Dental Implants

What are Dental implants?

Dental implants have revolutionized the art of replacing teeth. It used to be if you lost a tooth you could only have a bridge or a denture, but now you can have a solid tooth back where you once had one, without any damage to adjacent teeth. What’s more is implants will never decay.  That’s great news for someone who gets a lot of cavities. Tooth decay is the most common reason for needing fillings, root canals and crowns.  Next to gum disease, it’s the biggest reason for losing teeth. What’s the number one risk for bridgework? Tooth decay (a cavity).

A cavity under a bridge anchor poses a problem for the whole bridge, not just that tooth. Decay can spiral quickly. That’s part of what makes implants so revolutionary. Implants may have a marginally higher cost for the replacement of a single tooth compared with a bridge, but over a lifetime, implants are much less expensive (in dollars, needles and time spent in the dental chair).

In the replacement of a single tooth – by comparison with a bridge – you can floss around an implant. Flossing under a bridge is possible but it is more tricky and requires a special kind of floss instrument. Also without damaging the teeth on either side of the space, you keep your tooth structure intact, reducing the future risk for cavities, root canals and further tooth loss.

What determines if dental implants are for you? 

While each scenario is unique, dental implants rely on a missing tooth or teeth and availability of healthy bone.  When planned and placed well, dental implants have an excellent success rate.  The chances that the implant will be in place and in use 10 years down the road is commonly over 95%.  Think about how that compares with other medical procedures. There are other factors that affect implants. Patients need to be able to tolerate a minor surgery – not unlike a tooth extraction. Implants are successful even in patients with osteoporosis, diabetes, in older patients and patients who smoke.  Smoking does interfere with healing and so it reduces success rates, but it is not prohibitive.

Is a dental implant like a normal tooth?  

Yes.  Most of the time, after the treatment, patients are unaware that it is not a real tooth. Sometimes the gumline feels slightly different around an implant – but unless otherwise directed, you can eat a wide range of food including nuts, hard bread, apples and corn-on-the-cob.

What happens if I want an implant but I’m told I don’t have enough bone? 

This happens sometimes, especially if the tooth has been missing for a long time.  There are some instances in which implants are just impossible, but most of the time a bone graft is the solution. A bone graft is a minor surgical procedure where a material is placed in the area of the missing tooth and then left to heal. During that healing period of 2-4 months, our bodies replace that graft material with our own real bone.  The goal is to have enough bone after healing to place an implant.  That may sound like a lot to go through just for one implant, but if an implant is favored over the bridge, then in the long term it may be worth it.

Does a bone graft hurt?

No more than an extraction or a deep cleaning. There may be some normal post op discomfort, but most patients do fine. Many even go to work the same day.  During the healing period, most patients are unaware that anything was done. The time is needed for the area to mature into bone so that a successful implant can be placed. After the first 1 or 2 weeks, patients frequently don’t need to see the dentist to check it until the healing period is up. You are free to work, travel, exercise, etc.

Do dental implants require maintenance or follow-up?

Implants are a revolutionary way to replace teeth – and they will never get a cavity or root canal. But we do need to examine them from time to time. It’s also very important to keep them clean at home and to have them professionally cleaned twice each year.  Like teeth, there is a great benefit in periodic exams and x-rays.

Dr Oh and Dr Estafan generally prefer an X-ray of each implant on an annual basis. This way we can assess the integrity of the, the fit of the restoration and the state of surrounding bone and tissues. Implants and implant crowns and bridges can last a long time but they may also need maintenance.  Crowns can become loose and need to be cemented again – and parts may occasionally need to be tightened if they loosen.

Dental implants depend on healthy bone for support. If that bone level changes. the earlier we can identify it the better.  Early intervention in dentistry is almost always preferable.

Implants may also be used to support dentures.  These are called overdentures – and they need a different kind of maintenance.  The clips that snap the overdenture into place wear out over time.

As this happens, the overdenture becomes progressively looser.  We stock the parts to tighten them again. It’s a relatively simple and painless procedure that makes the overdenture feel so much more secure. This maintenance is generally done every 12 months.

In short, implants are an excellent solution for so many patients, but they do require maintenance.