Frequently Asked Questions
What is a dental implant?
A dental implant is a man-made replacement for the natural tooth root, made of titanium, a very biocompatible material. By utilizing titanium implants, or fixtures, your dental team can replace your missing teeth or stabilize a loose denture in a manner not available through routine dentistry. Dental implants are not transplants and therefore, cannot be rejected. Dental implants are divided into two basic categories:
- Endosteal those placed INTO the bone
- Subperiosteal those placed ON the bone
With the use of modern technologies, endosteal implants have become the most utilized implant method in use today.
How do dental implants and my natural teeth compare?
Your natural teeth are the best implants that exist. In fact, the goal of implant dentistry is to mimic the natural condition of the mouth as much as possible. However, your mouth and teeth is a functioning unit, and any loss of your teeth can cause significant changes in this function. The fewer teeth that are present in your mouth, the greater the bite forces each remaining tooth must support. As each remaining tooth is required to resist greater forces, it becomes more difficult for these teeth and any restorations to avoid failure. This failure may result in further tooth loss, which continues to compound the difficulties in rehabilitating the mouth to its natural condition. The only repair or restoration option in dentistry, which significantly increases the resistance to this bite force, is dental implants. This being the case, dental implants are often used to restore the mouth to a more natural state where each tooth or implant will equally support the bite force.
Can I have teeth immediately on my implant?
In many cases teeth can be immediately placed on implants. However, your implants will still require time for the bone to heal to them. Therefore, we recommend light function be applied to the implant during this period. The more implants that are placed, the more stable immediate teeth placement becomes.
Do my teeth help to maintain my jawbone?
Much of the jaw bone develops with the eruption of the adult teeth. After
this bone is formed, the tensile force on the bone applied by the teeth help
maintain the bone itself. If teeth are lost, because the appropriate forces are no longer being applied, the bone begins to resorb or melt away. In many cases, bone loss can be so excessive that jaw fractures may become a concern. In order to avoid this bone loss, it is essential to maintain your teeth in a healthy state. However, if teeth are lost, the ONLY methods of dental restoration that can provide the appropriate force to bone are dental implants. In fact, studies show dental implants can actually increase the bone height of the jaws when bone loss has occurred.
Does tooth loss effect your ability to chew?
The mouth operates as a unit and each tooth provides a chewing surface
which allows the mouth to effectively chew food. Therefore, missing teeth
will cause it to work less efficiently. This is of no great surprise for anyone who has lost a molar tooth. It seems as though food always finds the empty space and the natural tendency becomes to chew away from the area. It is, however, very difficult to return to the efficiency of chewing that is present with a natural set of teeth in good alignment. In fact, once tooth loss occurs, it is difficult to return to the efficiency present from a full set of teeth in proper alignment. This decrease in your ability to chew food efficiently can be as much as 15% of normal value. The same phenomenon is present with the maximum bite force (how hard you can bite down). With full dentures your bite force can decrease to 10% of your normal ability. Imagine, biting into an apple but only being able to use 10% of your strength! Fortunately, this loss of bite force can be reversed and may approach 85-90% of its normal value when tooth replacement therapies, such as dental implants, are utilized.
What options of treatment are available for tooth loss?
Fixed bridges are often used for missing teeth in the mouth. Unfortunately,
the hard enamel covering of the tooth must be removed in order to fabricate
fixed bridges, which may cause complications later. In any event fewer teeth
will be used to support the same bite force that was present prior to tooth loss. Dental implants, on the other hand, do not require the teeth on either side of the missing tooth to be treated. They are the only treatment method that actually increases the amount of support present to resist the bite forces, which are applied in normal chewing and functioning. The same situation exists for partial dentures. The force of the bite is transferred to the remaining teeth and/or gum tissue. If the gum tissue supports the partial denture, it will cause pressure to be placed on the bone in an adverse fashion and over time, will cause the bone to be lost under the denture. A loose or mobile partial denture accelerates this bone loss. Unlike fixed bridges, partial dentures need to be removed from the mouth. Dental implants, like fixed bridges, are not removed from the mouth, but they are unique in that they add support to the remaining teeth to resist the bite force and enhance bone maintenance.
Does age effect the ability to have dental implants?
Advanced age does not affect one’s ability to utilize tooth replacement
therapy with dental implants. In fact, most patients who take advantage of
this therapy are older since the need does not develop until one or more adult teeth are lost. On the younger side, skeletal growth must be completed prior to placement of implants. Dental implants offer patients the ability to return to a time when they felt confident and comfortable with their teeth and are an excellent choice for anyone who has lost a permanent tooth regardless of age.
Am I a candidate for dental implant treatment?
There are many factors that determine if implants are right for you. For
instance, you must not have any uncontrolled medical problems such as,
poorly controlled insulin-dependant diabetes. Most controlled medical conditions such as high blood pressure, osteoporosis, heart disease, chronic obstructive pulmonary disease (COPD), and joint replacement do not affect dental implant placement. However, they may affect the type of anesthetic used at the time of placement. Your implant surgeon will review your medical history, medications, and allergies with you and discuss treatment options. We invite you to openly discuss any concerns you may have with your doctor. Remember, there is no substitute for a thorough medical evaluation, and an examination by your physician may be necessary if you have not had one recently and/or you are experiencing any symptoms or problems.
How do we determine what dental implants are right for me?
Dental implants are usually placed by a team consisting of an oral surgeon
and a restorative dentist. Your team will evaluate four factors; (1) the
number of missing teeth, (2) the amount of supporting bone, (3) the force
that will be applied to the implants, and (4) the general restorative needs of each patient. Sometimes the evaluation is simple and requires minimal diagnostic tools. Other times, more in-depth studies may be necessary. You will require x-rays in the form of a panorex and/or peri-apical films, or special x-rays such as cone beam scans, molds or models may be needed as well as of your teeth to aid in the evaluation of your specific needs. Occasionally, other specialists in dentistry will be asked to evaluate specific issues that may impact your final treatment plan. Although this may seem complex, in most cases it is very straightforward and simple.
Are there any risks associated with the placement of dental implants?
All surgical procedures have risks associated with them. Some surgical risks
are universal, such as bleeding, infection, and anesthesia, mostly associated
with the anatomical structures in the area of the operation. Certain risks vary
because every patient and situation is different, but be assured, the risks of dental implant therapy is very similar to the risk of tooth extraction and restoration. When we operate on the lower jaw, the nerve to the lip can be injured resulting in numbness. When we operate between teeth, the teeth on either side can be damaged which may result in tooth loss. When we operate on the upper jaw, the sinuses can be perforated which may result in an opening or chronic infection. Fortunately, these complications are highly unusual and a thorough review of your particular risks will be covered by your surgeon and outlined in your consent process.
Is the placement of dental implants painful?
The actual placement of dental implants is usually performed under local
anesthesia and intravenous sedation, which makes the procedure very easy
for the patient. Most patients find the post-operative discomfort about the same or less than having a tooth or teeth extracted. Now if your procedure includes extensive grafting before or during implant placement, then you will likely experience more discomfort. In any event, any pain after surgery will be controlled by oral analgesics (pain pills) and will usually last a couple of days. As you are well aware, each individual will respond differently to the same level of pain. Therefore, you should anticipate your response based upon how you normally tolerate discomfort.
What determines the initial success of dental implants?
The long-term goal of dental implants is to provide you good service without
any evidence of problems. In order for them to do this, the dental implants
must heal to the bone, or osseointegrate, following surgery. If this osseointegration occurs, we consider the implant stable and successful. If it does not occur, additional healing time will be allowed. Occasionally, the implant will need to be removed and if this is necessary, the implant can either be replaced immediately or replaced after a short healing period. It is important to note, lack of integration is unusual and most implants become firmly attached to the bone within 3-6 months.
What do I need to do to maintain my dental implants?
Much like automobiles, implants, which are well maintained, are more likely
to give you trouble free miles. Smoking, although not a contradiction, will
increase your chances of problems around not only your natural teeth, but also your implants. Routine brushing and flossing of your implants will be needed on a daily basis. We will also prescribe an antibiotic mouthwash to be utilized on a daily basis. We may recommend increasing your professional cleaning appointments up to four times a year, initially, to assure that you are adequately maintaining your implants. It is necessary to see your surgeon on a yearly basis for at least the first two years to check bone height and health of the tissue around your implants. These measures will assist you in maintaining your implants.
How long do implants usually last?
Dental implants have developed an amazing track record for success. The
statistical success rate for dental implants is 98-99% for the first five years, and 80% for the first 15 years. In some cases, dental implants have been in the mouth for over 30 years! Although each person and their circumstances are different, our goal is to give you at least 80% chance of your implants to providing you with continuous service for at least 15 years.
What factors determine the long-term success of my implants?
After implants are placed in function, they must remain free of problems.
Inflammation is the usual sign that a problem is developing around a dental
implant. This is caused usually by poor oral hygiene and/or an
overload of the implant. Oral hygiene must be excellent around your dental implants. Overload of your implants can occur from bruxism (grinding of your teeth) or from changes in the bite due to slight tooth movement that occurs throughout life. In patients who grind their teeth, a night guard may be prescribed to keep them from injuring their natural teeth and implants. Routine follow-up care is necessary and usually performed with your implant team. We want your dental implants to last forever, but we cannot obtain this end without your assistance on an everyday basis.
Can my dental implants be placed for cosmetic reasons?
Although dental implants can be very natural and esthetic, the purpose
behind your implants are primarily to provide missing tooth support. Of
course, cosmetic enhancement is possible and you should discuss your expectations with your surgeon prior to treatment.
Are dental implants expensive?
Implant procedures vary greatly in the extent and complexity of the
treatment. Obviously, the more extensive the loss of the normal dentition, the more expensive the procedures can become. Patient desires too, will influence the complexity and cost of the treatment, and in some cases, the investment can become significant. In simple cases though, implant therapy is similar in cost to routine fixed bridgework. In either event, our treatment team will tailor a plan that best suits your individual needs and desires.
Will my implants be covered by insurance?
Some insurance policies will assist you in the cost of your implant treatment.
Just like most complex, restorative, dental treatments, it is unusual that you
will receive total coverage for your implant expenses. However, due to the significant variation in dental and medical insurance coverage, our office will be happy to verify if any coverage exists from your insurance.
How much time should I block out of my schedule for implants?
For routine implants, we recommend patients block out the day of surgery. Most patients can return to work the next day on mild analgesics (Advil). We will normally have a short follow-up appointment with our
surgery patients a week after placement. And then we will check the implant for healing 2-3 months after placement. Occasionally, we will have a patient return earlier to check for specific issues.
Will I have the opportunity to ask questions about my procedures?
During our consultation, we welcome all questions in order to allow your
implant experience to be an informed and pleasant one. We have found our
patients to be excited about implant dentistry and especially happy when they
see for themselves how implants have restored their chewing ability and esthetics.