Q: I need some teeth pulled and would like permanent teeth with porcelain crowns anchored to implants. I thought I could afford the work until the dentist told me I also would need costly bone grafting before the implants are placed. Is there an alternative? Leonard B. in Palm Beach Gardens

A: My fitness trainer recently argued with a salesman who wanted $500 for a set of floor mats on a $30,000 car. I told him to tell the dealership to keep the mats and just throw in some of those nifty paper mats from the service department with the graphics of shoe prints.

A recent article in a widely read dental journal posed the same question to an authority on all things dental. Here are the hi-lights:  Firstly, adding bone grafts to all sockets after extractions is not yet ‘standard of care’, but certainly should be, at least in the “smile zone” (anterior portions of the mouth) or in any area where the bone is deficient warranting more “bulk” to better anchor the implant or to improve the final aesthetic outcome of the case.

Not all grafts are created equal. Placing freeze-dried cadaver bone covered by dissolving membranes with multiple sutures can be costly. More economical methods consist of synthetic bone graft materials, (Osteogen) covered by collagen plugs (OraPlug) and minimal suturing can often do the trick just fine. Three to four months later, you are ready to pop in the implants and begin the road to getting teeth close to the real thing! For a free copy of my book, “Tooth Talk: What Educated Dental Patients Need to know About 21^st Century Dental Care”, drop us an email request.

Dr. Mitchell Josephs practices Cosmetic, Implant and General Dentistry in Palm Beach and hosts “Tooth Talk” on WBZT AM1230 (www.radiotoothtalk.com) Dr. Mitchell Josephs is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry and completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.

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44 Cocoanut Row, Palm Beach, FL 33480

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