Why wait for implants or dentures

I see all kinds of ads for immediate placement of dental implants with no waiting, yet I read your articles and you say to wait. I want to do the right thing, since it is my mouth, HELP! Anxious

Dear Anxious,

The marshmallow test

In the 1960's a psychologist decided to test a large group of five year olds. Each five year old had a marshmellow placed in front of him. He was told that he could eat it immediately, but that if he waited fifteen minutes he could have two. Thirty percent waited and the other seventy percent did not. That was the end of his study and he moved on.

Ten years later he began to wonder about the kids that he had tested. He tracked them down and found that the thirty percent had higher grades and had progressed much more than the seventy percent. Twenty years from the original study these kids were now the business leaders and had done well while the seventy percent were working for others pay check to pay check.

The conclusion was that those that learn to wait generally get a greater reward. Immediate satisfaction is not always long lasting satisfaction.

When will we be able to count on immediate implants

I will gladly make you a deal. The day that science is able to have a man and a woman conceive one night and have a baby to play with the next day I will be able to predictably do implants with teeth immediately.

Until then, it still takes nine months to grow a baby. It takes nine months for bone to regenerate. Placing a 4 millimeter screw into an 8 millimeter wide hole still does not create a good long term solution. I have been placing and restoring dental implants for over twenty years. I have tried most of the techniques people talk about and I have found that if I try and mess with mother nature, she almost always wins. I find that if I work with her on her time line I get better results.

I have found that most of my patients would fit in the thirty percent group. They are not afraid to wait a little longer for a better result.

Immediate dentures or should I wait?

Dr. Brooksby,

I am afraid that I am going to lose all of my teeth and my dentist says that I have to wait for three months before I get new teeth. Help! Horrified

Dear Horrified,

The only reason I can see for this type of scenario is if you have told your dentist that you want to keep the cost as low as possible and you do not want to hassle with your teeth anymore. If this is not the case you may want to consider a second opinion.

Usually if the teeth need to be removed we make new teeth that go in at the time the others are lost. This way you never go without teeth. The supporting gums shrink as the bone remodels and the teeth get more and more loose. We refit them and tighten them up to make them more comfortable. After about six months we make new better fitting teeth and substantially improve the smile.

The reason the dentist wanted you to go without teeth for three months is to avoid the cost of the first set of teeth and the refittings. The disadvantage of this approach is that you are left socially crippled for months and then you do not adapt as easily to the new teeth. The first set of dentures are training dentures. They can also be used later as spares in case something breaks and you need something to wear.

Alternatives to dentures