Dr. Kat: Hi. It's Dr. Adrian Kat here from Advanced Dental Artistry here in West Perth. I want to have a chat with you today about dental implants and all-on-four treatment and what we're really talking about here is either replacing one tooth all the way through to replacing all of the teeth. When it comes to a single missing tooth and especially a back tooth, what we normally find is that it's usually because the tooth has been extracted and that could have been because of decay, gum problems or fracturing. And it's also caused those here that can't be saved because of these problems. It's exactly the same with front teeth. Either the tooth has been lost due to trauma, or it's a situation where a tooth has broken to the point where we can't save the tooth anymore.

When it comes to missing all of the teeth or the teeth are unsavable, usually, if all the teeth are missing, of course, the patient will present with dentures. And we know that historically dentures have been very good, they normally fit very well when they're first placed, but over time as the mouth changes and the dentures become bigger, the dentures become much harder to deal with. They lose suction, they move, and they become very irritating. If it comes to people that have unsavable teeth, generally, it's patients that have broken down teeth, decay, or they've got very aggressive gum problems, and in these instances, it's either removing the teeth and going to dentures or looking at another alternative.

So what are the problems with missing teeth? I took this photo of a patient who lost a lower molar around about 15 years ago and you can see how the top molar that was opposing it has actually dropped into the space. Also, the back tooth has actually started to tilt forward into this space, and I've also put a line here where the gum and the bone that was out towards the front of the mouth where there are teeth, and you can see that the bone in the gum has actually shrunk away. So what we're looking at is when a tooth is lost over time, the gum and bone will start to shrink.

On a kind of mass scale is that when we see someone has had multiple teeth taken out, you can see that it's different areas of the mouth that have got teeth missing so, therefore, they don't have any bone, and in teeth areas that they do have teeth, there are some... there is bone actually present. So this is what it looks like with a patient that has their denture in. When they have their denture in, you can see that they have lip support, but when they take their denture out, you can see how their face actually changes. So what is the real impact of poor or missing teeth? I'd like to play you a video of Ian and in his words, he describes what it's like to live with teeth like that.

Ian: I could have been a ventriloquist. I could have. I was getting to that point where I could talk without any movement whatsoever. Just having that...not having that conscious feeling continuously, like getting up in the morning... It loses you 24/7, you know, the fact that, are they gonna break today? Did a customer notice? At 14 jobs and inspections a day, you know, every customer has spent thousands of dollars with Trevis [SP], they've all got problems with it, and I'm trying to, you know, keep them happy and you know, I was just so self-conscious of it. Unbelievable. Now watch out.

Female: I watched him being a really confident, outgoing person to somebody that was quite inward and quite anxious if we went out or was quite happy to stay indoors.

Ian: You know, going to... Trevis had put on a lot of parties and every single social event, you'd be going and going, "Right, now I gotta keep my lip down, got to stop. Don't laugh too much, you know, laugh with your hand up." And it's just surviving. But I know now I can just laugh and not have that conscious, you know, plate and then the missing ones.

Female 2: It's wonderful that you feel that already.

Ian: Oh, it is. It can only get better from here on out. Truly amazing.

Dr. Kat: So what is the solution? Over 50 years ago, an orthopedic surgeon learnt that if titanium was placed near the bone, the bone would actually fuse to the metal and this became like a root of a tooth. From there, they were able to place things like porcelain crowns over the top and this was really the forefront for all knee reconstructions and hip reconstructions and of course, plates when someone breaks a bone. If someone's missing all of the teeth, it's possible to replace all of the teeth and this is between 12 to 14 teeth by just using 4 implants. And what all-on-four is, is basically replacing teeth, but also replacing the lost gum and the lost tissue. This is a closeup photo of an all-on-four bridge and you can see the beauty in the teeth, but you can also see how we've copied the gum too. So when someone comes to get all-on-four treatment, the idea is to make sure that not only do we give them a beautiful smile and bite, but we also replace the gum, so they get an aesthetic looking result. The undersurface of an all-on-four is actually very, very smooth, and very polished so therefore it makes it very easy to clean.

So a bit about the practice, we're located in the center of Perth in West Perth, but we're on the north side near Leaderboard [SP], there's parking on-site. The practice has been designed around patient comfort, but on the other side of that, we also have an operating theater that allows us to do everything in-house.

A bit about myself is I've been a dentist for over 20 years, I've been placing implants for almost 15. I actually hold a mastership in implant treatment, and I lecture both nationally and internationally. More important than this is I have a team behind me, and the team is there really to support the patients and without the team, it would be impossible to do this type of treatment. I want you to remember that all the photos you see on our websites or cases that you see are all our own clients, and this is very important because we don't ever use any stock photos or we don't ever get images from other websites. We use the latest technology here at Advanced Dental Artistry, and that includes 3D imaging and virtual surgery. That means that we can get an image in three dimensions of a patient's jaw, and we can place where the implants actually go. We're also able to use computer-generated surgery where we're actually using the computer to help us guide exactly where the implant should go. This is a 3D image of a patient's mouth, and you can see, we can tilt it in every direction and basically see everything that's happening in the patient's mouth.

Digital Smile Design has become a very important part of doing cosmetic dentistry and what that means is that we look at the patient's face and we analyze the patient's face in order to determine where the smile should actually go. And this is very important because we really want to make sure that the smile and the teeth are in harmony with the patient's face. A very important aspect at Advanced Dental Artistry is that we have in-house specialist anaesthetists. Anaesthetists are, of course, doctors that have been qualified further, and it's their role to ensure that a patient is safe and comfortable throughout all dental procedures. In order to ensure the best outcome for the patients, we also have in house technicians. We have two. We've basically got a ceramist who does all the porcelain work and the cosmetic work. And we also have a dental technician, Patrick, who actually does all the all-on-four and denture work.

We're also affiliated with Nobel Biocare and they have over 60 years of science and research behind their dental implants. Just a few things before I go. We offer complimentary visits to see if you're suitable for this procedure. There are financial options available. This is a warm and caring team and environment, and we're definitely a judgment-free environment. Our team includes on-site anaesthetists for your safety and a laboratory team to make sure that the end result is perfect. We have been performing dental implants for almost 15 years. You can get permanent teeth in one to three days, which means you get an immediate bite and immediate smile. There is generally no bone grafting required with all-on-four treatment which means that your healing is faster. We are experienced in complicated, difficult, and combination cases, and there's a proven success rate and guarantee on Nobel Biocare implants. If there's any questions, please feel free to give us a ring on 1800SMILING. You can organize a complimentary visit, or you can email me directly at dradrian@adaperth.com.au. I look forward to seeing you in the practice.