Implant Dentistry

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Of all the ways modern dentistry has to replace missing teeth, dental implants are by far the best. There is no tooth-replacement option that will give you a longer-lasting result. Implants also help preserve tooth-supporting bone that naturally deteriorates when a tooth is lost. Loss of bone is one of the major hidden consequences of losing teeth.

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A dental implant most often takes the form of a small, screw-shaped titanium post that replaces the root-part of a missing tooth. The surgical procedure used to place an implant is actually quite minor and routine, requiring only local anesthesia in most cases. After a healing period, the implant is topped with a lifelike crown custom-made to match your existing natural teeth. Implants have a documented success rate of over 95%, which is significantly higher than any other tooth-replacement option.

How Implants Work

During a minor surgical procedure, your dental implant is inserted directly into the jawbone in the space vacated by the missing tooth. It will then be left to heal for a period of months before the final crown is attached. During this healing period, the implant actually fuses to the bone surrounding it.

Tooth Replacement Options Using Dental Implants

Implants can replace missing teeth in a variety of ways. They can be used to:

Dental Implants Replace One Tooth.Replace One Tooth — When you have one tooth missing, a single implant is inserted into the bone to replace the root part of that tooth; a crown then goes on top to simulate an actual tooth. This treatment choice has the highest success rate, making it the best long-term investment for replacing a single missing tooth. Even if the initial cost is slightly higher than other options, it is the most cost-effective solution over time. An implant will never decay or need root canal treatment, and feels just like the tooth that was there.

Dental Implants Replace Multiple Teeth.Replace Multiple Teeth — When you have more than one tooth missing, implants provide an ideal replacement mechanism. You don’t even need one implant for every missing tooth. Instead, implant teeth can act as supports for fixed bridgework. For example, if you are missing three teeth in a row, we can place two implants, one on either side of the gap, and a crown in between that has no implant underneath. That way, you won’t need to use any of your remaining natural teeth as bridge supports, which could weaken them and make them more susceptible to decay.

Dental Implants Replace All Teeth.Replace All Teeth Permanently — Implants can support an entire arch of upper or lower replacement teeth that are fixed into the mouth and are never removed. Sometimes the new teeth can be supported by as few as 4 implants. It’s comparable to the structure of a table, which only needs 4 legs to hold it up. In cases where jawbone density and volume have deteriorated, 5 or 6 implants might be needed to support a row of 10 to 12 teeth. Dental implant replacement teeth protect your jawbone, won’t slip, and should last a lifetime.

Dental Implants Support Removable Dentures.Support Removable Dentures — Implants can even make removable dentures more comfortable, effective and healthier to wear. Traditional dentures rest on the gums and put pressure on the underlying bone. This accelerates bone loss so that the jaw shrinks and the dentures slip, particularly on the bottom. But today dentists can attach a removable denture onto implants, transferring that pressure into the bone structure rather than the bone surface. This prevents the dentures from slipping while you eat and speak, and preserves the bone directly beneath them.

Implant Care and Maintenance

There are only two ways an implant can lose attachment to the bone and fail once it has successfully fused: poor oral hygiene or excessive biting forces. Poor oral hygiene and/or a lack of regular cleanings can lead to a destructive bacterial infection called peri-implantitis. Flossing and brushing your teeth on a daily basis, along with regular professional cleanings, can prevent this. Excessive biting forces can come from either a habit of clenching or grinding your teeth, or an insufficient number of implants to handle the forces generated by your bite. You should receive the correct number of implants so this does not happen. And if you have a habit of grinding or clenching your teeth, a nightguard will be recommended to protect your implants. After all, implants are a long-term investment in your smile, your health and your well-being, so it’s best to protect your investment.

Bone Grafting

5Replacement teeth supported by dental implants function so well and last so long because, like natural teeth, they are securely anchored in the jawbone for maximum support. In order to benefit from this remarkable technology, however, you need to have enough tooth-supporting bone in your jaw to hold a dental implant in place. Unfortunately, after tooth loss, the surrounding bone almost always deteriorates — decreasing in width, height and density — and this process starts immediately. The longer a tooth has been missing, the more the bone that used to surround it resorbs (melts away). If you want a dental implant but don’t have enough bone to support it, can anything be done? Yes. Very often you can still get the replacement tooth you want, thanks to routine bone grafting procedures.

How It Works

Bone grafting, normally a minor surgical procedure done in the dental office, is used to build up new bone in the area of your jaw that used to hold teeth. A small incision is made in your gum to expose the bone beneath it, and then grafting material is added. Most often, the grafting material is processed bone that serves as a scaffold, around which your body will actually deposit new bone cells. The grafting material will eventually be absorbed by your body and replaced by your own new bone.

The grafting material needed can come from a variety of sources. Sometimes it comes from your own body. Very often, however, it is bone from an animal or human donor that is processed by a laboratory to make it sterile and safe. Grafting material can even be synthetic. It comes in a variety of forms: powder, granules, putty or even a gel that can be injected through a syringe.

Types of Bone Grafts

There are a variety of sources of bone grafting material used for preserving or augmenting bone for dental implants. All of these bone grafting materials are backed by significant research. They are processed (except autografts, which do not need processing) so that they are safe to use, eliminating the potential for rejection or disease transmission.

  • Autograft: If you are already familiar with the concept of bone grafting, an autograft is probably what you’re thinking of: taking bone from one site in your body and moving it to another. This is the only type of bone graft that involves creating two surgical sites: the one from which the bone is harvested and the one where it is deposited.
  • Allograft: This refers to laboratory-processed human bone from a deceased donor that comes from a tissue bank.
  • Xenograft: This bone grafting material comes from an animal — usually a cow.
  • Alloplast: This type of graft uses synthetic (man-made) materials.

What to Expect

The procedure for placing a bone graft usually requires only local anesthesia, though oral or IV sedatives can also be used to achieve a higher state of relaxation. Because a small incision in your gum tissue needs to be made to access the underlying bone that will receive the graft, you may experience some soreness in the area after the surgery; this can usually be managed by over-the-counter anti-inflammatory medication and/or pain relievers as well as ice therapy after the procedure. Though you will soon feel completely back to normal, it may take your body up to seven months for bone maturation to take place to receive your dental implant. The waiting time allows the healing process enough time to achieve the desired result: ideal support for replacement teeth that look great and will last a lifetime.

Dental Implants FAQs

What are dental implants?

Dental implants are small titanium posts that replace the roots of missing teeth (View Example). They are inserted into your jawbone during a minor surgical procedure that takes place in the dental office. After the implant has been placed in your jawbone, a completely lifelike porcelain tooth crown is attached. In some cases, the implant needs to fuse with the bone for several months before it is permanently crowned; in other cases, you can have new (but temporary) teeth the same day your implants are placed.

How many teeth can be replaced with dental implants?

You can replace a single tooth, multiple teeth or all your teeth with implants (View Examples). You don’t even need one implant for every missing tooth. As few as two Implants can support a removable lower denture, while as few as four implants can provide a full, permanent set of top or bottom teeth.

Is dental implant surgery painful?

Most people find dental implant surgery very easy to tolerate. Any post-operative discomfort can usually be managed with over-the-counter anti-inflammatory medication such as ibuprofen or OTC pain-relievers. Ice can also be helpful.

Are dental implants expensive?

At the outset, implants are more expensive than other tooth-replacement methods such as dentures or bridgework. But they also last many years longer and in fact should never need replacement. So they offer the best, most cost-effective option when viewed as a long-term investment in your health, comfort and well-being.

How do you care for dental implants?

They require exactly the same care as natural teeth: daily brushing and flossing, along with regular dental checkups and professional cleanings. Although implant teeth will never decay, the gum tissues around them can become inflamed or infected in the absence of good oral hygiene. Properly cared-for dental implants should last a lifetime.

Can my body reject a dental implant?

Strictly speaking, implants can’t be rejected because they contain no living cells or genetically coded material. The titanium of which they are made is completely biocompatible, and allergies are extremely rare. But an implant can fail to integrate with the jawbone if an infection develops in the absence of good oral hygiene, or if it is subjected to biting forces too soon. However, this is rare; implants regularly achieve success rates in excess of 95%.

Am I a candidate for dental implants?

There’s a good chance that you are, but this can only be determined after a complete oral examination that includes x-rays of your jaws. Please schedule a consultation to begin the exciting process of restoring your smile and bite.

Fixed Dentures

6If you have lost an entire arch of teeth (top and/or bottom), or are soon to have your remaining teeth removed because they are too unhealthy to save, you may be able to replace them with fixed dentures supported by dental implants. Doctors and patients alike prefer fixed over removable dentures because they:

  • Look, feel and function just like natural teeth
  • Don’t slip when you eat or talk
  • Prevent bone loss in the jaw
  • Last a lifetime

How It Works

Dental implants serve the same purpose as the roots of natural teeth: anchoring the replacement teeth to your jawbone. Just like natural tooth roots, they lie under the gum line and therefore are not visible in the mouth. Only the lifelike prosthetic teeth attached to them (the fixed denture) can be seen by you or anyone else. Because dental implants are made of titanium, a metal that has the unique ability to fuse to living bone, they are extremely stable and reliable. How many implants are needed? The number varies because each individual has unique conditions: Depending on the volume and density of the bone in your jaw, you will need as few as four implants or as many as six for your new teeth to function as well as a set of healthy, natural teeth.

What to Expect

All-on-Four.The surgery to place dental implants that support a fixed denture is a simple, routine procedure carried out in an office setting, under local anesthesia in most cases. (If you need to have failing teeth removed, that will be done first, often the same day your implants are placed). After numbing the area, the appropriate number of implants will be placed in your jaw at precisely planned angles and positions to maximize support and avoid anatomical structures such as nerves and sinuses. Depending on how many implants are needed, the surgery can take anywhere from one to three hours. Most people who have dental implants placed find that any post-operative discomfort can be managed with over-the-counter anti-inflammatory medication such as ibuprofen or acetaminophen. Some don’t even need to take that.

What happens immediately after surgery will depend on what’s best to promote healing in your individual situation. Sometimes a set of temporary teeth can be attached immediately, so that you can leave the office with new teeth. A few months later, your permanent replacement teeth with be installed. In other cases, the implants will be left to heal for several months before any teeth are attached. Sometimes that is the best way to insure that the implants remain undisturbed as they go through the process of fusing to your jawbone, which is known as osseointegration.

In either case, you will need to go easy on your newly placed implants during the crucial healing phase following surgery. You will be advised to eat a softer diet and avoid hard, chewy foods until the process of osseointegration is complete — about three months. While this may seem like a long time, keep in mind that people who wear removable dentures often avoid these foods permanently. The good news is that once your implants have fused to your jawbone and your new permanent teeth are attached, you will be able to eat anything you want. In fact, you are likely to forget you even have dental implants!

Hidden Consequences of Losing Teeth

7If you have lost any of your teeth, you no doubt realize there are consequences to living without them: Your smile may not look the way you want it to; eating, speaking and intimacy may be more difficult; and your self-confidence may fade. Though serious, these are not the only impacts. There are hidden consequences of losing teeth that affect not only your appearance but also your health.

Importantly, a loss of jawbone inevitably follows tooth loss. Bone needs stimulation to maintain its form and density. In the case of the jawbone, that stimulation comes from the teeth, which make hundreds of fleeting contacts with each other throughout the day. The small stresses produced by these contacts are transmitted to the bone, prompting it to regenerate constantly. When a tooth is lost, the stimulation it provided disappears. In just the first year of tooth loss, there is a 25% decrease in bone width. This is followed over the next few years by an overall 4 millimeters decrease in height. If enough teeth are lost, and as bone loss continues, the distance from nose to chin can decrease and the lower third of the face partially collapses. With a lack of structural support, the lips sag; that’s why toothless people often appear unhappy. Also, extreme loss of bone can make an individual more prone to jaw fractures.

You may also find that some of your remaining teeth actually shift into the spaces left open by your missing teeth. This in turn can cause additional bite problems and even jaw joint (TMJ) pain. Finally, compromised nutrition and poor general health can result if eating healthy foods like raw fruits and vegetables becomes too difficult without teeth.

Now here’s the good news: Dental implants — the state-of-the-art tooth-replacement method preferred by dentists — can prevent all this.

How Dental Implants Prevent Bone Loss

8Besides helping a person without teeth look and feel great again, dental implants actually prevent bone loss. That’s because they are made of titanium, which has a unique ability to fuse to living bone. By actually becoming a permanent part of the jawbone, dental implants stabilize and stimulate the bone to maintain its volume and density.

Dental implants are placed during a minor surgical procedure using local anesthetic and then, after a healing period, topped with a lifelike dental crown. Together, these precision components look, feel and function exactly like your natural teeth. Dental implant success rates exceed 95% — the highest of any tooth-replacement option.

Other Options for Tooth Replacement

Other than dental implants, your tooth-replacement options include fixed bridgework that incorporates or uses the adjacent teeth, and removable dentures. You should be aware, however, that the disadvantage of both of these options is that they may damage the anatomical structures on which they rest. For example, fixed bridges rely on support from two adjacent, possibly healthy teeth, which must be filed down and capped; this can make them susceptible to decay and root canal problems. Removable partial dentures hook onto existing teeth, which may become loose over time. And full dentures press on the bony ridges that used to support the teeth, accelerating the bone loss that began when the teeth were lost in the first place.

The above tooth-replacement options are all less expensive than dental implants, but only when viewed in the short term. Since bridgework and dentures may cause new problems and will likely need replacement themselves, they don’t offer the same long-term value. When viewed as an enduring investment in your comfort, health and well-being, implants offer the best return by far.

Top Reasons to Choose Dental Implants

The dental implant is today’s state-of-the-art tooth replacement method. It consists of a very small titanium post (the actual implant), which is attached to a lifelike dental crown. The crown is the only part of this tooth-replacement system that is visible in your mouth. The implant itself rests beneath your gum line in the bony socket that used to hold your missing tooth. Two, four or more implants can be used to support multiple crowns, or even an entire arch of upper or lower replacement teeth. Whether you are missing one tooth, several teeth or all your teeth, dental implants are preferred by doctors and patients alike. That’s because dental implants are:

1. Most like natural teeth

Your natural teeth have roots that keep them securely anchored to your jawbone. In a similar way, implant teeth form a solid attachment with the bone in your jaw. This is possible because dental implants are made of titanium, a metal that has a unique ability to fuse to living bone. After an implant is inserted during a minor procedure done in the dental office, it will become solidly fused to your bone over a period of several months. Once that happens, your implant-supported replacement tooth (or teeth) will feel completely natural. It will also be visually indistinguishable from your natural teeth. Implant teeth allow you to eat, speak and smile with complete confidence because they will never slip or shift like removable dentures often do.

2. The longest-lasting tooth replacements

Because dental implants actually become part of your jawbone, they provide a permanent solution to tooth loss. Whereas other methods of tooth replacement, including removable dentures and bridgework, may need to be replaced or remade over time, properly cared-for dental implants should last a lifetime. That’s what makes this choice of tooth replacement the best long-term value.

3. Able to prevent bone loss

You may not know it, but bone loss inevitably follows tooth loss. Bone is a living tissue that needs constant stimulation to rebuild itself and stay healthy. In the case of your jawbone, that stimulation comes from the teeth. When even one tooth is lost, the bone beneath it begins to resorb, or melt away. This can give your face a prematurely aged appearance and even leave your jaw more vulnerable to fractures if left untreated long enough (View Example). Dental implants halt this process by fusing to the jawbone and stabilizing it. No other tooth replacement method can offer this advantage.

4. Safe for adjacent natural teeth

Dental implants have no effect on the health of adjacent natural teeth; other tooth-replacement systems, however, can weaken adjacent teeth. With bridgework, for example, the natural teeth on either side of a gap left by a missing tooth must provide support for the dental bridge. This can stress those adjacent teeth and leave them more susceptible to decay. Likewise, a partial denture relies on adjacent natural teeth for support and may cause those teeth to loosen over time. Dental implants are stand-alone tooth replacements that don’t rely on support from adjacent natural teeth.

5. Easy to care for

Caring for implant teeth is no different than caring for your natural teeth. You must brush them and floss them daily. But you’ll never have to apply special creams and adhesives, or soak them in a glass overnight, as you would with dentures. They’ll also never need a filling or a root canal, as the natural teeth supporting bridgework might. While implants can never decay, they can be compromised by gum disease. Good oral hygiene and regular visits to the dental office for professional cleanings and exams is the best way to prevent gum disease, and to ensure your dental implants last a lifetime, as they’re designed to do.