The Long-Term Value of Dental Implants

[Eon Engelbrecht E-Radio] (0:04 – 0:54)
Welcome to Save Your Money, Save Your Teeth, the go-to podcast on eRadio, where curiosity meets dentistry straight from the experts. I’m Eon, and every week I’m joined by Dr Clifford Yudelman from OptiSmile as we dive deep into the world of dental care from a consumer’s perspective. Whether you’re looking to brighten your smile or protect your wallet, we’ve got you covered with practical advice and the latest insights.

So stay with us as we uncover the secrets to maintaining both your dental health and your finances. Today, we are wrapping up the segment on dental implants, and we ask the question: why are they worth the investment? Dr Yudelman, welcome back.

[Dr Clifford Yudelman – OptiSmile] (0:54 – 1:13)
Hi Eon, thanks. I hope you’ve had a great week. It’s great to chat with you again, and the weather’s fantastic here in Cape Town—the birds are singing, the sun is shining.

So, it’s a great day here. Looking forward to today’s episode.

[Eon Engelbrecht E-Radio] (1:13 – 1:24)
Yes, absolutely. So, Dr Yudelman, why are dental implants considered a valuable long-term investment for your oral health?

[Dr Clifford Yudelman – OptiSmile] (1:24 – 3:34)
So, dental implants—if you haven’t heard our previous two podcasts, they were both on implants—today we’re just looking at it from a slightly different point of view, as you just asked me about long-term, investment, and oral health. Those are the things we’re going to address.

They offer a permanent solution that can, in many cases, last a lifetime with proper care. Not in all cases—implants can and do fail for various reasons. Usually, it’s if the person is not getting regular cleanings or keeping their mouth clean, or if they have diabetes and they don’t control the diabetes, and so on.

But for the average person, they can last a lifetime. They prevent bone loss, maintain your jawbone health, and preserve your facial structure. When you lose teeth, if you don’t replace them, the bone disappears as well.

So, after losing a tooth, for instance, if you lose a canine or an eye tooth or a premolar and you get an implant placed at the correct time, the bone will be saved. You won’t lose the bone in that area, and your face won’t collapse in that area. They also eliminate the recurring costs associated with dentures or bridges, which need replacement all the time.

In general, once the implant is osseointegrated—where it’s integrated into the bone—and a crown or a bridge is put on the implant, that superstructural crown or bridge will last a very long time, especially with today’s materials. It improves overall oral health by reducing the risk of decay in adjacent teeth and enhances quality of life by restoring full function and aesthetics. You can chew on them, you can smile with them, and they really are, although expensive, whichever way you look at it, an investment for the long term.

And it’s not only your oral health but also your self-esteem.

[Eon Engelbrecht E-Radio] (3:34 – 3:42)
Okay. And how do they offer durability when compared to, say, dentures or bridges?

[Dr Clifford Yudelman – OptiSmile] (3:42 – 5:41)
They’re made from strong materials like titanium. So, the main type of implant is titanium, which is very strong and integrates into the bone. And these days, the crowns and the bridges that we put on top are made from zirconium in most cases, which are very, very good, very strong, and very natural.

They don’t decay. They’re not susceptible to cavities like natural teeth. They’re securely anchored into the jawbone, so they provide stability over time, and they don’t require periodic adjustments or relining like dentures do. They withstand all normal biting and chewing forces effectively. Dentures can move around and irritate the gums, or if you have a bridge—the average bridge worldwide, where you file down the tooth in front and the tooth behind and you put three crowns in—those bridges are susceptible to coming loose or damaging the abutment teeth, which are the teeth that had to be drilled down.

In this case, you’re not drilling those teeth down. In many cases of bridges, within a few years, one or both teeth end up needing root canals. And within seven years, one or both of the teeth—or sometimes both—can be lost.

So, instead of just one missing tooth, you now have three missing teeth. Most dentists these days, except in very special circumstances, won’t file down a perfectly good tooth in front of or behind a lost tooth. If you’ve got a big filling or already have a crown on the tooth in front or behind, then there’s not much to say against putting in a bridge. But you don’t get the bone preservation.

Not to answer too long, but yeah, that’s, in a nutshell, more than a nutshell—that’s a whole bag of nuts right there.

[Eon Engelbrecht E-Radio] (5:42 – 5:52)
Yes. Okay. And in what ways do they improve functionality in everyday activities, like, for example, eating and speaking?

[Dr Clifford Yudelman – OptiSmile] (5:53 – 7:10)
Well, when people get dentures, the upper denture can generally fit quite well—you get good suction with an upper denture. Lower dentures, on the other hand, the lower ridge keeps disappearing or resorbing once you lose the teeth.

People with full upper and lower dentures find that they can’t chew meat, they can’t eat nuts, and they can’t eat a lot of healthy foods like carrots, celery, and salads. They tend to stick to softer foods. Implants, by contrast, allow you to screw in a denture or have an overdenture that clips in, or by having some bridges in the back, your ability to chew a variety of foods improves without restrictions.

Speaking with loose dentures is also common—there’s often slippage, and speech can be impeded. Implants feel and function like natural teeth, providing comfort and confidence. They remove the need for adhesives or special cleaning routines, and they enable patients to enjoy social situations without worrying about their dentures becoming loose.

[Eon Engelbrecht E-Radio] (7:10 – 7:23)
Yeah, that could definitely be embarrassing. Can you discuss how implants contribute to better oral health over time, Doctor?

[Dr Clifford Yudelman – OptiSmile] (7:23 – 10:06)
Sure. Let’s say you lose a lower molar—let’s use the six-year molar as an example, which is one of the most common teeth people lose. If your wisdom teeth are already gone, that leaves your canine (number 3), your premolars (numbers 4 and 5), your six-year molar (number 6), and your 12-year molar (number 7). Now, if you lose the six-year molar, and you don’t replace it, within less than a year, the upper molar will start growing down because there’s nothing stopping it. You’ll start getting cavities and gum disease on the upper molar because it’s no longer in a good position, and the 12-year molar (number 7) will start tilting forward into the space.

This misalignment causes your lower teeth to grind and hit incorrectly. Instead of your front teeth hitting first, the tilted molar might hit an over-erupted tooth, leading to a misaligned bite. It turns into a real mess. So, if you can get a tooth replaced within three to six months of losing it—whether with an implant or at least a space maintainer—you can stop the teeth from drifting. It’s crucial because the risk of gum disease and misalignment increases.

When you replace a missing tooth with an implant, the oral hygiene routine is similar to caring for natural teeth. You just brush and floss as you normally would. In many cases, if someone loses a tooth on their favourite chewing side, they tend to shift to chewing on the other side. Even if they have some teeth left on that side, they’ll favour the other side, which can create imbalances. An implant restores the balance and helps maintain overall oral health.

[Eon Engelbrecht E-Radio] (10:07 – 10:17)
And as you mentioned earlier, it also helps preserve jawbone density and prevent facial structure changes. Would you like to elaborate more on that topic?

[Dr Clifford Yudelman – OptiSmile] (10:17 – 12:36)
Yes. So, implants stimulate the jawbone because the forces on the implant cause it to integrate. Once the bone has integrated around the implant, it generally stays healthy unless you neglect oral hygiene or develop gum disease elsewhere in your mouth.

You can get gum disease on an implant—they’re not bulletproof. You still need to look after them. But implants do prevent bone resorption. If you lose a tooth, like the lower left molar we discussed earlier, and you don’t get an implant, you’ll experience bone loss in the area. The bone in front of the neighbouring molar (number 7) will start to disappear, and the gum will recede around the premolar (number 5).

Even if you’ve waited for years, in many cases, you can still get an implant if enough bone remains. However, the gum won’t grow back, and you may need bone or gum grafts to cover the roots. So, if you’re on the fence about whether or not to get an implant, these are some good reasons to go ahead with it.

Preserving bone density and facial structure is particularly important when multiple teeth are lost, especially in the upper jaw, where losing teeth can affect the cheekbones. If someone loses front teeth and experiences bone loss, they may also lose lip support. Many people, especially women, turn to lip fillers to restore volume, but often it’s better to address the underlying issue by restoring the teeth, which can provide natural lip support.

If implants are placed correctly, they support the lips and give a youthful appearance by preserving bone. So, they’re more than just a functional investment—they also help maintain aesthetics.

[Eon Engelbrecht E-Radio] (12:37 – 12:55)
Yeah, but I think a lot of women actually go overboard when it comes to lip fillers. It’s supposed to be a subtle thing. If you want to do it, just do it subtly—it shouldn’t be so “pow” in your face. A lot of them have what you call “duck face.” That’s basically a trend right now.

[Dr Clifford Yudelman – OptiSmile] (12:56 – 14:22)
Yeah, I believe that trend was made popular in Moscow. If you go on Instagram—because one of my patients from Russia showed me what she thought were perfect veneers—all the women had these excessive lips. This patient had the same duck lips too.

It seems to be a trend. I think people who do things like that can get addicted to it—plastic surgery and cosmetics can become addictive until you reach a point of no return. But in the right hands, and with a qualified plastic surgeon, these things can help a lot.

I recently met a plastic surgeon at dinner, and he explained how they can do liposuction on your backside, micronise the fat, filter it, and then inject it into your cheeks or lips. It’s your own natural fat, and it can give your face a more youthful appearance by adding back volume as we age and our faces become more drawn.

[Eon Engelbrecht E-Radio] (14:22 – 14:26)
Goodness gracious. Wow. That’s next level, eh?

[Dr Clifford Yudelman – OptiSmile] (14:28 – 14:34)
Yeah, I’m going to have to look into it since he told me my face is looking quite sunken.

[Eon Engelbrecht E-Radio] (14:35 – 14:37)
He’s looking for new patients, man.

[Dr Clifford Yudelman – OptiSmile] (14:39 – 14:47)
He’s in Joburg. I asked him if we could do this in Cape Town or if I have to go to Joburg. He hasn’t answered me yet—this was a few weeks ago.

[Eon Engelbrecht E-Radio] (14:48 – 14:55)
Yeah, I wonder. No, you look fine, Doctor. Don’t worry about that.

Okay, so we just discussed the health benefits…

[Dr Clifford Yudelman – OptiSmile] (14:56 – 14:57)
Everyone looks good on the radio.

[Eon Engelbrecht E-Radio] (15:00 – 15:16)
Amen, brother. I agree. So, Doctor, we just spoke about the health benefits. What financial benefits do implants offer in the long run compared to other dental solutions?

[Dr Clifford Yudelman – OptiSmile] (15:16 – 18:55)
These days, not a lot of dentists specialise in dentures. You can go to a lower-cost clinic and get a standard denture, but in general, dentures can be quite expensive, and they don’t last long. You can drop them, break them, and they need replacement.

There’s a lot of advancement now with same-day and 3D-printed dentures. We’re looking into that at OptiSmile. We haven’t yet scheduled a podcast on dentures—maybe in the future when we start doing digital dentures—but the technology is expensive. The process is faster, and they’re more durable (they bounce when dropped), but the cost can still be high.

For example, if you lose a lower molar and need a bridge, you’ll have to file down the adjacent teeth and place crowns on them, which means getting three crowns done. Sometimes, an implant can actually be cheaper than a bridge because you don’t have to sacrifice the adjacent teeth. The biological cost to your body is much higher with a bridge because you lose all the enamel on those teeth. Within a few years, they may need root canal treatment, and then you have to drill through the bridge, which can lead to further issues down the line.

With implants, 99% will last at least seven years, if not longer. Bridges, despite what some dentists claim, don’t tend to last more than seven years on average. You also avoid the need for adhesives and special cleaning solutions required for dentures.

There are even broader financial benefits to maintaining your health. The Mayo Clinic used to say that people who can still chew properly into their 70s tend to live about ten years longer than those without teeth. And implants allow for better nutrition, which supports overall health.

Many medical aids now cover implants, especially if they’re done in a hospital setting by an oral surgeon under sedation. While we don’t generally get involved in medical aid claims at OptiSmile, we have had patients who have managed to get implants covered under their hospital plans.

Ultimately, the value lies in the increase in quality of life, and personal confidence—something you can’t really put a price on.[Eon Engelbrecht E-Radio] (18:56 – 19:02)
Dr Yudelman, what are the maintenance requirements for dental implants versus other tooth replacement options?

[Dr Clifford Yudelman – OptiSmile] (19:03 – 20:22)
I’ve yet to meet a patient who can floss underneath their bridges properly—or, well, I’m exaggerating—there are one or two who manage. But in general, it’s difficult, and people often notice a bad taste or smell. Bridges can be challenging to clean and maintain.

With implants, people really love them. Taking care of them is similar to caring for natural teeth unless you have something like all-on-4 or all-on-6, where you’ve got a denture that’s screwed in. In those cases, you’ll need to use floss threaders, but we design them in such a way that they can still be cleaned effectively.

Regular professional cleanings are essential to maintain gum health, and you’ll need your dentist to monitor the integrity of the implant. This includes getting an x-ray every so often and ensuring there’s no bleeding or signs of gum disease.

Unlike dentures, you don’t have to use any special soaking solutions or adhesives. Most of the implants we deal with are single implants or for patients who’ve lost a molar or multiple teeth because a bridge has failed. So, that’s quite common.

[Eon Engelbrecht E-Radio] (20:23 – 20:32)
Okay, and can you share any patient experiences that highlight the long-term benefits of choosing dental implants?

[Dr Clifford Yudelman – OptiSmile] (20:33 – 21:57)
Yes, we see it all the time—patients absolutely love their implants. I’ve had people come back and say, “I can’t believe I went three or four years without this. I wasn’t eating properly on that side.”

I’ve also seen patients who were treated by other dentists 20 or 30 years ago, and they’re now in their 80s. They still have their implants, and they look like spring chickens! They’re fit, healthy, eating whatever they like—lots of nuts, carrots, celery—and they’re still active, playing tennis or golf.

I think it’s because they’ve got a full set of teeth, which helps their self-esteem and quality of life. I’ve never had anyone come in and say, “I wish I never got these implants because I would’ve saved so much money.” That just doesn’t happen.

I don’t want to sound like a second-hand tooth salesman, but it’s true that the first two sets of teeth are free, and the third set is the one you pay for. It’s like they say: you don’t have to floss all your teeth, just the ones you want to keep.

[Eon Engelbrecht E-Radio] (21:58 – 22:07)
True story. Lastly, Doctor, what would you say to someone who’s a bit hesitant about the upfront cost of dental implants?

[Dr Clifford Yudelman – OptiSmile] (22:08 – 25:57)
That’s very understandable. Implants are expensive. The range here in Cape Town, depending on the clinic or specialist, is anywhere from about R35,000 to R50,000 for a single tooth implant.

When you need multiple implants or teeth replaced, the price per tooth comes down. For instance, if you need a three-tooth bridge, you’ll only need two implants, with a bridge on top, so you’re not paying for three separate teeth. Each case is unique—your friend may get an implant in one visit with a crown because they’ve got strong bone, while you might need a bone graft or a temporary crown, which increases the cost.

At OptiSmile, we only use the best quality implants and materials—you get what you pay for. There are South African implants, Chinese implants, and others, but we use what we believe is the best for our patients. Among dentists, we know which brands are better, and those are the ones we’d use on our own family members.

The cost-effectiveness over time is important to consider. Implants are a long-term investment in your overall health and well-being. At OptiSmile, we also offer finance options, like Float, which allows you to spread payments over six months with no interest. You can bring the cost down significantly that way.

It’s more than just the cost—it’s the quality of life, the confidence you gain. I always encourage people to discuss their concerns with their dentist. Don’t just assume it’s out of reach—book a free video consultation at OptiSmile, send us photos, and we’ll give you a better idea of your options.

Of course, at some point, you’ll need to get a scan and a 3D x-ray. At OptiSmile, we include 3D x-rays at no extra charge during your full, one-and-a-half-hour consultation. If you have missing teeth or problems with dentures or bridges, you might be looking at implants sooner rather than later.

I hope that helps. That wraps up our three-part series on implants. Next week, we’re moving on to something very different. As promised, we’re doing this to help listeners—not just to sell dental services. Our next three podcasts will be about snoring and sleep apnoea. You might wonder, what does a dentist have to do with snoring or sleep apnoea? Tune in to find out.

[Eon Engelbrecht E-Radio] (25:57 – 26:30)
Looking forward to that, Dr Yudelman. A big thanks to you once again. And remember, while we strive to provide valuable insights on this podcast, you should always consult with your own dental professional for advice tailored to your personal health.

Subscribe to our podcast for more enlightening discussions, and join us again next week as we continue exploring the fascinating intersection of dental health and financial savvy. Until then, keep smiling and taking great care of your teeth.

[Conclusion] (26:51 – 27:35)
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.