Dr. Nammy Patel from Green Dentistry talks with John Maher about bone grafting and regeneration in relation to dental implants. She explains why some patients need bone grafting before getting dental implants. Then, she describes how these processes work.

John Maher: Hi, I’m John Maher, and I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California. Helping patients recognize the vital connection between dental health and whole-body health and author of the best-selling book, Age with Style: Guide to a Youthful Smile and Healthy Living.

Today, our topic is bone grafting and regeneration for dental implants. Welcome, Dr. Nammy.

Dr. Nammy Patel: Hi, John. Thank you for having me.

When Do You Need Bone Grafting Before Dental Implants?

John: Sure. Dr. Nammy, when is bone grafting necessary before getting a dental implant?

Dr. Nammy: You know, John, my honest opinion about bone grafting is that it’s recommended all the time before getting a dental implant. And the reason for that is when you extract a tooth, what happens is the bone starts dying. And so if the bone starts dying and deteriorating, the quality of an implant that you’ll get isn’t as great. So my preference would be to any time a tooth is extracted, to place a bone implant in, right there and then. And then let it heal for three to six months, and then we put the implant in.

And when we do that, it’s kind of like when there’s soil there’s trees, and then there’s roots, right? So the soil is there because it’s got roots, and the same thing with the teeth. When the tooth is there, there’s roots, and that root keeps the soil in place, which is the bone. And if you pull the tooth, or if you pull the tree, there’s no more roots left, so the soil will erode if rain comes.

And so what we want to do is when the tooth is taken out, we want to secure that soil or secure that bone. And that’s the reason why we add bone grafting: to keep the bone there, so it’s available to us in three to six months, when we actually place the implant.

How Does Bone Grafting Work?

John: Can you tell me a little bit more about what bone grafts are, and what the different types are that you use, and how a patient can decide which one might be best for them?

Dr. Nammy: Sure. So there are many different kinds of bone grafts there. My favorite types are collagen bone grafts. I’m a vegetarian… So there are ones that are made from bovine. There’s also ones that are made in a lab. I prefer to have the ones that are made in the lab, because I’m not harming anyone, and it is a great way to make sure that the bone integrates and the bone heals. And our body is able to use the raw materials it needs, in order to regenerate the bone that’s really needed when we actually do the actual implants, so it can have good support around it.

How Long Does a Bone Graft Take to Heal?

John: Okay, and how long did you say that it takes for a bone graft to heal? And what can a patient expect during that process?

Dr. Nammy: So my honest opinion is it takes three to six months for the actual bone graft to heal and completely integrate. So the reason for that is we talk about our immune system. We talk about when we fall. For example, when you fall, it takes your body seven to 10 days for the scab to heal. The same analogy occurs when we pull a tooth and put a bone graft in. That bone graft is a form of material, and your body has to digest everything and make it a part of its own. And in order to do that, it takes about three to six months for the actual bone integration to occur.

The Dental Implant Process

John: And so what’s the process, then, of getting a dental implant? Are you removing teeth, doing a bone graft, waiting three to six months, and then doing the implants after that? Is that sort of the process?

Dr. Nammy: That is. If there’s an existing tooth, the best thing to do is extract the tooth, put the bone graft in, let it heal, then go ahead and put in the implant. And the main reason for that is usually, the reason why a tooth has to get pulled out is because of disease or decay. When there’s disease or decay, that means you’ve got a lot of bad bugs around there.

So we want to clear out all the bad bugs. We want to go from the swamp to a pond all over again. Make sure that our soil… if we’re going to plant crops, we want to make sure the soil’s in really good shape. And so when we extract the tooth, we want to take the tooth out, put the bone graft in, let it heal. And then you go ahead and plant the crop or plant the implant in.

What Do Patients Do While Their Bone Grafts Heal?

John: Right. So what do patients do in the meantime, while they’re waiting for the bone grafts to heal? Do they wear dentures in the short term?

Dr. Nammy: Yes, so there are things called Valplast partials or interim partials. So it basically looks like a tooth, and it’s really great, because patients can take it in and out. But it’s really nice, because there’s a nice tooth there, so they don’t have to worry about aesthetics.

There’s also different ways we can put a tooth there. There’s also Essix retainers, where you could take the retainer in and out, and it has a tooth attached to it. So there are different ways to make sure that there is a tooth in the area, but the tooth is actually there for more aesthetic purposes, rather than functional.

What Causes Bone Loss in Your Jaw?

John: Okay, and going back to the beginning, what is it that really causes bone loss in the first place? And how can people prevent that from occurring?

Dr. Nammy: So bone loss occurs if a tooth is pulled out. The other reason that bone loss occurs in a different environment is actually gum disease, when there’s a lot of bad bugs. For example, patients who need implants are either because you had a tooth pulled out, and the reason you had to have a tooth pulled out could be a number of reasons. It could be because you fractured it, you had a root canal that failed, or you had gum disease and the teeth became loose and you needed to pull it out. So there’s different reasons why you need to get the tooth pulled out.

Regardless of that, the bone grafting would help bring back the soil, make it nice and healthy, in order for implants to be planted there in the future.

Contact Green Dentistry to Learn More About Dental Implants

John: Okay, all right. That’s really great information, Dr. Nammy. Thanks again for speaking with me today.

Dr. Nammy: You’re welcome.

John: And for more information about Green Dentistry, visit the website at sfgreendentist.com. Or call (415) 433-0119.