Dental Implants: What to Expect
What are dental implants?
A dental implant is essentially an artificial root of a tooth which is attached inside the jaw and replaces the root of a real tooth. A prosthetic tooth is attached to this implant. The implant anchors the prosthetic tooth in place.
If you have one or multiple missing teeth, dental implants are one of several options to replace them. Other options include dental bridges, dentures, implant-supported bridges and implant-supported dentures. Implants are comfortable and function like the rest of your teeth but there are clear differences.
Who can get dental implants and who can place them?
Dentists can place dental implants but if you have a more complicated set of teeth or medical history, your dentist may refer you to a specialist.
There is a huge connection between being generally healthy and dentally healthy. If you are medically healthy, have well-controlled medical conditions, have healthy gums (perio), healthy teeth and good quality bone to hold an implant, then dental implants may be the right option for you.
If you have not had teeth for years, likely your jawbone has shrunk from lack of use and may benefit from a bone graft or soft tissue graft. A bone graft is a technique of adding new bone to your upper or lower jaw. You generally need 10 by 6 mm of bone for a dental implant and bone grafting can definitely aid in creating what has been lost. Dental implants and teeth need 2-3mm of pale pink attached connective tissue around to prevent periodontal disease from progressing. A soft tissue graft is a technique of adding attached gum tissue to areas in which it has been lost. The clinical decision to have a bone or soft tissue graft is on a case-by-case basis.
What is the dental implant procedure?
Prior to the procedure, your dentist will perform an examination of your mouth: taking pictures, x-rays, measuring your gums and checking your teeth to make sure all basic dental treatment has been taken care of. Once you have healthy gums, teeth and if necessary, your medical history cleared by your doctor, your dentist will come up with a treatment plan for the implant and grafting procedures listed above.
On the day of the procedure, your dentist or specialist will give you dental anaesthesia to make you more comfortable and will raise an area of gum tissue to get to the bone. The bone is gradually prepared in the area where the implant will be placed and the dental implant will be placed into your jawbone beneath your gum tissue—just like a real tooth root. Some cases will be stopped here and the gum tissue will be stitched up for healing. During this healing, the implant integrates and bonds to the bone in a way that only titanium can, much like other joint replacements. The integration into the bone can take several months and this will be monitored at your follow up dental appointments.
Some cases can go immediately to the second stage of surgery which is when an abutment is connected to the implant. A dental abutment connects the actual prosthetic tooth to the implant. A temporary crown is then placed onto the abutment.
The implant (and bone graft in some cases) and gums will need to heal properly in order for a crown to be designed to fit that soft tissue. Once this healing has occurred, a few appointments are required to fit the new prosthetic tooth to the abutment.
How to care for your dental implants
Dental implants act just like natural teeth but there are key differences. Although dental implants cannot get cavities, then can get gum disease just like natural teeth. Just like natural teeth, this gum disease, also known as periodontal disease, can lead to moving implants and failures.
Your dental implants need to be kept clean with a tooth brush, floss and other interdental agents that your dentist will prescribe you. You need to attend regular dental hygiene appointments to make sure the implants are healing well and remain stable inside your jawbone.
Possible risks of dental implants
Although rare, complications can happen. These complications include bleeding, bruising, infection, temporary or permanent numbness, failure of the implants or bone graft. If you have certain medical conditions or bone conditions, your implant may fail to fuse to the bone properly.
Success of Dental Implants
Dental implants integrating into the bone are directly affected by your general health, your medications and your dental health. If you are a heavy grinder, special precautions must be taken to ensure you are a candidate for dental implants. The position and number of implants that will be placed are directly related to your chewing habits as well.
A well integrated implant will have a success rate or 93-98% over 5 years and many last for 15-20 years.
A few health conditions are absolute contraindications for dental implants because they increase the risk of failure. These conditions include: poor dental hygiene, heavy smoking, poorly controlled diabetes, immunosuppression, long term corticosteroid usage, severe osteoporosis and certain diseases of the bone.
Overall, dental implants have a very high success rate when they are treatment planned in a comprehensive manner and the patients are fully aware of their part in keeping their dental implants healthy.