When Implants Should Not Be Done

When Implants Should Not Be Done

Q: I am in my eighties and take many medications for several medical conditions. Am I still a candidate for implants to replace my missing teeth with permanent teeth? Dentures are not for me.

A: Rodney Dangerfield used to tell this old joke:

A man is told by his doctor that he has cancer. He then tells the doctor: “I want a second opinion!” To which the doctor responds: “Ok, you’re ugly too!”

I understand and appreciate the loyalty patients have to their dentists, but sometimes a second opinion is a good move. I perform over 200 extractions, bone grafts and implants each year. Many of our cases are folks that were seeking second opinions. Some of these patients were told they could not get an implant, but we managed to find a way.

The conditions that could cause an increase in the chance of your implants failing are:

  • Immunosuppressed or immunocompromised patients
  • Patients taking IV doses of bisphosphonates like Boniva, Aredia, Fosomax and Prolia for osteoporosis. (Not the pill form.)
  • Untreated periodontal disease; periodontitis (not gingivitis)
  • Uncontrolled diabetes
  • Pregnancy or lactation
  • Addiction to alcohol or drugs
  • Psychiatric problems
  • Lack of opposing teeth
  • Insufficient bone at time of placement
  • Acute infection at or fistula in the area intended for implant placement
  • Inability to have professional cleanings every three months
  • Smoking
  • Auto immune disease
  • Titanium allergy (Have not met a patient in 31 years with that one.)

Next week I will discuss the controversial recommendations many periodontists and general dentists make in having patients undergo gum graft surgery prior to implant placement. The recent studies are quite surprising to the dental profession, but good news for the patient. (I can feel the excitement building!)

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