You have probably heard of the term, but there is a lot of confusion as to what dental implants are. To help you understand this topic, here are some common questions that patients ask about this treatment, complete with brief answers.
“What are dental implants?”
Put simply, they are metal posts placed into the jawbone for replacing teeth that have been lost already or need to be extracted. These metal (titanium) posts will fuse to the bone tissue to give a stable support for the new tooth/teeth. They are a versatile option, in that they can support crowns, bridges or dentures.
To clarify, the implant here refers to the metal ‘screw’ under the gum (you can’t see this) and the crown, bridge or denture is the ‘false tooth/teeth’ that is visible. Thus they can be used to replace one missing tooth or all the missing teeth in a jaw, if this is required.
“What are they made from?”
The metal post that makes up the ‘screw’ is made from titanium. This metal is excellently tolerated by the bone cells, which ‘accept’ it as one of their own, so to speak! The process of the bone binding to the titanium surface is known as ‘osseointegration’. This means that in the majority of cases, the prosthesis settles into the jaw with little problems.
“Does dental implants surgery hurt?”, “What is involved with getting this treatment?”
Getting implants does involve a minor surgical procedure. It also takes several visits that can be quite lengthy. For many people, using local anesthetic in the area is enough to make the procedure pain-free. Depending on the complexity of the treatment and your levels of anxiety around dental work, some form of sedation may be used to help. The procedure itself should not hurt, but there can be some pain in the immediate period afterward, as the area heals.
For more information on the dental implant procedure, click here.
“What is a bone graft for dental implants?”
A bone graft involves the dentist adding extra bone into the area where the prosthetic screw is to be placed. For a brief look at this common technique read our page on bone grafts.
“Why should I replace teeth that are missing?”
There are several good reasons to replace missing teeth, from the obvious to more subtle:
- For cosmetic reasons, avoiding any gaps in your smile and maintaining the shape of your face.
- To reduce the pressure on the other teeth (and any dental work that may be on them).
- Reduce the chances of developing jaw problems (TMJ).
- To prevent changes to the bite as teeth can move when there is a gap.
- To help keep the other teeth more cleansible and therefore reduce the potential for diseases such as tooth decay and gum problems.
- For proper speech.
- To help with chewing.
“Are these the best option for me?”, “Can I get them?”
Which treatment is best for you is dependant on a host of factors. You’ll need an assessment with your dentist to get guidance on this. This assessment will involve X-rays and possibly more detailed scans to determine the amount of bone available to hold them.
Factors that are involved in deciding if implants are suitable include:
- The health and amount of bone in the area(s). As the titanium is held into place by the bone, this is the most important factor. If there is insufficient bone, a graft may be needed. See more on this here.
- The health of your gums. Severe gum (‘periodontal’) disease destroys bone tissue. If it is present and active, this procedure is not advised. Any such disease must be treated before they should be considered.
- Smoking. If you smoke, the treatment is much less likely to do well in the long term. Smoking disrupts the healing process which is the most important phase in terms of success. Heavy alcohol intake has a similar effect.
- General health. Some health conditions prevent proper osseointegration. Patients that are ‘immuno-compromised’ (i.e. the immune system is weak) cannot get the surgery. Such patients include those on long-term steroid (or some other immune-suppressant drug) treatment, those undergoing radiation treatment or suffering from a disease that affects the immune system. Having bone disease such as osteoporosis also rules out this treatment option.
- If you grind your teeth, this can affect the success rate. If done at night, wearing a nightguard will be needed for the long-term stability of the prosthesis.
“What are the alternatives to implants?”
There are three basic alternatives if you have any missing teeth:
- Dentures, the cheapest option. But for many not the best, as dentures are not ‘fixed’ into the mouth. Implants offer a way to ‘fix’ dentures into place.
- Bridges. These are fixed into the mouth, but are not always possible and also involve some level of drilling to your own teeth to make the space needed for them. This is a major advantage of implants vs bridges, in that the former do not involve any harm to your own teeth. See a more detailed comparison of a dental bridge vs. implant here.
- Do nothing, which is not advisable for the reasons outlined above.
“How many teeth can a dental implant replace?”
As noted above, this treatment is very versatile. They can be used to replace the whole range of problems, from replacing a single tooth to all ones teeth needing replaced. In general, a single titanium screw can replace two missing teeth. More than two missing teeth will require two or more screws. The implants (the part under the gum) will hold in place either a bridge or denture (which are the ‘teeth’, the parts that are visible over the gum).
If there is only one tooth being replaced (a ‘single tooth implant’), a crown is attached to the metal ‘root’. A bridge is attached to one or more metal ‘screws’ when more than one tooth is missing. If all, or nearly all, the teeth are missing a denture is often used. The titanium prostheses support the denture and fix it into place. Mini dental implants are smaller than standard ones and are often ideal when holding dentures in place.
The exact number needed does depend on each person’s own circumstances. Your dentist will devise a treatment plan based on these factors.
“Do they need much care afterwards?”
Immediately after they are placed, you need to follow the advice given by your dentist/oral surgeon. This will include advice around any pain-relief, antibiotics, and mouthwashes (avoid rinsing your mouth out in the first 24-hours after surgery). You need to be careful to avoid hard foods around the area. Again, your dentist will give you more detailed and personalized advice on the surgery recovery.
They do require good care and attention in the long-term. The area must be kept clean, to reduce the risk of gum diseases (‘peri-implantitis’) caused by plaque bacteria. Your dentist will show you how to go about keeping them clean. You will need to alter your oral hygiene slightly to incorporate cleaning the implants. Some areas may be more difficult to clean, again your dentist will demonstrate how to negotiate these places. You may need more regular trips to the hygienist, but your dentist will advise you on this.
“How much do dental implants cost?”
There is no doubt that in general, this is the most expensive dental treatment. This is down to a host of factors including the time taken for the treatment, the cost of materials (of the implants and the crown/bridge/denture that overlies them) and the expertise needed by the dentist/oral surgeon.
Note that most insurance providers do not cover the price of this procedure. For more information on the average cost of dental implants see here.
“How long do they last?”
Implants have a fairly long and growing track record. They have been used for over 30 years as a treatment option to replace missing teeth. They have in this time proved themselves as a long-lasting treatment. This work can last a lifetime, provided certain criteria are met:
- They are used in the right circumstances.
- You look after the prosthesis properly. This includes not smoking and keeping up a good level of oral hygiene.
- They are not damaged, say by trauma.
Note that while the implant (the ‘screw’ part) can last a lifetime, the overlying false tooth/teeth (crown, bridge or denture) will likely need replaced at some stage. These parts are more prone to wear and tear, but are more easily replaced than the metal part itself!