Dental Implants

Dentists can use dental implants and dental bridges to replace missing teeth. Dentists will evaluate the condition of the existing teeth, gums and bone structure before determining what is best for the patient.

Please explain what a dental implant is and why someone would need one.

Dr. Anthony Bielkie: The way I like to describe a dental implant to a patient is the implant itself is the artificial root. If we were to take three parts of a tooth, the root, the part that we see above the gumline and the crown that fits on top, the dental implant is the part of the tooth that goes below the gumline or an artificial root. We then can fix it many different ways, either putting a crown or using it to make attachments to make other kinds of dentures. Majority of the reason that somebody would need an implant is because they are missing a tooth, either congenitally, born missing the tooth, or due to disease or trauma.

What is the process for getting a dental implant? Can you get more than one at a time?

Dr. Anthony Bielkie: Absolutely. We have, on a number of occasions, placed as many as 10 or 12 implants in a given day. It really depends on what the patient’s need is. We start with a personal consultation about what their goals are and how many teeth that they’re missing. Sometimes it’s as simple as somebody comes in with a trauma and their tooth is broken, we remove the tooth and immediately put an implant in the same day, the day that we met them, and put a temporary on there and they leave smiling.

Other times, people have more chronic, long-term issues where we’ll work up multiple different options at multiple different price ranges to give people an idea of what they may want to do. Frequently, after we place the implant, it’s not uncommon to allow the bone to grow around the implant for three or four months. But with today’s technology and new root adherences to the implant, we’re able to speed that up quite a bit and many times can get fascia institute the same day.

There are many different types of bridges. Can you explain them and the benefits of each?

Dr. Anthony Bielkie: Absolutely. One of the options for replacing a missing tooth is to do a bridge. I’d like you to think of a bridge like a bridge over water, over the water is where the missing tooth would go, the tooth that we’re going to place, and then the bridge is connected on either side. It would connect, obviously, three teeth, so it would be a tooth on either side and the artificial tooth in the middle.

The advantages to a bridge is frequently it can be done quicker and simpler and many people are nervous about having an implant placed, worried about having, they would say, a screw placed into their jawbone. But with today’s technology, generally the standard of care is the first option to replace the missing tooth is generally an implant, unless we’re having some other particular issue that is very specific to that patient. The disadvantage to a bridge is now if you have a problem with either part of the bridge that you still have an extended three tooth problem as opposed to a one tooth problem.

Could you describe the process of getting a bridge again, and how long it takes?

Dr. Anthony Bielkie: Yeah, that’s a good question. If we decided, for instance, think back to that trauma scenario where someone lost a tooth due to trauma, we’ve seen people hit in the mouth with a golf club or car door, in that tooth, if the tooth is determined to be non-salvageable, we would remove that tooth. We would prepare the teeth on either side, meaning we need to, I don’t really like the expression, but people say, “whittle it down,” so we do, we need to take a couple of millimeters off the top of the tooth and a millimeter-and-a-half or so off the sides of the tooth to prepare the tooth. Then we would make a temporary bridge. We would take an impression. We could either do that with a physical impression, people will sometimes say, “the goopy stuff,” or now we can scan impressions with a scanner, take a digital impression. We’d fabricate a temporary crown. Patient would leave looking very nice. We’d bring them back in a few weeks and give them the permanent crown.

How long do bridges and implants last? Or how often do you need to replace them?

Dr. Anthony Bielkie: Obviously, our goal would be to never have to replace these prostheses. But we have to remember, at some point the patient had a perfect tooth and somehow it got decayed, so a bridge at some point the bridge ends and the patient’s tooth starts, so impeccable oral hygiene and regular care at the dentist is going to help extend the longevity of that tooth. I’ve been doing this for over 25 years and I have some bridges in that I did very recently out of dental school and they’re still in the mouth. Other times the insurance agencies say every five to seven years is about the average lifespan of a bridge needing to be replaced. The materials should last indefinitely. It’s what the tooth looks like that the bridge is connected to. So, again, impeccable oral hygiene, regular care so that if we do find a problem we can try to fix it sooner.

Implants are interesting. We’re finding that they’re over 95% successful. They’re titanium, so I can assure you you’re not going to get a cavity in there. Our thoughts are that the longevity of these implants will be considerably longer. Again, people need a home care, just like you can get periodontal disease, you can get peri-implantitis so we can’t completely neglect those areas. We still need to do home care, we still need to have follow-up care. But our goal is for them to last an extremely long time.

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If you are interested in speaking with Dr. Anthony Bielke, visit or call (586) 739-6400 to schedule an appointment.

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