Glasgow dentist reports ten-fold increase in demand for implants after lockdown extractions

A LEADING dentist says he has seen a ten-fold increase in demand for implants amid fears that lockdown caused a spike in tooth extractions that might have been avoided.

Duncan Black, one of Scotland’s most experienced dental implantologists, said many patients are coming to him after having teeth – including front teeth – removed at emergency dental hubs which under normal circumstances dentists would have tried to save.

Mr Black, who is based at Halo Dental in Glasgow but treats patients from as far afield as Ayrshire and Lanarkshire and also runs an outreach clinic in Galashiels, said it is probably an inevitable consequence of lockdown.

He said: “People have not been able to access their usual dental care, that’s the crux of the matter.

“We were told by the Chief Dental Officer to leave the practices and not come back again, but no one thought it would be nearly three months before we came back.

“During that time we had to provide an emergency service.

“I don’t want to beat up on them [dental hubs] too much because it was scary times for everyone.

“Some people were in extreme pain.

“There was probably a lack of PPE available for normal dentistry to carry on so the hubs were the best solution, but yes, I think that due to Covid some people had teeth removed rather than, if they had been accessing normal care through their own dentist, attempts would have been made to save the tooth.

“I think that’s fair comment.”

CASE STUDY: Ayrshire man’s lockdown ordeal as rotten tooth has to be pulled out without anaesthetic

Mr Black’s practice, which is part of the Clyde Munro dental group, re-opened in mid-July and since then has seen ten times as many people requesting dental implants as they have in previous years, with most patients self-referring.

Implants are titanium screws which dentists attach directly to the jawbone, replacing the missing tooth root. A false tooth, such as a crown, can then be held securely in place.

Unlike dentures, which tend to last around five to 10 years, implants can last as long as natural teeth provided they are cared for properly.

However, they are more expensive. Mr Black said a single implant, without any other complications, will cost around £2000 in Glasgow.

The service is only available on a private basis, meaning NHS patients have to pay the full cost of the treatment.

Mr Black said: “Normally, if someone goes to their dentist and says ‘I have a problem with this tooth’ and the dentist takes and X-ray and concludes it’s unsalvageable, that they need an implant or whatever, they’d be sent along to us and we’d order everything for them so that they wouldn’t go without a front tooth.

“They’d have a temporary of some description.

“But because the dental labs weren’t open either during lockdown there wasn’t even a possibility for any sort of temporary provision to be made for people.

“So quite often they just had to

New Cancer Risk With Textured Breast Implants?

Use of textured breast implants for postmastectomy reconstruction led to a small but significant increase in breast cancer recurrence as compared with smooth-surface implants, a retrospective study from South Korea showed.

Overall, 4% of 650 women had some form of disease recurrence during a median follow-up of 52 months after receiving breast implants. The 5-year locoregional recurrence-free survival (LRRFS) rate was 95.9% among women who received textured implants and 97.8% in those who had smooth implants, a nonsignificant difference, reported Sa Ik Bang, MD, PhD, of Sungkyunkwan University and Samsung Medical Center in Seoul, and colleagues.

As shown in their study online in JAMA Surgery, the 5-year disease-free survival (DFS) rate was significantly lower with textured implants: 93.3% vs 97.8%.

In a Kaplan-Meier survival analysis, LRRFS did not differ by implant surface type, but DFS remained significantly lower in the textured-implant group at 3, 4, and 5 years.

“Textured implant use could be associated with a lower DFS and high risk for recurrence than use of a smooth implant,” the researchers concluded. “This association may be valid regardless of other factors, including tumor stage and ER [estrogen receptor] status. Further investigation is required to verify these results.”

The results added to the well-documented risk of anaplastic large-cell lymphoma (ALCL) associated with breast implants, which have been blamed for 733 cases of ALCL and 36 deaths worldwide as of early 2020. The accumulation of adverse data makes a case for discontinuing use of textured implants, according to the authors of a commentary that accompanied the article by Bang and colleagues.

“Given the association of textured implants with ALCL, and now the suggestion that they are associated with increased risk for breast cancer recurrence, surgeons who choose textured implants should counsel their patients with breast cancer about their possible consequences,” wrote Michael R. Cassidy, MD, and Daniel S. Roh, MD, PhD, both of Boston University School of Medicine. “Many reconstructive surgeons across the world have already abandoned the use of textured implants altogether.”

The sudden emergence of the breast implant-associated (BIA) ALCL, and its possible relationship with implant-surface texture, focused more emphasis on implant safety, Bang and co-authors noted. Patients have raised concern about whether the implants might also be associated with breast cancer recurrence when used in reconstruction procedures after mastectomy, the team added.

No clinical studies had examined the association between breast implants and breast cancer recurrence. Chronic inflammation associated with an implant or the surgical procedure has been hypothesized as a potential trigger for BIA-ALCL.

Clinical and preclinical studies showed that surgery-induced inflammation could have implications for local residual or dormant tumor cells, including the potential to trigger tumor regrowth and metastasis, the authors continued.

To examine the issue, Bang and colleagues retrospectively analyzed data for patients whose breast cancer treatment included use of an implant during reconstruction procedures performed at Samsung Medical Center in Seoul from 2011 through 2016.

The researchers identified 650 patients who received a total of 687 implants, which had textured surfaces in 413

Dental Implants

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What To Do If You Cannot Afford Dental Implants

It is suggested that a toddler start visiting a dentist as soon as the first tooth emerges, so it will likely be very early on in your child’s life when you may be faced with the choice of whether or not to make use of a pediatric dentist or a family one. Veneers have a definite benefit over dental crowns in that there isn’t a requirement for the tooth to be floor down previous to the veneer being bonded to the tooth. After some three weeks of mouth swishing (for an extended 15 minutes on daily basis), I noticed that my tooth not had the arduous nodules of plaque that have been a nightmare each time I visited a dental hygienist.

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People still believed that their movement across the mouth was the reason for toothache, and used all kinds of cures to kill them off. With regular dental check-ups, a great cleaning routine, and a diet low in sugary snacks you’re likely to still have all your teeth by the point you are in your sixties.

Folks with inborn defects can also method esthetic dentists for restoration of the deformation. Whether or not the affected person receives dental implants or a dental bridge, the affected person must proceed a each day oral hygiene routine together with common dental checkups and cleanings.

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