There certainly are a lot of people in this country walking around with missing teeth.
According to the American College of Prosthodontists 178,000,000 Americans are missing at least one tooth, 40,000,000 have no back teeth, and a whopping 35,000,000 have no teeth at all!
The unfortunate reality is that the vast majority of these people have trouble eating, talking, and even smiling because they have not had their missing teeth replaced. Why?
The single greatest deterrent to addressing complete or partial edentulism (the condition of being toothless) is limited funds. The cost of dental implants, dentures, and bridges can be quite high. And while dental insurance can helpful to defray some out-of-pocket expenses, the fact remains that most policies place restrictions on benefits paid with annual maximums or even the outright exclusion of certain procedures or dentists if they are not on a list of covered procedures or participating providers.
Unfortunately, most commercially available dental insurance policies shift the bulk of financial responsibility for major dental care – including the replacement of lost or missing teeth – squarely onto the shoulders (and into the pocket) of the patient.
Modern technology has enabled us to use dental implants more often to replace one or more missing teeth than even just a few years ago. However, there is a prevailing belief that implants are much more expensive than other replacement procedures. Is it really true?
What follows is a brief description of the two most common tooth replacement procedures, the costs associated with them, and a comparison with the cost of dental implants. Obviously everything is not equal because not all dental practices are alike. In every city you’ll find boutique-type practices, insurance-based clinics, and varied types of practices in between. The philosophy of patient care combined with geographic location and associated fee schedules are as varied as the dentists themselves and the patients they treat.
For purposes of illustration the cost comparison and fee ratios that I outline below are consistent within a given practice and are helpful as a guide when seeking potential solutions to fill one’s dental gaps.
Due to the fact that most people are unfamiliar with more advanced dental treatment and the associated costs, I’ve tried to offer a financial frame of reference for procedures by comparing them to a common benchmark – in this case, the cost of a single crown. The cost comparisons in this article are illustrative of relative dollars spent on frequently requested dental care. I use the cost of a crown as the common currency for purposes of comparison. If you have a crown, you may be able to gain some perspective on the cost of dental implants vs. the cost of other procedures.
The Cost Of Dental Implants vs. Other Tooth Replacement Procedures
What it is: In general, a removable denture (also called a prosthesis) is the least costly technique to replace a missing tooth. Most commonly, partial dentures get their stability and ability to stay put by means of metal or plastic clasps that wrap around adjacent teeth. An upper denture generally covers the entire palate to create suction. A lower denture is horseshoe-shaped because it needs to circumvent the tongue. Lower dentures are much less stable than uppers because of the decreased surface area and movement of the tongue, cheeks and floor of the mouth during function.
What it costs: Dentures are a relatively affordable treatment option to replace all the teeth in a given arch. As a point of reference, the cost of a complete set of dentures, upper and lower, could be in the range of 2-3 times the cost of a single crown. The actual fee varies widely from area to area, but I think the price ratio is consistent.
Obviously the cost of a single crown is irrelevant if one is missing many if not all his natural teeth; but the point that I am trying to make is how the cost of tooth replacement relates to another commonly sought dental procedure.
What it is: A permanent (fixed) bridge is commonly used to replace a single tooth. The dentist makes crowns for the supporting teeth (called abutments) so the bridge can connect to those teeth and straddle each side of the empty space.
What it costs: The cost of permanent bridgework is not insignificant. The treatment process involves preparing the teeth for crowns, fabricating temporary bridges to protect the anchor teeth, taking impressions of the prepared teeth, and sending the impressions to a dental laboratory. For the patient it involves several intermediate visits to the dentist for fittings and delivery of the bridgework.
The fees associated with a permanent bridge can vary between dental practices depending upon the multitude of factors that distinguish one office from another. But in general, the cost of a bridge can generally be determined by multiplying the number of teeth involved in the treatment (including the missing teeth) by the cost of a single crown.
Hence, the cost of the aforementioned three-unit bridge is approximately 3 times the cost of a single crown. Plus, there are potential hidden costs commonly associated with the making of a permanent bridge. One such example may be that one or more of the abutment (supporting) teeth might require root canal either because of pre-existing deep fillings or the process of reducing and preparing the teeth to receive the necessary crowns. There is a 15% greater chance of needing root canal in teeth prepared for bridgework vs. for a single crown.
In some instances, such as in the case of a young patient missing one front tooth, a special type of permanent prosthesis called a Maryland or bonded bridge can be made. In this scenario the supporting teeth are not prepared for crowns. Instead, wings or extensions attached to the replacement tooth are bonded to the backs of the neighboring abutment teeth. While in time the Maryland bridge may loosen or de-bond, it is an effective and economical way to offer a permanent bridge. The cost of a three-unit Maryland bridge can be a third less than one involving crowns.
What It Is: A dental implant is a cylindrical or tapered post generally made of commercially pure titanium or titanium alloy that is designed to replace the root of a single tooth. A dental implant is surgically placed where the root of the missing tooth once resided.
After a prescribed period of healing a crown (ceramic or porcelain) is placed onto the implant. And since the neighboring healthy teeth are left unadorned and intact there is no chance of unanticipated root canal therapy and the “hidden” expense associated with it.
What It Costs: The cost of dental implants may surprise you – placing and restoring a tooth with a dental implant is less than the cost of a conventional three-tooth bridge by at as much as 30%. In fact, the cost of a dental implant is often the same as the cost of placing a crown on a healthy tooth.
Implant dentistry can actually be a more affordable approach to replacing a single tooth than any other treatment.
What’s more, the beauty of implant dentistry is its versatility. Dental implants can replace a single tooth or many teeth. Dental implants can even be strategically placed and spread apart to support a permanent bridge so the patient doesn’t need an implant placed for each tooth that has been replaced.
And implant dentistry is not restricted to permanent tooth replacement either. Implants are often used in conjunction with removable dentures to improve stability and comfort. For new denture wearers or veterans who are struggling with discomfort and poor mastication due to insufficient support from the underlying bone and gum, implants are a miracle.
In the above scenario, the additional cost of dental implants (placing two and the attachments used for anchoring) might be about 2 1/2 times the cost of a single crown.
Another benefit of dental implant therapy is that it can be staged over time, sometimes even over years. This allows the patient to manage the costs and still end up with a stable, healthy and fully functional set of teeth. It’s worth the wait.
If you have lost one or several teeth ask your dentist to help you explore your options. You just may discover that the cost of dental implants, what you thought was beyond your reach, is in fact a definite possibility.
Michael Sinkin practices cosmetic, implant, and restorative dentistry in New York City. He is known for the wonderful care he provides to his patients, and for his wicked sense of humor! To contact Dr. Sinkin, link here.