Pricey Dental Implants Often Best but Insurance Rarely Pays

By THE ASSOCIATED PRESS MARCH 14, 2018, 4:28 P.M. E.D.T.

TRENTON, N.J. — Dental implants are increasingly being used to replace missing or failing teeth instead of dentures or bridges, which can be uncomfortable and hasten further deterioration. But implants can be very expensive and rarely are covered by insurance.

Experts say dental implants — usually titanium screws inserted into jawbone and capped with a permanent crown — are long-lasting and the best option for most people. About 1.9 million Americans are expected to get one or more dental implants this year, up from 1.6 million in 2016, according to market research firm Decision Resources Group.

“It’s probably the greatest thing that’s happened to dentistry since fluoride came to the water,” says Dr. Carl Driscoll, former president of the American College of Prosthodontists, the specialty providing artificial tooth replacement.

When missing teeth aren’t replaced, the jawbone below deteriorates faster, chewing can become difficult and one’s smile and self-confidence can be affected. Implants feel and function like natural teeth and can last a lifetime, partly because the titanium helps maintain surrounding bone.

That’s helped make them the standard of care over older options: Dentures need to be replaced periodically as fit worsens, and bridges are attached to adjacent teeth that must first be ground down, increasing jawbone loss and risk of cavities.

Step	Custom Denture	Stock Denture	Explanation of Step
Final impression	x	x	The ideal denture process uses a 2 visit impression process that allows for greater detail and therefor a better fit. This involves custom molding wax so that it accurately captures the personal contours of your mouth.
Establish Facial reference points	x		The midline of the face is determined. Proper width of teeth is determined using other facial features. Height of teeth is determined by evaluating lip movements during smiling.
Jaw /Bite Registration	x		The upper and lower models are mounted on an intricate articulator machine that accurately simulates the patients exact jaw movements. A stable bite is critical for a denture. If not, the denture will easily tip and loosen.
Tooth selection	x	x	Premium Quality teeth are used in a custom denture. All denture teeth are not the same. High quality teeth look much more real and life like than a stock denture. Premium teeth are also much more wear and stain resistant than stock dentures.
Try in visit	x		In a custom denture, one or more visits are spent trying the teeth in BEFORE finishing to optimize the esthetics. Stock dentures have no tryin visits.
Final Bite adjustments	x		The final denture is mounted on the special jaw simulator articulator and final bite adjustments are made to dial in the exact bite.

Step	Stock Denture	Custom Denture	Explanation of Step
Tooth selection	x	x	Premium Quality teeth are used in a custom denture. All denture teeth are not the same. High quality teeth look much more real and life like than a stock denture. Premium teeth are also much more wear and stain resistant than stock dentures.
Try in visit	x		In a custom denture, one or more visits are spent trying the teeth in BEFORE finishing to optimize the esthetics. Stock dentures have no tryin visits.
Final Bite adjustments	x		The final denture is mounted on the special jaw simulator articulator and final bite adjustments are made to dial in the exact bite.
Final Impressions	NO	x	The ideal denture process uses a 2 visit impression process that allows for greater detail and therefor a better fit. This involves custom molding wax so that it accurately captures the personal contours of your mouth.
Establish Facial Reference points	NO	x	The midline of the face is determined. Proper width of teeth is determined using other facial features. Height of teeth is determined by evaluating lip movements during smiling.
Jaw/Bite Registration	NO	x	The upper and lower models are mounted on an intricate articulator machine that accurately simulates the patients exact jaw movements. A stable bite is critical for a denture. If not, the denture will easily tip and loosen.