For instance, if the crowns are fastened to the implants with screws, the screws will loosen frequently. If the crowns are cemented to the implants, the crowns can come out often. This should alert the dentist to a problem, and he or she should take the appropriate steps to correct it.

Infection is another possible problem associated with dental implants. Although this problem usually presents itself shortly after the implant is inserted into the jaw, it can occur at any time after the implant has been placed. Patients with certain diseases or who take medications that affect the immune system can have an increased risk of implant infection. An implant can become infected if the dentist's surgical technique is unsound, and patients who smoke or have poor oral hygiene can also risk premature failure of dental implants. An infected implant can sometimes be treated, but in most cases, the implant has to be removed.

Dental implants may not always be the most cosmetic dental option available. A fixed bridge (a series of joined crowns) may be a better choice than dental implants to replace missing teeth in the front of the mouth. The reason is that dental implants sometimes reveal the metal collar by the gum line, and the porcelain used for the crowns can sometimes stand out from the natural teeth. Careful consideration of the patient's functional and cosmetic goals is needed when considering how best to replace missing teeth.

Cost is also a factor when replacing missing teeth with dental implants. In general, dental implants can be more expensive than either a fixed bridge or a removable full or partial denture. Even so, in some cases, dental implants are the best or only option available

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Dr. Gordon is the dental columnist for the Bucks County Courier Times. He has published more than 300 articles since 1998. Dr. Gordon was recently asked to provide commentary about mid-level providers for the influential dental journal Dental Abstracts.

Dr. Gordon responds to an article in Dental Abstracts challenging his views.

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