The good and the bad in dental implants
For Patients
Dear patient

Good dental implants are those which always:

  • give you the ability to bite and chew as with your normal teeth
  • give you a beautiful smile
  • don’t give rise to infection, pain or similar
  • last for many, many years (twenty, thirty years and longer)
  • feel like your own teeth
  • don’t let you struggle with unpleasant side effects after surgery i.e. numbness of lips, difficulty to clean etc

Bad implants will not last for many years and may exhibit complications which good implants would not give you.

In several news reports, you can read about the “time bomb” in dental implants, which actually is the so-called peri-implantitis.

This is by now a well known disease of which, 15 years ago, the professionals did not know even it existed. It is a bacterial infection which causes the loss of the bone which supports the dental implants. Because bone loss is painless, many people don’t realize that they have the condition.

International surveys found that about 20% of patients with dental implants are affected and 10% of all implants are affected. It means that a patient with two or three implants may have one with peri-implantitis.

This news was so shocking to me that I have undertaken, in Oxford over the last five years, a study of all my patients treated with implants who were available for a free review with free X rays to find out about the possibility for peri-implantitis.

Most of the patients were not seen by myself but by colleagues from three European Universities – we just organised the patients to come in and be seen by these researchers. I am somewhat proud to be able to publish that, from more than 390 patients with more than 840 implants seen, only 17 implants (2.%) revealed signs of peri-implantitis. The cumulative success rate was 99.17 %.

And this in the context that I see and treat as a surgeon also some patients with very difficult situations.

Unfortunately, dentists are uncertain how to treat it. Up ‘til now, the majority of the affected implants will be lost eventually. If that was not bad enough on its own, it has to be said that the situation for the patient after implant failure is worse than the situation before implant treatment begun. The reason for this is that for the implant, a hole has to be drilled into the bone, if then the surrounding bone melts away you can imagine that the anatomical situation is considerably worse.

x-ray implant

On this X-Ray you can see an implant which has lost most of the bone around it due to peri-implantitis. The implant has to be removed. However, and worse, is that it is destroying bone at the neighbouring tooth!

What to do about it ?

Firstly, one has to say that the reason for peri-implantitis can be prevented. It can be prevented fistly by the implant surgeon who has to be extremely well-trained. The dentist who provides you with the final teeth has to be highly trained too. And you as a patient must clean your dental implants and the gums around them, at least as good as your teeth, if not better! Also you should not smoke and if you have any certain medical condition, the dentist/implantologist must investigate this condition thoroughly and then advise you whether it is appropriate for you to have dental implants.

If you have dental implants, you need to see a dental hygienist at least twice a year and once a year have a check-up with your dentist. If you are on the verge of peri-implantitis, these professionals will, in most instances, be able to stop the process before it becomes irreversible.

Taking all the above into consideration, I can say that during twenty five years in implant placement with more than 2000 implants in Switzerland and Oxford, I have lost in six patients, each one implant. Therefore the success rate is well above 99%. This is due to a high level of education, training and a high level of experience.

There are many more points of interest and we will discuss these during a consultation which is of course designed to address your own situation. There is of course also the question of money! Treatment with implants is expensive - the more important then that they last long or better very long and are not affected by peri-implantitis!

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With kindest regards

Peter F. Carls,

Peter F. Carls, Consult. Oral-Maxillofacial Surgeon,
69 Banbury Road, Oxford OX2 6PE, Tel 07868 346 821

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