Frequently Asked Questions

Click on any question for its answer.

There are several reasons that lead a dentist to extract a tooth, such as: advanced gum disease (where the bone that held the tooth has been lost), advanced decay that could prevent the tooth from being reconstructed, or root fracture, normally after an accident.

Some of the consequences of tooth loss are: aesthetic compromise, decrease of masticatory efficiency (it is harder to chew), overload of the remaining teeth as they have to compensate for the lost tooth (therefore the remaining teeth could be damaged or lost too), difficulty to talk or to say certain words, loss of lip support (wrinkles), tilting of the neighboring teeth, unstable bite, head and face muscle and joint problems, decrease in size of the bone that held the lost teeth (bone resorption).

The simplest option is removable partial dentures, which are held in place by hooks and stabilized by a plastic or metallic structure that fits over the palate or under the tongue. The patient can remove them from their mouth and place them back themselves.

The next option is a bridge, which involves trimming the tops of the neighboring teeth so they can be fitted with porcelain crowns that will hold between them the replacement tooth.

The third option consists of dental implants, which involve placing a titanium post that will serve as an artificial root that will support a porcelain crown.

An implant is an artificial object that is surgically placed in the body. They are generally used to replace a missing part of the body or with cosmetic purposes.

Dental implants are artificial tooth roots that are placed into the jawbone. They are small cylinders (3.75 mm diameter), most commonly made of titanium. The artificial teeth can be anchored to these new roots zero to four months after their placement, once the implants are fixed strongly to the bone.

Dental implants will improve your smile, speech and chewing function, greatly increasing your confidence. An advantage of dental implants is that there is no need to alter, trim or injure the neighboring teeth to replace the missing tooth.

They are a type of intraosseous dental implants that fix to the bone by means of the phenomenon of "osseointegration", creating true artificial roots implanted inside the mandible or maxillary bone. They provide a solid base for the restorations built to replace one or several lost teeth.

Osseointegrated implants will allow us to chew, speak and smile with the same confidence as with our natural teeth.

The main advantages of dental implants are:

  1. With dental implants there is no need to trim (damage) neighboring teeth to replace lost teeth. Bridges have long been a good option for tooth replacement, but they do require trimming the adjacent natural teeth, which over time can lead to failure of these teeth due to overloading or decay.
  2. Dental implants make it easier to maintain good oral hygiene, as they can be brushed and flossed just like natural teeth. Bridges on the other hand require a special technique with a special floss.
  3. Dental implants have a longer life span than bridges or removable dentures. In 10-year studies, it was found that the success rate for implants was 90%; while for bridges and dentures it was 50%. The studies also showed that when a bridge failed the supporting teeth often had to be extracted or required root canal treatment. The few times that implants failed they simply had to be replaced, with no harm to the neighboring teeth.
  4. Dental implants stimulate bone growth in the area surrounding the implant, unlike dentures or bridges which do not prevent the bone loss that occurs over time when teeth are missing.

The disadvantages of dental implants are:

  1. Dental implants must be placed inside the bone, and this involves a minor surgical procedure. Although it is relatively painless, the fact that it is surgery might make some patients feel anxious.
  2. The amount of time necessary to complete the treatment is longer than with other tooth replacement options. It can normally take between two to six months from implant placement to crown placement. This is also known as osseointegration time, and it varies depending on the area of the mouth where the teeth were lost.

Through the years many materials have been used for dental implants, but currently the most widely used is titanium.

Apart from being extremely strong, light-weight, corrosion-resistant and very durable, research and experience have shown titanium to have exceptionally high biocompatibility, which is the ability to interact with the body without causing harm. Since it fixes strongly to the bone (osseointegration), these types of implants last for very long periods of time.

Bone resorption is a process by which specialized cells break down the bone and release its minerals.

The function of the maxillary and mandibular bones is to support the teeth. When we loose one or all of our teeth, because of decay, gum disease, trauma, etc., the bone that supported the lost teeth looses its purpose and the process of bone loss or bone atrophy begins. The aesthetic and functional consequences of bone resorption can be dramatic. Bone loss is greatest during the first months after a tooth is lost, and it can be accelerated by the use of full or partial dentures due to the pressure they exert on the gums and underlying bone.

Dental implants not only replace teeth that have been lost, restoring function and aesthetics, they also stop bone loss as the bone once again receives the stimulus of mastication. Therefore, it is important to replace missing teeth with implants as soon as possible in order to minimize bone resorption.

Let us imagine a house. The teeth would be the columns or pillars that support the roof. If some of these columns were to be removed, the rest of them would have to support more of the weight of the structure. These remaining columns would be overloaded, and this could lead to the whole structure collapsing.

The same thing happens in the mouth when teeth are lost. The remaining teeth have to endure all the forces of mastication, suffering an important overload that could injure them and their bone support, and with time they could be lost too.

The treatment consists of two stages: A surgical phase and a prosthetic phase.

The surgical phase consists of the placement of the artificial roots or implants inside the jawbone. It is performed with local anesthesia and is painless. Sedation and general anesthesia are options for nervous patients. The duration of the intervention is from one to two hours, depending on the number of implants, which will remain covered for two to six months (depending on the area of the mouth where they were placed). In some cases a second very minor surgical procedure is needed afterwards to uncover the tip of the implants, especially in aesthetically important areas.

The surgical treatment consists of the placement of the artificial roots or implants inside the jawbone. It is performed with local anesthesia, and is painless. Sedation and general anesthesia are options for nervous patients. The duration of the intervention is from one to two hours, depending on the number of implants, that will remain covered for two to six months (depending on the area of the mouth where they were placed). After that time sometimes there is a need of a very small second surgical phase, to uncover the tip of the implants, especially in esthetic related areas.

The post-operative stage is not painful. The day after the procedure there may be some minor swelling and bruising. Painkillers, antibiotics and anti-inflammatories are prescribed for a short time period.

While the dental implants integrate to the bone, your removable dentures can be modified and conditioned to be used temporarily until the implants are ready to receive the fixed porcelain crowns. If you use a fixed bridge, it will be cemented immediately after placement of the implants and remain in place until the dental implants are ready to receive the fixed porcelain crowns.

The time between the surgical phase and the placement of the crowns varies with each case.

The range varies between two and six months, to give time for the implant to integrate or fix to the bone.

The system used consists of a series of very precise machine made abutments that anchor to the implant with a gold screw, and that will retain the crowns.

Implants should receive daily flossing and brushing, just as natural teeth. The flossing of the implant-supported crowns will be much easier than for bridges, because the first ones will not be fixed to the neighboring teeth.

If you answer affirmatively to any of the following questions, you can be considered an ideal candidate for dental implants:

  • Have you lost one, some or all of your teeth?
  • Do you have difficulties with your removable dentures? (bad retention, pain, etc.)
  • Do you feel insecure when you smile, speak or eat?
  • Has a dentist told you that you have teeth in very bad shape?
  • Is there an area in your mouth where the corresponding tooth never came out?

Age is not a decisive factor when determining who is a candidate for dental implants, but it is advisable not to use them in patients under 15 or 16 years old, as maxillary growth is not yet complete. Older patients can receive implants just as well as younger ones, with the same success rate.

No. A treatment with implants involves a surgical procedure, but pain and all other implications can be perfectly controlled.

It is very important to respect the times of osseointegration or integration of the implant to the bone. In general, for the lower jaw it takes two to four months between the time of implant placement and the prosthetic phase (start of the construction of the implant supported crowns or dentures), and six months for the upper jaw. The prosthetic phase lasts between one and three weeks, depending on the case.

In spite of the excellent clinical results obtained with implants (93 to 97% success rate), there is a 3 to 7% rate of failure. No other dental treatment has such a high long-term success rate.

If an implant fails, it is possible to substitute it for another one to solve the problem. Nevertheless, most of the implant-supported prosthesis are designed to work, even if an implant fails.

In medicine it is complex to say that a treatment will last a lifetime, especially in this case because of the fact that teeth are a tool that we use constantly, every day, subjecting them to a lot of pressures and forces while being placed in a humid and very septic environment (the mouth). There are multiple studies, some over 35 years old, that show very high long-term success rates for dental implants. The most recent studies indicate that 90% of the implants placed 10 years ago, are still working properly today. This is much higher than the 50% ten-year success rate described for tooth-supported bridges or dentures.

Dental implant treatment is sophisticated and demands a very complex armamentarium. More than one experienced professional (specialist) is required. The components used have to be very precise, and precious metal alloys (gold, silver, palladium) have to be used in the prosthetic phase. The implants and the prosthetic components have to be from a recognized brand. All of this makes dental implant treatment more expensive than tooth supported treatment, at first. But over time, since implant treatments last longer, require less maintenance and lead to less additional procedures, like the redoing of tooth-supported bridges or dentures (which sometimes implies root canals, extraction of supporting teeth, longer bridges, etc.); implant treatment becomes actually less expensive, and will prevent the loss of more natural teeth.

Costa Rica is a small peaceful country in Central America that is known throughout the world for its high quality, low cost dental care.

Politically stable and with no army, Costa Rica is one of the most bio-diverse countries in the world: 25% of its territory is dedicated to parklands and wildlife refuges. Costa Ricans are known for their warmth and hospitality, and tourists love the country's natural attractions, from beaches, deep-sea fishing, white water rafting, and surfing; to mountains, rain forests, volcanoes and hiking. The capital city of San Jose offers museums, a national theater, and casinos. All visitors love San Jose's Central Market, and you can also visit coffee plantations, butterfly farms, and villages offering local handcrafts - all within a twenty-mile radius!

It is safe and easy for patients from other countries to have their dental implant treatments done in Costa Rica, as the country has highly trained dentists who work in state-of-the art facilities with the latest materials and technology. As an added bonus, patients can get to know this beautiful country in between appointments all for a much more affordable price than in their home countries, even tough most of the materials used, including the dental implants, are made in the United States and Europe.

According to Costa Rican Law, a specialist is a dentist who after the regular six years of Dentistry school completes at least two more additional years of studies and training (full time) in a specific branch of dentistry. This has to be certified by the official Costa Rican Board of Dentists, which reviews the program and the University that offered the specialty (some programs may not be accepted as a specialty if they do not reach a specified degree of excellence).

The Costa Rican Board of Dentists, in article 29 of their Code of Ethics, prohibits dentists from claiming to be a specialist if they do not fulfill the above mentioned requirements.

There are only three certified Oral Implant Specialists in Costa Rica, and Anglada & Castro offers one of them.