People lose teeth for various reasons including trauma, decay, and gum disease. Whatever the reason for losing your teeth, it is best if they can be replaced, both for aesthetic and functional reasons. The most common treatments for missing teeth in years gone by, were either a removable denture or a fixed bridge cemented to other teeth. Now, dental implants are usually a preferred treatment, as they provide a more stable solution, slow down bone loss and do not require trimming other healthy teeth.
As dental implants become the standard of care for tooth replacement, it is important to have answers to some of the most common questions:
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What is a dental implant?
A modern dental implant is a small titanium screw the size of the root of a tooth. It is placed into the bone where a tooth has been lost. When the bone heals around the implant, it can be used to support a crown to replace a missing tooth, or it can be used as a foundation to help stabilize a denture.
How is a dental implant placed?
Placing an implant is just the reverse of having a tooth removed, but is less difficult. The area to receive the implant is well anesthetized, and the gum where the implant is to be placed is cut and a small hole is drilled in the jawbone at the precise location of the intended implant. The titanium implant is tightly fitted into this socket and the gum is stitched back over the implant. Once the implant has been placed, it is left to heal and integrate with the jawbone for between six weeks to six months. The bone tissue will grow and anchor itself into the microscopic rough surface of the implant. During this “healing period”, patients are usually given temporary teeth (bridges) or continue to wear dentures. After the healing period, the gum is again lifted and a post is attached to the implant with a temporary crown. Four to six weeks later, when the surrounding gum tissue has matured, the final permanent restoration can be fitted to the implant.
What are the advantages of dental implants over dentures and bridges?
Reduced bone loss
Normally, the bone tissue surrounding the root of your tooth is maintained by your body’s natural renewal process. However, if you loose a tooth, you will be left with a hole where your tooth root used to be and the bone around this area will slowly begin to disappear (atrophy) which may change the shape of your jaw. A dental implant placed in that area can actually stimulate bone growth and production, preventing loss of valuable bone structure. In some patients where bone loss is substantial, a bone graft may be required before placing a dental implant. Bone loss is a problem for people who have dentures, and as the shape of the jaw slowly changes, the dentures need to be adjusted or re-made to fit the new shape of the jaw. Bone loss can also make a person look older, since the area around the mouth can sag as bone is lost. Bone loss after losing teeth is of particular concern to women who are prone to osteoporosis. An old fashioned full lower denture is NOT a long term option as lower jaw bone loss can eventually make it impossible to properly chew any hard food. An implant supported denture will allow enough loading of the bone to prevent this in most people.
Once dental implants are fully integrated into your jaw, they function just as well as your own natural teeth: you can eat the foods you want and speak with complete confidence. With dentures, eating hard foods such as an apple can be a problem: either the dentures come loose or patients cannot withstand the hard biting forces as they cause pain in the gums. Irritation and inflammation of the gums is a common problem amongst denture patients. There is a range of Implant Choices and costs for supporting dentures, all of which are huge improvements to chewing ability.
Improved dental hygiene
Dental implants need regular cleaning with toothbrush, floss, are electric devices, just like teeth, since the gum tissue around the implant must be kept healthy.
No need to drill or remove any healthy tooth structure
When replacing missing teeth with dental bridges, the teeth adjacent to the gap need to be trimmed to support a crown, and healthy tooth structure is removed. In some cases these adjacent teeth may require crowns anyway so this is not an issue. However, if the adjacent teeth are perfectly healthy it is preferable not to use them.
In the long term, since the implant preserves the bone around the tooth the cosmetic result will be better.
Am I a suitable candidate for dental implants?
The critical issue for successful implants, is strong, healthy bone to hold the implant. Dental implants can be placed in patients of any age (with fully developed jawbones), provided that they have a sufficient quantity and quality of bone tissue available. Most healthy individuals that maintain a good oral hygiene program are suitable candidates for dental implants. Circumstances where implants may not be suitable, or situations that have an increased risk of implant failure, include:
- Heavy smoking – this slows down and hinders the healing process.
- Excessive alcohol intake – disrupts healing of the gums.
- Periodontal gum disease – all active gum disease must be treated prior to any implant procedure to ensure the long-term success of any treatment. Periodontal disease is a major cause of bone loss, which would hinder the success of any implant procedure.
- Immuno-compromised individuals (steroids, auto-immune disease, patients undergoing radiation treatment).
- Teeth grinders (bruxism) – a night-time splint can be given to minimize this. Excessive force on the implant, and in turn on the bone around the implant, is the main cause of implant loss.
How will I know if I have enough bone for implants?
Using a combination of dental X-rays or a CT scan, your bone density and volume can be assessed, and information about nearby anatomical structures to avoid (such as nerves) can also be gathered.
What if I don’t have enough bone for dental implants?
The alternatives for replacing missing teeth include dentures and bridges. However, there are various bone-grafting and tissue-regeneration procedures that can be carried out to enable treatment with dental implants.
How long do dental implants last?
The real question is; “How long will my bone last?” Generally an implant is as good as a new tooth and can last a lifetime. Dental implants have been used for over 30 years to replace missing teeth and they can last a lifetime depending on how well you look after them. Like any other restoration, your implant-supported teeth can still be damaged by trauma and affected by gum disease and poor oral hygiene.
How much do dental implants cost?
The price of dental implants tends to vary considerably and depends on several factors, including the level of skill of the surgeon, the type/quality/brand of implant used, the clinic where the treatment is carried out, the level of aftercare service provided, the amount of work required (i.e., bone grafting) and the number of implants required. A single implant in healthy bone along with the crown can cost as little as $3000. To place permanent teeth in an arch where all teeth are missing, 7 implants plus bone grafting and crowns might cost $30,000 or more.