Dental implants are replacement tooth roots that are put into your jawbone to provide a solid anchor for crowns and replace missing teeth. When put together with a good dental crown, they can make a great alternative to dentures and bridges.
Dental implants can replace one or more missing teeth – even a whole mouthful! They look and feel almost like your own real teeth. In other cases they can be used to hold a denture using clips similar to press studs and stop your dentures from slipping. A dental implant is designed to last for many years, but good oral hygiene is still really important and will help the implant last longer.
Dental Implants Benefits:
- Help withstand greater bite pressures than dentures (you can eat an apple)
- Prevent bone loss in your jaw – helping keep nearby remaining teeth on a solid base.
- Help prevent the hollowed cheek look
- Cleaned just like natural teeth with toothpaste and floss
- Firmly secured in the jaw.
- Help prevent receding gums
- Do not need to cut or re-shape neighbouring healthy teeth in order to implant.
Are dental implants for you?
Before undergoing dental implant surgery, your dentist will discuss with you whether it’s the best treatment for your dental problem. There are many things to consider and the decision to proceed with or cancel the surgery is entirely up to you. However, there are exceptions to who can have dental implants:
- Children under 17 are not suitable candidates for dental implants because their bones are still growing
- Patients who lack sufficient jawbone. However, bone replacement techniques can be used to rebuild enough bone for the surgery to be possible.
- Smokers. Smoking affects the healing process and can prevent implant-bone integration or cause a breakdown in the integration over time.
- Pregnant women. General anaesthesia and other medications may pose risks to the unborn baby’s health.
- Patients with uncontrolled diabetes may have increased complications with the surgery including infection and delayed healing.
- Patients with alcohol and/or drug problems may have dietary problems or fail to follow the dentist’s instructions and maintain proper oral hygiene.
- Patients with mental health issues may have trouble following the dentist’s instructions.
Your medical and dental history
It is important to talk to your dentist about your full medical and dental history in order to increase your surgery’s chances for success. Medications you take, major illnesses, or previous surgeries can greatly influence the procedure. Tell your dentist if you have had:
- Haemophilia or any kind of blood disorder
- Heavy bleeding when injured or following surgery
- Rheumatic fever
- Heart problems or heart surgery
- Facial radiotherapy
- Blood-thinning medication (aspirin or warfarin) and other regular medication
- A reaction to an anaesthetic drug
- An allergy to antibiotics or other medicines.
It’s best to give your dentist a complete list of all the medication you are taking currently or have recently taken. This includes prescription drugs, biphosphonates, over-the-counter medicines, and herbal remedies.
For your dentist to confirm that you are suitable for dental implants, he will perform diagnostic tests to plan the best approach. These include:
- Dental examination
- Dental x-ray radiographs (films)
- CT scans of your jawbones
- Dental casts of your mouth
The size, shape, and appearance of your artificial tooth will depend on the remaining teeth you have. This will be the best time to share your suggestions with your dentist.
Other dental health problems
If you have tooth decay, a gum disease, or other oral health problems, these must first be diagnosed and treated before the implant procedure.
If you have bruxism (teeth-grinding), you may damage your dental implants and crowns.
To counter this your dentist may:
- Insert extra implants
- Make the artificial teeth out of stronger materials
- Fit you for a special type of guard or splint to wear at night in your sleep.
It’s important to set realistic expectations for the procedure. The crowns and implants will not look ‘life-like.’ Biting and chewing may feel differently and could take some time to get used to. Regular visits to your dentist after the surgery are still important to ensure your implants are well-maintained.
There is no guarantee your surgery will be successful or without risk. Around one in twenty implants fails to integrate with the bone or comes loose over time. Here are factors that contribute to implant failure:
- Density and strength of the bones
- Location of the implant (the most difficult is at the back of the upper jaw)
- Patient’s general health and ability to heal after surgery
- Patient’s commitment to oral hygiene
If your implant fails, talk to your dentist about alternative treatments.
Procedure Different types of implants are available and your dentist will help choose which one is right for you. Most are made of materials like titanium that form a strong integration with the surrounding jawbone.
In most cases the treatment involves 3 separate stages.
- Inserting the implant into the jawbone
- Inserting the abutment (the connector) onto the implant
- attaching the artificial tooth (crown) onto the connector.
The process can take from three to six months from start to finish, the time depends on how fast you heal, how much bone is left in the jaw when you begin treatment, the degree of bone-implant integration, and your general oral health.
Here are important reminders for after your surgery:
- Arrange for someone to drive you home.
- You may take a few days off work.
- Avoid driving, operating heavy machinery, and vigorous exercises for a few days unless otherwise advised by your dentist
- Swelling, bruising, pain, and headaches normally may occur and should disappear in a week. Ice packs and over-the-counter medicine should help with the discomfort. You can also ask your dentist to prescribe you stronger medication if needed.
- If your dentist prescribes a course of antibiotics, take them as directed.
- Drink plenty of water from 2-3 hours after surgery but not hot drinks.
- Avoid alcohol especially if you are on medications.
- Avoid hard foods. You may be put on a soft-food diet up to six weeks.
- Your dentist may advise rinsing with a saline or antiseptic solutions.
- Go to your follow-up appointments and check-ups.
- Should pain or swelling worsen or a fever develops, see your dentist immediately.
- Follow your dentist’s directions.
Caring for your dental implants
- Brush carefully after every meal. Use fluoride toothpaste.
- Use a toothbrush with a small head and soft bristles.
- Use interdental brushes.
- Floss at least once daily.
- Do not smoke.
- Limit intake of sugary food and drinks.
Dental implant surgery is not without some degree of risk. It’s important to be fully informed and express any concern you may have to your dentist. The following list will help you weigh the risks, benefits, and limitations of your treatment:
General surgical risks
- Allergic reaction to the anaesthetic
- Some nausea following general anaesthesia
- Excessive bleeding may happen and require a blood transfusion. This is rare.
- Infection may require antibiotic treatment.
Specific risks of implant surgery
- Sinusitis. Inserting an implant into the upper jaw may contact or perforate the lining of the sinus and cause an infection. This is usually treated with antibiotics.
- Fractured lower jaw. This is a rare occurrence during the procedure and requires special treatment.
- Damaged nerve. An implant can damage he nerve along the lower jaw. This can cause numbness in the gums, lips, or around the mouth. In most cases, this resolves within 6-18 months but can possibly be permanent.
- Inhaling or swallowing equipment or parts. If a patient inhales or swallow the implant, attachments, or piece of equipment, surgery may be needed to remove them.
Specific risks of implant treatment
Some patients may develop speech problems but this usually goes away once they get used to the different feel of the mouth. If not, speech therapy is recommended.
Hyperplasia or gum tissue growth may occur if gum surrounding the implant enlarges and pushes above the gum line, causing redness and pain. This can be reversed with good oral hygiene or with surgery.
The area around the implant may get infected. If antibiotics don’t work, the implant may have to be removed.
Sometimes the implant may cause a systemic infection. People who have had prior heart surgery are most at risk of developing endocarditis- a potentially life-threatening infection of the heart.
In most cases, strong bone tissue may grow around the implant due to biting and chewing. Rarely, bone loss occurs and the implant becomes unstable.
The artificial tooth may come loose from the abutment and vice versa. Either requires treatment to tighten or replace screws.
A tooth may chip or break. In some cases, a new artificial tooth must be fitted.