Dr. Mark Sowell regularly provides dental implants for patients—a common treatment in his Plano cosmetic dental practice, Sensational Smiles. However, implants are not always the best treatment option, as not every tooth with dental problems needs to be replaced. Some teeth, Dr. Sowell says, can and should be saved for the best long-term outcomes.
“About a decade ago, implants started being diagnosed as the treatment of choice for advanced dental problems,” he says. “Implants are often used to replace teeth that were affected by a failed root canal. Some dentists extract those teeth and replace them with dental implants. Implants are not perfect and can fail over time.”
“The failure, in some instances, is caused by cement getting below the gum during crown attachment to the abutment and implant. The gum doesn’t attach to the implant like a natural tooth, leading to bone loss around the implant and infection. Because of this lack of attachment, implants are also more prone to periodontal disease (bone loss) than a natural tooth. Implants don’t have a periodontal ligament (shock absorber) like a natural tooth does, so the porcelain crown that’s attached to the implant has a higher fracture rate. Implants don’t flex like natural teeth,” Dr. Sowell says.
For an implant to be successful, there needs to be ample bone around it—more so than with natural teeth. A natural tooth can have just .5 millimeters of bone and survive just fine, but an implant needs at least two millimeters of bones, Dr. Sowell says. “Implants have more requirements to be effective,” Dr. Sowell says. “This doesn’t mean they are bad for patients. In fact, many patients need dental implants, and they can make a positive difference. However, if we can save the natural teeth, we should try.”
These implants, often known as All-on-Four, can cause overall health issues if the patient isn’t diligent with good oral hygiene. “A lot of bacterial growth can occur under the denture, which causes inflammation in your system that can lead to illness,” Dr. Sowell says.
Patients need to be informed that, to keep gums healthy, screwed-down implant dentures need maintenance. Dr. Sowell often finds that gums, upon denture removal for maintenance, are red, swollen, and bleeding underneath. The best way to ensure the implants stay clean underneath is with a specialized in-office cleaning where the dentures are removed—a procedure that can cost up to $1,000 per visit. “In my opinion, patients with these types of implants need to receive thorough cleanings once a quarter,” Dr. Sowell says. “As long as a dentist is trained and experienced in implants, they should be able to do this type of cleaning if they have the proper instrumentation.”
With today’s modern dental techniques, natural teeth can be saved, Dr. Sowell says. “Some dentists go straight to an implant, and others are more conservative and will try to save the tooth,” he says. “If the success rate with saving the tooth is 70 percent or higher, I think the dentist and patient should at least have the discussion because the patient will have a better experience down the road. With this decision comes a commitment to improved oral hygiene. Natural teeth and implants will fail if a patient doesn’t practice good oral hygiene.”
When a dentist recommends an implant or denture implants, such as All-on-Four, Dr. Sowell recommends weighing all the variables before making a decision. “Get a second opinion from a private practitioner who does major restorative work,” Dr. Sowell says. “Sometimes, saving the teeth is the best solution, but you need to hear the pros and cons of each option. It could be that the dentist suggesting the implant may not do all the procedures required to save the natural teeth. There is a lot to look into and research before making the decision so that you have healthy teeth and gums.”
For nearly three decades, Dr. Mark Sowell has served the community by providing state-of-the-art dental care. He is a nationally recognized expert in the fields of cosmetic dentistry, implant dentistry, and restorative dentistry. Because of his relentless commitment to excellence in all aspects of dental care, Dr. Sowell is often asked to lecture to other dentists and attends over 200 hours of rigorous postdoctoral training each year. He is visiting faculty at Spear Education in Scottsdale, Arizona, where he teaches advanced restorative dentistry and bite designs. Dr. Sowell is a member of an elite group of dentists who have achieved both Master’s status with the Academy of General Dentistry (AGD) and Accredited Membership with the prestigious American Academy of Cosmetic Dentistry (AACD). Fewer than 40 dentists nationwide have earned both professional distinctions. While these recognitions illustrate Dr. Sowell’s dedication to providing the best that dentistry has to offer, he has achieved numerous other merits in the field of dentistry. To learn more about the extreme safety and sanitation measures Dr. Sowell has implemented into his state-of-the-art dental practice, visit smilesbysowell.com.
