What can I expect from my first appointment

At your implant consultation we will perform a history and examination that is specific to implant treatment, discuss your options (as well as their pros and cons), and provide you with an estimate for any treatment that you are suitable for - even if any of these options do not include dental implants.

 

What is a dental implant

A dental implant is a small titanium screw that is inserted into the jaw bone in order to replace the root of a missing tooth. The implant acts as an anchor onto which prosthetic teeth are attached. These attachments can be fixed or removable, single teeth or part of a larger restoration, and can join onto the implant via many different mechanisms. Implant retained prostheses can provide the greatest quality of life through excellent aesthetic and functional outcomes. Today, this is a safe and predictable procedure and is the reason why dental implants are the gold standard for the replacement of missing teeth.

 

Does a dental implant hurt

Dental implants are inserted into the jaw bone under local anaesthetic so the procedure is not painful. 

 

Just like with any other dental procedure, local anaesthetic takes away any painful sensation for a number of hours so that you can comfortably undergo the procedure without the risks that are carried by the use of general anaesthetics (where you are not conscious). 

 

Following the procedure, it is normal to experience some discomfort for 2-3 days after which symptoms should begin to resolve. In this time, you should carefully follow postoperative instructions to ensure quick and uneventful healing. 

 

Over-the-counter painkillers (analgesics) are often recommended and are sufficient to get you through this period comfortably. After a few days, and from thereon in, you will feel no sensation from your implant.

 

Does a dental implant include a crown

It is possible to use dental implants (the screw that remains inside the jaw bone) to support many types of restorations in the mouth.

 

An implant could support a single crown or a small number of teeth (called a bridge). Multiple implants could work together to support many teeth that are joined together. These are restorations that remain fixed inside the mouth and are cleaned like your natural teeth.

Dental implants can also be used to support removable teeth (known as dentures) which must be taken in and out and cleaned at home daily. A removable denture attached to implants provides function that is far superior to a conventional denture.

 

Because the type, size and materials used for the restorations listed above can vary, the price that is quoted for the implant often does not include a crown unless specified.

 

Dental Implants Cost

The cost of treatment varies depending on the complexity of the treatment and on the materials required. A consultation with a good implant dentist is often the best way to find out how much treatment would cost. This is determined by the number of implants indicated, the need for additional procedures to regenerate bone, and the type of prosthesis that will be used to restore the implants.

 

As each individual’s body and jaw is unique, you will need a bespoke treatment plan that takes into account your medical, anatomical, functional and social variances. This is impossible to produce without an in depth examination and discussion. 

 

A good implant dentist will talk you through all of your options (including those that do not involve dental implants), provide their professional recommendations and explain the reasons behind them. Following this process, and further investigations such as x-rays and jaw scans, you will receive a cost estimate that is tailored to your particular circumstances. 

 

Do dental implants last forever

Dental implants can last forever but this is not always the case. It is best to make your decision on the assumption that you will need some form of maintenance of your implant and restoration in your lifetime - the younger you are, the more likely this will be.

 

Complications related to dental implants can be categorised as short and long term, and biological or mechanical.

 

In the short run, it takes a few months for your body to grow bone onto the implant surface - a process known as osseointegration. The success rate is excellent, in excess of 95% if certain protocols are followed.

 

In the long run, biological problems can cause the development of gum disease around your implant. This is more likely to happen if you smoke, have gum disease (periodontitis), do not clean your implants thoroughly and regularly (with toothbrushes and interdental brushes), do not visit your dentist and hygienist regularly or have certain medical conditions (for example diabetes).

 

Mechanical complications can lead to chipping, staining and wear of your restoration. Over time, as with anything manmade, more extensive maintenance may be needed, such as replacing the crown/bridge/denture. Dentures are often cheaper than ceramic restorations such as crowns and bridge, but the softer materials will need replacing more frequently. 

 

If the implant under the gum is healthy, then replacing the restoration on top is normally straightforward but can be costly and should be factored into your decision.

 

Same Day Dental Implants

Once your bone has grown on to the implant (a process called osseointegration) the risk of complications when attaching teeth to the implants (referred to as ‘loading’) decreases. It is possible to attach restorations to your implant before this process is completed, but this will increase the risk of complications or failure. The gold standard and best way to ensure that your dental implants integrate into the jaw bone successfully is to wait for a minimum of 8 weeks before making a custom restoration. In the meantime, another type of temporary restoration (such as such a denture or bridge) can be used to fill the gap so that you can smile.

 

Should you replace missing teeth

In short, you do not have to. You may replace missing teeth because you are conscious of smiling without them, are having difficulty chewing, are not enjoying your food as much as you used to, or need to support the remaining teeth that are under greater pressure. Implants can also help to preserve jaw bone and face shape to reduce the appearance of ageing. Over time, the jaw bone shrinks after teeth are lost and adjacent teeth can move or tilt; both of these circumstances could prevent or complicate the possibility of dental implants in the future.

 

If you are considering dental implants, this website by the Association of Dental Implantology (ADI) contains factual, evidence based guidance for patients considering treatment. The ADI is a charity that provides impartial advice as it has no commercial interests.

 

What does a dental implant look like

A dental implant is a very small titanium screw. This is the part that stays inside the jaw bone and is not seen. The prosthesis attached on top looks just like your natural teeth.

 

What does a dental implant feel like

A dental implant cannot be felt as it sits inside the jaw bone, under the gum. The restoration will feel similar to your natural teeth. It may feel different when first attached to your implant but you will quickly become used to the shape, size and texture of your prosthesis.

 

Is a dental implant worth it

The honest answer is that it depends on the problem you are trying to solve. If you lost a tooth a long time ago and have not replaced or missed it then dental implants are unlikely to add value to your quality of life. The exception is if your dentist recommends replacing missing teeth in order to prevent problems associated with the overuse of the remaining teeth.

 

If you have a tooth gap that bothers you or you wear a removable denture then it is likely that dental implants could well be worth it for you.

 

Is a dental implant safe

Yes. As with any minor surgical procedure, it carries risks that your dentist will be able to explain to you. These risks are dependent on your own circumstances, the site of the implant and your individual anatomy.

 

The gold standard for diagnosis and planning is the use of Cone Beam Computed Tomography (CBCT) scans which are relatively low dose x-rays that provide your implant surgeon with an accurate 3D model of your jaw. This can be used to further minimise the risk of complications associated with implant placement.

 

Is a dental implant better than a crown

Dental implants replace the part of the tooth below the gum (known as the root). A crown restores the part of a tooth that is above the gum. If a tooth can be predictably restored with a crown then it is better to save the tooth. Dental implants are a good alternative for missing teeth but they are not better than your natural teeth.

 

Dental implant problems

Problems with dental implants can range in type and complexity. Problems often involve crowns that have become loose and need tightening (a simple, quick and painless process if the right tools are at hand). Our minds often go to the worst case scenario so it is best to see your dentist before panicking. Ideally you should go back to the surgeon that placed and restored your implants as they will have accurate records and the right tools to help you.

 

How long does a dental implant procedure take

Depending on the number of implants being placed, the complexity of the procedure and whether you are having teeth removed on the same day, the time you spend in the dental chair can range from 45 minutes to a few hours. Your implant dentist should be able to give you a better idea.

 

Do dental implants look real

There are two parts to making an implant retained prosthesis look natural. The camouflage is dependent on the pink aesthetics (gum) and the white aesthetics (teeth). The pink aesthetics are the most difficult part and will depend on:

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  • the healed shape and texture of your gums following tooth loss 

  • the surgical techniques used by your dentist and your subsequent healing 

 

The appearance of your teeth (white aesthetics) will be down to the quality of the dental laboratory and skill of the dental technician creating the teeth. Sometimes it is not possible (or very difficult) to restore the natural appearance of the area where you lost the tooth or teeth. Your dentist will be able to warn you about this and suggest ways in which the outcome could be improved when they are planning your treatment. If you show a lot of gum when you smile then it is more difficult to hide these areas. This may be a consideration in your choice of treatment and again, your implant dentist will be able to talk you through this.

 

What is the dental implant procedure

The appointment where you have your implant placed typically involves the following steps:

 

  • Local anaesthetic to numb the area

  • The gum raised in the area where the implant is being placed

  • A series of drills being used to create space for the implant

  • The implant being gently placed into the jaw

  • Stitches to hold the gum in position

 

It is common for patients to exclaim their surprise at how straightforward and comfortable this process is.

 

Do dental implants cause cancer

In short, no. Despite the vast number of implants placed on a global scale, there is no evidence to suggest this. In the UK alone, over 10,000 implants are placed in the lower jaw (mandible) alone every year. This is a safe and common procedure.

 

Gum Disease Treatment

Gum disease can affect implants and is more likely to occur if you have a history of gum disease (periodontitis) around your natural teeth. Cleaning your teeth well everyday is essential in maintaining the gum health around your implants. 

 

Smoking is also a big risk factor for peri-implant disease and will affect the longevity of dental implants.

 

It is important to see a dentist and dental hygienist regularly for monitoring and maintenance of your gum health. Gum disease around implants can rarely be felt so it is not something that you will notice in time.

 

Initial signs of peri-implant gum disease can be spotted early and rectified by adjusting the way you clean - perhaps with something as simple as changing how you hold your toothbrush! This early form of disease is called peri-implant mucositis. If plaque is removed effectively and regularly then the condition is reversible and your gums will become healthy again.

 

If the problem is not addressed early, or if your peri-implant gum disease is resistant to conservative measures, then the disease can progress to peri-implantitis, where bone around the implant is lost. This does not necessarily lead to loss of the implant, but this gradual process can be difficult to stabilise and could eventually lead to loss of the implant. 

 

Treating peri-implantitis can involve minor surgery which does not always work. In order to maximise the chances of success, oral hygiene must be excellent and where applicable, smoking has to have stopped. Even if treatment is successful in stabilising the condition, the damage is often irreversible and may lead to the implant not looking or feeling as nice as it used to.

 

Do I have enough bone

The only way to evaluate the availability of bone for dental implants is with x-rays. The best form of x-rays to use for implant planning are Cone Beam Computed Tomography (CBCT) scans because they give an accurate 3D picture of your jaw bone, nerves and other anatomical features. It will be difficult for your implant dentist to answer this question before having a scan, but it is worth discussing your suitability for treatment before being referred for this scan.

 

Can dental implants cause nerve damage

Yes, they can. However, if the surgery is well planned then the risk is extremely low due to the advent of modern diagnostic and surgical techniques. Cone Beam Computed Tomography (CBCT) scans  will give an accurate three dimensional picture of vital structures such as nerves. This plays a key role in selecting the size and location of implant that can be carefully placed to minimise the chances of nerve damage.

    ©2020 by Aly Virani