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What Role Does Gum Tissue Play in Receiving a Dental Implant?

In the dental literature, a biotype typically refers to the thickness of your gum tissue that surround your teeth or dental implant restorations. This thickness has major effects on the esthetic outcome of your front teeth. A thick biotype is typically easier to manage and allows a more predictable response if handled correctly. The gum tissue between the teeth (papilla) is typically shorter and thicker which has more blood supply to handle healing and insult better. Many times teeth tend to have a more squared shape. Thin biotypes are very difficult to manage and expertise of the dentist must be at the highest level to provide natural appearance of the gum tissue that resembles the teeth next to it. Many times extra procedures are required with additional appointments to maintain tissue and get the best outcome. Unfortunately, it is a common oversite by the inexperienced clinician, but once the tissue has changed, it is almost always non-reversable. What does attached tissue mean???

In my next blog, we’ll discuss the importance for the long-term success of the dental implant solution.

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Why Bone Density Plays a Role in Your Implant Surgery

Jaw bone density is different from patient to patient.  It is graded from D1 which like Oak wood to D4 which is like Styrofoam.  Different bone densities require different preparations, different implant designs, different waiting periods before connecting a tooth to the implant, different temporary designs and progressive loading techniques, and different tooth designs to manage forces in softer bone.  Some of these factors require additional appointments, chair time, and costs to do things correctly with the best outcome.

Have you heard of a biotype and how that could affect the results of your dental implant solution?  In my next blog, I’ll discuss why.

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Why can’t a patient get an exact price quote over the phone?

So why can’t I just get a number for what is the cost of a dental implant?  We get this question probably as much as any other question and it makes sense if an implant was a commodity that you could just purchase like a TV.  There are many factors that go into the treatment and what is needed for the implant to be successful.

Over the next few weeks, I’ll be discussing some of these factors that affect the type of treatment required for a dental implant solution to be successful.  For example, did you know that you have different quality of bone in different areas of the jaw and sometimes major differences between the upper and lower jaw bone?  How much bone is left after the tooth has been taken out?  How long ago was the tooth removed?  Are you a healthy patient?  What modifications from ideal do we have to accommodate for to give you a predictable result for your implant restoration.

If you are calling and the practice gives you a quote for the cost, it may be a red flag that the experience level or education level doesn’t know the answer to some of these questions.  Many of these accommodations are relatively costly in materials and time to prepare the position for an implant that if not dealt with correctly compromises long-term results.  We want investments to be sound and predictable.  A patient has to be evaluated and a 3 dimensional radiograph taken to answer most of these questions.

Many dentists provide a free consult to meet the patient, discover the needs and desires, and determine modifications or treatment options to accomplish the patients goals.  This does take time, but it is the only way for you to truly know you are getting what you want and a price you can plan for.  In my next blog, I’ll go into more details about some of these accommodations and planning concerns.

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Pricing should be based on overhead costs and a fair reimbursement for service and care provided.  There is a delicate balance of controlling costs as much as possible, but not compromising care.  It is very expensive to provide surgical care in the cleanest environment with proper aseptic technique.  Are the patient’s gowned and draped properly, are lines new or uncontaminated?  Is there a process to ensure consistent quality of care?  Are prescriptions and meds understood well and used to minimize infections, pain and swelling?

All these come at a cost, but what are you willing to skimp on to save money?  In implant dentistry, quality does come at a price.  The decision for who you choose should be vetted and researched to validate the quality of care you are seeking.  Make sure the dentist is skilled to the appropriate level of care you desire.  In my next blog, I’ll try to answer the question we get on the phone calls of perspective patients of “How much do you charge for an implant?

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The Cost of Dental Implants

Everybody wants to get the best “deal” when you are making a significant investment. Dental implant treatment is sometimes confused with buying a commodity that you can wheel and deal with dentist to get the price down. Understand that dental implants are not a commodity. The implant itself isn’t expensive, but just like any product sold, you can buy knockoffs and get a cheaper product. Are they sterilized, cleaned and packaged correctly to avoid infection and problems? Do they have the best characteristics for long-term predictability and stability? Was the surface prepared properly? You can buy cheaper products, but the consequence of failure is increased as you take chances on cutting corners. It is not just the cost of the implant.

A short list of other components necessary for a dental implant solution would include: cover screw, healing abutment, impression coping, lab analog, digital scan body, transitional prosthesis to develop soft tissue and esthetics. These components are necessary to be included to make a tooth that connects to the implant. All of these components have a cost and all can be bought at different price points (again with different risks). Finally, you have to have a lab fabricate the custom abutment which is what connects to the implant and comes through the gums and a crown which is the shape, size and color of a tooth (again many material options with different price points and different levels of esthetics and function based on the experience and expertise of the lab. You can choose the best with the least risk or the cheapest with the highest risk or somewhere in between, but all of these factors go into pricing for a dental implant.

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What is the Difference in Costs in the US Among Different Dentists?

What about the difference in costs in the US among different dentists?
Obviously, cost of living is different in different areas of the country.  Oklahoma is one of the best value states for cost of dental care comparatively.  Even in the same bigger cities, there can still be a big difference.   So much goes into training to be an expert.  Hundreds of hours go into studying dental implant treatment that is minimally covered in undergrad dental education.  From my own personal experience, I’ve studied occlusion (the way your teeth come together to chew) at the Dawson Academy, implant training under John Kois Center, Misch International  Implant  for surgery and prosthetics for over 250 hours, IV sedation training at Albert Einstein College of Medicine, Chicago Maxicourse for 300 hours, and 20 years of annual meetings with the International Congress of Oral Implantologists and the American Academy of Implant Dentistry for lastest science and state of the art materials and workflows.  This list is not all inclusive, just a glimpse of the investment put into my practice as it relates to implant dentistry.  All this training is after I received my dental degree.  This represents hundreds of thousands of dollars in education, travel, loss of production, etc that I have invested.  I’m happy to have done this for my practice and my patients, but it does come with a cost that I’d like to be compensated for differently than a dentist with a license and little experience with implants.  There is no way that you get the same result, or worse, managing complications which do and will occur in implant dentistry (more importantly how to avoid these complications).
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Why Are Dental Implants So Expensive?

The implant itself is not expensive. There are several factors that contribute to the expense of a dental implant procedure. In the next few weeks I’m going to discuss some of them for you to be more educated in the area and be able to make the best decision for yourself.

So why is there such a range of costs when you get estimates from different dental practices for dental implants? You can go across the border and have this procedure done for 2/3rd’s the cost. With the oversite of the FDA, ADA, State governing boards, ABOI standards, etc. there is a difference in the standards of care required for healthcare. With little to no standards or oversite, the service provided and the outcome may be vastly different. They may not take the time to check for underlying factors that can affect the success of the dental implants such as high sterilization standards, A1C levels in diabetics, bone loss in the lower mandibular jaw, how close the implant runs to the alveolar nerve, along with many other critical factors. I’ve had patients who have told me how much they spent in Mexico for treatment and actually spent more money than they would have in my practice for the same procedure because of needed revisions from a poor standard of care. When you pay for treatment a second time, it is much more expensive than doing it right the first time. Next week more on implant cost discussion.