“For you new readers of WeLoveCostaRica.com I am Dr. Mario and I have had the pleasure of knowing Scott Oliver as a friend and a patient for many years. Together with Charlie Dennard, my US Patient Consultant, we work together to help educate WLCR readers how to get the best dental work available for an incredibly affordable price.

I am a graduate of the University Of Miami Dental School as a Oral Surgeon and I have been practicing in San Jose, Costa Rica for the past 22 years. I specialize in dental implants, all types of oral surgery and full mouth rehabilitation.

However, in most cases, we find that people have lost, not only teeth, but the function and aesthetics of the whole system itself and it needs more than a dental ‘fix’. We call this a full mouth rehabilitation that will include not only the restoration of individual teeth but it will also include the reestablishment of the function and the aesthetics of the whole system.

In most cases, when we’re talking about a full mouth rehabilitation, it can either be full upper and lower new dentures. It could be implant-supported dentures. It could be implant-supported fixed bridges. It could be crowns and bridges supported by teeth or it could be crowns and bridges supported by implants and teeth as a combination.

For example, I just had a patient this week that upon examination, using our 3D tomography, we identified some cavity lesions that resulted in shifted teeth. This resulted in the loss of several teeth over time. Our comprehensive examination determined that his vertical height, which is the distance between his nose and his lower chin, was very short.

Why was that happening? Because he did not have any back teeth to provide support. The resulting gap left me no space to work on his aesthetics or either to work on his function. So in order to reestablish that, I needed to reestablish his vertical height. How? First, we needed to build on his posterior support. This required implants in the upper and lower back. Using these implants we reestablished the proper height that enabled us to rebuild the aesthetic portion of his anterior mouth.

This results in a proper bite and alignment between your jaw and teeth, better known as your ‘bite’. A bad ‘bite’is no fun. A bad ‘bite’ can result in headaches, cracked and fissured teeth and at times excruciating pain. What about TMJ? That’s a very interesting question because TMJ, it’s not a disease itself. It’s a symptom that a patient develops over time because they have lost vertical dimension.

This results in losing the support of their bite which needs to be reestablished in order to provide optimisation to the balance between the skull and the jaw through articulation, so that the ligaments and cartilage can start working normally again. In many ways I am describing almost a mechanical realignment of the teeth to provide what you would call ‘a good bite’.

Ok Dr. Mario, what are the symptoms of TMJ ? Do you hear of clicking,or popping granules like sand in your mouth, or like the sound when a eggshell breaks? These are common symptoms which are often ignored.

There are others that are more symptomatic, more pain-related. In advanced cases it can result in jaws locking in position. TMJ is progressive in its symptoms which are more painful with greater physical manifestations..

The idea is not to get to this point. My goal is to make the diagnosis at a point and time when the early symptoms are identified.From that point I can reestablish your vertical height and restore the bite function properly. Early diagnosis will save you not only a great deal of discomfort, even pain but also a great deal of money and restore your dental health.

Now for those of you who have not been to a dentist in the last 20 years, and I’m sure there are a few of you out there, the new way of treating missing teeth are with dental implants.

That’s the most predictable and longest-lasting way of restoring a missing tooth or many missing teeth. Let me make a quick aside here. When you lose a tooth, bone loss begins almost immediately. If you go any length of time with a missing tooth, you will begin to notice your gum receding.

This is a critical telltale sign of bone loss and you can anticipate needing not only an implant but potentially a bone graft. Waiting only will compound the cost.
Time is not on your side after tooth loss!

Lets talk implants.First, let me say here that the BEST time to do a implant is immediately after the tooth is lost. There is nothing to be gained and no reason to wait. Waiting only complicates the eventual healing process. DON’T WAIT!

There are two ways: the classic two-stage protocol, which is most common, and the immediate loading type of protocol. Let me explain the difference.

Immediate loading of an implant is when the ‘post’ which is made of titanium, is placed where the tooth existed. If the implant is done in a younger candidate or before there has been much bone loss then immediate loading is possible.

Probably 2 out of 10 patients qualify for this procedure. The reason titanium is used is because titanium actually meshes with bone tissue. The titanium post actually anchors itself in the bone tissue becoming as one. After a short period, a few days or so while the crown is fabricated, the permanent crown is placed over the crown. Thus ‘immediate’.

The safest way and most common is to follow the two-stage protocol. Just like immediate loading we place the implant first. At this point, usually because there has been a lag of time between the loss of the tooth and the implant, there has been bone loss.

It is this bone loss which prohibits ‘immediate loading’. The titanium post will need more time to integrate with the bone tissue. We do not want to place the abutment and permanent crown until the post has time to osseointegrate, usually 3 or 4 months later.

If we place the abutment and permanent crown before osseointegration occurs then within a short period of time, you would lose the complete implant and your total investment. Back at square one.

So not everybody is a candidate for the immediate loading protocol and it’s not one of my favorites. I prefer to go the safe way. That way you will have a good, long-lasting result for a long period of time.

Let me discuss in greater detail about the two myths that I have heard in implant dentistry. One of them is, “Doctor, if I have a tooth pulled, do I need to do the bone graft and then come back to get the implant placed?” Well, no.

I have been performing implant surgery for over 20 years. Thousands and thousands of implants. When I take a tooth out then that is the best time to put the implant in and the bone graft at the same time.

When you take a tooth out, there’s a lot of healing factors that are secreted from your tissue, from your bone, from your gums that help the healing process in a natural way. By taking the tooth out, immediately placing the implant, sometimes including a bone graft, it’s facilitates a completely normal process and heals beautifully.

That’s something you have to understand. Likewise there is no need to wait when we do sinus bone grafts. Experience has taught me to do my bone graft and my implants at the same time.
The implants will support the bone graft in a better way, will give it more stability and you will have better and faster result.

In general, those are two myths that I don’t agree with and I want you to understand the reality of things. When you come to our office for your initial consultation the most important part is when we do the diagnosis and the determine best treatment option for you.

To arrive at a diagnosis, it’s imperative that we use that 3D tomography imaging that is much more effective that normal panoramic x-rays.This is the newest technology available that shows by the millimeter the state of your dental health.

Through the tomography imaging, we’re able to pinpoint every dental detail you can imagine based on your teeth, your bone health, your sinuses, the location and health of your nerves. We can examine everything and address every single aspect of your current dental health.

I can assure you that through our proper diagnosis, we will determine your best treatment option and we will be giving you the highest quality dental service that you can expect anywhere in the world and you will be saving at 40- 50 percent.

You want a perfect smile at a perfect price? Come to Costa Rica! I’ll be waiting for you.

For more information about our Blue Cross preferred Dentist Dr. Mario, please contact Charlie using the simple form below:

Andrew Makarik

to@welovecostarica.com

Andrew Makarik is the main editor of WeLoveCostaRica, a fan of this sunny country. He is also a loving husband and a has a lovely daughter. By being a devoted family man and the biggest Costa Rica fan, he wants to make more people feel at home there. WeLoveCostaRica unites people and helps them find new home or a new travel destination. This website is a friendly community where everyone can find not only information, but also new friends and travel pals. Andrew is also passionate about IT and programming, so he himself maintains a friendly atmosphere in this cozy environment of WeLoveCostaRica.com.