By Alexander Germanis
While it is no surprise that strategy is an essential element in the game of chess, few may realize strategy also plays an exceptionally important role in dentistry, particularly implant dentistry. While a chess player must think several moves ahead, a dentist must often think several years ahead in behalf of the wellbeing of their patient.
“Dentistry is a lifelong process,” confirms Emil Verban, Jr., DDS of Bloomington. “You always want to plan for the immediate needs of the patient, but always have as eye on the future.”
Due to a multitude of variables, teeth do not always behave the same way or have the same weaknesses. One tooth may succumb to cavities, be in need of a root canal, or need to be pulled entirely while the tooth directly next to it will remain strong and healthy the person’s entire life.
Rate of deterioration is also of particular issue with implant dentistry. “You may have a missing tooth and you want to replace it,” Dr. Verban says, “yet there are teeth that are in the process of deterioration adjacent to it.”
This is where looking forward comes in. A good dentist can recognize the potentially problematic teeth that may not be in immediate need of replacement but will certainly need to be in the coming years. In implant dentistry, it is often better to head such problems off at the pass, as it were. “Sometimes you have to extract those teeth and place more implants,” Dr. Verban says, “restoring it sooner in order to solve problems down the road.”
“Sometimes implants are placed strategically, so you use them to replace more than just the teeth that are currently missing,” he continues. “You might take that [implant] prosthetic off and convert it over to a larger prosthesis for later, when more teeth are lost.”
“It can be hard to plan for the future when you don’t know how long that future is going to be,” Dr. Verban explains. For instance, he has had some patients who started seeing him in their retirement years and are still seeing him for their dental needs over 30 years later.
Making those extremely long-term calls regarding a patient’s teeth is made more difficult when you realize how much a part of the patient an implant becomes. “Because the implant is going to be a permanent fixture in the bone,” he says, “you sometimes have to be more proactive about what you’re doing around the implant, as far as the adjacent teeth are concerned. Part of the long-term strategy for implant dentistry is cutting down on the chances of short-term complications.”
One complication in implant dentistry is the risk of infection. With a titanium implant — a root that will not decay — there is still the potential for the gum tissue around that implant to become infected. Part of the plan to avoid that risk involves selecting the proper size of prosthetic tooth.
“After you place the implant, you want the tissue to heal up around the neck of that tooth,” Dr. Verban explains. “So you use the prosthesis to condition and mold the tissue to heal in the way you want it to heal. If you make the provisional tooth too big, it’s not going to heal properly and cinch up around the neck of the prosthesis.”
Implant dentistry is clearly not a specialty with a narrow scope. Whether it is one implant being placed or several, multiple factors need to be taken into consideration. “You cannot have a limited, myopic vision of what you’re doing for the patient,” says Dr. Verban.
Keeping one eye on the future is the only way to ensure the continued success of the implant and the continued health of the patient.
Read “Treatment of Choice, Part 5,” in next month’s Healthy Cells to learn how implants and dentures can co-exist. If you missed the previous articles in this series, you can read them online at www.HealthyCellsBN.com or call Cheryl at 309-664-2524.
For more information, you may contact Emil Verban, Jr., DDS at 309-662-8448 or visit www.mcleancountydental.com. McLean County Dental is located at 2103 E. Washington Street in Bloomington. Dr. Verban provides his patients both general dentistry expertise and the ability to provide specialized services such as sedation dentistry, cosmetic procedures, and dental implants.