Years of dental neglect left Madam Agnes Fong with irreversible tooth loss. By her mid-40s, she had already lost seven upper (maxillary) and lower (mandibular) molars, which are required for chewing and grinding food.

The 59-year-old business owner used dentures initially but it left her feeling unsatisfied. The removable dental prosthesis made chewing harder foods like red meat and nuts challenging. In addition, her self-esteem plummeted – having to remove and rinse her dentures after every meal and at night made her feel “old”.

Switching to dental implants, she said, improved her quality of life tremendously and allowed her to enjoy many of her favourite foods again.

Like many older adults who have opted for dental implants, Madam Fong considers the implants one of her best health investments. Once considered an unconventional tooth replacement option, dental implants are now becoming the standard of care for older adults.

Prior to the availability of dental implants, there were only two ways to replace missing teeth: the use of removable dentures or a dental bridge. Today, improved imaging and surgical techniques as well as lower costs have driven the demand for dental implants.

But there is another good reason why dental implants are currently one of the fastest growing segments in dental care around the world, particularly in the Asia Pacific market where the geriatric population is growing: It is almost always the optimal way and best long-term solution to treat edentulism (missing teeth), said dental surgeon Dr Emmanuel Taylor.

“While there may be some rare exceptions, such as when extensive bone grafting may be necessary (due to severe bone loss), dental implants are superior in function to a removable denture or dental bridge,” he said.

Suitable for all ages and even in cases of complete tooth loss, a dental implant is a fixture surgically inserted in the jaw, which replaces an absent tooth root and has properties to fuse directly into the bone. Each implant should last the patient for the rest of his life if good oral hygiene is maintained, said Dr Taylor.

After the implant fixtures integrate into the natural jawbone, a process that may take weeks to months, an individual tooth, implant-supported bridge or denture containing multiple teeth will be attached permanently to the implant.

More than just aesthetics; Dental implants halt bone loss


Dr Emmanuel Taylor Interview 3
Apart from the discomfort and inconvenience, one of the main challenges of using removable dentures is gradual bone loss.

Teeth help support the jaw, and the lack of an anchor and stimulation initiates bone resorption. Over time, removable dentures would need to be remade or modified to maintain a proper fit due to tissue changes, shared Dr Taylor.

A similar effect can occur with traditional dental bridges, whereby the adjacent natural teeth have to be altered to fit them with crowns. Besides weakening the surrounding teeth, it also offers no protection against bone loss in the jaw due to the lack of tooth roots for natural bone maintenance.

However, a dental implant has the advantage of behaving almost like a normal tooth, and has the ability to physiologically support the surrounding hard and soft tissues to halt bone loss associated with the edentulous spaces, said Dr Taylor. In addition, patients can brush and floss as with normal dentition, leading to better oral health over the long run.

Current technologies and materials used for dental implants allow faster integration into the natural jawbone, shortening the time between the surgery and restorative phase of the treatment (crown placement). Moreover, better imaging and bone grafting techniques enabled dental implant placement even in difficult cases such as severe bone loss, said Dr Taylor.

While risks are inherent in any form of surgery, Dr Taylor shared that dental implant placement risks are “minimal” if proper surgical techniques are employed. Overall, the success rate is over 97 per cent. Even if an implant fails, there is an option of replacing it with another one depending on the bone available at the site.

In his practice, Dr Taylor sees many older adults with partial or complete edentulism, often a result of a lack of awareness and poor oral hygiene in their youth.

Studies from the United States suggest that over two thirds of adults aged 34 to 44 lose at least one permanent tooth. By the age of 74, it is estimated that a quarter of all adults will have lost all their permanent teeth.

“I have seen several cases in their 50s to 70s, whose entire maxilla or mandible is edentulous. In fact, it is far more common to see elderly patients who are entirely toothless by the time they are around the age of 70 than not,” he said.

Improved quality of life


Dr Emmanuel Taylor - Interview
For these patients, a new set of functioning teeth can be “life-changing”, he added.

Several studies have shown that dental implants can enhance patients’ quality of life, including one by Case Western Reserve University School of Dental Medicine which was published in the International Journal of Dentistry.

The researchers evaluated the emotional and sexual health, as well as the quality of life of 237 osteoporotic women and compared participants with dental implants with those without. Women with dental implants reported a higher overall satisfaction with their lives, compared with those who had non-implant-based restorations.
As life expectancy and dental needs increase, Dr Taylor expects demand for dental implant-related treatments to rise.

“Although dental implants are currently costlier in the short-term compared to fixed dental bridges or removable dentures, they are an economical long-term treatment for edentulous spaces as their advantage in health, function and satisfaction, as well as longevity, is superior to other replacement options,” he said. MIMS

Read more:

In conversation: Prosthodontist Dr Jeffrey Sng on the need for good oral health among the elderly
Tooth loss may be associated with other health problems