There is no doubt that being ‘citizens of the 21 century’ provides us with increased life expectancy as a direct result of both technological advancement and scientific research. However, living longer doesn’t necessarily mean living a better life if you can’t continue to enjoy everyday things without being self-conscious about your appearance, smile or ability to chew the foods you would like to eat. Missing or decayed teeth, gum disease or loose dentures can severely impact upon your ability to interact and socialise with friends and family, leading to social isolation and anxiety states; in the worst cases even developing into clinical depression.
It isn’t unusual for patients older than 50 years of age to have a few missing teeth; the situation may result in some patients having dentures made to replace these teeth. Partial (some teeth) dentures or full (all teeth) dentures can contribute to further tooth and supporting bone loss resulting in further deterioration of the individual’s dentition. Gum tissue can become sore (gingivitis) with more advanced cases resulting in irreversible gum and bone damage (periodontitis or gum disease). Dentures are never as stable as the teeth they replace; they can be loose and difficult to control thus making eating and speaking quite challenging. Fortunately, contemporary medical and dental research has refined the science of bone biology (bone healing/growth factors/bone grafting) to enable pecialist surgeons to provide dental implant treatments in both a predictable and affordable manner. But are dental implants for elderly patients really a good idea? Are you too old to have dental implants?
What’s Wrong with Conventional Dentures for Elderly Patients?
Dentures (dental plates) are essentially ‘false teeth’ and are often made of materials like acrylic or cast metal, with either porcelain or plastic teeth attached. The dentures are created from moulds of a patient’s teeth and jaws; tooth sizes, shapes and colours are based on the adjacent teeth; the dentures are designed to balance the opposing factors of appearance needs (complimenting the smile) with functional needs (having a broad area of contact with the gum and other teeth to improve stability). Dentures can be prepared in advance of planned tooth removal to be inserted on the same day that the teeth are removed (immediate denture – same day teeth/all on four/teeth in a day). Quite often the dentures will need to be relined (renewal of the fitting surface of the denture) approximately three to four months after the denture was inserted; this is due to changes in the shape of the supporting bone after the extractions sites have healed.
The downsides of wearing dentures include discomfort from an unstable appliance, a large appliance that causes gagging, diminished sense of taste, difficulty with eating and speaking (the dentures tend move or dislodge while chewing or talking); they also require ongoing cleaning and maintenance and renewal (periodical replacements due to ongoing bone loss).
The prolonged use of conventional dentures can also irreversibly damage gums and the supporting jaw bone; this can lead to chronic disability as the elderly person’s ability to control the denture in social and functional settings continues to deteriorate. For this reason, seek specialist advice to establish whether dental implants are an option to replace your missing teeth.
What Exactly are Dental Implants?
Dental implants allow for tooth replacement that is essentially as good as your current tooth in that:
- The implant/crown is self-supporting (not reliant on or damaging to your other teeth)
- The implant/crown is fixed to your jaw (like a tooth root)
- The implant/crown is long lasting (in well-maintained mouths, it may outlast all other dental treatments)
- The implant/crown is looked after with standard oral hygiene techniques (tooth brushing/flossing/dental check-ups)
Dental implants are made of commercial grade titanium; this material has been proven to be inert in humans and promotes bone cell growth directly onto the surface of the implant, thus creating the perfect tooth root replacement to support new crowns or dentures for patients.
Are Elderly Patients Good Candidates for Dental Implants?
The simple answer is ‘yes’. Dental implants are equally successful in elderly people or any patients with reduced bone density (osteoporosis/osteopenia) and heal with the same predictability as those in younger patients. It’s also worth noting that osteoporosis, which is often treated with bone-sparing medications (eg. Bisphosphonates – Prolia/Fosamax/Actonel) doesn’t necessarily affect the outcome – of course, specialist surgical advice is suggested.
Some patients I have successfully treated have been told – ‘you don’t have enough bone left to place dental implants’ by other Dentists they saw previously. As a specialist surgeon, I offer a broad range of options for dental implant placement without the need for bone grafting or replacement (eg. Zygomatic implants), allowing patients to experience the benefits of eating for enjoyment and confidence in social interactions.
There isn’t really an age that is considered ‘too old for dental implant treatment’. A reasonably healthy person can safely and predictably have implants placed resulting in a vastly improved quality of life, assisting them to maintain a balanced nutritious diet and active lifestyle; remaining every bit as confident and social engaging as a person with their own natural teeth.
What are the Treatment Options for Elderly Patients Considering Dental Implants?
Consultation with a specialist surgeon is imperative prior to considering any dental implant treatment; the extensive knowledge and broad experience of a specialist surgeon is essential to navigate you through the myriad of options available; they can devise treatment options incorporating the latest minimally invasive techniques utilising 3-dimensional guides and CT based digital scanning that speed your recovery and reduce potential complications. Some aspects of treatment (Consultation, CT scans, Cone Beam Scans, Bone grafting including sinus lifts) will also be covered by Medicare rebates when provided by a specialist surgeon, making treatment more affordable.
Dental implant treatment can be carried out either whilst you are awake (local anaesthetic) or whilst you are asleep (general anaesthetic); in both instances, the procedure is usually performed as a ‘day surgery’ procedure. A specialist surgeon routinely operates within hospital theatre settings, maintaining regular operating sessions and has the experience to ensure your safe passage through any hospital based procedures.
In the hands of a highly skilled specialist surgeon, quite often tooth removal can be achieved with no or minimal bone loss; this creates the opportunity to immediately place a dental implant (immediate implants). Tooth removal and immediate implant placement is technically difficult but the results are highly successful and have the following benefits:
- one procedure (rather than tooth removal followed by a second procedure for implant placement 3 months later)
- one recovery period (less time away from work / study / timetable)
- shorter treatment time (the implant is ready to be restored in 3 months rather than 6 months; this technique is also suitable for ‘teeth in a day’, ‘same day teeth’ and ‘all on four’ type treatments.
- Less need for bone grafting (bone support for implant placement can be lost whilst waiting for the extraction socket to heal, increasing the likelihood for bone grafting and / or sinus lift procedures).
The dental implant attachment to the bone (implant integration assessment) is checked 3-4 months after implant placement. The implant, adjacent teeth and other structures of the mouth are digitally scanned (TRIOS 3-D optical camera), thus avoiding the need for uncomfortable and often gag inducing impressions of the mouth); these scans form the basis for creation of custom shaped and individually shaded crowns or bridges (crowns linked together) to be attached to the implant(s).
A single implant can be used to support a number of teeth; it isn’t necessary to place an implant for every missing tooth; a full arch (Implant retained hybrid bridge of 10-12 teeth) for the upper or lower jaw can be supported with 4 (‘all on four’) or more (‘all on six’) implants (depending on the number of teeth required). Implant retained hybrid bridges offer patients the benefits of more natural looking teeth, will less mouth filling bulky prosthetics The design is much more refined (bridges have less need for extensions and flanges that dentures need for stability) and very close to the appearance, feeling and function that your own natural teeth once provided.
Another highly successful option for patients dissatisfied with their current loose or ill-fitting full dentures is placement of implants beneath the current denture (implant retained over-denture) to improve the stability and function of the denture.
In both cases the jawbone accepts and fuses with the dental implant (implant osseointegration); this connection anchors your new teeth and restores not only masticatory (chewing) functionality, but enhances your vitality and self-confidence by creating a natural-looking stable dentition that will make you want to smile again.
How Do Elderly Patients Recover from the Procedure?
The placement of dental implants by specialist surgeons is a minimally invasive and gentle procedure. For most patients, the 24-48 hour period after implant placement will see the development of moderate pressure pain (controllable with simple scripted pain relief) but with minimal swelling; beyond 48 hours the implant site quickly settles and is usually unremarkable and trouble free for the rest of its existence in your mouth.
What are the Benefits of Dental Implants for Elderly Patients?
Dental implant treatments can significantly improve the quality of life for many older individuals; advancing age is no absolute barrier. Attaching bridges and dentures to dental implants allows for a more refined, less bulky final product (less palate and gum coverage, no deep extensions or denture flanges irritating the cheeks and tongue); having direct bone-implant contact protects patients from further bone loss (commonly a result of conventional dentures) preventing further oral health deterioration. The crowns / bridges / dentures are rigidly supported by implants and limit accidental dislodgment during function, resulting in improved self-confidence in social settings.
Dental implants usually look, feel and function more like your own natural teeth once did; a result rarely achieved with regular dentures. The implants are easily maintained via your usual daily oral health routine (brushing, flossing and having Dental check-ups). Implants are susceptible to gum disease (periodontal disease), smoking, some medical conditions (eg diabetes) and age related bone loss, but when properly cared for, could last a lifetime.
Implants provide a stable platform to improve masticatory (chewing) function and thus enjoyment of eating; allowing many people to return to a broader range of menu items, including foods long considered off limits (secondary to denture induced limitations). A more nutritious and varied diet also improves vitality, longevity and promotes greater well being in patients of all ages, but is especially important for older individuals. Do you want to enjoy your favourite foods without reservations or restrictions and experience the benefits of better nutrition?
A patient’s quality of life can also markedly improve as a result of dental implant treatment; reducing the embarrassment of loose and un-natural appearing teeth / dentures allows them to more comfortably interact socially and lead more vital and active lifestyles; enjoying quality time with family and friends without the worry of whether their teeth will let them down.
Do you want to know more about dental implants or find out whether your current denture could be replaced with dental implants? Contact our specialist surgeons today on (07) 5503 1744.