Can old people have dental implants?

        　　According to the statistics of the Ministry of the interior, since 1993, the proportion of the elderly population (over 65 years old) in Taiwan has exceeded 7%, which is in line with the World Health Organization (who) recognition standard for the aging society. Even from February 2017, the elderly population officially exceeded the young population, which has exceeded 14%. In other words, Taiwan has become a silver haired society. We must pay more attention to the elderly's medical care, especially oral health. This issue of "health column" will provide explanations for the common dental implant questions of the elderly.

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        At present, there are two types of dentures: movable denture and fixed denture. The former is the denture that can be removed freely by patients, while the latter is the denture fixed in the mouth for a long time, which can not and does not need to be disassembled for maintenance and cleaning at ordinary times. They are divided into "traditional denture fixed with natural teeth" and "denture fixed with artificial implants".

        Q: can the elderly implant their teeth? What needs special attention?
         In fact, age is not the key condition for artificial tooth implantation. Generally speaking, even the elderly over 80 years old can still receive dental implantation as long as they are in good health. However, artificial tooth implantation is an invasive operation after all. Because the elderly are more likely to suffer from systemic diseases, more careful preoperative evaluation is needed. The following conditions are not suitable for dental implant patients:
         1. Uncontrolled hypertension and diabetes
         2. Performed heart surgery in the last year
         3. Severe osteoporosis patients
         4. Patients with long-term kidney washing

        Q: is there any limitation of blood pressure and blood sugar in dental implant?
         Different doctors may have different criteria, but generally speaking, if the blood pressure is more than 160 / 100mmhg, it is not suitable for surgery, and the physician should be consulted for diagnosis and treatment first. In general, HbA1c is recommended to be at least below 8%, and it is better to control it below 7% before dental implantation.

        Q: what are the preoperative examinations for dental implant?
         Dentists must first understand the patient's general condition, medication status of chronic diseases, and whether there is a history of drug allergy. First of all, we need to do a careful intraoral examination to find out whether there is periodontal disease and occlusal condition needs to be greatly adjusted, as well as to adjust the occlusal height. Then, we take X-ray film and CT to analyze the bone condition in the implant area, whether additional bone filling operation or other special treatment is needed before the implant, and the plaster model can help to determine the treatment plan.
        
         After all the preparations are made, whether before or after the dental implant or the denture impression is installed, usually the dentist must take photos as the diagnosis reference and medical record before, during and after the operation, so if the dentist keeps taking photos with the camera, don't think he is wasting time, instead, it represents that the doctor pays great attention to the operation process, so he is willing to take more time to record. 。

        Q: will tooth implantation hurt? If afraid of pain can also implant teeth?
         Pain is a very subjective feeling, which can be seen from the physiological and psychological level. On the physiological level, before performing all operations, dentists will give appropriate local anesthetics. Through the correct application of anesthesia, most patients can implant their teeth in a painless condition. Even if the pain starts to subside due to anesthesia during the operation, they can make up for anesthesia again. If you still feel very scared, now there are many hospitals to implement the Shumian implant, so that patients can complete the operation in the state of shallow sleep with the assistance of sedation or narcotic drugs, so as to greatly reduce the tension and fear.
        
         From a psychological point of view, the first step is to find a professional and trustworthy medical team, including doctors and their assistants or nurses. When listening to the treatment plan before operation, the doctor can fully understand the whole plan, and the doctor has patience and careful operation, so that the patient can feel that he is being treated by heart; in addition, the professional assistant can do the preparation work before operation, and also can give the patient encouragement and comfort during and after operation. Many people will believe in famous doctors, but rather than blindly pursue famous doctors, it is better to find a doctor who feels comfortable and explains clearly. Once a medical team is selected, it should be assured to follow the doctor's orders. Only when there is tacit understanding and mutual trust between doctors and patients can the treatment process be smooth.

        Q: why is dental implant so expensive? Is it once and for all?
         The cost of dental implant includes the following points:
         1. Depreciation of equipment
         2. Use of consumables
         3. Value recognition and learning cost of dentists for surgery
         4. Maintenance time and consumables after operation

        Dental implant is a medical technology that has developed for nearly 60 years. Up to now, it is still evolving and innovating. In order to maintain the progress of knowledge and technology, dentists must always put in learning. The hard work and effort behind is invisible to patients. Although various studies have shown that the 10-year success rate of dental implant is as high as 90%, many problems may still arise if it is not taken good care of. First of all, implant and outer denture are made of metal and ceramic, although they will not decay, but under the excessive bite force or improper chewing loss, there may also be complications such as ceramic fracture, loosening and fracture of fixed screws in implant, or even fracture of implant itself.
        
         In addition, if the implant is not kept clean, the accumulation of dental plaque may also cause inflammation of the surrounding tissue of the supporting implant. If it evolves into peri implant inflammation in the near future, the bone around the implant will gradually lose, and finally the implant will fall off. Therefore, after dental implantation, it is not a once and for all, but it is still necessary to find the original doctor for follow-up. Even if the problem happens unfortunately, the original doctor is usually obliged to help solve it. Because there are many patents for the design of implants, the designs of different brands are often slightly different, and the equipment of different manufacturers are often not universal. If patients implant teeth in hospital a, but think of the maintenance in hospital B, they may be rejected. The reason is not that the doctors in hospital B have no medical ethics, but that hospital B may not have. Corresponding equipment can be maintained. In addition, the follow-up maintenance cost of dental implant has been included in the original medical expenses, so the doctors of hospital a are obliged to carry out the maintenance, and the long-term maintenance is also a very significant cost for dentists.
        
         In conclusion, although dental implant is still a relatively expensive medical treatment, it still has many advantages compared with traditional dentures. It is suggested that if there are patients with missing teeth or about to remove bad teeth, they can go to major dental institutions for careful consultation and evaluation.