Health & Wellness

Choosing dentist for implant

  • Last Updated:
  • Sep 2nd, 2021 12:41 pm
[OP]
Member
Dec 24, 2010
398 posts
265 upvotes
Montreal

Choosing dentist for implant

Hi

Not sure this is the right forum to discuss this but I need some advice regarding dentist to make implant.

I got one tooth implanted about 9 years ago. Lately I also lost the tooth and need another implant.

My current dentist could do this implant, but he said that should my other implanted tooth cause any problem ) he is unlikely be able to correct it.

Now I am torn of whether I should let my current dentist do this implant.

1) does tooth implant last "forever"?
2) does tooth implant carry any warranty?
3) is it wise to have 2 different dentist do different implants should something happen?

would appreciate some advice
14 replies
Deal Addict
Jul 26, 2004
4903 posts
1942 upvotes
So did you lose the implant with the crown that was placed 9 years ago or did you lose another tooth?

Depending on the cause of the implant failure, it might not be wise to re-do. If the problem with the implant is caused by implantitis or you have uncontrolled gum issue then there might be issues for future implants. Case selection is fairly important for implant viability.

To answer your questions...

1) Nothing lasts forever, however, with proper maintenance, there are no reason why implants can't lasts decades. Implants are still susceptible to " gum issues" which they call implantitis, severe cases can lead to gradual rejection of the implant and eventual lost. The crown part of the tooth can still be damaged since they surface layer is frequently made of ceramic, which can chip or even wear eventually with time.

2) Depends on what part of the implant and cause of the failure. If you're saying the crown/tooth part of the implant chipped/broke within a year or two. There might be warranty depending on the lab that made the crown. Another possible failure point is the screw that holds the crown to the implant. Breaking of that screw is uncommon, but not unheard of. But there must've been some design failure for a screw to break since it does take some force to break.
If you're talking about the actual titanium implant that goes into your jaw bone, those usually come with a long warranty period, however, its rarely the implant that " breaks" and its the conditions around it that causes failure. Its very difficult for a titanium implant to " break " .

3) Thats to your comfort level and confidence in your dentist. Might be better to have the same person do both so they understand your mouth? But as long as the dentist is competent in implants, it'll be ok.
Deal Addict
Aug 17, 2008
1551 posts
1171 upvotes
My opinion is that while some general dentists can do implants, I would always go with a specialist to do implant work. Even if a general dentist can do implants, they would do only a handful each month, and will not have the same depth of training as a specialist. I'd rather see a specialist for implants.

Periodontist is the specialty that does the most dental implants. another specialty that does implants is "Oral and Maxillofacial Surgeon" -- oral and maxillofacial surgeons can fix traumatic jaw injuries, birth defects, and have a lot more training in complex oral surgery. But in day to day practice, periodontist is the specialty that does the most dental implants. If there is something wrong with your old implant, you would likely need to see an periodontist, or perhaps even an oral and maxillofacial surgeon.
Deal Expert
Feb 7, 2017
22774 posts
21609 upvotes
Eastern Ontario
Nothing says all your dental work has to be done by one person …
Infact for most people that just isn’t possible
As we move many times in our lives

Agree with @multimut go to a specialist like a Periodontist or an Oral & Maxillofacial Surgeon
Those folks have the most expertise & experience with implants … and other issues of the jaw bone etc

I take it right now there is nothing wrong with your current implant
You are a happy customer … that’s good

As for the second one …
You can go back to the same guy who did the first
Or somewhere else

These two things are similar (both implants)
But not necessarily tied to each other

A specialist … will be able to advise & care for both what you have & what you need
[OP]
Member
Dec 24, 2010
398 posts
265 upvotes
Montreal
coilz wrote: So did you lose the implant with the crown that was placed 9 years ago or did you lose another tooth?
I lost another tooth next to the implant due to the 2 month 1st wave covid could not go to any dentist and tooth got infected at the root.
coilz wrote: Depending on the cause of the implant failure, it might not be wise to re-do. If the problem with the implant is caused by implantitis or you have uncontrolled gum issue then there might be issues for future implants. Case selection is fairly important for implant viability.
I am getting an infection but it seems that it is not due to the implanted tooth. But my current dentist said that should my old implant run into some problems, it would be very difficult for him to correct since he has no information on what the original implant is made, brand etc except for the xray. Hence I worry that hwne i reach the advanced age and may have dental implant failure, I have to trace back to who ever installed it, if he or she is still in the business. if for example I have 3 different dentists do 3 teeth, my then-dentist would then have to send me to trace back to which dentist did the orginal installation, and each time it would be new x rays diagnostics etc.... Seem like to be a nightmare when you get there...

coilz wrote: 1) Nothing lasts forever, however, with proper maintenance, there are no reason why implants can't lasts decades. Implants are still susceptible to " gum issues" which they call implantitis, severe cases can lead to gradual rejection of the implant and eventual lost. The crown part of the tooth can still be damaged since they surface layer is frequently made of ceramic, which can chip or even wear eventually with time.
Does it mean any dentist can correct the crown part for example?
coilz wrote: 2) Depends on what part of the implant and cause of the failure. If you're saying the crown/tooth part of the implant chipped/broke within a year or two. There might be warranty depending on the lab that made the crown. Another possible failure point is the screw that holds the crown to the implant. Breaking of that screw is uncommon, but not unheard of. But there must've been some design failure for a screw to break since it does take some force to break.
If you're talking about the actual titanium implant that goes into your jaw bone, those usually come with a long warranty period, however, its rarely the implant that " breaks" and its the conditions around it that causes failure. Its very difficult for a titanium implant to " break " .
Thanks - good to know
coilz wrote: 3) Thats to your comfort level and confidence in your dentist. Might be better to have the same person do both so they understand your mouth? But as long as the dentist is competent in implants, it'll be ok.
Understood. Is it really a challenging art, and does the specialist worth maybe a 30% premium? I would not fool around with my jaw bone and implant (I only got one jaw bone and one life) but my worry is more that my current dentist is younger and likely to be in business a decade from now, whereas the other may not be. So if problems arise and finger pointing occurs, is it better to trace the one that has retired or the one still there but does not have all the orginal medical file/info on the original installation?
[OP]
Member
Dec 24, 2010
398 posts
265 upvotes
Montreal
PointsHubby wrote: Nothing says all your dental work has to be done by one person …
Infact for most people that just isn’t possible
As we move many times in our lives

Agree with @multimut go to a specialist like a Periodontist or an Oral & Maxillofacial Surgeon
Those folks have the most expertise & experience with implants … and other issues of the jaw bone etc

I take it right now there is nothing wrong with your current implant
You are a happy customer … that’s good

As for the second one …
You can go back to the same guy who did the first
Or somewhere else

These two things are similar (both implants)
But not necessarily tied to each other

A specialist … will be able to advise & care for both what you have & what you need
Thanks. Appreciate the feedback
[OP]
Member
Dec 24, 2010
398 posts
265 upvotes
Montreal
multimut wrote: My opinion is that while some general dentists can do implants, I would always go with a specialist to do implant work. Even if a general dentist can do implants, they would do only a handful each month, and will not have the same depth of training as a specialist. I'd rather see a specialist for implants.

Periodontist is the specialty that does the most dental implants. another specialty that does implants is "Oral and Maxillofacial Surgeon" -- oral and maxillofacial surgeons can fix traumatic jaw injuries, birth defects, and have a lot more training in complex oral surgery. But in day to day practice, periodontist is the specialty that does the most dental implants. If there is something wrong with your old implant, you would likely need to see an periodontist, or perhaps even an oral and maxillofacial surgeon.
Thanks.

So a specialist would be a periodontist? Both dentists I am referring to are general dentists.
Deal Addict
Jul 26, 2004
4903 posts
1942 upvotes
BestFind wrote: I lost another tooth next to the implant due to the 2 month 1st wave covid could not go to any dentist and tooth got infected at the root.


I am getting an infection but it seems that it is not due to the implanted tooth. But my current dentist said that should my old implant run into some problems, it would be very difficult for him to correct since he has no information on what the original implant is made, brand etc except for the xray. Hence I worry that hwne i reach the advanced age and may have dental implant failure, I have to trace back to who ever installed it, if he or she is still in the business. if for example I have 3 different dentists do 3 teeth, my then-dentist would then have to send me to trace back to which dentist did the orginal installation, and each time it would be new x rays diagnostics etc.... Seem like to be a nightmare when you get there...



Does it mean any dentist can correct the crown part for example?

Thanks - good to know

Understood. Is it really a challenging art, and does the specialist worth maybe a 30% premium? I would not fool around with my jaw bone and implant (I only got one jaw bone and one life) but my worry is more that my current dentist is younger and likely to be in business a decade from now, whereas the other may not be. So if problems arise and finger pointing occurs, is it better to trace the one that has retired or the one still there but does not have all the orginal medical file/info on the original installation?

Ok I see what you mean now. You do bring up a good point that needs consideration with regards to brands of implants. In north america dentists commonly use just couple brands of implant systems, those being Strauman, Nobel biocare, Dentsply astra, and Zimmer. Knowing what brand/system/model used is important when it comes to restoring the implant since the screw head/attachment is slightly different between some brands. Hence lays the problem for the dentist when he/she encounters an unknown system, won't know what parts to order to make the crown. So good practice to keep a record yourself of what brand/model and size of implant was used to facilitate repair of the implant in the future if needed. As long as the dentist restoring the implant ( making the crown) knows what system is used, they'll be able to get you a new one.

Is it a challenging art? With advent of 3D CBCT scans and guided implant placement it does make implant placement easier. The premium you pay for specialist is for when complications arises. That's not to say some general dentists don't have experience placing implants, I personally know a few general dentist that in fact some actually do alot of implants and have great success. But when it comes to more extreme complications, specialists such as a periodontist and oral surgeons will be able better equiped to handle them. It comes back to case selection, if it's going to be a difficult case, best to leave it to the specialists to handle.

As long as the dental clinic you went to do the implant didnt burn to the ground, there usually will be records. It's rare that established clinics close down and disappear, what usually happens when the dentists retires is they'll sell their practice and the records continue to be passed to the next owner. A non-owner dentist that moves around don't usually take records with them when they switch jobs.
Last edited by coilz on Aug 31st, 2021 5:46 pm, edited 1 time in total.
Deal Addict
Aug 17, 2008
1551 posts
1171 upvotes
BestFind wrote: Thanks.

So a specialist would be a periodontist? Both dentists I am referring to are general dentists.
Yes, the dental specialist that does the most implants is periodontist.
Oral and Maxillofacial Surgeons, is another speciality that does dental implants, but also do all sorts of more complex surgeries like reconstruction of jaws after traumatic accidents.

FYI, here's an article on why dental implants may fail:
https://www.healthline.com/health/denta ... ss-factors
Deal Fanatic
Dec 12, 2009
5417 posts
2910 upvotes
Toronto
A Prosthodontist once told me they refer based on what the patient presents. If they are concerned about the soft tissues i.e. gums they tend to refer to a Periodontist. If the hard tissues i.e. bone they lean towards the OMFS. And they consider who has given the better results for similar cases.
For a simple single tooth replacement they said that many GP's now have adequate training and experience.
Implant dentistry has developed over the last 25 or so years.
Deal Expert
Feb 7, 2017
22774 posts
21609 upvotes
Eastern Ontario
For the record …
(Pun intended )

Laws have changed in recent years
Drs / Dentists / Specialists / Surgeons MUST make your records available if you choose to use another in their field
Or if you move

Lots of folks don’t realize this

And so when they start over with a new Dr or Dentist
The medical professional starts again … a file from scratch

May not matter a whole lot when it comes to a GP

But it DOES MATTER when it comes to a Dentist

Cuz their starting from scratch means they want a full set of X-rays
Which is both costly …
And unnecessary (not to mention too many X-rays can be harmful over time )

So … OP if you find a Dental Specialist you like … be it a Periodontist or a OMFS
And can track down who did your prior implant

Just fill out the forms to have your past records moved over to your new specialist

By moving any past records around … you’ll be closing the loop between past & present
And insuring that the person you are with today is well informed of your total dental health situation
Deal Addict
Jul 21, 2004
1301 posts
234 upvotes
If you go seek another opinion just ask your General dentist to forward any recent radiographs to avoid repeat imaging. If you have a recent Cone-Beam CT done depends where often those files can be shared electronically.

Simple single tooth can be performed by GP. I would caution in the upper front teeth area. Either go with a periodontist or a prosthodontist. (Yes they will cost more, but they can general manager the gum tissue better). Any complex bone grafting. Likely Oral and maxillofacial surgeon.

As for record. Nowadays most dental implant company at least the major brands will give you a card identifying the type, size of the implant for the patient to keep. Old one usually your general dentist (unless you switched) should have a record of which brand, type and size.
[OP]
Member
Dec 24, 2010
398 posts
265 upvotes
Montreal
PointsHubby wrote:
Laws have changed in recent years
Drs / Dentists / Specialists / Surgeons MUST make your records available if you choose to use another in their field
Or if you move
Is the law applicable to Canada, or to the province (in my case it's Quebec)
Can I ask my current dentist to request that my record be moved to him?
Not that I doubt my previous dentist skills but I feel that since I am not a regular customer for regular follow ups I would rather have all my info with my current dentist.
The only benefit to come back to the previous dentist is that should there be a warranty on the implant, maybe I can claim a credit, if there is correction work to be made, but my dental implant is 9 yrs old so maybe it is of no benefit, hence the advantage to have all info in one place.

I would have thought that the personal data like dental implant should belong to you, and the dentist should be in legal obligation to pass the records to follow you, even x rays etc. But each time I want to attempt to get 2nd opinion, boom, another x ray and another bill....and the old dentist has exclusive right to your personal information. Seems hardly logical and a cartel to make switching cost onerous and lock you to a service provider.
Deal Addict
Jul 26, 2004
4903 posts
1942 upvotes
BestFind wrote: Is the law applicable to Canada, or to the province (in my case it's Quebec)
Can I ask my current dentist to request that my record be moved to him?
Not that I doubt my previous dentist skills but I feel that since I am not a regular customer for regular follow ups I would rather have all my info with my current dentist.
The only benefit to come back to the previous dentist is that should there be a warranty on the implant, maybe I can claim a credit, if there is correction work to be made, but my dental implant is 9 yrs old so maybe it is of no benefit, hence the advantage to have all info in one place.

I would have thought that the personal data like dental implant should belong to you, and the dentist should be in legal obligation to pass the records to follow you, even x rays etc. But each time I want to attempt to get 2nd opinion, boom, another x ray and another bill....and the old dentist has exclusive right to your personal information. Seems hardly logical and a cartel to make switching cost onerous and lock you to a service provider.
It's fairly common to send records around. Alot of the times it's just the office staff not wanting to do the paperwork/scan records and copy xrays to send to another office for " Second opinion", it definitely won't be on top of their To-Do list to gather up everything to send. But with digital xrays, it's easier to send xrays to other offices. But still, unless you arrange ahead of time and have xrays sent before a second opinion appointment, it just wastes everyone's time to wait for the other office to send an email. Much quicker to just take a new one on the spot, to charge you or not for that xray is upto the discretion of the new dentist. Also depending on what problem you're seeking a second opinion for, an up-to-date xray could be more useful for a diagnosis than looking at an old xray anyways.

As for is it beneficial to have the old records ? For some cases such as yourself with info like implant system/size used, and people with significant dental history, then it is useful.
Deal Fanatic
Dec 12, 2009
5417 posts
2910 upvotes
Toronto
BestFind wrote: I would have thought that the personal data like dental implant should belong to you, and the dentist should be in legal obligation to pass the records to follow you, even x rays etc. But each time I want to attempt to get 2nd opinion, boom, another x ray and another bill....and the old dentist has exclusive right to your personal information. Seems hardly logical and a cartel to make switching cost onerous and lock you to a service provider.
The laws vary from place to place. Essentially you have to consider your health records in two ways, the physical or digital record and the content contained within. The physical/digital record usually must stay with the person or office that created it, typically for a period of 7-10 years from date of last entry before destroying. The content of the record can be shared with the appropriate permissions following specified guidelines to protect your personal health information.

To give you an idea of the complexity surrounding records, here is a link to the 99 page document that was the relevant Bill in Ontario: https://www.health.gov.on.ca/en/common/ ... ll_159.pdf


As @coilz indicates, some time & effort is involved in sharing a record so you should expect to pay a "reasonable" amount for that "service". OTOH if your provider is referring you to specialist they will usually send a brief history and the relevant portion of the record (a couple of x-rays for example) to introduce you to the specialist as part of the referral. The specialist may then determine if they require additional information.

On edit: When it comes to implants, the basic information is generally shared at no cost over the phone or by email without any effort on the patients part. E.g. Make, model and size of implant for each location. Some offices play strictly by the "rules" and will want you to sign a release of information form to retain in their records prior to releasing information. They don't want to face any legal issues or want to look sloppy during a practice audit/assessment by their regulators.

Top