Monday, June 20, 2005
Copyright © Las Vegas Review-Journal

Word of mouth hails dental implants

Procedure provides bite strength 10 times that of dentures

Dr. Richard Seberg examines Jewel Mlynek at his office last week in preparation for her dental implants. Photo by John Gurzinski. Anatomy of a dental implant After a dentist surgically places an implant into the jaw, a post is attached to the implant. Finally, a porcelain crown is placed on top of the post. Depending on the patient, the process can take as little as one day or as long as eight months.

When Jewel Mlynek chews her food, she never can forget how reality bites.

"My family followed the fruit harvests around the country, so we had enough money from picking fruit for food but not for dental checkups," the 67-year-old mother of three said recently after her Las Vegas dentist, Dr. Richard Seberg, checked on a bone graft he made to her gums. "We only went to the dentist if a tooth was hurting."

That lack of preventive care cost her almost half her teeth.

And it's now costing her nearly $50,000, or about $4,000 a tooth, to get 12 dental implants.

It's a price that she and her husband, who retired from the Air Force, are more than willing to pay.

"I can't tell you how exciting it is to know I'll soon be able to really smile and to be able to chew food with something other than my front teeth," she said. "I never wanted to get dentures because my mother and sister had so many problems with them."

In the most simple terms, dental implants are metal posts surgically positioned in a patient's jawbone -- a solid foundation for replacement teeth.

Statistics show that nearly 800,000 dental implants were done nationwide in 2004.

"The number done has more than quadrupled since 1986," said Dr. David Johnson, a spokesman for the American Dental Association. "I think dental implants, along with fluoridation of the water to help prevent decay, are the two most exciting things in dentistry in my lifetime. It's revolutionizing the way we treat patients."

A person with dentures, he said, can chew with 40 pounds of force, compared to 400 pounds of force for someone with dental implants.

"Having implants is just about the same as natural teeth," he said.

At least 69 percent of adults ages 35 to 44 have lost at least one tooth, Johnson said. And 26 percent of people between the ages of 65 to 74 have lost all their teeth, becoming what Johnson calls "dental cripples."

"We have too many people whose nutrition and self-confidence are hurt by dental problems," Johnson said. "More and more people are moving toward dental implants both for self-esteem and health."

The demand has become so great in Las Vegas that Seberg devotes almost his entire practice to implants. "People with dentures have come to me because they have had them fall out in public and they can't take the embarrassment," Seberg said.

Kevin Mosher, vice president and general manager of Switzerland-based Nobel Biocare, a leader in dental implants, said the industry is growing by 20 percent a year.

"It is a $1.5 billion-a-year industry, and it's going to grow more now that many people can go into an office and walk out with beautiful teeth the same day," he said.

Seberg said about 40 percent of his patients can do that.

To start the procedure, a dentist surgically places the implant into the jaw. Next, a post is attached to the implant. An acrylic crown is then temporarily attached to the post. Finally, after eight to 10 weeks, the acrylic crown is replaced by a porcelain one.

But for people who have bone damage, the process can take as long as eight months.

"We put the permanent teeth in as soon as the tissues return to normal from the implants," Seberg said.

It was a Swedish researcher, Dr. Per-Ingvar Branenark, who really gave birth to the idea. He discovered more than 40 years ago that titanium dental implants would fuse with jawbone.

Many people, including Mlynek and George Jones, also a patient of Seberg, have lost teeth or suffered gum disease resulting in bone loss that initially makes dental implants impossible. So they get bone grafts.

Donor bone graft is sewn into the gum and takes about four months to heal.

Once that process is complete, the dentist places the titanium implants under the gum. They fuse in about three months, and then the surgeon places the posts and teeth.

"He makes a prosthesis for you to wear while you're waiting for your new teeth," said Jones, who had 14 implants. "You're not left out there looking like an idiot."

The operations can be done under local anesthetic, but Seberg often does it using sedation, calling in an anesthesiologist to handle that part of the procedure.

"There's very little pain involved," Mlynek said.

Though few insurance plans currently cover dental implants, that could change.

Elizabeth Risberg, a spokeswoman with Delta Dental Insurance Co., said Delta does offer coverage at a higher premium cost. "It's up to employers whether they want to offer it and what part of the cost they want to cover," she said.

Dr. Gordon Douglass, a spokesman for the American Academy of Periodontology and former president of the organization, said the initial cost for a dental implant isn't much more than for a fixed bridge.

"And it lasts longer, and you don't have to file down nearby teeth like you do for a bridge," he said.

Maintenance often is needed on bridges after five to seven years, and implants have a life expectancy of 15 years, studies show. "I personally have patients who have had their implants more than 20 years," Seberg said.

Out of 100 implants, Seberg said, five to seven "won't take the first time."

"They have to be redone because they won't adhere to the bone," he said. "Or there could be an infection."

Jones, a founder of an energy conservation company, couldn't be happier with his implants.

"I can eat well for the first time in a long time," the 78-year-old executive said. "And I can tell you something else. They always say that you can't take it with you when you die. Well, I am. I paid a lot for these teeth. I've got a Mercedes mouth now, and it's definitely going with me."