Showing off your Smile [BC Edition]

The loss of a tooth or multiple teeth, for whatever reason, can cause a lot of distress. Often times, people are given one solution: dentures. However, the stigma behind having to remove one’s teeth every night can make dentures an unappealing option. Dr. Andrew Willoughby, a dentist and healthcare consultant at the Vancouver Dental Spa, specializes in cosmetic dentistry. He handles many cases of tooth loss, and has some advice on an alternative solution — dental implants.

Willoughby and his staff understand how nerve-wracking undergoing dental procedures can be. “We were and still are the first and only fully integrated dental day spa in Canada where our entire staff has been extensively trained to cater to patients’ needs and dental phobias, in a setting specifically designed to provide a spa-like environment capable of offering a tranquil, peaceful and relaxing setting for our patients,” he says. Being surrounded by the kind of environment Willoughby describes combined with the provision of world-class dentistry is the first step to achieving a smile worth smiling about.

Dental implants have been around for more than 20 years, but have only gained popularity in the last five to seven years. Titanium is commonly used to make the implants due to its high strength, low weight, corrosion resistance and excellent biocompatibility. According to Willoughby, implants work due to osseointegration, which means that a dental implant fixture surgically embedded into the patient’s jaw bone has fused to bone. He says, “This procedure is no more complicated or painful than most common tooth extractions and is in fact very quick and simple. Once the implant fixture has knitted to bone, subsequent appointments are made to rigidly attach small screw-retained anchors or ‘abutments’ to the implant — on top of which the crown bridge or denture can be fabricated.”

A full dental examination and a full medical workup are required before a patient can get any implants. It’s important that patients do this before undergoing dental implant procedures. Otherwise, any disease or health issue they might have needs to be treated before implant therapy. “Patient should be in good general health with no underlying major health issues, no smoking, [and they] require adequate density and volume of bone [which only a clinical exam and appropriate x-rays can help determine],” says Willoughby. As well, the patient’s teeth and gums should be in stable condition and free of dental disease. Finally, the patient’s oral hygiene should be well-maintained.

Losing a tooth or multiple teeth can be a problem. If left without any sort of treatment, adjacent teeth can tip and rotate, causing food impaction and difficulty cleaning. A patient’s occlusion (bite) may be altered as well. Willoughby says, “If you are missing a tooth you only have a set number of options: live with the space — not a very functional or cosmetic option — restore the ‘tooth gap’ with a fixed bridge, which requires removal of healthy tooth structure on the adjacent teeth, fabricate a removable denture to replace the missing tooth, or place a dental implant and restore with an implant-supported crown.” The human jaw bone needs function to remain healthy. The only stimulus to maintain the bone is a healthy tooth or an implant. Although these other options are readily available and can be effective, it seems that there is really only one, clear option. “Today, dental implant-supported restorations are the most permanent form of dentistry — bar none,” says Willoughby.

“WE ENCOURAGE AND INSTRUCT OUR DENTAL IMPLANT PATIENTS TO CARE FOR THEIR IMPLANT RESTORATIONS THE SAME WAY THEY CARE FOR THEIR NATURAL TEETH — DILIGENTLY.”

Patients who need full dentures often don’t wear their lower dentures or change their lifestyle to eat only softer processed foods. However, most people don’t realize that these two options are not mutually exclusive. At the Vancouver Dental Spa, Willoughby regularly performs procedures relating to this issue, and with great success. He says, “As long as an existing denture wearer is in good health [and doesn’t smoke], and has adequate density and volume of bone, dental implants can often be retro-fitted or made to fit underneath an existing denture to dramatically improve the fit and stability of the denture.”

Once you have dental implants, don’t forget about maintenance. “In our office we encourage and instruct our dental implant patients to care for their implant restorations the same way they care for their natural teeth — diligently,” says Willoughby. Just like your natural teeth, flossing and brushing is key. Visits to the dentist allow them to examine patients for signs of inflammation and check for signs of implant mobility. “There are of course added precautions which can be taken for dental implants, which involve use of a water pick or electric toothbrush — which can make cleaning around the implant a little easier,” says Willoughby. Implants can develop gum disease around them just like your natural teeth, so remember to keep them clean.

Unfortunately, not everyone is a good candidate for dental implants. People who have had a recent heart attack, severe renal disorder, generalized secondary osteoporosis or treatment-resistant diabetes can be contraindications for implant surgery. Willoughby says, “An overwhelming amount of recent clinical and scientific research now indicates that oral infections do in fact play a significant role in a variety of systemic health ailments, including diabetes, high blood pressure, osteoporosis, respiratory illness, pregnancy complications, hyperlipidemia and end-stage renal disease. There also exists a definite etiological and pathological link between chronic inflammatory dental disease and the above conditions.” His advice: “Seek immediate dental treatment for even minor signs of infection — because even if they are not good dental implant candidates there are many other viable and cost effective treatment alternatives.” Other conditions such as chronic alcoholism and drug addiction are also contraindications for implants.

Willoughby warns that although implants are one of the best options out there, they can fail. Failure of an implant usually means the loss of bone followed by mobility of an implant. He says, “There are a couple of different reasons why [failure of an implant] can happen: If they are not surgically placed or prosthetically restored properly this can sometimes lead to bio-mechanical overload, resulting in bone loss around the implant fixture and even de-integration or total loss of the implant.” According to Willoughby, however, implant failure occurs more commonly as a result of health complications. He says that as long as patients maintain their good health, don’t smoke, and if the implant fixture has been placed and designed properly,  “the long-term research states that there is better than a 95% chance of long-term success with dental implants.” •