To save or to implant?

Should one bother to treat "sick" teeth, or give up, and with the "bang and it's over" method insert implants and say goodbye to the teeth?

להציל או להשתיל ?

In this article, we will discuss the dilemma that many patients present, a topic that confuses them and sometimes, yes, sometimes also confuses dentists. And we will focus on the question "to save or to implant"?

What is the source of this dilemma?

What is the origin of this dilemma and how do you deal with it?

The dilemma arises from two opposing forces, which collide with each other: one side is the human and cultural nature that has taken root in our society in recent years, and the other side is the medical nature – i.e., the characteristics of teeth and implants. Let's start with the cultural aspect. The contemporary Western person – the 21st century – is exposed to a huge amount of advertisements and sales, and in all of them the message repeats – what you want, get here and now. Mobile phones, television, football game, car – here now and immediately. Pay and take, don't settle for less!

This urge interferes with us in many aspects of our current lives, and especially in health issues. The human body, bones, gums, these are factors that move and change slowly – for better, and for worse. You don't start a diet and see results within two days, and even with the best gynecologist, pregnancy lasts nine months. And then, when it comes to the smile, and the desire to chew and look good, suddenly we need to stop ourselves, patience, delayed gratification! We start a process, pay, sit in the dentist's chair, and yet, we don't see results overnight! Ah... difficult coping...

The second force is the characteristics of teeth and implants. Implants – those screws made of titanium alloy that can be inserted into the jaw and have crowns and bridges mounted on them, are a wonderful thing, which has contributed and contributes a lot to the dental health of Western people.

But, and this is a big but, like any other device or accessory, it has characteristics that you need to know before using it, in order to use it correctly. In this article, we will focus on only two characteristics:

The first – the restoration: restoration on implants is composed of an implant that sits – fixed – inside the bone, in a structure that is connected to it by screwing or other means, and on it a crown.

This is a complex system, especially when it comes to several implants at different angles connected together. As a result, the professional literature recognizes that the percentage of restorative complications in implants exceeds the amount of complications in restoration on natural teeth. It is important to say, this does not mean "not to use implants," it does mean "to use implants with discretion, considering the end result from the beginning."

A second important issue is to remember that implants – what a surprise – are something artificial that we insert into the jaw, into the bone, and it needs to live in peace with the bone, with the gums, with additional teeth, with the oral bacteria and all the surrounding ecology. As a result, the implant is exposed to the same bacteria that sit on the teeth – and if the patient suffered or suffers from gum disease, the bacteria can infect the implant and cause surgical and other complications.

Teeth, on the other hand – are a natural body in the mouth. Teeth can heal – to a considerable extent. In a tooth where the pulp of the tooth dies ("the nerve"), a root canal treatment can be done and still rely on it for restoration. Removal of tartar, healing from gum disease, gum surgeries, can save "sick teeth" and give them new life for many more years."

The bottom line regarding the implant and teeth dilemma is:

"Implants are intended to replace, or support, areas where there are no teeth, to replace teeth that cannot be avoided to extract – crack, destruction of the crown to below the gums, and the like extreme cases. When in the mouth there are teeth that can be saved – even at the cost of a root canal or crown, even at the cost of gum surgery – in the vast majority of cases this is the correct medical treatment to do, which will give good fruits for many years.

True, you need to be treated by a good doctor, one who has patience – remember the expression we said at the beginning of the film "delayed gratification"? Removal of tartar, waiting for gum healing, removal of caries and temporary crowns – there are many preparatory actions to save teeth, but as our sages said – whoever saves one soul is as if he saved the whole world."

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With feelings of writing and health, Dr. Eyal Tagari | Specialist in Prosthodontics