Implant Consultation Summary

- Before and After
- Testimonials

Dear Patient:

We realize that a great deal of information is given at the time of your dental implant consultation. Some patients find it difficult to remember the details of our conversation, particularly if more than one dentist is consulted. Please read this at home and call with any questions. As always, we welcome your calls and encourage communication.

Dental implants are placed in the jaw bone to simulate the root of the tooth. They are made of titanium, which is a biocompatible material. It is the same material used by orthopedic surgeons for many joint replacements.

The procedure for placing dental implants is fairly straight forward and not terribly traumatic to the patient in most circumstances. It is generally painless and quick, depending upon the anesthetic selected. After numbing the area, a small incision is made in the gum tissue to expose the bone. Then we start with a small drill, moving to a larger and larger size until an opening of the correct size is created for the particular implant we want to use. Like the roots of a tooth, it is always best to use the longest, widest implant we can for the available space.

Many patients simply take Extra Strength Tylenol postoperatively for discomfort. We do offer intravenous sedation in this office if you prefer to doze off during theprocedure. A small butterfly needle is placed in your arm, and small amounts of Valiium and Demerol are given slowly over a period of time. You are relaxed but not deeply asleep while sedated. If you are asked to open your eyes or turn your head you will be able to do those things. You simply won’t care what we are doing. Instead of feeling apprehensive about what is going on around you, you may even drift off into a light sleep. Most patients lose track of time and are a little surprised to find we are finished. It is quite comfortable and makes the time go quickly. Intravenous sedation is available, however, a local anesthetic alone works well for most.

In the lower jaw, our main structural concern is the mandibular nerve. The nerve runs along the side of the face, surfacing between the first and second bicuspid areas. Although it is generally not difficult to plant around this structure and avoid it altogether, the nerve can be bruised or even damaged. The result of this is called paresthesia, or numbing. Your lip will not droop as if you had a stroke, but will feel as if you are numb with anesthetic. This may be a temporary paresthesia, lasting anywhere from weeks to months, or even permanent. Diagnostic tests and measurements are made to reduce this risk, including CT scans. This procedure allows us to see the bone in three dimensions and can allow us to virtually place the implant using our computer software prior to ever touching you. You can discuss this mode of diagnosis with Dr. Kosinski. In the upper jaw, our main concern is with the maxillary sinuses. Obviously we do not want to place anything into the sinuses, which are empty holes or air spaces. In the premaxilla or front part of the mouth, and in the symphysis (chin area), there is very little anatomy that will contribute to a risk with our implant placement.

Implants today are very successful. Dr. Kosinski has lectured all around the country, and has heard many other speakers, and read a great deal of literature about implants. We can tell you that statistically we are talking about a 95% success rate. What does that mean? To be a statistical success in medicine means something lasted five years after treatment. Meaning if you had cancer, and a medication was given that allowed you to live another five years, statistically that treatment would have been a success. Obviously, we are not doing this procedure with the idea that our implant will last five years. It is much more important to look at why 5% of our dental implants do not heal properly.

Implants do not heal for a number of reasons. Number one, the inability or unwillingness of the patient to keep it clean. Obviously you are making a big investment in your implant and we want you to maintain it. We need to see you periodically, and we need to take a radiograph once a year to detect any bone changes.

Number three, cigarette smoking can significantly reduce our successes with implants. We would comfortably say that it reduces our success 40 to 50%. If you’re going to continue to smoke, you have to accept the risk that our implants will not heal properly or fail in the future. Number four, sometimes denture adhesives cause problems in the initial stages of healing. When we put Fixodent or a similar product in the denture, it can affect healing. We may ask that you not wear a prosthesis during the initial healing.

Some implant surgeries are more complicated than others. If yours is one of those, Dr. Kosinski will tell you in advance. If a nerve or muscle requires repositioning or a sinus membrane raised, you will be told ahead of time to expect more postoperative discomfort than a simple placement.

Following your implant procedure, Dr. Kosinski will ask you to do three things. Number one, he will give you a prescription for an antibiotic in advance. You will start that the night before and carry it through until the antibiotic is completely finished. He will give you a prescription for pain medication, which you will take as needed. The day after the procedure you may not wish to take a narcotic and can simply switch to Extra Strengh Tylenol. Finally the most important thing is that you use ice to your face. When you get home take a plastic baggy and put some ice cubes in it, wrap a dish towel around it and hold it up to the surgical site extraorally (outside the mouth). The ice will minimize swelling. If we minimize swelling, then we minimize discomfort, and you will feel fine.

There are two basic criteria for placing a dental implant. First you must be relatively healthy, meaning no uncontrolled medical problems such as uncontrolled hypertension or uncontrolled diabetes. Also immunosuppressive diseases like AIDS can be a concern. Second you must have enough bone to be able to place something into it. If you do not have enough bone Dr. Kosinski will discuss the option of building up the bone.

If you have any questions concerning the procedure please contact Dr. Kosinski or one of the staff. The staff is very well educated and can answer most questions. If they cannot Dr. Kosinski will come to the phone or set up a time for you to discuss your concerns. The office phone is 248 646-8651, the e mail address is allquestions@smilecreator.net. Dr. Kosinski’s cell phone number is 248 444-4033. He can be reached after hours or if any emergency arises.