The day might come when you have to say adios to a tooth. It can happen to the best of us even after a lifetime of conscientious care. Maybe you’ve had an accident, maybe age has taken its toll, or maybe illness has impacted your oral health. Whatever the reason, now your dentist is talking about removal. Maybe they’re suggesting implants.
Dental implants are artificial roots that serve as a fixed base for replacement teeth. Usually made from titanium, the dental implant is surgically and permanently embedded in the jawbone. An abutment attached to the implant holds in place a crown that looks and functions like a natural tooth.
Dental implants offer superior results and performance compared with other tooth replacement options such as bridges or dentures. Placement of an implant does involve surgery, though, and it can be expensive — but the long-term results are worth it for eligible patients.
Anatomy of a dental implant
There are three parts to a dental implant:
The first is the screw, or the implant itself. The screw is permanently embedded in the bone of the upper or lower jaw, taking the place of the missing tooth’s root.
Once the screw is solidly in place, an abutment is attached to the screw. This abutment rises up like a fencepost, and becomes the attachment point for the crown.
The dental crown is the visible replacement, which should look and act nearly indistinguishable from a healthy, natural tooth.
What is dental implant surgery like?
Dental implant surgery can be a somewhat involved process taking multiple appointments with time in between to allow for recovery and regrowth. Fortunately from the patient’s side of things, these steps should seem relatively simple and painless, with the initial tooth removal being the most dramatic moment of all.
You might need a bone graft
After the offending tooth is out, you might need a bone graft to correct any damage or deterioration to the jaw bone. It’s important to have a solid base of bone in which to place the implant. Some patients who have suffered significant bone loss from periodontal disease or other conditions might need to consider options other than dental implants. But for others, a bone graft transplanted from a cadaver or animal source will give the dentist enough of a base to work with. Bone grafting is often performed by an oral surgery specialist, and you’ll need to wait several months afterward before the healed bone is ready for the implant. Depending on your situation, your dentist might make a temporary removable retainer — a “flipper” — as a placeholder while you heal.
Dental implant surgery
Once the bone is sufficiently strong, the implant can be placed. Implant surgery is regularly performed by periodontists and prosthodontists. The process might involve cutting through the gums, drilling a hole in the bone, and placing the implant. Sometimes the abutment is placed at the same time as the implant. At other times, this is part of a later procedure. Placing the dental implant only takes about an hour, but afterward you’ll need to wait for osseointegration — the process in which the bone grows into the implant and anchors it securely in place. This can take six weeks or more.
Your new crown
Finally, your new crown will be seated and adjusted for a proper fit. Congratulations on your new tooth! The whole process from start to finish — from tooth removal to new crown — can take several months or more.
Oral care during and after the implant process
We love to talk about oral hygiene. Keeping your teeth and gums clean is critical to maintaining a healthy mouth. And it’s especially important following any surgery, when you really, really want to avoid infection. Your dentist will give you specific instructions, but here’s some of what you might hear:
- Brush gently with a soft-bristled brush to avoid damaging the sutures.
- Rinse ever so gently with mouthwash or warm salt water a few times a day.
- Brush your teeth twice a day for two minutes each time, and floss once a day.
- Look into special brushes or floss that might help you with hard-to-clean areas of the implant.
- Keep up with your routine dental exams and cleanings.
Who should not get dental implants?
Dental implants are a great option for anyone who’s able to have them, but they won’t work for everyone. You need to have a solid underlying bone structure that will accept the implant. And certain conditions put you at a higher risk of implant failure. These include uncontrolled gum disease, uncontrolled diabetes, cancer, alcoholism, and smoking. Also certain medications such as steroids or immune-suppressing drugs could interfere with the success of your implant. Your dentist will discuss all of this with you while considering your options.
Alternatives to dental implants
The main alternatives to dental implants are bridges and dentures:
- Bridges are replacement teeth that are fixed in place by permanent attachment to existing, neighboring teeth. The replacement teeth thus form a “bridge” connecting the existing teeth.
- Dentures are removable replacement teeth. You take them in and out of your mouth at your convenience.
- Going toothless. Please don’t do this!
Advantages of dental implants
- Dental implants are stronger and more stable than bridges or dentures.
- Dental implants promote bone strength and growth around the implant, whereas the bone beneath bridges and dentures can weaken from lack of use.
- Dental implants look and act more like natural teeth, without any of the awkward cleaning, eating, or speaking situations that you’ll have with some bridges or dentures.
- And while dental implants might be more expensive up front, they are usually more cost effective than bridges or dentures because they are meant to last a lifetime. Dental bridges, on the other hand, have a life expectancy of five to ten years, while dentures are expected to last seven to ten years — or until you lose them in the cafeteria.
What are the risks of getting dental implants?
Dental implants have a very high success rate — in the range of 95% or above — and failure can often be traced to things like smoking or poor oral hygiene.
One of the bigger worries when it comes to dental implants is failure of osseointegration. When this happens, the implant might fall out or need to be removed. Your dentist will explain your options, which will be either to try again or to go with an alternative such as a bridge.
Other concerns with dental implants include sinus damage (for implants in the upper jaw), nerve damage, and infection. Your dentist will take great care to avoid these outcomes, but you should always be aware of the possibilities related to any surgery.
