Implants beat dentures

Implants beat dentures
June 14, 2005
Orlando Sentinal
By William Hathaway
Those with dental implants eat better and seem to be healthier and enjoy life more than those who have mouths filled with dentures, studies show.
Even denture wearers eat more healthful meals if they have just two implants, says Dr. Jocelyne S. Feine, professor of dentistry at McGill University in Montreal, who has studied the health benefits and costs of dental implants.
"Their reactions are phenomenal," Feine says. "It makes such a difference in their lives."
Though technology is making implants easier to perform and making the crowns they support better-looking, their high cost keeps them out of the mouths of those who might benefit the most from them: the poor older people on fixed incomes, Feine says.
She says implants, titanium screws inserted in the jaw to provide secure support for dental crowns, should become the standard of care in the United States and Canada.
"We have to find ways to provide the service at an affordable cost," Feine says. "It is good for the patients and good for the public."
Feine has an uphill fight. Most insurance policies will not pay for dental implants. Medicare also does not cover any dental costs. That means patients must pay out of pocket. Although the prices of dental implants and crowns vary greatly from region to region, from dental office to dental office and from procedure to procedure, they aren't inexpensive anywhere.
In some areas of the country, a single rudimentary implant and crown can run as low as $1,500. In other markets, the cost can be $5,000 or more per tooth for more complicated procedures. Those costs do not include periodontal work or bone grafts that sometimes are needed before an implant.
A costly solution
The high costs of implants drive patients to seek other options. If they lose a tooth, a few patients decide to simply do nothing to replace it. But adjacent teeth can drift into the gap on the gum, which can lead to other dental problems.
Sometimes insurance will partially cover the costs of a fixed bridge, in which crowns replace the teeth on each side of the missing tooth, and a replacement tooth is suspended between the two crowns. Bridges are slightly less expensive than implants, though dentists say they are less desirable because they often need repairs.
"There are some people without dental plans who say they can't afford a dental restoration and simply find somebody to take all their teeth out. It happens all the time." says Dr. Thomas Taylor, head of the Department of Oral Rehabilitation, Biomaterials and Skeletal Development at the University of Connecticut Health Center.
Dentures may be the least expensive option, but they fall far short of matching the chewing efficiency of natural teeth or implants, Taylor says.
"There are very good studies that show one or two implants can lead to dramatic improvements in self-image, quality of life and nutrition," Feine says, adding that blood tests of older subjects who have received two implants indicate an improved diet.
Dentists need to do more to educate people about the value of their teeth, says dentist Dr. Joel Rosenlicht.
"The value people associate with their teeth is something that dentists have neglected," Rosenlicht says. "Patients really don't appreciate the value of their teeth until they are gone."
Shopping around
Economic considerations, not those about health, often dictate what patients ultimately decide to do, he says.
"It's become like buying a car," Taylor says. "You have to decide whether you want a Chevy or a Cadillac."
That's why patients need to shop for implants as they would for a car, he says