Dental Implants

Dental implants are artificial tooth roots, usually made of titanium, that are placed into your jawbone to support replacement teeth. They are a method of replacing missing teeth or can also be used to support dentures or fixed bridges. They may be an option for people who have lost teeth due to disease, an injury, or for some other reason. A single dental implant can be used to support one or more replacement teeth and just like a natural tooth root it will fit directly into your jawbone and hold false teeth in place.

The dental implant itself is a metal post which has an internal screw or clip with an artificial tooth attached to the top of it. Dental Implants are a safe and well-established treatment and, much like natural teeth, may last for the rest of your life if the bone they are fitted to is strong and healthy and if you look after them properly, maintain good oral hygiene and attend regular maintenance appointments.

If you lose even one tooth, the bone in the area of that tooth shrinks while the other areas stay intact. Dental implants help to preserve your jawbone and prevent the natural shrinkage that can occur with bone loss. A bridge or removable partial denture does not preserve or maintain your bone in the same way.

The Dental Implant Process

The Dental Implant process itself will involve at least one operation. You need to be in good general and oral health, have healthy gum tissues that are free of periodontal disease. You must also have adequate bone in your jaw to support the implant. Typically a single implant can support one or more replacement teeth and should you wish to replace all of your teeth with implants then this would require at least six implants in your upper jaw and between four and six in your lower jaw.

Dental Implant treatment normally comprises of two stages:

• The first stage involves a titanium post being planted into a hole in your jaw bone with a local anaesthetic. Sometimes your dentist might give you a sedative if you are feeling very nervous or if your case is a complicated one. General anaesthetics are rarely used in dental implant procedures and are usually only used for complicated cases. The gum is then stitched after the insertion of the titanium rod and your jawbone will eventually fuse with the post – this process typically takes several months.

If you are having one, two or three teeth replaced, you may have a temporary denture in the meantime for aesthetic reasons. If you already have full dentures, you can keep wearing these while your implants are healing however these will need to be altered, to fit properly after the surgery, and a ‘healing cap' will usually be placed onto the implant site to protect it.

• The second part of the Dental Implant process involves attaching the replacement artificial tooth to the titanium rod which involves a small cut in the gum above the dental implant. The replacement tooth might be fixed permanently (like a crown or a bridge) or attached in such a way that will let you remove it for cleaning (like a denture).

Usually the replacement artificial teeth are fitted onto the dental implants 3 to 4 months after they are put in. Sometimes treatment may take longer and your dentist will be able to talk to you about your treatment timescales.

Immediate Dental Implants

In certain cases, such as if you know you are about to lose a tooth, the artificial replacement teeth may be fitted at the same time as the implants are placed - these are called ‘Immediate Implants'. You will have to check with your dentist to see whether this treatment is suitable for you.

If you are in the position where you have to lose a tooth, it may be the best option to replace it with an implant on the same day or within the first 6 months after losing it to prevent jaw bone loss.

An immediate dental implant will only be possible if:

• The bone around the failing tooth is intact

• The gum and the surrounding area is infection free

Immediate implants can save months of waiting for the new tooth to be placed and will reduce the number of visits you need to make to the dentist but they are not suitable for everyone.

Are you suitable for Dental Implants?

Dental Implants are not suitable for everyone due to various reasons:

• If you are a smoker some dentists won’t insert dental implants as it can affect the outcome of the treatment. If you are a smoker and want to receive treatment you will probably need to give up smoking for at least a month before the procedure. Giving up smoking will substantially improve your chances and prevent any future harm to your body that smoking could cause.

• If your alcohol intake is high or you regularly drink to excess it is likely you will be denied treatment. Your level of alcohol consumption may have a direct effect on your suitability for implants. Alcohol can seriously retard the healing process which can result in a higher chance of failure.

• A weakened immune system can compromise the healing process involved in the success of a dental implant. You may be immunodeficient for a number of reasons such as genetics, age, radiotherapy, disease or if you have recently had a transplant.

• If you taking some prescription medicines e.g. bisphosphonates (used to treat bone diseases) as these significantly delay healing.

• If you have gum disease – this may destroy too much bone so there will not be enough to attach your implant to. A bout of gum disease could also seriously complicate the healing process after your implant and lead to infection and failure.

• If you are prone to grinding or clenching your teeth you may not be able to have dental implants because your new, implanted tooth will not have the structure which protects it from the pressure grinding or clenching produce. This will complicate the healing process and could damage your prosthetic teeth and it can be extremely expensive to repair.

• Type II Diabetes – poor blood circulation associated with this type of diabetes can jeopardise your healing after a dental implant.

• If you don’t have enough bone to support the implants - If you have too little bone, or if your bone is too weak, your dentist will not be able to secure an implant to it and you may be deemed unsuitable for treatment. There are some treatments which can solve this problem but they are invasive and expensive. It is possible to undergo bone grafting, tissue regeneration and sinus augmentation in order to make your jaw suitable for dental implants.

Aftercare

When it comes to Dental Implants aftercare is of utmost importance if you want to have a long-lasting and successful implant. Your dentist will be able to give you detailed advice on how to look after your dental implants. Cleaning should be no more difficult than cleaning natural teeth although there may be areas that are harder to reach so your dentist will be able to show you how to clean these. You may also need to visit a dental hygienist more often.

The Next Step

If you have decided that you would like dental implants then the first step is to talk to your dentist. They may already carry out some or all of this type of treatment, and will give you the advice you need. Or they may refer you to an experienced ‘implantologist' for assessment and treatment. Consultations such as these are usually free of charge although it is always best to check ahead of time.

Don’t forget to ask:

• exactly what treatment you will receive

• if the dentist will perform the procedure ‘in-house’ and if so what training and experience they have had or if not then which implantologist they will refer you to

• an estimate of what the treatment is likely to cost

• if there are any alternatives and what they are

• if a guarantee is included in your treatment

If you are not happy with any of the answers you get to these questions then don’t be afraid to get a second opinion. You will be spending a lot of time, effort and money, so you must be sure that you know what you will be getting in terms of treatment and results and that you are happy with this.

If you do wish to proceed with having dental implants then make sure you receive a treatment plan.

If you would like more information about dental treatments then please check out this page to the British Dental Health Foundation :

https://www.dentalhealth.org/tell-me-about/topic/cosmetic-dentistry/implants

Or if you would like further details on Dental Treatments in general then please check out the NHS Dental Treatments page :

http://www.nhs.uk/Livewell/dentalhealth/Pages/Dentaltreatments.aspx