I have commenced dental treatment in Krakow- to date I have had 4 front teeth removed, a temporary bridge fitted and bone regeneration work in readiness for 2 implants. The dentist in Poland insists that I have about 20 fillings replaced (mainly old amalgams) before having implants fitted because it would give the implants more chance of surviving. My local dentist, in Wales, does not believe this is necessary as x rays do not reveal any evidence of infection or cavities. I still have to cost the various options available to me but I am extremely disappointed that the respective dentists are not in agreement. Does any reader share a simiar experience or have any thoughts on this matter.
I really do not see how replacing old yet still intact fillings in unrelated teeth will help implants to intergrate with the jaw bone and survive unless there was some underlying periodontal (infected bone or tissue) issues - but that still would not warrant replacement of fillings unless they had become porous and allowed debris to infect the under lying tooth structure. Is it perhaps that the dentist wants to replace the fillings with more aesthetically pleasing fillings such as composite or white fillings? I had 7 implants many yrs ago and it was suggested back then I replace my old amalgams with composite fillings but for cosmetic reasons since my new bridges attached to the implants would be so pretty and white - I had 2 replaced and stopped since I did not like how they felt and decided a few nice teeth and bridges were enough for me and left the others alone since they remained intact. I think you could be opening yourself up for a lot more than you bargained for by redoing every filling - especially since they are fine and not bothering you.
Keep this in mind - those who wear dentures and opt for implants to secure their dentures do not have teeth at all and their implants survive none the less - fillings don't really have a role in an implant intergrating with the jaw bone. The density and condition of the underlying bone, the actual placement of the implant by a competent dentist or surgeon in a sterile environment and the overall health and lifestyle of the patient including their oral hygiene routine are what matters.
Last edited by Thelma-Louise; 11-20-2007 at 02:20 PM.
Thank you for your swift response Thelma-Louise. I am not interested in having the work undertaken for cosmetic reasons.Anyway I believe that the dentist in Poland is saying that it is to promote 'sterility'.Please see the reply from an intermediary (a person arranging the treatment for me in Poland) when I raised the issue before.
Thanks for your email. I've just spoken do the dentist. He said that your old fillings and any cavities in your teeth must be healed before implant insertion. This is because, as any dental book says, the main condition for implants is sterile environment in your mouth i.e. healthy gums, bones and teeth. Without that, it is a medical mistake to put implants. As you realise it is a major dental operation, and also, there is 97% acceptance rate for implants. With bad teeth, this rate can be lowered drastically, and your implants are more likely to be rejected after some time. It would mean that you lost money and time you spend on them. Moreover, after successful implant insertion you still have to keep sterile condition in your mouth, how can you do this when 20 of your teeth are neither healthy or have old amalgam fillings? We give 10 years guarantee on implants, it means that we can assure you that our implants, if accepted and properly looked after by you, will be there for at least 10 years. Please ask your local dentist, if he could place implants, despite these 20 fillings and at the same time guarantee you financially that they will be there in 10 years time? Dr (Name removed), our implantologist, who holds PhD diploma in dental surgery, said that he would not take a risk to place implants, without providing you proper conditions in your mouth.
The intermediary is implying that your teeth and existing fillings are in a state of decay and therefore pose a risk in terms of exposing the implants to a non-sterile or compromised environment during surgery. Since you have already checked with a local dentist who confirmed your existing fillings were intact and not decaying and the health of your teeth and gums appears to be Ok - the only other thing I might do is to ask the dr in Poland to send you a copy of your xrays and bring them to a 3rd local dentist or oral surgeon for his evaluation. There seems to be a difference of opinion in terms of whether you have existing cavities and whether existing fillings are viable and sound. Its one persons word or opinion against another so a third evaluation by an unbiased party may be necessary.
I had 7 implants done and only 2 of my remaining 14 teeth, all of which had old fillings, were redone (for cosmetic reasons) and the implants lasted 15 yrs (and they offered no guarantees) - they would have lasted longer but I chose to have them removed due to tmj issues I developed shortly after having the bridges replaced. They never got infected despite my developing 3 new cavities in teeth with older fillings over the next few yrs. While yes it is true it would be a waste of time and money to perform implants on an unhealthy mouth it seems they are more concerned about financially guaranteeing the implants for 10 yrs which to be honest I have never met a dentist that could guarantee such a thing. If they re-do the fillings and you still lose an implant then they will try and suggest you did not maintain it properly and will, I am sure, re-implant it at no cost meanwhile you paid more out of pocket to have your other fillings done with no justification. Most dentists get 97% success rate with implants ( I doubt you will find one who says he get 80% or less) - failure of an implant usually occurs within the first 6 months to a yr or during the healing period and once a implant fully intergrates with underlying bone it can take a few years of neglect or improper or lack of cleaning before signs of an infection become apparent and longer before failure actually occurs, just like with natural teeth. To be honest I feel once an implant intergrates with surrounding tissue the prosthetics (crown, bridges, dentures) is what matter more since they cover the implant and can torque them if not made or fitted correctly or can interfere with the ability of keeping the underlying implant area near the gum tissue clean. What does surprise me is that they did not suggest periodontal surgery such as root planing or scaling to remove any plaque that may be residing on the base of existing teeth beneath the gum surface - this would pose more of a risk and would be more likely to be present if your mouth was actually in the condition they are suggesting - certainly more than a than a few cavities might cause.
I know its not easy wading through the options , pros/cons, different opinions ,etc - so take your time and eventually you will be able to make an educated decision about what to do I am sure.
Last edited by Thelma-Louise; 11-20-2007 at 10:55 PM.