Thinking To Get Dental Implants in Malaysia ?

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PFM Crown Supported by Dental Implant
PFM Crown Supported by Dental Implant

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Are you anticipating tooth replacement? 

Perhaps you are missing teeth now or plan to have teeth extracted. Whichever the case, you are not alone.

A growing number of Malaysians are exploring dental implants. In fact, the trend toward implants has tripled in the last decade. Are implants right for you? Making a choice may be easier if you better l understand the differences between traditional tooth replacement and dental implant treatment.


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Traditional Tooth Replacement Measures

Crowns

Often called a “cap”, a traditional crown restores a tooth to its natural size, shape, and color. A crown is often used to cover a cracked or broken tooth or one that is too decayed to fill. In addition, a crown is sometimes placed for purely cosmetic reasons. Receiving a crown requires two or

more visits to the dentist. During the first visit, old fillings and decay is removed, then an impression is made of the tooth so that the crown can be made to look like the original tooth. A temporary crown is placed over the tooth. During the second visit, the temporary crown is removed and the new permanent crown is cemented onto the tooth structure. The procedure helps save a tooth that would otherwise be lost.

Fixed Bridges

A fixed bridge is an appliance that replaces one or more missing teeth. The appliance “bridges” the gap caused by the missing tooth. It is cemented into place and can be removed only by your dental care professional. Most bridges are constructed with a “dummy crown,” where the bridge is flanked by two crowns cemented onto the natural teeth on both sides of the gap. The crowns provide a solid anchor. If the natural teeth are in good condition, they may be used to anchor the bridge. Fixed bridges are a common choice among those who need tooth replacement. They are usually more attractive than dentures, and unlike dentures they have no prosthetic material covering the roof of the mouth or under the tongue. The average life of a fixed bridge is five to seven years.

Fixed bridges carry several disadvantages. The health of adjacent teeth is compromised if they are shaved down to accommodate crowns necessary for anchoring the bridge. The chance of recurrent decay around the edge of the crown or on the root also increases. The potential for gum disease increases. The anchor teeth frequently require root canal treatment.

Dentures

Full dentures, or “false teeth,” are appliances often used by individuals who are missing all upper and/or lower teeth. Dentures are made of acrylic. There are two options for dentures. One is immediate dentures-the dentures are placed in the mouth immediately after the teeth are removed. 

Conventional dentures, the second option, are placed in the mouth four to eight weeks after the teeth have been removed and the gums have healed. In the case of immediate dentures, the appliance is sometimes lined with a soft material so it will sit comfortably on the gums. Conventional dentures are adjusted over a period of weeks until the fit is more comfortable.

Dentures offer several advantages. They are durable and will usually last three to five years. They improve appearance by replacing decayed or missing teeth. If you have no teeth, they make chewing easier, and aid speech; dentures are generally economical.

However, dentures also have disadvantages. Dentures may affect appearance and speech, eroding one’s confidence. Gum sores may develop, making it difficult to wear the appliance. It may take several months to learn to eat with dentures, and they have only 25 percent of the chewing efficiency that natural or non-removable teeth have. The plastic roof of the denture diminishes taste. Taste is further impaired if glues are used to hold dentures in place. Even with dentures, bone loss continues, caused by the uneven pressures of the dentures “bouncing” over the gums hundreds of times a day. This process of bone shrinkage and deterioration is known as resorption. In the long term, this may cause shrinkage and structural damage to the lower third of the face.

A long-term denture wearer, this woman has a "bite collapse” caused by bone shrinkage, resulting from tooth loss. At right the same woman is shown with dental implants.
A long-term denture wearer, this woman has a “bite collapse” caused by bone shrinkage, resulting from tooth loss. At right the same woman is shown with dental implants. 

Partial dentures are frequently used today as an option for replacing one or several teeth. Partial dentures are made of a pink plastic base with white replacement teeth attached. Their metal framework attaches to your natural teeth with metal clasps. Partial dentures are a quick, economical solution to missing teeth, and offer essentially the same benefits as full dentures; however, they also bring similar disadvantages. Since partials clamp onto remaining, natural teeth, they may cause the natural teeth to loosen over time. Decay may develop where the clamps rest on the natural teeth.

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Advantages of Dental Implants

As an alternative to traditional tooth replacement, dental implants are gaining favor around the world. The materials used to make implants are compatible with human tissue and offer greater strength and comfort than traditional dentures and bridges. Research shows the following as key reasons why the use of implants is on the rise.

• Improved appearance: Implants slow or stop bone from shrinking. Facial structure is not affected. Teeth appear natural. Bone growth is strengthened and stimulated by implants.

• Improved Comfort: Gums are not irritated or injured as they often are with moving dentures.

• Improved Speech: Implants are stable. Loose dentures may impede speech and make clicking sounds.

• Improved Eating: Chewing efficiency is similar to that of natural teeth. Ability to taste is not affected.

• Better Health: Better nutrition is possible with improved eating ability.

• Convenience: Implants are secure. You can’t lose or misplace your implanted teeth.

• Reliability: Peace of mind, knowing the teeth are permanent.

• Self Esteem: Improved appearance increases confidence.

Are You a Candidate for Implants?

To undergo implant surgery, you must have reasonably good health. Some doctors say if you’re healthy enough to go to the dentist to have a tooth pulled, you’re probably healthy enough to have dental implants. Still, there are several factors to be considered.

Are Your Bones and Gums Healthy?

In addition to good health, one of the most important criteria for being able to have dental implants is the quality of the bone in your jawbone, where the implants will be inserted, The bone must have sufficient thickness and height to accommodate the implants. Problems with bone may arise if your jawbone has been injured in an accident, if the bone is diseased, or if you have been without teeth or worn dentures for a long time. If these problems arise, the solution is often a bone graft.

Also, you need to have adequate gum tissue. The dentist must check to see if the level of the gum where the tooth is missing matches that of the neighboring teeth. A check is made for any defects in the gums that may prohibit the use of an implant. The health of the teeth adjacent to the implant is important too. The presence of periodontal disease can lead to bone loss. Such loss not only affects the quality of the bone but also causes gums to pull away from the teeth. Either of these conditions would affect the esthetics of the implant. 

These criteria for implants will vary, depending on whether you’re replacing one tooth, several teeth, or all teeth.

Does Age Matters for Dental Implants?

For adults there is virtually no age restriction. Although seniors often express concern that their age may prevent them from having dental implants, their health is more of a determining factor than age. Patients in their 80s and 90s have permanent implant-supported teeth.

X-ray of implant with abutment
Top of implant
New, left front tooth
New, left front tooth

For young people, it is best that they wait to get implants until their jaws have come to maturity. This usually means age 18 for both boys and girls. However, each patient can be evaluated individually. For a child who may be missing teeth due to a congenital abnormality, an implant may be an appropriate choice.

Does Smoking affect the outcome of the Dental Implant?

Just as smoking increases the risk for periodontal disease, it may also create problems for implant surgery patients. As the toxic elements from smoke enter the bloodstream, circulation may be impaired, delaying the healing process. As a result, new bone formation could be diminished and the bone may not fuse to the implant. The implant may be lost. Smoking is highly discouraged for anyone who has undergone dental implant surgery. Studies show that smokers have a higher failure rate with dental implants than nonsmokers. 

What About Underlying Health Problems?

As stated earlier, if you are in reasonably good health and have adequate bone structure and gum tissue, you should be able to have dental implants. Even if you have an underlying health problem, such as heart disease or diabetes, you may have implants as long as your medical condition is well controlled. You are not at increased risk for having an implant failure.

Congenitally missing lateral incisors.
Congenitally missing lateral incisors.
Missing incisors replaced with dental implants
Missing incisors replaced with dental implants

What if you have osteoporosis? Many patients with osteoporosis have been successfully treated with dental implants. If you have osteoporosis, your surgeon will likely contact your physician; jointly, they will evaluate your health status and determine whether you should have implants. Osteoporosis by itself does not present a risk for implant placement; to date, there is also no scientific evidence that osteoporosis presents a risk for implant failure. In fact, some patients have shown increased bone deposits around their implants.

You would not be a candidate for dental implants if you have uncontrolled diabetes, are receiving chemotherapy or radiation therapy to the face or jaws, or have an untreated parathyroid disorder or blood or marrow disorder. 

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Finding the Right Doctor

You must choose a highly skilled, experienced doctor to perform your surgery and place your crowns. The doctor’s skill is a key factor in the success of your implant treatment. If you’re not sure whom to contact about dental implants, you may wish to ask your dentist. He or she may be trained in implant surgery and will treat you or will refer you to other doctors. You may also get referrals from your primary care physician as well as from family members and friends. 

Keep in mind that that you may work with one or more doctors. For example, an oral surgeon, a periodontist, or a prosthodontist may surgically insert your implants. Then another dental professional who specializes in tooth restoration may place your crowns. Or, in some cases, one doctor may perform both the surgery and place the crowns. Depending on their area of expertise, any of the following doctors may perform your implant surgery and/or placing your crowns.

General Dentists

Dentists are educated and licensed to engage in all aspects of oral health. They are required to have a college degree as well as 5 years of training in dental school. The D.D.S. you might have noticed after your dentist’s name stands for doctor of dental surgery. Some dentists hold a D.M.D. degree, meaning a doctor of dental medicine. These are equivalent degrees. All dentists must have a license to practice from the state in which they operate their practice. Dentists acquire additional training to receive one of the following titles associated with a specific dental specialty.

Prosthodontist

A prosthodontist is a dentist who has had two or more years of advanced training in cosmetic dentistry, dental implants, denture therapy and fabrication, crowns and bridges, fixed and removable partial dentures, tempro-mandibular dysfunction (TMD), facial prosthesis, and total mouth rehabilitation.

Periodontist

A periodontist is a dental specialist who diagnoses and treats the gums and supporting structures and tissues. Training takes three additional years after obtaining the D.D.S, degree. Periodontists are trained in all phases of implant surgery, bone and gum grafting, as well as non-surgical and surgical methods for treatment of periodontal disease

Oral and Maxillofacial Surgeon

Oral and maxillofacial surgeons are dentists who have completed four to seven years of surgical training in a hospital. They specialize in surgery of the mouth, face, and jaw, including implant surgery and reconstruction of jaw defects. Oral surgeons perform bone grafting for implant patients, patients with jaw fractures, and those with facial deformities. Oral surgeons are trained to provide IV sedation and general anesthesia.

Do Dental Implants Cost More?

Dental implants cost more than traditional dentures and bridges for several reasons. A team of highly skilled professionals is involved in the process, To make a comprehensive diagnosis, dental professionals must perform several diagnostic tests. Based on their evaluation, a patient receives a highly customised treatment plan that takes into consideration overall health needs as well as the esthetic and functional requirements related to implant placement. In Malaysia , the price range of a dental implant (tanam gigi / implan gigi) is from RM 6500 – 10,000*

Some patients may require additional procedures, such as bone grafting, to ensure the long-term health of their implants. Bone Grafting plus collagen membrane (GBR) prices in Malaysia normally ranges from RM 2000 to RM 3500* . Other patients may require sleep sedation or anesthesia. In addition, implant bridges and dentures contain precious and semiprecious metals and are fused with porcelain. These must be artistically applied by experienced technicians. Normally for one unit of porcelain fused metal (PFM) for an implant supported in Malaysia ranges from RM 1500 – RM 3000*

*estimated prices only without official verification or survey

Fees will also depend on the number of teeth you are having replaced and the number of implants required to support your replacement teeth. Typically there is a fee for surgical procedures and a separate fee for attaching the posts and constructing your replacement teeth. After a thorough diagnostic examination, your doctors will recommend a treatment and outline costs.

The cost for implant replacement of a single tooth is greater than the cost of a three-tooth fixed bridge. Generally, crowns and fixed bridges are expected to last about five years to seven years, while an implant should remain in your bone for the rest of your life. In the end, the decision to have implants is a personal one. One must evaluate the cost of treatment with the physical and psychological long-range benefits that come from having secure, functional, attractive teeth.

Does Insurances in Malaysia Pay for Dental Implants?

Does dental insurance pay for dental implants? Unfortunately, most insurance plans do not. Most insurance companies do not see implants as a medical necessity and will pay only for less costly restorations. Some insurance companies will pay for the special bridges or dentures used with implants but will not pay for surgical fees for the implants themselves.

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