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 When researchers asked 75 people who received dental implants in the
past year if they had complications such as bleeding, pus or loose
replacement-tooth “roots,” they expected clinicians to routinely
catch problems that the patients missed.
But that didn’t happen.
Because the mouth is a very sensitive part of the body, it’s not
surprising that patients and clinicians had a similar opinion about
post-implant oral health, said Bruno Chrcanovic, a researcher in
odontology at Malmo University in Sweden who wasn’t involved in the
study.
That doesn’t mean patients are forever in the clear, however, or
that all problems can be easily detected without regular dental
checkups, he said.
“Some patients have the feeling that they understand the problem and
can properly deal with it by themselves,” Chrcanovic said by email.
“It is not always true.”
About 3 million people in the U.S. have dental implants, and another
500,000 implants are placed each year, according to the American
Academy of Implant Dentistry.
Implants are artificial tooth roots – typically titanium posts -
inserted into the bone of the jaw to replace missing teeth. An
implant with an attached crown, functions like a normal tooth and
can help preserve the jaw structure and prevent bone loss, unlike
bridgework or dentures.
While generally safe, dental implant procedures, like any surgery,
are not risk-free. Patients can develop damage to blood vessels,
nerves, sinuses or other teeth. They can also get a serious
condition known as peri-implantitis, a bacterial infection that can
lead to inflammation around the post and bone loss.
The study, co-authored by Dr. Simon Wright of the Implant Centers of
Excellence in the U.K., tested a hypothesis that patients can’t
perceive the difference between successful and unsuccessful
implants. Wright didn’t respond to emails seeking comment.
Patients who received implants from one of two dentists at the
practice within the previous one to 11 months were asked to complete
questionnaires and have an exam to see if their responses lined up
with what clinicians saw in their mouth.
The patients ranged in age from 23 to 92 years old, and none of them
was treated as part of the National Health Service, the U.K.’s
publicly funded health system.
Researchers focused on five areas of post-implant health:
aesthetics, loose restorations, bleeding or pus, fractured implants
and what’s known as occlusion, when the upper and lower teeth
collide when the mouth is closed.
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On all five of these variables, there wasn’t a significant
difference of opinion between the patients and the dentists,
according to the results published in the British Dental Journal.
Patients perceived fractures in 5.3 percent of restorations, whereas
dentists detected fractures in 1.4 percent.
For loose restorations, patients thought this of 14.7 percent of
implants, while dentists found 13.3 percent of restorations to be
loose.
With occlusion, patients reported this 1.3 percent of the time, but
dentists found it during 5.3 percent of exams.
Patients may have been fairly accurate in assessing their own oral
health because they were educated on the potential risks before
implant surgery and then taught proper implant care after the
procedure, the researchers note. The study is also too small to draw
conclusions about a broader patient population.
Patients who aren’t well educated may struggle to spot complications
and also be less likely to continue with routine checkups, said Dr.
Frank Strietzel, an oral health researcher at Charity Medical
University Berlin.
“If the patient will not follow the advice of the dentist, there is
a risk of undetected inflammation around the implants,” Strietzel,
who wasn’t involved in the study, said by email. “A dental implant
is a foreign body like a prosthesis, which requires regular
observation.”
SOURCE: http://bit.ly/1gqkVc1 British Dental Journal, online June
12, 2015.
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