Chapters
Introduction
(0:05 – 0:49)
In this episode of *Save Your Money, Save Your Teeth*, Dr Clifford Yudelman and Eon Engelbrecht from OptiSmile dive into the world of dental implants. They explore the main question: Are dental implants right for you? This podcast helps answer questions about how much dental implants cost, who is eligible for them, and why they are often a better option compared to bridges.
What Are Dental Implants?
(1:09 – 3:13)
Dr Yudelman explains that dental implants are artificial tooth roots, typically made from titanium. Surgically placed into the jawbone, they fuse with the bone through osseointegration. A dental implant is essentially a tiny screw that supports replacement teeth like crowns or dentures, restoring both appearance and function.
Ideal Candidates for Dental Implants
(3:14 – 4:48)
The best candidates are people with missing teeth, good jawbone density, and healthy gums. Dr Yudelman highlights the importance of quitting smoking and managing chronic conditions like diabetes before undergoing the procedure.
General Health Requirements for Dental Implants
(4:48 – 6:11)
Dental implants aren’t suitable for everyone. Patients need to be in good overall health, free from uncontrolled chronic diseases. The podcast discusses how treatments like radiation therapy may impact eligibility and addresses potential side effects.
Oral Health and Dental Implants
(6:12 – 7:27)
Healthy gums and adequate jawbone are critical before an implant procedure. Gum disease can compromise implants, and bone grafting may be necessary for patients with insufficient jawbone density.
Dental Implants vs. Bridges: Key Benefits
(7:28 – 9:38)
The podcast compares implants and bridges, noting that implants are a more durable solution. They stimulate the jawbone, prevent bone loss, and offer a more natural appearance. Long-term benefits like improved chewing and fewer maintenance needs justify the cost.
The Dental Implant Process
(9:39 – 12:17)
The implant process starts with a consultation involving 3D x-rays and digital scans. Dr Yudelman describes the surgical steps, side effects, and recovery. While implants are long-lasting, they may require occasional maintenance.
How Do Dental Implants Integrate with the Jawbone?
(12:18 – 13:26)
The fusion of implants with the jawbone (osteointegration) ensures stability and durability. OptiSmile boasts a high success rate, with very few cases of implant failure.
Patient Concerns: Fear of Surgery, Cost, and Recovery
(13:27 – 15:57)
Dr Yudelman explains that dental implant surgery is minimally invasive and most patients experience little discomfort. Cost concerns, including financing options in Cape Town, are also addressed.
Age Considerations for Dental Implants
(15:58 – 17:33)
There is no upper age limit for implants, as long as the patient is in good health. Older patients, even those with osteoporosis, can benefit from implants, but younger patients must wait until full bone development in their early 20s.
Long-Term Benefits of Dental Implants
(17:34 – 18:47)
Dental implants improve chewing, speech, and appearance. Good oral hygiene can extend their lifespan. The podcast wraps up with answers to common questions like cost and the long-term value of implants.
Conclusion and Next Episode Preview
(18:48 – 19:43)
The episode concludes with a preview of the next topic: full-mouth implant solutions. Listeners are encouraged to subscribe for more information on dental health and affordability.
Transcript
[Eon Engelbrecht E-Radio] (0:05 – 0:49)
Welcome once again to Save Your Money, Save Your Teeth, here on eRadio, a podcast where curiosity meets dentistry, straight from the experts. It’s Dr Clifford Yudelman with you, as well as Eon Engelbrecht from OptiSmile. We’re here once again to take a deep dive into the world of dental care from a consumer’s perspective.
So, if you’re looking to brighten your smile or maybe you want to protect your wallet, Eon Engelbrecht has got you covered with practical advice and the latest insights. So do stay with us as we uncover all these secrets to maintain both your dental health and your finances. A big welcome to you once again, Eon Engelbrecht, at the start of another series.
[Dr Clifford Yudelman – OptiSmile] (0:49 – 1:09)
Yes, great, thank you and thanks for having me back. I’m really excited. We’re about 34, 35 podcasts in and we finally get to implants, dental implants.
Today, next week and the following week, we’ll be taking a dive into implants.
[Eon Engelbrecht E-Radio] (1:09 – 1:30)
Well, okay, that sounds good. It’s going to be very, very interesting. And the question we’re asking today is, are dental implants right for you?
So, we’re going to explore the suitability and benefits. My first question to you, Dr Yudelman, can you start by explaining what dental implants are and how they function?
[Dr Clifford Yudelman – OptiSmile] (1:31 – 3:13)
Yeah, so look, quite simply, dental implants are artificial tooth roots made of 95% of the time titanium, which is very biocompatible. They’re surgically placed into the jawbone where teeth are missing. In essence, they’re tiny little screws.
When you see a dental implant, it just looks like one of those very small little wood screws. They don’t really look like anything special. Over time, they fuse with the bone through a process called osseointegration.
So literally, the body doesn’t see the titanium as a foreign object and the bone grows right up into the little grooves and the little recessions in the threads of the implant, and that’s called osseointegration. My wife just recently had a hip replacement operation and they removed the bad part of the hip, the top of the femur and the hip socket, and they used titanium. They just clip it into the top of the bone there and it engages, and the bone grows right up.
It’s very much like a hip replacement, but obviously, this is for teeth and you can walk on it and everything. In this case, once they’re integrated, the little screws provide a stable foundation for replacement teeth. We’ll mainly talk about single crowns, bridges, or even dentures.
They function and appear just like natural teeth and they restore both the aesthetics and the oral function. That was a long explanation about what they are and how they function, but we’ll get into more detail as we go along.
[Eon Engelbrecht E-Radio] (3:14 – 3:22)
Okay, great. I also want to ask you, Dr Yudelman, who is considered an ideal candidate for these dental implants?
[Dr Clifford Yudelman – OptiSmile] (3:24 – 4:48)
People who have one or more missing teeth that are looking for a long-term solution. People who’ve got adequate jawbone density and healthy gums. If your upper jawbone doesn’t have a lot of bone, if it’s very spongy, or you’re quite elderly with osteoporosis, we’ll get into things like how one gets around that, but generally, you want to have very healthy gums and good jawbone.
People who are in good overall health without any conditions. Again, we’re going to talk about certain conditions that will impede any kind of healing. Non-smokers or people that are willing to stop smoking during the healing process.
If you smoke, you can’t get dental implants. Very few dentists will place an implant in a smoker, even if you’re a light smoker, so you’ve got to go on gum or get hypnosis or do something to stop smoking, at least during the period while the bone is integrating. Then you’ve got to be committed to maintaining good oral hygiene and regular dental visits.
You can’t just go, if you haven’t looked after your teeth, your teeth are now not in good shape, you’ve got to pull them out. You can’t just go and put in dental implants and think that you’re not going to go back to the dentist. You’ve got to look after them just like regular teeth.
[Eon Engelbrecht E-Radio] (4:48 – 4:55)
Any general health requirements that a person should meet if they want to undergo a dental implant procedure?
[Dr Clifford Yudelman – OptiSmile] (4:56 – 6:11)
You want to be in good health so that you can, with any surgery, start off being in good health, that it heals nicely. You really don’t want uncontrolled chronic disease. If someone’s got uncontrolled diabetes or heart conditions, it’s better to take care of those first.
You need a good immune system. If a person is really prone to lots of infections or you’ve got uncontrolled HIV or you’ve had other conditions where you’ve gone on immunosuppression, things like that, the healing won’t be good. In the same realm, if you’ve had radiation therapy, if you’ve had cancer removed from your jaw, or you’ve had any kind of head and neck radiation, it can get complicated.
My late dad was a dentist and he had some radiation to his jawbone, but he was able to actually get implants in Johannesburg. They took extra precautions, but there’s always ways to do certain things, but in general, we’re talking there. Then you need clearance from a physician if there are any underlying medical concerns.
[Eon Engelbrecht E-Radio] (6:12 – 6:17)
How does one’s oral health impact their suitability for dental implants?
[Dr Clifford Yudelman – OptiSmile] (6:18 – 7:27)
You need healthy gums. If you’ve got gum disease on your own teeth and you remove a tooth or if there’s a missing tooth and you go and you put a dental implant in, the bacteria from the gum disease teeth will also infect the dental implant. So you have to have a healthy, clean mouth.
You need sufficient bone in the area where we’re putting the implant, which as I said earlier, we’ll get into that. You can’t have any active infections or a lot of untreated tooth decay. You’ve got to make sure your mouth is in pretty good shape before you start with implants.
Then good oral hygiene practices. We make sure patients are able to look after their teeth before we go and put an implant because if they’re not able to brush or floss properly, the implant will fail. It can get infected.
Sometimes you require preliminary treatment like bone grafting if there’s a lot of bone loss. If there was trauma, say a front tooth was knocked out and the bone went with it, you’ve got to have preliminary bone grafting. It can take sometimes more than one or two surgeries to build up some bone again and then get the implant placed.
[Eon Engelbrecht E-Radio] (7:28 – 7:36)
Doc, talk to us about the key benefits when choosing dental implants over things like dentures or bridges.
[Dr Clifford Yudelman – OptiSmile] (7:37 – 9:38)
So, implants can offer a permanent or somewhat permanent durable solution that can last a lifetime. Although these days we’re not promising we’re putting an implant in that you’re going to have it in 25 or 30 years’ time, they can give trouble out of the blue 10 or 15 years later. We don’t promise people that an implant is forever, but they do last a long time, certainly longer than a tooth that maybe has a dodgy root canal that’s been retreated and it’s got fractures and it’s got a crown and now you want to do some herodontics to try and save the tooth.
In a case like that, sometimes an implant is better. They prevent bone loss by stimulating the jawbone and maintain the facial structure. So if someone’s lost four front teeth and they get implants, the bone will be maintained in that area.
But if you don’t replace the teeth, the bone disappears as well. So we sometimes get patients that have had a few teeth removed and they come to us two or three years later and there’s no bone because the bone belongs to the teeth. Once the teeth are gone, the bone disappears as well.
And there’s also no need to alter, damage, or drill down adjacent healthy teeth. With bridges, we have to file down adjacent teeth into little nubs, like turkey teeth and put crowns on them. There are ways to do bridges that you bond to the teeth that I’m quite in favour of wherever possible.
We call it a Maryland bridge or a bonded bridge. But in many cases, an implant is superior with better comfort and functionality. Bridges are very difficult to keep.
Also, we’ll get into the difference between a denture and a bridge and single crowns. And implants provide better chewing efficiency, speech, and improvement in overall quality of life.
[Eon Engelbrecht E-Radio] (9:38 – 9:46)
Can you walk us through the dental implant process from consultation to the actual completion?
[Dr Clifford Yudelman – OptiSmile] (9:47 – 12:17)
So, it always starts with the initial consultation. You get a comprehensive exam and treatment planning. There are x-rays.
There’s 3D x-rays where you can actually see where all the nerves and sinuses are. These days, it’s very important that you get a 3D x-ray. It’s very rare that a dentist will put an implant in without a 3D x-ray.
At OptiSmile, we have a CBCT x-ray. We include a CBCT x-ray with all of our exams at no extra charge. You will generally pay about three and a half thousand Rand for a CBCT.
And then also a 3D scan like an iTero scan like we do for Invisalign or injection moulding. So that’s using a little camera that we wave over the teeth instead of taking a goopy impression. And it creates what’s called the STL, a 3D model of your teeth.
And those images, the 3D x-ray and the 3D scan, can be combined. The actual placement of the implant is planned using 3D guides. Then there are preparatory procedures like extractions or bone grafts or treating gum disease.
During the implant surgery, the implant is placed into the jaw under local anaesthetic. It’s a very minor surgery, just a little hole made in the gum. And then we use tiny drills to get the right angle using a guide and progressively larger ones. When you see an actual implant, they are quite tiny.
Most patients, after having a single implant or a couple of implants, don’t need much more than Panado or two. They don’t have a lot of pain. It sounds more painful than it is. Then there’s a healing period, generally about three months in the lower, up to six months in the upper for the implant to fuse with the bone. After that, there’s the abutment placement and restoration.
The abutment is the part that goes into the implant that the crown, bridge, or denture attaches to. Then, after that, you get regular follow-up care, such as check-ups to monitor the implant, take x-rays, and maintain your oral health.
[Eon Engelbrecht E-Radio] (12:18 – 12:28)
Doc, I’m quite curious to know how these dental implants integrate with your jawbone, and why is this integration so important?
[Dr Clifford Yudelman – OptiSmile] (12:28 – 13:26)
It’s very rare these days to hear about an implant that didn’t integrate, though it does happen occasionally. At OptiSmile, I can think of maybe three cases in the last nine years, out of literally hundreds of implants placed, where they didn’t integrate.
And that’s during the early healing phase. Once it integrates, the jawbone literally fuses to the implant. This fusion provides a stable and strong foundation for a crown, bridge, or even a denture, and it prevents bone deterioration where teeth are missing.
Because once the implant is there, the bone generally stabilises, and implants can withstand normal biting and chewing forces. The integration is vital for the longevity and success of the implant.
[Eon Engelbrecht E-Radio] (13:27 – 13:35)
What are some common concerns that patients have about dental implants, and how do you, doctor, address them?
[Dr Clifford Yudelman – OptiSmile] (13:35 – 15:57)
Well, the biggest concern is fear of surgery. We explain the minimally invasive nature and the use of anaesthesia to ensure patient comfort. We do get patients that request sedation, and we have an anaesthetist who comes in.
It’s not a big deal, just sedation, not a general anaesthetic. We had a patient recently who had quite a lot of work done under sedation, and they always leave with a big smile on their face. They don’t remember much, even though they were basically awake but sedated. They obviously can’t drive after that.
In terms of pain and discomfort, we manage expectations by giving information on how much pain to expect after the treatment. Like I mentioned, it’s usually minimal, and pain relief options are available.
It’s rare for me to prescribe something like Tramacet or a strong painkiller. I don’t like codeine-based medications. Patients can usually take Panado or combine it with ibuprofen.
Cost is another concern. We discuss financing options and the long-term value compared to other treatments. Then there’s the healing time, where we provide temporary crowns, bridges, or dentures and encourage patients to be patient during the healing phase.
Regarding risks, we highlight the high success rate and the steps we take to minimise any risks.
The dentists at OptiSmile who place implants are highly specialised. Personally, I don’t place implants because I’m not comfortable with surgery, but we have several dentists on the team who specialise in this. One of our implant specialists is a prosthodontist who’s been doing implants for over 40 years and was trained in the US. He’s probably one of the most experienced in South Africa.
[Eon Engelbrecht E-Radio] (15:58 – 16:02)
Any age considerations or limitations, doctor?
[Dr Clifford Yudelman – OptiSmile] (16:04 – 17:33)
Not really. If a person is healthy and looks like they’ll be around for another 5, 10, or 15 years, it’s definitely worth considering implants. I mentioned my dad earlier—he had jawbone issues after cancer treatment and was already 80 when he had some implants. He lived to nearly 95, and those implants never gave him any trouble.
So, age is generally not a concern. However, we don’t recommend implants for younger patients whose bone is still growing. You can’t get an implant if you’re 16 or 17. There’s some debate on when males versus females should get them, depending on growth.
There’s no upper age limit, but for younger patients, we usually wait until their early 20s, depending on bone growth. Bone density can be an issue for older patients, particularly postmenopausal women with osteoporosis, but each case is evaluated individually.
[Eon Engelbrecht E-Radio] (17:34 – 17:43)
Okay, and our final question for today, Doctor, what long-term benefits can patients expect after getting these dental implants?
[Dr Clifford Yudelman – OptiSmile] (17:43 – 18:47)
Well, the natural appearance is a big one. Like we’ve mentioned in other podcasts, being confident that what you’ve got in there is not going to fall out and looks just like a real tooth is a significant benefit. You’ll have improved ability to chew and enjoy a wide variety of foods.
The preservation of jawbone health and prevention of further bone loss is another advantage. Compared to removable dentures or flippers, implants provide enhanced speech, comfort, and minimal maintenance beyond regular brushing, flossing, and check-ups.
We make it sound easy, and it is if you know what you’re doing. But it’s quite involved, and we always encourage people to make sure they see a professional with the right tools and experience—not just go with the cheapest option, which isn’t always the best.
[Eon Engelbrecht E-Radio] (18:48 – 18:58)
Okay, and there you have it—the first edition of our series on dental implants. Big thank you to you once again, Dr Clifford Yudelman. It’s been very interesting.
[Dr Clifford Yudelman – OptiSmile] (18:59 – 19:12)
Thank you, and I look forward to speaking to you next week, where we’ll discuss the difference between a single implant and full-mouth solutions. We’ll explain all the options.
[Eon Engelbrecht E-Radio] (19:13 – 19:43)
Ah, can’t wait. And to you listening, thanks so much. Remember, while we strive to provide valuable insights with this podcast, always consult your own dental professional for advice tailored to your personal health.
Don’t forget to subscribe to the podcast for more enlightening discussions, and join us again next time as we continue to explore the fascinating intersection of dental health and financial savvy. Until then, keep smiling and take great care of your teeth.
[Announcer] (20:04 – 20:48)
Discover the world of dental excellence with OptiSmile. Join us for a weekly podcast featuring Dr Clifford Yudelman, a seasoned expert with 40 years of dental experience across four continents. Gain unique insights and expert dental advice by visiting OptiSmile.co.za for articles that illuminate the path to optimal oral health. If you’re seeking unparalleled dental care in Cape Town, get in touch with OptiSmile or book directly online at OptiSmile.co.za. OptiSmile, where global expertise meets local care.
Disclaimer: The content provided in this podcast, “Save Your Money Save Your Teeth” on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations.Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns.The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.
