FAQ’s about Dental Implants
A dental implant is nothing more than a metal screw that is placed into the jawbone. It acts as an anchor for a false tooth or a set of false teeth. A dental implant is a replacement artificial tooth root that provides a stable foundation for a replacement artificial tooth, functioning very much like the root and crown of your natural teeth.
Your natural teeth are stable biting and chewing surfaces because your jawbone supports them. This is also true of dental implants. Successful dental implants become firmly embedded in the jaw through osseointegration, a natural process where the bone grows onto the implant surface. This provides the same stability as natural teeth, making it possible for your replacement teeth to look, feel and function like natural teeth.
Every way you look at it, dental implants are the best way of replacing missing teeth.
- Aesthetic: Dental implants look and feel like your own teeth. Since dental implants integrate into the structure of your bone, they prevent the bone loss and gum recession that often accompany bridgework and dentures. When teeth are lost, there is ongoing shrinkage of the jawbone, which may make your face look older. Dental implants stimulate the bone and prevent bone resorption. No one will ever know that you have a replacement tooth/teeth.
- Tooth-saving: Dental implants do not sacrifice the quantity or quality of your adjacent teeth like a bridge does, because neighbouring teeth are not altered to support the implant. More of your own teeth are left untouched, a significant long-term benefit to your oral health! Implants are also very beneficial for stabilizing teeth loosened from periodontal disease.
- Confidence: Loose dentures and metal clasps can cause embarrassment, pain, and difficulties with eating and speech. Implant supported replacement teeth are like natural teeth because they are anchored securely to your jawbone. Dental implants restore the chewing power lost with missing teeth. Dental implants will allow you to once again smile, speak, laugh and eat with comfort and confidence. They are secure and allow you to say goodbye to worries about misplaced dentures and messy pastes and glues.
- Reliable: The success rate of dental implants is highly predictable, with success rates between 98% and 100%. They are considered an excellent option for tooth replacement. Research shows that the average lifespan of a bridge is 7-10 years. If you are in your 40’s, you may have to change your bridge at least 3-4 more times!
- Prevents problems associated with jawbone shrinkage: Since dentures sit on top of the jawbone and gums, continuous shrinkage of the jawbone alters the fit of the denture resulting in slipping or rocking. Exposed nerves and irritation of the gum tissue may add to the discomfort. Implants help by minimizing the erosion of jawbone that occurs when teeth are lost or removed.
Whatever your particular circumstances, dental implants can provide a sense of security and well being by providing comfort, function and appearance.
There are very few disadvantages to dental implants:
Dental Implants can only be placed if there is enough bone present in the jaw. When teeth are lost, the bone that supported the teeth gradually disappears. That is way it is so important to replace missing teeth as soon as possible after extraction. We prefer to replace failing teeth immediately after removal. See Immediate implant placement.
Careful evaluation and x-ray studies will help us determine if you have enough bone or whether it may be possible to re-grow the lost bone. See Bone Grafting.
Your oral health affects implant success. Implants survive best in a healthy environment. Good oral hygiene and normal wound healing are essential for implant success. Implants can fail due to gum disease, just as teeth do. Success may be improved with your diligent attention to oral hygiene. Before implantation, natural teeth must be rehabilitated and any gum disease treated and eliminated.
Your systemic health affects implant success. Systemic conditions that impair your body’s ability to heal, such as uncontrolled diabetes, are contraindications to implant therapy. In addition, both smoking and heavy alcohol consumption reduce the survival of implants (and teeth). If you think that either of these two habits could be a problem for you and your implants, it may be advisable to avoid this form of dental treatment or accept the higher risk of implant failure.
Due to the complexity of treatment and the high cost of materials, dental implant treatment requires a substantial financial investment. However, the beauty of implants is its “upgradeable” nature. In some instances, you may consider placing a few implants now and use them for a while. In the future, you may be able to add more implants and improve your prosthesis. For example, a patient with no teeth in the lower jaw may have two implants placed to stabilize their denture. Later on, if adequate bone is present, more implants may be placed and a fixed bridge may be supported on the implants, eliminating the denture altogether.
The success rate in our practice for the past five years has been 99+% for all implants placed.
Although it is impossible to give an absolute guarantee, our aim is that your implants should last you the rest of your lifetime. With the proper home care and professional maintenance, there is every reason to believe that they will.
Nutrition, oral hygiene, genetics, diseases (such as diabetes), and smoking have an effect on the long-term survival of dental implants.
Implant success also depends very much on where the implants are placed (bone quality and quantity) and what they will be called upon to do. The best-case scenario is the placement of implants in the front portion of the lower jaw. Here success can be as high as 98-100%. In other areas of the mouth, success rates can be slightly lower, but these are improving with new materials and techniques, and are approaching 100%.
In the past we had to wait three months in the lower jaw and six months in the upper jaw before placing any load on implants. In recent years, however, there has been a movement within the profession to speed up this process. Today, with better techniques and implant surfaces, it is possible to shorten the healing time. In a large proportion of cases we can even load implants right away! Nevertheless, one thing to keep in mind with implant therapy is to “respect nature”. It is important that neither the patient nor the implant provider attempt to rush the treatment or try to advance the various stages faster than the time required for complete healing and maturation of bone and soft-tissues.
Treatment duration also depends on the complexity of the treatment. Initially there is a treatment planning stage. Then there may be some time spent on preparatory procedures as improving gum health, removing any hopeless teeth and growing bone. This may take anything from a few weeks to many months. After the implants are placed they are left to settle in place from six weeks to six months. The final fitting of crowns or bridges or the attaching of dentures to the implants takes a month or two. The time depends on your individual situation.
Anyone who is in reasonable health and wants missing teeth replaced. You must have enough bone in the area of the missing teeth to provide for the anchorage of the implants. Some people are missing all their teeth and most of those are excellent candidates for dental implants, but today, we use implants to replace small bridges, removable partial dentures and even missing single teeth.
The actual procedure to surgically place a dental implant is done under local anaesthesia and is generally not at all painful. Most of our patients report that the implant placement was less traumatic than the extraction of the tooth, and that they only took painkillers for 1-2 days after the procedure. When the anaesthesia wears off about three or four hours later, you might expect some discomfort. 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 pain or discomfort, which may last for several days. Pain medication is always prescribed usually which alleviates this discomfort. Patients generally prefer a soft diet for the healing period following surgery. Swelling and bruising may also develop, depending on the amount and positions of the implants placed.
For more complex treatments or if you are very anxious, we offer intravenous conscious sedation. A qualified anaesthetist will administer a mild sedative, which will keep you calm and relaxed for the duration of the procedure. Conscious sedation is very safe (much safer that general anaesthesia) and do not leave you feeling awful for days after the procedure!
The fee depends on several factors, including the number of teeth being replaced, the number of implants required to support your replacement teeth and the complexity of the overall procedure. Some additional procedures may be required prior to the placement of your dental implants to ensure the long-term health of your dental implants.
Typically, there is a fee for the surgical procedure and a separate fee for the restorative procedure. To obtain a specific fee estimate, it is necessary for us to examine your mouth. After a thorough diagnostic examination, we will recommend the treatment that is best for you and what your investment would be for the procedure.
Dental implant treatment can involve a significant investment, with fees ranging from £ 2000 for a single tooth replacement. However, the cost of non-treatment can be considerably more expensive. Continual bone loss occurs from the wearing of full or partial dentures (plates). This progressive loss of bone can eventually cause nerve exposure, jaw fracture and a complete inability to function with regular dentures. Correction at this point may be very expensive and can involve extensive bone grafts, which requires hospitalisation and an extended recovery period. Placing implants before the bone loss becomes severe not only saves money in the long run, but also slows the bone loss process, increasing the likelihood of long-term success.
Some may believe that dental implants are expensive. However, when one evaluates the return for the investment and the long-range benefits that come from having secure, functional, attractive teeth and a winning smile – implants are not expensive. For those who prioritise dental health, we have been able to provide comprehensive dental implant treatment to patients of every income level. For some, a home equity loan is a good solution. Others forego a new automobile or a family vacation in lieu of a longer lasting benefit. Finally, in many cases, a treatment program can be broken into several phases, accomplishing the more serious needs first. It is not unusual to design a plan that is delivered and paid for over a period of several years.
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The question is really who should you see about getting missing teeth replaced? Before implants, you went to either your general dentist or, if you wanted a specialist, to a prosthodontist. It’s the same today. If you want to replace missing teeth, talk to the people who do that job and they will be glad to discuss the use of dental implants in that process. If you decide that dental implants are for you, then your general dentist can either place the implants for you or refer you to a qualified periodontist or oral surgeon for that phase of the treatment.
Unfortunately, there are dentists out there who, after only a week or two of training, call themselves “Implantologists” or say that they are specialists in Implantology or “Board Certified” in Implantology. While there are people and organizations that would like the general public to believe that there is such a thing as a dental specialty of Implant Dentistry, there is NO SUCH THING! There are organizations that give credentials and awards to dentists that make it look like these dentists are highly trained implant specialists, but these credentials are not recognised by the General Dental Council. It is considered illegal to advertise these credentials. The specialty areas of dentistry that are most aligned with dental implants are Periodontics, Prosthodontics and Oral and Maxillo-facial Surgery.
Our suggestion is to check with the General Dental Council (http://www.gdc-uk.org/), on the qualifications of a dentist before allowing him or her to treat you. Professionals practising implant dentistry should also be active members of societies involved in continuous training and professional development, such as the Association of Dental Implantology ( http://www.adi.org.uk/), and the Academy of Osseointegration (http://www.osseo.org/).
Occasionally dental implants fail or, as some people say, they are rejected. In most instances, they can be replaced with another implant, usually of a slightly larger size. Failure rates should be about 1-2%. Each year we place and restore approximately 200 implants and each year 1 or 2 of them fail. Failures are considered no more than a temporary setback that can lengthen the total treatment time.
In the past patients had to go without wearing their dentures for at least two weeks after implant placement. Over the years, this has been modified considerably and in most situations, patients leave the office wearing their teeth the day the implants are placed. In more and more cases we are able provide temporary crowns, bridges or dentures on the implants immediately after placement with excellent success rates! Only in very rare cases may it be recommended that a patient go without his or her denture for a short period of time. Every patient and procedure is evaluated separately and you will be informed of the type of temporary prosthesis that will be used in your case.
Sometimes it is necessary to build up the jawbone before, or at the same time as implant placement. The procedure of building up the bone is known as Bone Grafting or Bone Augmentation. Bone grafting is a very common procedure in dentistry and it is often used for dental implants and in periodontal procedures around natural teeth.
To do bone grafting, we need a source of bone. The bone that we use can be one of three types. The best bone is your own bone. This bone can be taken from other areas of the mouth or collected in our suction apparatus as we prepare the sites for dental implants. 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 operating theatre.
Another very common source of bone is bone taken from cadavers. This bone is harvested under very strict supervision at several bone banks around the world and it is used in many dental and medical procedures. There has never been a case of a transmitted disease with this type of bone. It is very safe and very useful in our work to help patients.
A third type of bone used is taken from a bovine source, and again treated to eliminate any possibility of disease transmission or allergic reactions. In our practice we prefer to use human bone, preferably your own.