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When it comes to suitable alternatives for dentures or bridges, people often look to dental implants. Dental implants can serve several purposes, be it replacing a single tooth, multiple teeth, or acting as a support for dentures. So, what are dental implants? Below we have provided answers to some of the most common questions about dental implants, including what they are, how they work, and any potential concerns or side effects that you might want to be aware of.
When someone tells you they have recently gotten dental implants, it is not uncommon to think that they had a brand-new tooth fitted into a space where a tooth had previously been extracted or was never formed. While, in the end, this may be true, the dental implant itself is not the actual tooth.
Dental implants are not new to the field of dentistry. They were first utilized in the early to late 1950s, and the technology surrounding implants and implant surgery has continued to advance at a rapid pace since then. Today, dental implants are often considered the first-line option for prosthetic replacement of a single or multiple missing teeth.
A dental implant is a fixture that is implanted surgically into the jawbone, and throughout the course of a few months, fuses or integrates with the bone and tissue. The “dental implant” is a titanium fixture that, once placed in your jaw, allows for a prosthetic tooth to be placed on top of it. The dental implant serves as a replacement for the root support system of the missing tooth or teeth.
Having an implant is the closest thing you can have to a natural tooth because it does not require a connection to surrounding teeth to hold the prosthetic tooth in place. Dental implants also provide greater stability than bridges and removable dentures. Most dental implants are made of titanium, which is highly compatible with the tissue and bone in the human body. Most titanium implants placed anywhere in the body integrate with the bone without being recognized as a foreign object, and therefore, the chances of allergic reaction or rejection are minimal. The advances in technology surrounding implant surgery have advanced significantly, and today’s success rate for dental implant surgery is approximately 98%.
A dental implant is a replacement for the root system of teeth that may be missing in your mouth. Implants are designed to provide a robust foundation for either fixed or removable replacement teeth custom made to match the shape, color, and size of your natural teeth. Some patients may choose to have individual crowns (a false tooth), whereas others use dental implants as attachments to support a removable or fixed denture.
When you are missing teeth, you typically have a few options:
Dentures are indeed a more affordable option when compared to dental implants; however, they are often much less desirable. For many, having a removable appliance or appliances (if you have a top and bottom denture) in the mouth is inconvenient and sometimes uncomfortable. Depending on your dentures, food can get caught under them while you are eating, and they often have to be cleaned or rinsed during the day. In some cases, dentures can also adversely affect how one tastes food and their speech patterns. Over time the bone and tissue beneath the denture changes, causing looseness and discomfort which may or may not be fixable.
Before a more recent shift to dental implants, dental bridges were a more common restorative procedure. Like dentures, bridges have disadvantages. The primary drawback to bridgework is a significant dependence on healthy natural teeth in the surrounding area for support. If your natural teeth are not healthy, or one or more of the supporting teeth becomes unhealthy, the bridge may be lost. If you are missing too many teeth in a particular area, a bridge will be difficult, if not impossible, to utilize. Also, because a bridge consists of multiple teeth that are fused or attached, hygiene underneath the bridge may be very challenging and could potentially lead to other problems.
Implants do not require surrounding teeth for support as they depend solely on the bone structure for support. Although implants are often the desirable alternative, not everyone is a candidate for implants. The ability to place an implant depends on several factors, including the location of the missing tooth (or teeth), the health of the individual, quality and quantity of the bone structure where the implant is to be placed, patient preference, and cost. If you are interested in implants, your periodontist will conduct a thorough assessment of your mouth and consider the structure and health of your bone and the surrounding tissue before deciding if you are a good candidate for a dental implant.
Dental implants have several advantages over other forms of tooth replacement. They help to replace missing teeth without affecting or altering the health or placement of surrounding teeth. Also, because dental implants become part of the bone structure as they heal, they are highly stable, and once a crown is placed, they mimic the look and feel of one’s natural teeth.
Historically, there were two types of dental implant options; endosteal and subperiosteal. Endosteal implants are placed in the bone. Conversely, subperiosteal refers to a kind of implant that rested on top of the jawbone just under the gum tissue. This form of implant is no longer in use today due to poor long-term success when compared with that of endosteal implants. Although the primary reason most people get a dental implant is to replace missing teeth, they can be used for other reasons. As dental implants are relatively stable, they can be used to provide additional support and security while improving the fit of a removable denture.
The first step in the dental implant process begins well before you schedule a date for surgery. Your first step is to consult and plan with your periodontist. He or she will visually examine the site in your mouth where the implant will go. In addition to a visual inspection, they will also do x-rays, panoramic films, and, in some cases, CT scans to ensure they have a complete picture of your gum, mouth, and bone health. These intensive imaging studies also provide a clear understanding of how much bone remains in the area of the missing tooth and how healthy that bone is. If you do not have sufficient bone or the tissue is unhealthy, you may not be a suitable candidate for a dental implant, or a plan to regenerate lost bone must be made prior to implant placement. Once your periodontist determines an implant can be placed in the area of the missing tooth or teeth, an appointment for your surgical procedure(s) can be scheduled.
Depending on your specific dental needs, the first stage of surgery may not be the actual implant placement. For many, the first stage of oral surgery will consist of having one or more teeth extracted. It is not uncommon for the future dental implant site to have an existing, damaged tooth that needs to be removed. To adequately prepare your mouth for a future dental implant, the tooth or teeth will need to be extracted before any further work can be done. Also, in many cases, a bone graft may be necessary to help achieve a stable, healthy base for the implant to integrate with. Once any extractions and bone grafts are complete, the site will be allowed to heal for a period of two to six months.
In many cases, the implant procedure can take place at the same appointment as your extractions. This is known as “immediate implant” placement. Also, there are some places in the jaw where implant placement is more difficult due to an already limited amount of bone. For example, suppose implants need to be placed in the upper or lower jaw’s rear portions. In that case, the available amount of healthy bone may be limited due to how the jaw is formed or the location of the implant site in relation to the sinus cavities or nerves. In these cases, specific procedures are performed to elevate the sinus floor and graft more bone into the sinus cavity. This will make more healthy bone available to support a dental implant.
Once your bone has had adequate time to heal, and enough strong, healthy bone is available, your dental implant can be surgically placed. At the implant appointment, the implant (a titanium post) is placed in the jawbone using special tools. A “healing cap” is placed over the implant and the gum is sutured shut, allowing the opportunity for healing. During the healing phase, a temporary denture could be made to replace missing teeth if the patient desires for esthetic purposes. The length of time you will require to heal depends significantly on the quality of the bone present and the individual. On average, however, healing usually takes between two and six months. During this time, the titanium implant will become integrated with the bone and become more stable. It is essential to avoid placing any force or stress on the implant while it heals as it could become dislodged, or damage to the bone and surrounding tissue could occur. A series of follow-up appointments will occur during the healing period to monitor progress and ensure healing is on track.
After the healing period has ended, the implant is tested to ensure it was successfully integrated into the surrounding bone. Once this has been confirmed, a prosthetic device is connected to the implant via a screw on the top. This component is called an abutment, and its job is to hold the replacement tooth or “crown.” Once the abutment is placed, the dentist will take an impression of the abutment and the surrounding teeth to have a custom fit crown made. The completed crown is then either cemented or secured with a screw to the abutment providing a replacement tooth that mimics the look and feel of your natural teeth.
The cost of a dental implant can vary significantly depending on who is performing the procedure, how many implants are required, how complicated the case is, or the region in which you live. A conservative estimate for the cost of a single dental implant ranges from $3,500 to $5,500. This estimate would include the surgery for placement of the implant, all of the components, and the crown. What your dental insurance would cover will vary depending on the policy and the provider. Most standard insurance policies typically do not pay for the implant placement; however, some may help pay for the crown portion. Unfortunately, in many cases, dental insurance considers implants to be an elective procedure regardless of why dental implants are necessary.
There are always certain associated risks with any surgical procedure, and dental implants are not an exception. To ensure the success of the implant and assist with easy recovery, careful planning is essential. If you have a bleeding disorder, ongoing infection, allergies, take medications daily, or have another existing medical condition, these should all undergo careful review before your procedure. The success rate for dental implants is relatively high, and failures occur quite rarely. However, in the unlikely event of a complication, some of the most common issues include failure of the implant to fuse to the bone, infection, damage to the surrounding area (teeth, nerves, etc.), poor bone health, and issues pertaining to the implant positioning. Again, careful consultation and planning with a qualified periodontist can help avoid these complications and help ensure the success of your implant. Should your implant fail, it can be possible to replace the failed implant the same day as removal of the failed implant or after an appropriate healing time has elapsed.
Dental implant surgery and the associate procedures leading up to the surgical procedure itself are usually performed under local anesthetic, and therefore no pain should be felt during the procedure. In some cases, a stronger anesthetic is used depending on patient needs. After the anesthetic has worn off, the level of discomfort experienced post-surgically will vary with each person. In most cases, pain can be managed successfully using over the counter pain mitigation techniques such as ibuprofen and acetaminophen. Ice packs can also be used to help reduce any swelling.
After getting a dental implant, routine at-home oral care and follow-up care with your periodontist are essential to avoid complications from the procedure. One such complication is called “peri-implantitis,” a condition whereby the gum and bone surrounding the implant become inflamed. If left untreated, this condition can result in bone loss and loss of the implant. In addition to post-surgical follow-up care, good oral hygiene and routine dental exams are critical to the health of both the implant and the mouth as a whole.
It is crucial to ensure the specialist who performs your implant surgery is trained and experienced to do so. Because implants are surgically placed in the bone, dental specialists who frequently perform surgeries in the jawbone typically perform implant procedures. Periodontists treat diseases of the gums and jawbone. Both oral surgeons and periodontists often specialize in the placement of dental implants. Some periodontists are board-certified in both dental implant surgery and periodontics.
If you are struggling with tooth loss or difficulties with bite and appearance resulting from teeth that did not properly form, dental implants may be the right choice.
If you do not want to wear dentures, or perhaps you do not have a dental situation that allows for a bridge, contact your local periodontist to learn more about whether dental implants might be right for you.
