Hi Ian, I am 72 and only have about half my teeth left, most of them have fallen out painlessly but relentlessly for the last five years. I recently visited two dentists, who gave conflicting advice. Both said the problem was caused by gum disease. One reccommended extracting the remaining teeth, which he said would cure the gum disease problem. He then proposed an ‘All-on-4′ dental implant procedure to replace all teeth. The second dentist suggested leaving most of the teeth untouched, and making plates in my mouth to replace the missing teeth, the idea being to slowly transition to a full set of false teeth, getting used to eating with dentures gradually.
I have some questions – with Dentist 1’s method of full extraction, is it ok to do the implant surgery on the same day as extraction, or would it be advisable to wait for the gum disease to heal first? Will removing the teeth cure the gum disease (they are badly stained and cannot be cleaned properly as they are too unstable). Finally, with Dentist 2’s method to leave the teeth in,surely the gum disease will continue, so I will still have bad breath and receding gums. Any advice would be appreciated.
The All -one -four concept is well documented and the research papers have good success rates but there isn;t a lot of long term data on the success rates. Placing on the day of extraction is part of the protocol and immediate placements are acceptable but do carry a slightly higher risk of complications.
Removing the teeth will “get rid of the gum disease” as there are no teeth left to affect but as a “gum disease” patient, you are also at higher risk of developing peri-implant problems as there is a similar disease that affects implants called Peri-implantitis. I am not saying that gum disease patient shouldn’t have implants, we do loads in our clinic, but you do need to be aware of the higher risks.
Dentist 2’s method is also acceptable, they are just very different ie one of very conservative and the other is very aggressive. It really boils down to what you want at the end of treatment and what you are prepared to accept in the interim.
Dr Ian Dunn
PurelyPerio Clinic 334, PO Box 334, Wilmslow, Cheshire, SK9 0AG Web: www.purelyperio.co.uk Tel: 01625 419700
