Latest / Oral Surgery Answers with Dr. Juan Lopez / The #1 Reason You Should NOT Get Dental Implants

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The #1 Reason You Should NOT Get Dental Implants · Oral Surgery Answers with Dr. Juan Lopez

• 0:00
  SPEAKER_00: If you're wondering about getting a dental implant, there are a few things that can make it a really bad idea.
• 0:07
  SPEAKER_00: So let's start this conversation and I want to share some of the few things that can happen.
• 0:14
  SPEAKER_00: One of them is much more common that people realize most people don't even know they have it.
• 0:21
  SPEAKER_00: And if your dentist miss it, you can lose the implant and the bone around it, ending up worse than where you started.
• 0:31
  SPEAKER_00: I'm Dr.
• 0:31
  SPEAKER_00: Juan G.
• 0:32
  SPEAKER_00: Lopez.
• 0:33
  SPEAKER_00: I'm an oral and maxillofacial surgeon in South Florida.
• 0:36
  SPEAKER_00: I'm a board certified and diplomate of the American Association of Oral and Maxillofacial Surgeons.
• 0:43
  SPEAKER_00: I want to show you the number one thing that disqualifies someone from implants.
• 0:49
  SPEAKER_00: A few other things you'll need to consider and why a no right now may not be a no forever.
• 0:57
  SPEAKER_00: Let's start with what an implant actually is.
• 1:01
  SPEAKER_00: First, it's a titanium post or ceramic post that goes into the bone of your jaw.
• 1:08
  SPEAKER_00: And then the bone grows onto it and hold it there.
• 1:12
  SPEAKER_00: It can get a cavity, it doesn't decay, and really nothing about the implant itself wears out of the way a natural tooth does.
• 1:22
  SPEAKER_00: That's important to know.
• 1:24
  SPEAKER_00: So when an implant fails, the implant isn't what fails.
• 1:29
  SPEAKER_00: It's the bone and the gum around that it fails, most generally speaking.
• 1:34
  SPEAKER_00: Every one of the four things I'm going to give you is a reason that bone and that gum aren't in a condition to hold an implant yet.
• 1:43
  SPEAKER_00: The one I see most often is gum disease or periodontal disease.
• 1:49
  SPEAKER_00: And a lot of people don't know that they have it.
• 1:52
  SPEAKER_00: If you have an active gum disease in part of your mouth, that's the reason I'm not placing an implant in you today.
• 2:01
  SPEAKER_00: Think about what gum disease has already done.
• 2:05
  SPEAKER_00: It's a bacterial infection in the tissue that holds your teeth into your jaw.
• 2:11
  SPEAKER_00: It aids bone.
• 2:13
  SPEAKER_00: And in a lot of patients, is the reason the tooth came out in the first place.
• 2:18
  SPEAKER_00: Now, you want to put an implant into that same mouth, same bacteria, same tissue.
• 2:25
  SPEAKER_00: The infection that took the natural tooth sits around the implant and does the same thing to the bone holding that one.
• 2:35
  SPEAKER_00: Usually this will surprise people because they don't know they have it.
• 2:39
  SPEAKER_00: Patients tell me their gums bleed a little when they brush, or a tooth start looking longer, and they thought that they were just getting older.
• 2:51
  SPEAKER_00: Usually it doesn't hurt, so nobody's treating, and it keeps going and going.
• 2:56
  SPEAKER_00: This is actually periodontal disease.
• 2:59
  SPEAKER_00: Another thing about implants is that they don't just come loose and get replaced the way you replace a filling.
• 3:07
  SPEAKER_00: As you know, you replace a filling in one session.
• 3:11
  SPEAKER_00: When an implant fails, it does not work that way.
• 3:15
  SPEAKER_00: When the bone around the post is lost to the infection, the post gets loose because the bone that was holding it, it fails and it comes out.
• 3:26
  SPEAKER_00: The space it leaves is bigger than the socket the original tooth came out of.
• 3:33
  SPEAKER_00: Now there is a defect there.
• 3:35
  SPEAKER_00: And before we can try again, that side has to be grafted and it has to heal, and that takes months.
• 3:43
  SPEAKER_00: So that's the thing I want to know before anybody talks to you about implants.
• 3:49
  SPEAKER_00: Not whether you want them, but most important whether your gums are in a condition to keep one for the rest of your life.
• 3:58
  SPEAKER_00: If you're in South Florida and you've been told you're not a candidate for implants, that's the exact conversation I want to have with you.
• 4:08
  SPEAKER_00: There's a link in the description to set up an appointment or an assessment.
• 4:13
  SPEAKER_00: And while we're here, there are a few other things you should know about too.
• 4:19
  SPEAKER_00: You might not be able to get implants if you have a jaw that has been radiated because of a tumor, because of cancer, or because you have radiation to the head or neck.
• 4:30
  SPEAKER_00: That will definitely and apparently change the bone.
• 4:34
  SPEAKER_00: Radiated bone has a poor blood supply, and if it does, it will heal very badly.
• 4:41
  SPEAKER_00: An implant depends entirely on bone growing into it and hold it.
• 4:46
  SPEAKER_00: But if the blood supply isn't there, the healing is different.
• 4:50
  SPEAKER_00: So we have to plan accordingly.
• 4:52
  SPEAKER_00: That doesn't mean never, it means it's a very special case that wouldn't be the same protocol as everybody else.
• 5:00
  SPEAKER_00: And we have placed implants in radiation patients.
• 5:03
  SPEAKER_00: Other reason that I might think about uh implants that can disqualify you is the heavy bruxer.
• 5:11
  SPEAKER_00: Somebody who grinds or clenches hard at night, they don't know it.
• 5:16
  SPEAKER_00: But what is happening is that a natural tooth doesn't sit directly into the bone, it sits into a ligament, and that ligament is like a shock absorber.
• 5:27
  SPEAKER_00: It can give in, it has feedback to the brain.
• 5:30
  SPEAKER_00: And that is very important so you know if you're doing any damage.
• 5:35
  SPEAKER_00: An implant has no ligament, it fuses straight to the bone.
• 5:40
  SPEAKER_00: There is no give and no feedback to the brain.
• 5:43
  SPEAKER_00: And if you're damaging the bone, you will only know when that implant fails.
• 5:48
  SPEAKER_00: A heavy grinder puts pressure on an implant that a natural tooth would have complained about it over and over every night.
• 5:57
  SPEAKER_00: That pressure goes straight into the bone around the pose.
• 6:01
  SPEAKER_00: That happens in natural teeth when you see worn edges or the feeling keeps breaking or soreness in the jaw in the morning.
• 6:10
  SPEAKER_00: Usually they don't know what's going on.
• 6:12
  SPEAKER_00: But if that's you, I'm not saying no to implants.
• 6:15
  SPEAKER_00: I'm saying the grinding, the clenching gets handled first, or you will have more problems later.
• 6:22
  SPEAKER_00: These are the basics, so you can have an implant that lasts longer.
• 6:26
  SPEAKER_00: Now, another condition that I can be uhware is the imp the patients that had a different upper and lower jaw because they don't line up, because they're bigger in one side, or because they are asymmetrical, meaning they're not chewed in the correct pattern.
• 6:43
  SPEAKER_00: For example, the ridge is not fitting well to the lower ridge, and that force of chewing doesn't come directly through the teeth, the way it's meant to be.
• 6:55
  SPEAKER_00: It comes in an angle.
• 6:57
  SPEAKER_00: Now you put an implant in the middle of it, and what you're gonna see is that every time you eat, you're putting pressure in that implant in a lateral fashion, and that lateral force that the implant is handling is the worst.
• 7:12
  SPEAKER_00: When we see these conditions, it doesn't mean that you cannot have an implant.
• 7:16
  SPEAKER_00: It means again you have to correct the condition, and it has been done through graces or through what we call orthogonal surgery.
• 7:26
  SPEAKER_00: We correct the jaws surgically, so when you have the implants, you're aligned and the forces go directly in a very straightforward position and not in a lateral four.
• 7:40
  SPEAKER_00: In other words, your bite will be harmonic.
• 7:43
  SPEAKER_00: It's stable when you chew.
• 7:46
  SPEAKER_00: That's the time when you talk about influence.
• 7:48
  SPEAKER_00: The list again gum disease, radiated jaw, heavy grinding, or jaws that don't line up.
• 7:55
  SPEAKER_00: Now, a lot of doctors will see one of these conditions and will tell the patient they're not a candidate for influence.
• 8:02
  SPEAKER_00: The implants get frustrated, go home, and they believe they are not candidates for implants for a lot of time, six years, ten years.
• 8:10
  SPEAKER_00: At that time, the bone is getting worse.
• 8:13
  SPEAKER_00: Once the tooth is out, the body is signaling that you don't need the bone.
• 8:18
  SPEAKER_00: So it's the bone starts to disappear.
• 8:20
  SPEAKER_00: We call it reabsorption.
• 8:22
  SPEAKER_00: And if you have less bone, there's less bone to work with, meaning additional procedures, additional uh financial expenses.
• 8:32
  SPEAKER_00: So the most expensive answer is wait and see to see what happens.
• 8:37
  SPEAKER_00: Because with time you will learn that this will create a problem to your jaw.
• 8:43
  SPEAKER_00: If somebody has quoted for implants and ask them what they found in your gums.
• 8:48
  SPEAKER_00: Ask them what is the periodontal condition, ask them if the jaws are chewing in a harmonic condition, because these are important basic questions that can lead to a successful implant.
• 9:03
  SPEAKER_00: Now remember, being told no is not the same as not possible.
• 9:08
  SPEAKER_00: Every one of those four that I just described can be dealt first, and usually you can do the implant.
• 9:15
  SPEAKER_00: So a lot of patients will say, Well, should I be doing implants or just getting a denture?
• 9:20
  SPEAKER_00: The comparation everybody makes is about price, price, price, but they don't think on the difference or the lifestyle that you will get.
• 9:30
  SPEAKER_00: For example, when you go to a restaurant and you have ventures, you're not looking at prices.
• 9:36
  SPEAKER_00: You're looking what can I choose?
• 9:39
  SPEAKER_00: If it's the first time you've been here, subscribe.
• 9:42
  SPEAKER_00: That is what the channel is for.
• 9:44
  SPEAKER_00: And especially if you're in South Florida, there's a link in the description to set an assessment or a consultation that can lead you to better answers.