5 Questions to ask before getting Dental Implants in Ecuador

Dr. Victor Carreño

As an Ecuadorian dentist who has lived, worked and studied in North America and Europe, I understand that many visitors from these countries to Ecuador have worries and concerns about receiving medical and dental treatment here. In a recent issue of HiExpat magazine, I wrote about the Ecuadorian healthcare system and the wide range of experiences that patients encounter.

For those patients who are interested in dental implants, it can seem daunting to know what to ask the oral surgeon in Ecuador beforehand in order to make an informed decision. Fortunately for non-Spanish speaking patients, there are several bilingual dentists in Ecuador who can easily communicate with you and answer all of your questions.

The purpose of this guide is to identify the most important issues in implant placement in Ecuador and ensure that the patient is well-informed before undergoing this treatment.

1. Who will perform the implant surgery and what are their qualifications?

Make sure to ask who will perform your surgery. Ideally, your implant surgeon will have postgraduate training in oral surgery or periodontics. If your healthcare provider has a postgraduate degree from either Ecuador or abroad, it will be found in the public SENESCYT online system maintained by the Ministry of Education under "TITULOS DE CUARTO NIVEL" ("tercer nivel" is undergraduate level). You will need to know both apellidos (surnames) of the provider to look them up in the system; please do not hesitate to ask for this information which should be readily provided. For example, you may search “Carreño Alava” and click on “Victor Hugo Carreño Alava” to see my SENESCYT profile (see below).

If you live in a smaller city in Ecuador, be aware that some dental clinics might bring in a surgeon from out of town to perform your surgery. The surgeon may or may not be available should you experience a complication, so you may want to choose an experienced professional who lives in your city and will be available to help you. In the case of my dental practice TopDental in Manta, Ecuador, our in-house team of specialists does both implant surgery and rehabilitation (design and placement of the implant crown, bridge, denture, etc).

2. What kind of pre-surgical planning will my surgeon do?

In implant dentistry, pre-surgical planning with CBCT technology is key. Your surgeon should perform a Cone Beam CT scan, or a 3D x-ray of your mouth, in order to identify the height and width of the bone in your jaw as well as the location

of key nerves to be avoided in surgery. This allows your surgeon to choose the exact size and type of implant to be used in order to maximize implant success and avoid complications. TopDental is a digital dental practice and we also use a Medit i700 intraoral scanner combined with CBCT to achieve more accurate planning for complex cases and to design 3D printed implant guides. If your surgeon is planning to place an implant using only a 2D x-ray, you may want a second opinion before proceeding.

3. How will I know that my surgeon is following international hygiene standards?

Dental professionals who place implants should follow several important guidelines: sterilize all equipment using autoclave technology (steam sterilization, not dry heat). Look for or ask if a dental autoclave is used at the clinic. Your dentist should open a separately packaged set of instruments for each patient, and should have an up-to-date registration with ACESS, the government agency regulating healthcare providers and their offices, as well as municipal permits and biomedical waste subscriptions.

4. Are there any guarantees involved in this treatment?

Research done on dental implants over the past several decades shows that dental implants have a high rate of success, but this depends on several factors including the type of materials used, biological factors, pre-operative planning, the patient's postoperative care, and more. Even under the best conditions, implant failure can occur, so make sure to ask your surgeon's protocol should this happen, and what additional costs may be involved. The brand of implants that I work with is high-quality and provides a replacement at no cost in the rare case of implant failure.

5. What type of implants and materials will be used?

Many patients are unaware that brands of dental implants are like brands of cars. Each brand has proprietary parts, pieces and tools like the abutment, impression post, multi-units, healing cap, and more. Certain brands are compatible with others, but not all. If you have implants placed by one dental professional, there is no guarantee that another will be able to complete the crown, unless they work with the same brand or have that set of tools and the necessary parts. This is one reason that I choose to work with MIS implants, one of the best implant brands on the market, which has representation both in Ecuador and around the world and is compatible with several others. Some other top implant houses do not have representation in Ecuador, and there are also

lesser known brands that only have representation in South America (and will be difficult to rehabilitate outside this area), so this is an important factor to keep in mind, especially for dental tourists. At TopDental we are able to rehabilitate most brands of dental implants as we have acquired those tools over our years of treating hundreds of patients from abroad. Also ask what type of materials will be used for grafting, GBR (guided bone regeneration), and the final restoration of your implants.

If you are looking for dental implants in Ecuador, there are many good options available. I hope that the questions above help you to make a great decision in restoring your smile in our beautiful country.