When your smile doesn't make you smile

Are implants right for you?

Imagine not having your front teeth. You had a bad fall and weren’t able to save them in time, or your genes predispose you to losing bone mass. Or you lost them to severe gum disease. Whatever the reason, you’re missing two teeth. Would you have them replaced?

Dr. Tyler Verhaeghe, a professor at the School of Dentistry, says a lot of thought needs to go into that question. “It’s not always about aesthetics.”

On top of aesthetics, considerations include:

• The function of the teeth

• How others perceive them, financial matters

• Their own psychological wellbeing or confidence.

He says most often teeth missing in the ‘smile zone’ at the front of the mouth are replaced for aesthetic reasons while those at the back for functional reasons. “But it’s a really personal decision. Some people can manage just fine with missing teeth, depending on what stage of life they’re in and where their priorities lie.”

For prosthodontists, dentists like Verhaeghe who specialize in designing, manufacturing, and fitting artificial replacements for teeth and other parts of the mouth, Verhaeghe says it’s all about building the relationship with the patient.

He says, “Most doctors spend at least two — if not more — appointments before anyone makes a decision.”

Both sides need to have clear expectations of the prosthesis. What do you want out of it?

“And it can come down to little nuances,” he says. “Some patients don’t want something removable because that would make them feel like their grandparents.”

Dental implants, like any implant, pose risks. They can be rejected or fail for a number of reasons.

They also need to be maintained with a home cleaning routine and continued visits to the dentist. And even then, most implants last 10-15 years.

On top of all that, a treatment plan may include referrals to specialists before the implant can be safely put in. Straightening the teeth, or getting a root canal for example.

Verhaeghe remembers a patient at the clinic missing a few teeth on one side of her mouth. On the other side, she had a gold bridge.

During her initial appointments, she told the team that even though she was blind, she wanted her grandchildren to appreciate when she smiled at them. She wanted a second bridge to mirror the one she had. One instructor suggested she also put a diamond on her upper front teeth.

When she came back for her first checkup appointment, she was so happy she was almost in tears. Verhaeghe says, “She hugged everybody! Her grandkids had said, ‘Oh grandma your teeth are awesome!’ And that just gave us such a sense of accomplishment. It’s something the literature could never describe.”