Having done dental implants for over thirty years, I’m often faced with the dilemma, should you extract your teeth in favor of dental implants, or should you keep your teeth? While this question is subject to appropriate diagnosis and treatment planning, there are some rules that I’ve applied over the years that seem to be pretty consistent.
1. Those ads that you see about dental implants should be treated as advertising.
Whether you’re looking at my advertising or anyone else’s, please understand that the purpose of advertising is to bring you to our office. Many of the ads that you see extol the virtues of dental implants. We do a lot of dental implants, and for -most, they are great. And for some, they are not. Just because you see an ad, don’t think that the only answer is dental implants. There are often other answers that are better. It is still the doctor, still the diagnosis, still the evaluation of you as a patient that precede the determination of the treatment that will work best for you. The dental implant doesn’t replace the doctor. It’s a tool that the doctor uses. The better trained the doctor, the better he or she can explain the virtues of dental implants vs. saving teeth vs. a combination of the two.
2. Dental implants are subject to disease just as teeth are subject to disease.
Dental implants will not decay, but dental implants are subject to the other major dental disease, periodontal disease. Periodontal disease of an implant is called “peri implantitis.” While periodontal disease can be treated quite predictably in many cases, peri implantitis cannot. Those who have periodontal disease are also more prone to peri implantitis. Therefore, you should consult with a periodontist to see if your periodontal disease treatment may be a more predictable option for you than extracting the teeth and putting in dental implants.
3. If you are continuing to get more and more cavities, dental implants are a more predictable treatment in many cases.
Once you get decay, particularly root decay, and it becomes a continuous battle to fill your teeth, then implants may be a more predictable treatment if major work is required. Teeth decay for a lot of reasons, but one of the main reasons is acid in the mouth. When a mouth is dry, it is acidic. There are about 500 medications that cause dry mouth. If you’re one of the many who take those medications, and your teeth are suffering as a result, then restoring the teeth may not be the best answer. Even if a tooth is restored, bacteria and acid can still get under the restoration, causing the decay problem once again.
We need to consider all the variables in both your dental health and your general health before making recommendations to you. Take your time to see a good diagnostician. Get opinions from specialists who treat your problem. Get a second opinion if you’re not sure. The decision that you are making is a major decision. Make sure that you’ve thought through the entire problem with a dental specialist that you trust before making your decision on treatment.
Lee N. Sheldon, DMD