Are you okay with dental implants? No end of complaints about dental implants

Dental implants involve the insertion of synthetic roots into the jawbone where teeth have been lost and the fabrication of artificial teeth thereon. Dental implant treatment is characterized by restoration of long-lasting functions and natural appearance of teeth, which improves quality of life. The artificial teeth are securely fixed to the jawbone and remaining teeth are not burdened as in traditional bridges or false teeth.

In December 2011, the National Consumer Affairs Center of Japan (hereinafter called "NCAC") released an article titled "Issues with dental implants - physical health problems". After that, dental science societies and related administrative agencies in Japan took some measures to promote proper dental implant treatment, for instance, to develop dental implant treatment guidelines.

On the other hand, there were still many harmful incidents¹ registered with PIO-NET² (approximately from 60 to 80 cases per fiscal year) in which dental implants were said to have caused harm even after the press release in 2011. Among these, there were some cases where a dentist might not have followed dental implant treatment guidelines (e.g. "My gums kept feeling numb after the surgery," "My dentist started the surgery without checking my health conditions"), as well as some cases where a dentist gave up therapy and a patient was at a loss how to continue therapy.

Therefore, NCAC examined inquiries and complaints about dental implant treatment and conducted an online questionnaire survey. Here NCAC shares the findings to prevent the occurrence of similar problems and calls for further efforts by relevant organizations.

¹ Harmful incidents here refer to cases in which a product, service, or facility has caused harm (i.e. bodily injury, sickness or other disease, etc.).
² PIO-NET is a database that collects information on inquiries concerning consumer affairs by linking NCAC with local consumer affairs centers and similar organizations across Japan via an online network.

Outline of inquiries related to harm

PIO-NET received 409 inquiries in nearly five years starting form FY2013 (data registered through December 31, 2018), approximately from 60 to 80 per year.
Among the 409 inquirers, 240 inquirers informed the treatment cost. Those who paid more than 500,000 yen comprised 70.4% (169 cases). Those who paid more than 1,000,000 yen comprised 46.3% (111 cases).
Most of the affected areas were "mouth, oral cavity, or teeth". Common symptoms were pain, wobbling of implants, loss of implants, implants in need of removal, swelling, suppuration, etc.
Among the 409 inquirers, 211 inquirers informed the period of symptoms. Those who said "Symptoms remained more than one year" comprised 48.3% (102 cases). Those who said "Symptoms remained more than three years" comprised 20.9% (44 cases). Those who said "I still have symptoms (e.g. pain)" or "I still receive medical therapy" when inquiring comprised 91.9% (194 cases).

Sampling of inquiries and complaints

[Case1]: I consulted a dentist about dental implant treatment. On the next appointment day I received the surgery without prior notice. The bleeding didn't stop, and I was hospitalized.
[Case2]: I was taking medicine for osteoporosis, which increases risks from dental implant treatment. However, my dentist performed dental implant surgery.
[Case3]: I had pain and swelling soon after the surgery, but my dentist took a wait-and-see approach.

Results of questionnaire survey among those who received dental implant treatment

Consumers are more satisfied with dental implants than with bridges or false teeth.
The most common advantage of dental implants is "strong chewing force". Disadvantages are "expensive treatment cost", "fracture", "wobbling", etc.
The most common reason for choosing a dental clinic for the surgery was "family dentist".
One out of every four respondents received an oral or written explanation on risks during and after the surgery.
Those who underwent CT scan prior to the surgery comprised about 60%. Those who were not asked any question by a dentist comprised about 20%.
About 40% of respondents did not receive follow-up care.

Problems

Some dentists do not check general health conditions prior to dental implant treatment.
Some dentists do not have sufficient skills or knowledge.
Some dentists do not properly care physical damage caused by dental implant treatment.
Some dentists do not tell reasons why daily oral cleaning and regular checkups are important.
There is a need for dentists with sufficient expertise and skills on dental implant treatment.

Advice for consumers

Whenever seeking dental implants, gather sufficient information on your own, and request a full explanation of oral and general health conditions, treatment method, cost, risks, etc. from a dentist prior to the surgery.
If you incur any damage from dental implant treatment, consider consulting other medical institutions.
In order to increase the life of dental implants, daily oral cleaning, regular checkups and maintenance are necessary.

Request to dental science societies and other related academic societies

NCAC requests them to further disseminate dental implant treatment guidelines and to create a mechanism for consumers to choose proper dentists and dental clinics having sufficient expertise and skills on dental implant treatment.

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