The good doctor's first concern is whether I still have enough healthy bone to anchor the implants. A second worry is two specific nerves: Are these buried deeply enough in the jaw so screws won't penetrate them?
Some patients can have implants only after their jawbones are built up via bone grafts — a time-consuming, expensive procedure. Others, including those on intravenous drugs for osteoporosis, shouldn't have implants because of the risk of bone disease.
But the news for me is good. Even though my four lower molars have been missing for 11, 8, 7, and 1 year respectively, my underlying bone has not begun to erode. And the nerve canals are deep enough that the titanium screws can't reach them.
"Gorgeous!" says Kukunas's colleague Mark Ochs, D.M.D., of my X-ray. "You have great bone."
Kukunas tells me the success rate at his clinic exceeds 97 percent for lower-jaw implants, but I must practice scrupulous hygiene, including daily flossing. Those who don't are more prone to failure — as are heavy smokers, alcoholics, and diabetics.He says the process will take about six months. "And then," I ask, "I can eat nuts and hard pretzels again?"
"You can eat whatever you want," says Kukunas.
It sounds like a miracle. But at what cost? Across the nation the price of implants varies widely, and dental insurance rarely covers more than half. Because I've opted for treatment at a dental school, my cost will be about half that charged by a private-practice specialist. I'll pay $850 for the implant, $380 for a metal abutment to cover it, and $550 for each crown — a total of $1,780* for each tooth I get replaced.
I do a rough amortization based on best-case life expectancy. My conclusion: Each tooth will cost 17 to 19 cents per day, a relative pittance. Moreover, not getting the implants could have its own costs, especially if I continue on the ice-cream-and-lard diet that has become my routine.
I sign up for four.
(*Prices have risen since the writer's procedure.)