Dental Implants

Dental implants are best described as the art and science of replacing any or all missing teeth with prosthetic implants. A dental implant is a process also referred to as “implant dentistry”. The most common type of dental implant is known as an endosteal implant and it consists of surgically implanting a titanium anchor into the jawbone. It is implanted beneath the gums to support the realistic looking prosthetic. The implant anchor, or post, will fuse to the jawbone to provide a stable support for a prosthetic known as a crown. Dental implants are very sturdy, do not shift out of place and preserve tooth alignment. They look, feel and function like the natural teeth of a patient.

Am I a Good Candidate for Dental Implants?

A GOOD CANDIDATE for dental implants includes:

• A patient with one or more missing teeth and a fully-grown jawbone
• Patients with adequate jawbone density to support the implant
• A patient who does not want a dental bridge, removable denture or removable partial denture
• Patients with healthy gum tissue
• Patients with a history of periodontal disease may be implant candidates with treatment or extractions

The following patients are NOT GOOD CANDIDATES for dental implants:

• Patients with uncontrolled diabetes, connective tissue diseases, immune deficiency or hemophilia
• A patient who has received high-dose radiation treatments of the head or neck
• Patients with gum disease or periodontal disease

How is a Dental Implant Performed?

Dental implants are usually performed on an outpatient basis using local anesthetic, sedation or general anesthesia. The process can be a multi-step procedure depending on the patient’s condition. Damaged teeth may need removed and patients with insufficient bone density may need bone grafting prior to implant placement:

• Bone grafting consists of taking bone from another area of the body, or using a special bone grafting material, and placing it in the jawbone. The patient will need to wait between 4 to 8 months for the graft to create a new and stronger bone before the process can continue.
• For implant placement, a titanium post, which will serve as the tooth’s root, is placed into a hole made by the doctor. An X-ray may be taken to ensure the implant is positioned properly and stitches will be used to close the gum tissue. The post will infuse to the jawbone during a process called osseointegration but this can take several months. Therefore, a patient who is receiving implants in the front of the mouth may use a partial temporary denture which will be removed for cleaning and sleeping. After the post has fused to the bone, a minor surgery is performed to attach a healing cap or abutment to the post. During this process, the dentist will make an incision in the gums to expose the dental implant. The protective screw will be removed from the implant and the metal healing cap will be placed on the implant. This cap will sit above the gum and maintain the space so the gum can heal around the implant. The gum tissue is closed around the abutment piece. In some cases, the implant and abutment can be placed during the same surgery. However, this leaves the abutment visible when the mouth is open and most patients don’t want that. It will take a week or two for the gums to heal, after the abutment is attached, before the artificial tooth or crown can be fabricated and placed.

Alternative Treatments

An alternative procedure is implant supported dentures. They can increase the stability of the denture and support the dentures from slipping out. These types of dentures cannot be removed by the patient but can be removed by the dentist.

What is the Cost of Dental Implants?

The cost of a single tooth implant is $2000 to $6000. Two to four teeth, using multiple implants, costs from $8000 to $12,000. These price estimates include the dental implant surgery, the implant, abutment and crown. A portion of the cost may be covered by dental insurance if the procedure is deemed to be medically necessary. Therefore, patients are encouraged to check with their insurance provider to see what is covered and what will be an out-of-pocket cost.

Recovery and Downtime

RECOVERY after dental implants depends on the number of implants needed, the condition of the mouth and the health of the patient. A person having one implant will have a shorter DOWNTIME than a person having multiple, or full mouth, implants. After dental implants, the patient may experience mild to moderate discomfort but pain medications can help manage the discomfort.

Patients can resume normal activities the following day. Patients should only eat soft foods during the first few days. Patients should not smoke, spit or suck on straws during the healing process. Furthermore, patients should not try to clean the implant area during the first few days but they should clean the rest of the mouth normally. Stitches will be removed at a follow-up appointment after 7 to 10 days. The integration of the implant and jawbone can take 3 or 4 months for the lower jaw and 5 to 6 months for the upper jaw. Little to no downtime is required after the second surgery to expose the implant.

Results

Since dental implants usually require multiple steps, the results will take some time. Patients who had an infection in the gums, and those who needed a bone graft, will have the results delayed even longer. Patients can see results a few weeks after the second surgery once the crowns or false teeth are put in place.

The implants are considered permanent but any misuse of the teeth, such as chewing on hard or inedible objects, can result in damage to the crown. The crown will be very sturdy but can break, chip or crack just like natural teeth. To maintain the results of dental implants, patients should brush their teeth twice a day, floss daily and have regular checkups with the dentist.

Limitations of Dental Implants

• The limitations involved with dental implants include:
• Patients who do not have enough bone density in the jaw may be limited from implants without a bone graft
• A patient with gum disease or an infection may be limited from dental procedures until the condition has been adequately treated
• The recovery time can be a limitation since it can take multiple steps with some healing time between each step

Risks of Dental Implants

The risks associated with dental implants include:

• Bleeding
• Infection
• Allergic reaction to anesthesia
• Numbness from nerve damage that affects the lower lip, chin or tongue
• Periodontal disease caused by an untreated infection around the post
• Implant failure due to integration issues
• The need for a repeat process to place wider implants or bone grafting
• Breaking, chipping or fracturing of the crown

Dental Implant Options

Dental implants can replace a missing tooth, several teeth or an entire arch while providing better function and aesthetics. Patients should be aware there are multiple options available to them when deciding on dental implants. A consultation needs to be scheduled with a board-certified dentist to have their teeth examined. Once the dentist performs a full examination, a decision can be made about the best treatment option to achieve the desired results.

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Bradley Olson, MD in Waldorf, MD