Since he began practising dentistry in Prince Albert in 1990, Dr. Robin Slowenko has become a firm advocate of dental implants -- artificial tooth replacements in which titanium roots are attached with abutments and layered with a crown.
“One of the things with dental implants is that satisfaction of our patients just seems to be much higher than for a lot of the traditional procedures that we do in dentistry,” Slowenko said. “Because of that, it is something that we really take pride in and actually enjoy doing, and we also want to make sure that other people know that these treatment options are available.”
Far from a recent innovation, dental implants have been around for close to 40 years and are now widely accepted. More than eight million dental implants have been placed worldwide, with more than two million patients treated.
“Dental implants are not experimental,” Slowenko said. “They have a proven success rate and they’re one of the most predictable procedures that we can do in dentistry. We have a 95 to 98 (per cent) success rate over 10 years … They’re not new, but they’re becoming more widely available and they’re making us as dentists and our patients reconsider traditional tooth replacement, especially fixed bridges and removable dentures.”
Slowenko explained many of the drawbacks of standard dentures, which boil down to the fact that they consist of two pieces of plastic resting on tissue.
While suction from the roof of the mouth generally helps the top denture stay in place, the horseshoe shape and position of the bottom denture can cause problems.
“One of the main complaints is you can’t chew properly, and one of the main reasons is that there’s a tenfold decrease in bite force,” Slowenko said. “We get 10 per cent of the bite force with the lower denture that we do with our real teeth, so it’s not surprising that people are not able to chew properly.
“Chewing is the first step in digestion, so if we can’t chew our food, things like digestive problems and nutritional concerns (occur) because we’re not able to eat some of the hard fibrous high nutrition foods that contribute to a good healthy diet.”
Denture-wearers can suffer from decreased taste, speech problems and sore spots. There are also psychological ramifications from poorly-fitting dentures, which can make people afraid to leave the house or engage in social situations.
Making the case for dental implants, Slowenko outlined a number of different procedures ranging from single tooth implants to full arch dental treatment.
One of the things with dental implants is that satisfaction of our patients just seems to be much higher than for a lot of the traditional procedures that we do in dentistry. - Dr. Robin Slowenko
Generally, the more benefits of each procedure, the more expensive it is. A single tooth implant can cost anywhere from $3,000 to $4,800.
At $7,000, the cheapest comprehensive option is the two-implant ball attachment, in which dentures “snap in” to the attachments. However, this arrangement remains tissue-supported and sore spots can still be a problem.
Ranging in price from $13,000 to $17,000 depending on materials and number of implants, bar over-dentures represent a significant step up. By snapping dentures into a bar, the procedure can replace 60 per cent of natural teeth function.
“The advantage of that is its much improved retention, and the lower denture snaps in, it doesn’t want to fall out,” Slowenko said. “It is still a removable denture, and it’s still what we call tissue-supported. So there is going to be some movement and there can still be issues with sore spots, but much, much better than a conventional lower denture with nothing else to hold it in.”
Even better is the All-on-4 treatment, a permanent fixed denture bridge solution involving four implants that costs approximately $25,000. Unlike bar over-dentures, which require a healing period of three to four months after implantation, the All-on-4 procedure can be performed within the span of a single day.
At $50,000 per arch, the most comprehensive option is the permanent full arch dental bridge, a non-removable variant that offers the closest approximation to real teeth.
What makes dental implant treatments so expensive? According to Slowenko, it comes down to four factors: Quality of treatment, logistics and extra planning required, the amount of training necessary to perform the operation, and the level of service provided.
“We’re just not very service-oriented in health care, and the difference with dental implant treatment is it involves (the) exclusive and undivided attention of your dentist,” Slowenko said. “That’s one of the things we do like about it is that it’s not rushed, and it’s something that we can devote the time and care that we need.”
Dental implants are not for everyone. Slowenko listed bad oral hygiene, diabetes and smoking habits as contraindications that can decrease the success rate for individuals undergoing the procedure.