Basic knowledge of the implant

Q1.Does Japanese national health insurance cover implant?

 No, the national health insurance does not cover for dental implant. The exclusion is not limited to dental clinics, but it is rather due to nature of treatment.
 Plastic surgery and similar that is cosmetic in nature is not covered. Teeth whitening and orthodontic treatment are not covered by the insurance either.

Why can’t I use the health insurance for dental implant?

 The insurance covers treatment for cavities, periodontal diseases and others. There are two key points that determines if a treatment is covered under the national health insurance.
 A treatment is generally covered if it is deemed necessary to maintain one’s well-being and it is a basic treatment. Given this consideration, let’s apply the principals to the dental implant treatment.
 First, yes, dental implant is a treatment when one loses a tooth. It, therefore, meets the requirement of “necessity for one’s well-being.”
 Unfortunately, implant treatment is not considered a “basic” or minimum treatment; it is considered aesthetic.
 As stated, the insurance covers "basic" treatment only. A denture treatment is considered as basic treatment, and therefore, it is a covered by the insurance.

Q2. Is it true that, in certain cases, implant is covered by the health insurance?

 Starting April, 2012, Implant denture treatment is covered by the insurance under certain conditions when the treatment is associated with loss of jaw bone due to illness or accident. This exception, however, is limited to treatment received at some university medical hospitals today. In general, gum disease such as periodontal disease or decayed tooth is not covered by the insurance.

 ※The official name of "Implant denture treatment"
There are two type of implant procedures: endosteal and subperiosteal. Endosteal refers to an implant that is fixed into the bone, and subperiosteal refers to an implant that places on top of jaw bone under gum tissue.
  • Due to diseases such as tumor and jaw osteomyelitis, trauma of accident, etc., a state in which severe amount of the bone of the jaw has been lost(※)
  • or that jawbone is reconstructed by the bone graft
  • medically diagnosed as congenital disease (pedophilic illness), more than one third of chin bones are continuously missing
  • Jaw bone malformation

 ※About the range to be applied
〔In the case of the maxilla〕
One third or more of the bone of the jaw is lost in a piece, or it is diagnosed that it is connected to the maxillary sinus or nasal cavity
〔Case of lower jaw〕 One third or more of chin bones are lost in one piece, or it is diagnosed that the lower jaw was excised by a disease such as a tumor

Isn’t it rare, and exception applies to very few people?

 Insurance is applied only to such limited cases, and those due to periodontal disease and absorption of jaw bone due to aging (slimming thin) etc are not covered.
 It is not because the Ministry of Health, Labor and Welfare wanted to appeal that "People Morale is doing for the citizen!" Despite the fact that almost no targeted person is present, the advanced medical care was introduced to insurance Okay.

Q3. Do other types of insurance such as life or non-life indemnity insurance cover implant?

 It is very rare that an implant is covered by the Japanese health insurance. Cost of implant may be covered partially by life insurance. Please check with your insurance agent for full detail.
 An increase in number of insurance company in offering implant insurance, so be sure to ask your insurance agent/representative about it.

Q4. Implant insurance ( 10 Year Warranty )

 GuideDent Co. Ltd offers "Implant 10 Year Warranty System" policy which provides implant patient a long-term coverage with peace of mind.
 Guidedent will provide excellent service in supporting patients who may need a follow-up treatment or provide other support in an event of life change such as moving.
 We are happy to provide our patient with an option to purchase “Implant 10 Year Warranty System” policy for a complete care-free and safe implant treatment.

Q5. Implant safety

 Implant treatment is a treatment involving surgery that scrapes the jawbone and embeds a metal screw (implant). Some people may be uncertain and fearful about the fact it is a surgical procedure.

Is surgery safe?

 Implant procedure is usually performed with local anesthesia.
 Depending on your dental clinic, you can also ask for full anesthesia if fear is overwhelming.
 In any case, usually you will hardly feel any pains during procedure.
 Amount of pain after surgery depends on type of treatment and is subjective. It is said that level of pain is equivalent to one would experience in tooth extraction.
 Hospitalization is not required, and you can have normal life the next day.

Can one have allergic reaction to dental implant?

 The implant part is made of titanium, which is the same material as bolts and nuts used when treating with orthopedic surgery.
 As you can see, titanium is very unlikely to cause allergic reaction (about one in 100,000 people), and it is a material that harmonizes well with human body.

How long does an implant last?

 Your implant tooth can function as a second permanent tooth if proper care is maintained by regular maintenance and stay healthy.

Is there no risk of implants?

 There is no such a thing as a risk-free surgery.

 We have also seen examples of requiring re-operative surgery as a result of inadequate preliminary examination or inadequate assessment of the patient's overall health. Preventable risks must be eliminated as much as possible beforehand. Through examination, diagnosis, simulation etc are the best tools to mitigate risk. Accidental risk, such as allergy to titanium, is a risk that is hard to prevent with current technology.

Q6. Types of implant – are they all the same?

 After implant treatment, it may be necessary to remove the abutment or superstructure attached for some reasons. It is also possible that you cannot see your dentist who performed implant procedure because you need to move or office closes. You may get in an accident. We advise our patient to have first-hand knowledge about manufacture and parts to be used for an implant. Such knowledge can avoid some headache in the future. For example, you may have difficulty finding another dental doctor who have experience with implants that is no longer manufactured or supported.

 Strauamann, NobelBiocare and Astra dominate two third of implant market. You shouldn’t have any problems finding doctors to can provide care for if manufactured by one of these.

Q7. What is implant specialist?

 A certified implant specialist is a member who has been registered in “The Japanese Society of Oral Implantology” in good standing for over five years and passed specialist certification exam.

 There is a few professional claiming to be implant specialist. You should pay attention to see if a professional is affiliated with a manufacture or a certain interest group. A certified professional is one who is certified by an organization publicly and academically recognized.

Is there a specialist other than " The Japanese Society of Oral Implantology "?

 Yes, there are. Organizations “Japanese Academy of MaxilloFacial Implants”, Clinical Implant Society of Japan”, “Osseointegration Study Club of Japan (OJ) and “UCLA Implant Association Japan” are well established and academically recognized organization. A dental professional who possesses a certification from one of them is considered a legit specialist.

Q8. What is Society of Implant?

 The Japanese Society of Oral Implantology is generally referred as Society of Implant.

 There are fictious organization or group that bear name like "(latest or modern) ◯ △ □ Implant Society”. Please review background and activities of organization who claim to certify implant specialist.

Q9. How long is a implant treatment?

 Treatment of implants will be in following phases – ‘Implant’, ‘Preparation and attachment of dental prostheses (crown)’, and ‘Maintenance’.

 A dental implant requires a surgical procedure to implant in jawbone. If two procedures are required, additional procedure to incise the mucosa of upper part for the implant will be needed. If bone grafting is necessary, it can be accomplished in a procedure before implant, or at the time of implant procedure.

 A certain period of after implant procedure, we will create a denture (crown) to take a mold and denture on the implanted crown.

Is a maintenance necessary?

 Maintenance is a key to long lasting implant. After completing the implant treatment, a regular visit to a dental clinic is critical to successful implant.

(Partially quoted from Japanese Society of Oral Implantology)

Q10. How many visits do I need to make?

 Adaptation will change according to the condition of the bone and the whole body condition. Below is a general guide:
  • One procedure method
    Visit times1~2
    Days1 day~2 weeks

  • Two procedure method
    Visit times4~6
    Days3~7 months

  • Preparation of superstructure (artificial teeth)
    Visit times3~6
    Days1~3 months

 Method, need for bone grafting, and amount of time for treatment greatly vary by individual patient.
 Regular checkup is strongly recommended.

Q11. What is an orthodontic implant?

 "Orthodontic implant" or so-called mini-implant or temporary anchorage devices (TAD) temporarily fills the jawbone with a small screw (mini screw) or a miniplate and makes it a fixed base to the bone to a tooth to be moved. The procedure gained popularity in late 1990s but number of troubles increased also.
There are various types of dental implant. We recommend dental clinic that is equipped with state-of-art equipment and a specialist of wealth of experience.

Q12. Who is a prominent implant doctor?

 Years ago, I was asked by a publishing company in Tokyo for a permission to list me as one of prominent implant specialist in Japan. I was a bit hesitant to be called a prominent doctor, but I had agreed to the proposal.
 Turns out, the publisher asked for publishing fee of hundred thousand of yen at the end. Needless to say, I declined the offer to be published as a “prominent doctor” in Japan. My point is, no matter how popular a doctor is, always review thoroughly about your doctor so you are comfortable with and have confidence in your doctor and medical care you deserve.

Q13. How much does an implant cost?

 Market prices ranges from 300,000 to 400,000 yen per tooth. Price may be slightly higher in metropolitan or large cities.
 Implant treatment is 'free (self-sponsored)' treatment and it is not covered by the Japanese health insurance.
 As such, prices may vary by clinic, dentist, technology and manufacture of implant used.
 National average is between 300,000 and 400,000 yen, but you may find price as high 350,000 to 450,000 yen in Tokyo or other large city.

Can you provide breakdowns?

 Below is average breakdown of implant treatment for reference only.

Pre-procedure exam/diagnosis fee
15,000 ~ 50,000 yen
Surgical fee to implant
100,000 ~ 385,000 yen
Cost of artificial teeth (all ceramic etc ...)
100,000 ~ 150,000 yen
5,000~10,000 yen

 The cost of implant treatment depends on the clinic. From diagnosis, surgery, and maintenance after surgery, we recommend that you compare and consider all expenses, considering all such expenses.

(Quoted from Implant Net HP)

Q14. What causes the implant to fail?

 The biggest causes of implant failure are "force and bacteria". If this balance collapses, the implants may not survive or may be desorbed even after engraftment (called "osseointegration"). There is a possibility that fracture and/or movement may occur after the upper structure is installed. Symptoms such as "swelling, pain, numbness" that occurs in surgical procedures requires time, but they will go away.
 Just as body, implant does not last forever. The patient also become more susceptible to infection as one ages.
 What is important is that you learn about implant as much as you can. When in doubt, ask your doctor or research on your own.

 If you are considering an implant and you are expecting a procedure that does not come with pains or swelling at all, please look for an “Angel of Implant”. If you are looking for an implant but want to negotiate for a lower cost, please look for a dentist advertising "Cheap, no pains, no swollen, guarantee a lifetime lasting implant”. Or you may want to find a spiritual leader who can heal you like Sai Baba.

Q15. Tips for choosing an implant clinic

 Implant treatment, unlike other treatment, lasts for a long time. What good does it do if there is state-of-art equipment, but you don’t get along with your doctor? My only advice is to talk to your doctor, and make sure you are comfortable to be seen by him/her for a long time.

Anything else to add?

 Please refer to Q7. A certification from a recognized organization may aid in determining your doctor.

Q16. What are key during analysis?

 We would examine the below at minimum.
  • We would examine the below at minimum.panorama, dental x-ray, periodontal examination, inside and outside photo of the mouth
  • blood test
  • ECG (electrocardiogram), blood pressure measurement
  • CT shooting
 All of above is required.

Q17. Do you also draw blood for dental implant treatment?

 Implant treatment is an operation. You should avoid a clinic that does not blood test. It is not a routine dental work. The implant makes a hole in the bone, and places a foreign substance called titanium inside the body. It is necessary to assess all risks associated with the procedure, risk of intraoperative, postoperative risk, etc by blood sampling. Also, I think it is very dangerous for a dentist who is not capable of draw blood to perform implant. Can you trust a doctor who can’t draw blood to operate on you?