Dental Implant FAQs
1. What is a Dental Implant? A dental implant is an artificial tooth root made of titanium. It is placed in the position where the missing tooth used to be in the jaw bone and acts as an anchor for a new tooth or teeth. They behave like tooth roots by bonding to the underlying jaw bone. Some months after placement, titanium posts called abutments are connected to the implant to allow support for the replacement tooth or teeth.
Dental implants should only be placed in a healthy mouth and thus it may be necessary to have other remedial treatment prior to commencing implant treatment. This may include control of gum disease and hygiene, root canal therapy and treatment of tooth decay.
2. What are the benefits of Dental Implants? Teeth may be lost due to gum disease, injury such as a traumatic accident, previous surgery or failure of old dental treatment. If teeth are lost, implants placed in their place can help to arrest the inevitable gum and bone loss that occurs due to disuse of the residual jaw bone. Loss of the jaw bone can make people look older than they really are. Implants will help prevent these changes.
If single teeth or group of teeth are missing, implants can help replace these missing teeth without having to prepare and grind down the neighbouring teeth thereby preserving natural teeth and maintaining their life.
Patients who wear removable partial dentures can have these replaced by fixed teeth using dental implants. This enables a better quality of life, confidence to smile and speak as well as an improved ability to eat a much wider range of foods. It’s like having your natural teeth back again!
Missing back teeth often cause loss of support for the facial muscles giving a ‘sagging’ effect. Back teeth can be replaced with implants thereby improving facial support to provide a more youthful appearance as well as making eating your favourite foods a pleasure again.
Patients with all their teeth missing can also benefit from dental implants. Implants can be used to support or to replace dentures altogether.
If dentures are uncomfortable because they are bulky, move around, click or are painful, then implants can be used to support them and hence improve their function. This is a very cost-effective solution to an age old problem of loose dentures.
Of course, using implants it is possible to replace all the teeth and get rid of dentures altogether. This depends on availability of bone for implant placement. In cases of deficient bone, we will need to rebuild the lost tissues. Various innovative surgical techniques are available for dealing with even the most complex problems.
Some people who cannot wear dentures because they gag, find the denture too bulky in their mouth or indeed dislike the thought of anything foreign in their mouth are ideal candidates for implant therapy provided they satisfy the relevant criteria.
3. Are Dental Implants safe? Implants are made from titanium or titanium alloys and these are materials that have been thoroughly tested for many years to be inert and are easily accepted by the tissues of the body. There is no scientific evidence to suggest that titanium dental implants are not safe in any way.
There are always risks associated with surgery rather than the implants and these should be discussed with the implant surgeon prior to implant placement.
Millions of implants have been placed around the world and these people now enjoy the benefits that fixed teeth can provide including transforming a person’s confidence and improving the appearance.
4. What is the success rate of Dental Implants? With the rapid advances in implant dentistry, dental implants can be expected to function indefinitely. However, like any dental restoration, there is wear and tear associated with constant use and these restorations supported by implants will need to be repaired or replaced from time to time.
It is generally well accepted that late problems with the implants themselves are due to changes in the health of the patient which may result in implant loss.
Success also depends very much on quality of the bone into which they are placed. For example, implants placed in the front portion of the lower jaw can have a success rate as high as 98-100%. In other areas of the mouth, success rates can drop due to the thinness of bone. According to figures that we have today, the success of implants in the front part of the upper jaw are anywhere from 90-95%. Success rates of implants in the back part of the upper and lower jaw can be in the 85-95% range.
Occasionally dental implants do fail. In many instances, they can be replaced with another implant, usually of a slightly larger size. Failure rates in our practice are very, very low.
5. Does it hurt to have dental implants placed? Placing an implant is a very gentle procedure and is usually done with local anaesthetic, much like when having a filling. After implant placement most patients experience minor discomfort after the anaesthesia has worn off and this is usually controlled by simple painkillers. The level of discomfort is quite different from patient to patient, but most patients do not have significant problems. Some patients do have varying degrees of discomfort which may last for several days. Very occasionally there may be some swelling around the site.
Of course, if a patient is particularly nervous, it is possible to have the procedure with sedation to alleviate any anxiety during the procedure.
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6. How long will the treatment take? This depends on the density of bone into which the implants are placed.
Generally we wait 3-4 months for implants placed in the lower jaw and 4-6 months in the upper jaw due to the difference in bone densities.
During this healing time, OSSEOINTEGRATION takes place. This is the process whereby the bone fuses with the titanium implant which is placed into it hence anchoring it firmly.
After this time, posts are connected to the implants and temporary teeth are constructed. These are usually left for 4-6 weeks to allow the gum to mature and form a natural contour. The final teeth can then be made and fitted.
Treatment in most cases where there is no grafting is usually completed in 6-9 months.
7. Do I have to go without my teeth while the implants are osseointegrating? At Wotton Dental Clinic, our protocol is to progress our patients to fixed provisional teeth as soon as possible, usually before the implants are placed. Thus these provisional teeth then act as the temporary teeth whilst healing is taking place and therefore patients leave the practice on the day of the implants being placed with their teeth in place.
In patients wearing dentures, the old dentures can be usually be modified around the newly placed implants and patients leave the office wearing their teeth the day the implants are placed. Every patient and procedure is evaluated separately and there might occasionally be a recommendation that a patient go without their dentures for a short period of time but this is very rare in our practice.
8. Am I a candidate for Dental Implants? Anyone who is in good health and has teeth missing is a suitable candidate for implant therapy. Age is not a limitation to implant treatment except that under 18s are not usually treated due to growth considerations.
Patients with underlying medical conditions need to undergo a thorough medical examination with special attention paid to patients with conditions that affect the healing of bone and soft tissues.
There must be enough bone present to provide suitable anchorage for the implants. The implant surgeon can determine your suitability when he examines your mouth. A full medical history check is mandatory as are x-rays and models of the jaws. A CAT scan is sometimes required in special cases which provides a 3 dimensional image of the jaw bone. The surgeon can then advise you more fully about the suitability of implants and implant treatment options.
9. What’s the cost of Dental Implants? Modern dental implantology is an exacting field where there are many considerations to be made. The cost reflects the level of skill and training required in order to carry out such complex reconstructions. A single tooth at the front of the mouth is probably the most complex case requiring high levels of skill and ability to create a natural result and this must be reflected in the final cost to the patient.
It must be borne in mind that dental implantology is akin to hip and knee replacement and thus the skills required to carry this out are reflected in the costs.
Various materials are available for the construction of crowns and bridges and this is a consumer choice offered by us to our patients. Hence there are variables in cost at this level.
As well as the surgical skills required, implant reconstructions require a highly skilled team of dental technicians such as metalworkers who craft the titanium components as well as making the metal supports for the new teeth. We also need skilled ceramists who can create the natural contours of the teeth with porcelain.
Because each individual case is dependent on a number of factors, it is not possible to give an indication of fees. Once a comprehensive examination has been carried out by the implant surgeon and initial x-rays have been taken, only then can a treatment plan be provided with costings as appropriate for that particular case.
10. Why have Dental Implants become so popular? Due to the huge advances in medicine, we are living longer and longer and hence the need for permanent dental replacement becomes very important to our overall health. Dentures and removable bridges have obvious problems such as looseness, instablity and bulkiness. Implants can provide people with dental replacements that are both functional and aesthetic. Implants are not new, they have been around for a thousand years. But within the last 40 years, they have become increasingly predictable and are now the most successful form of dentistry including root canal treatment.
11. What is a bone graft and why may it be needed? If there is insufficient bone for the placement of dental implants, it becomes necessary to ‘create’ the bone in this area prior to placing implants. This procedure of building up the bone is known as Bone Grafting. Bone grafting is a very common procedure in dentistry and it is used commonly for dental implants and in periodontal procedures around natural teeth.
In order carry out bone grafting, we need a source of bone to place in the deficiency. The best bone is the patient’s own bone (autogenous bone) and this can be taken from other areas of the mouth usually the chin or the back of the lower jaw. Occasionally this bone is taken from areas outside the mouth, such as the hip. When bone is taken from the hip, it is usually done in the hospital by an orthopaedic surgeon and transferred to the dentist doing the implant procedure in the theatre.