New Age Dentistry

Technological advances make implants best choice for broken or missing teeth.

For nearly 30 years, Tom Miller was in charge of counting every nickel, dime and quarter that travelers tossed into the baskets at the toll booths along the Indiana Toll Road that runs between Chicago, Illinois and the Ohio Turnpike.

Tom learned how easy and painless the dental implant process is

“If you’re like me and they have to ruin two teeth on either side of the one you lost to do a bridge, why not get the implant? The process is very easy, and you wind up with something that looks and feels like a real tooth. It feels natural, it really does.” -Tom

“I was the controller and administrative services manager for the Indiana Toll Road for twenty-eight and a half years, until I retired in 1995,’’ Tom, 82, confirms. “After retirement, my wife and I moved to Florida. We wanted to get out of all that snow.”

Tom now spends most of his time reading (he especially likes John Grisham novels), doing odd jobs around the house and arranging teaching jobs for his wife, who continues to work part-time as a substitute teacher.

About a year ago, Tom’s retirement routine was interrupted when a tooth suddenly broke off one afternoon after he’d eaten some nuts. At first, Tom thought he had simply lost the crown on that tooth. He soon learned he’d lost much more than that.

“It was really strange because it was hours after I’d eaten the nuts, and all I did was brush my tongue against that tooth, and it broke off,’’ Tom recalls. “The first thing I did was call my dentist, who told me to come in right away.”

Tom’s dentist is Joseph H. Farag, DMD, of Port Charlotte Dental Care. Upon examining Tom, Dr. Farag determined that time had simply caught up with his patient and a tooth that been restored at least once before had simply failed.

“It was his upper left bicuspid, or premolar, and it had broken off right at the gumline,’’ Dr. Farag reports. “As it was, there wasn’t enough tooth left to build on, so it was a hopeless case, and we wound up having to extract the tooth.”

The extraction left Tom with two choices for a replacement. One was a bridge that would be supported by the two teeth immediately surrounding the now missing tooth. The other was to fill the void with a new tooth using a dental implant.

Titanium Strength

Tom wasn’t too keen on getting a bridge largely because his wife has had two bridges for years and is constantly forced to clean beneath them following meals because food gets caught between the bridge and the gums.

Not only that, but going with the bridge would have required Dr. Farag to cut down the two teeth that would have supported the bridge. Because those teeth were both deemed to be in good shape, Dr. Farag recommended the implant option and Tom agreed.

Dental implants are screw-like posts that are made of a titanium alloy that are surgically implanted within the bone of the patient’s jaw. Once the implants are in the jaw, they fuse over time with the bone and become a solid unit.

It typically takes three to six months to complete the fusion process, but once that solid unit is formed, it provides stability for an abutment, which is then capped off with a crown for a single tooth or a partial or full denture for patients replacing multiple teeth.

During the planning stage of the dental implant process, Dr. Farag uses computers to produce three-dimensional models of the patient’s jaw and virtual teeth that the computer fits into the gaps on the model where teeth are missing.

The computer allows for the perfect placement of not just the tooth itself, but the implant, which needs to be placed at a very precise angle to ensure the new tooth aligns with all the remaining teeth and functions properly alongside those teeth.

“When an implant is placed, especially in a tight space as we did with Tom, you have to get parallelism,’’ Dr. Farag informs. “That means the implant has to be in a parallel line to the adjacent teeth so that when you put the crown on, everything looks, fits and feels natural.”

Once the planning phase is completed, Dr. Farag begins the physical implant process. In Tom’s case, that process began with Dr. Farag performing a bone graft procedure in which a bone particulate was injected into the empty socket to ensure Tom’s jawbone would support the implant.

“The bone graft does a number of things,’’ Dr. Farag explains. “One of those things is, it helps to maintain the volume of bone that is already present in the jaw so that we don’t have any atrophy in the height, width and depth of the bone.

“We do a preplanned scan for that, too, so we know whether we can actually fit an implant and what the strength of the bone around the implant is. To place the implant properly, it’s critical to have that pre-knowledge of what you need before you start.”

Bone grafts are not always necessary. When they are, it takes about three months for the bone to heal to a point where it can receive and support an implant, which is put in place with the aid of a computer-assisted, 3-D guidance system.

Once it has been seated, the implant needs about three months to fuse with the bone. To ensure the implant is not disturbed during that time, it is protected by a titanium healing cover that is removed when the abutment and crown are placed.

The crown itself looks like a real tooth and is fashioned out of ceramic using a machine that allows the dentist to make it on the spot on the day it is screwed onto the implant. The total time the patient is in the chair for that appointment is about an hour.

“The longest step in this whole process is the extraction and graft,’’ Dr. Farag says. “That takes about forty minutes. Placing the implant takes about ten minutes for a single tooth, such as the one we did with Tom, and I might add that by using the guidance system, there are no sutures to worry about because there’s no scalpel incision as the implant is placed through a tiny tissue punch.

“Finally, on the day the patient gets the actual tooth, we’re only in their mouth for about four or five minutes. The patient doesn’t even have to be numbed up for that visit because we’re just taking the healing cover off the implant and putting the tooth in place.”

Easy and Painless

Dr. Farag says that in terms of the patient’s experience, the implant procedure is truly the easiest and most functionally efficient way of replacing either a single broken or diseased tooth, the way he did with Tom, or a series of teeth.

Tom learned how easy and painless the dental implant process is

Tom learned how easy and painless the dental implant process is

“If you have a broken tooth or a tooth that is a hopeless case, you will need to go through the removal of the tooth regardless, and that really is the longest part of the process,’’ he says. “So, if you’re going to have to do that anyway, why not get the implant?

“It really is one of the easiest options for a replacement, but a lot of people are intimidated by the idea of it because they don’t know how easy it really is for them or how much more function they’ll get from it in the end.”

Tom confirms that the implant process is indeed easy and provides great function. He adds that it is also a painless process. The only discomfort he experienced came when he broke the tooth. Everything else was a breeze.

“There was no pain associated with this process at all for me,’’ Tom marvels. “I definitely recommend this option to people, whether they’ve got one tooth that needs to be replaced or they need an entire denture of teeth.

“If you’re like me and they have to ruin two teeth on either side of the one you lost to do a bridge, why not get the implant? The process is very easy, and you wind up with something that looks and feels like a real tooth. It feels natural, it really does.

“I highly recommend Dr. Farag as well. He’s been my dentist now for a long time – my wife’s, too. And that’s because he and his staff are so good at what they do and so concerned about their patients. They’re the best.”

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    • Port Charlotte Dental Care

      Dr. Farag provides a full range of quality, caring dental services to the Port Charlotte community. He looks forward to hearing from the viewers of the Florida Health Care News website. For more information or to schedule an appointment, pl... Read More

    • Joseph H. Farag, DMD

      Joseph H. Farag, DMD, earned his Doctor of Dental Medicine degree from the University of Florida College of Dentistry, Gainesville, FL after completing his undergraduate degree at Florida Atlantic University, Boca Raton, FL. Dr. Farag served an... Read More