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Health Story: The Dentist Who Changed My Life

After a long history of unpleasant experiences, Jonathan finally found the right dentist. Read his story.
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Dental Implants

By

Megan Freedman

What is a dental implant?

Dental implants replace missing teeth with artificial teeth that are as strong and functional as natural teeth. A dental implant consists of a metal post inserted into your jawbone, which acts like a tooth root. The post is attached to a connector that is attached to a false tooth (crown) or dentures. Dental implants restore your ability to chew and speak, improve the appearance of your smile, and preserve your facial structure.

It is important to replace missing teeth because this condition can lead to the loss of jawbone tissue and the shifting of other teeth. This can result in changes in facial structure and problems with biting, chewing and speaking. 

A dental implant preserves the bone in your jaw and facial structure and is as functional and strong as a natural tooth. Dental implants can last a lifetime with proper care. Other tooth replacement options, such as bridges and removable dentures, fill gaps from missing teeth and help to improve or maintain facial structure. However, they do not save bone tissue and they generally need periodic replacement or repair.  

Placing a dental implant is generally considered safe, but there are risks and potential complications. A dental implant is only one method used to replace missing teeth. Discuss all of your treatment options with your provider to understand which options are right for you.

Types of dental implants

Types of dental implants include:

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  • Endosteal implants are screw-like devices drilled directly into your jawbone, like a natural tooth root. They are the most common type of implant.

  • Subperiosteal implants are titanium frameworks secured underneath your gums on top of the jawbone. They are used when there is not enough bone to insert implants directly into the bone. Subperiosteal implants are used in people who have lost jawbone after having missing teeth for a long time.

Your dental implants can be used to support two different types of false teeth. They include:

  • Implant-supported dentures are used when you have many missing teeth. They are similar to conventional dentures because they are made of false teeth attached to false plastic gums. However, implant-supported denFtures clip directly onto a post that is attached to your implants in the jawbone instead of lying loosely on your gums as traditional dentures do. Attachment of implant-supported dentures to the jaw prevents them from sliding and making noise when you eat or talk. You can remove implant-supported dentures yourself to clean and care for them.

  • Single-tooth or multiple-tooth fixed implants are not removable. They consist of individual false teeth (crowns) that are attached to abutment connectors that are secured to your metal post implants in the jawbone.

Other procedures that may be performed

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Your provider may perform other procedures before your dental implant procedure to improve the strength and security of the implant. These include:

  • Ridge modification builds up bone in your jaw so it can hold a dental implant securely. Ridge modification involves peeling back the gums and adding a bone substitute or bone from another part of your body to your jaw. You will likely wait several months to a year for the new bone to heal and develop before it is ready for a dental implant. Sometimes, a dental implant is placed during the same procedure.

  • Sinus lift surgery allows the upper back jaw to hold a dental implant securely. The back upper jaw is the area under your sinus cavity. Sinus lift surgery involves peeling back the gums, pushing a small area of bone higher up into the sinus cavity, and filling the space with bone from another part of your body or a bone substitute. You will likely wait several months to a year for the new bone to heal and develop before it is ready for a dental implant. Sometimes, a dental implant is placed during the same procedure.

  • Tooth extraction removes any teeth that are damaged or decayed beyond repair.

Why is a dental implant performed? 

Your dentist may recommend a dental implant to replace a missing tooth, several missing teeth, or to provide you with an entire set of stable dentures that attach to the jawbone. A dental implant is not appropriate for everyone. Many factors go into determining who is a candidate for a dental implant, so talk to your dentist about your situation and the best treatment option for you.

It is important to replace missing teeth because this condition leads to the loss of jawbone tissues and the shifting of other teeth. This can result in changes in facial structure, an aged appearance, and problems with biting, chewing and speaking. 

A dental implant attached to the jawbone prevents bone loss in the jaw and teeth shifting, and preserves facial structure much like a natural tooth does. 

Missing teeth can be due to:

  • Genetic diseases or mutations

  • Severe tooth decay or periodontal disease requiring and tooth extraction

  • Tooth, mouth, facial or jaw injury or damage

Who performs a dental implant procedure?

Different doctors are often involved in the dental implant process. An oral surgeon may perform surgery to help strengthen the bone material on your jaw. Either an oral surgeon or a dental specialist will place your implant, and another dental specialist may fit the crowns that create your new teeth. 

The following providers may be involved with your dental implant process:

  • General dentists prevent, diagnose and treat diseases and conditions of the teeth, gums, mouth, and associated structures of the jaw and face.

  • Oral and maxillofacial surgeonsperform surgery on the teeth, jaw, gums and face.

  • Pediatric dentistsspecialize in caring for the dental needs of children and teens.

  • Periodontistsspecialize in treating gum disease (periodontitis) including
    procedures that regenerate bone and gum tissue lost due to gum disease.

  • Prosthodontists specialize in restoring damaged teeth with crowns, bridges and other devices.

How is a dental implant performed?

A conventional dental implant procedure includes inserting dental implants and the crowns or dentures that create your new teeth. This typically requires two or more procedures performed over several weeks or months. Some implants may be completed within 48 hours after placement.

The number and types of procedures depends on various factors. These include the quality and density of the bone in your jaw, the number of teeth that you need to replace, and the type of dental implant.

Types of anesthesia that may be used

A dental implant may be performed using one or more types of anesthesia, depending on the procedure, your comfort level, and other factors. 

Anesthesia may include:

  • General anesthesia is generally a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.

  • Intravenous (IV) sedationis a type of conscious sedation or twilight sedation. You will receive sedation medication intravenously (through an IV). You will be relaxed and generally unaware of the procedure and likely not remember it.

  • Local anesthesiais the injection of anesthetics into the gums near your tooth. This temporarily numbs pain in a certain area of the mouth. Your dentist may apply a painless topical anesthetic to numb the gums partially before the injection.

  • Nitrous oxide is sometimes called laughing gas. You will breathe a combination of gases (nitrous oxide and oxygen) through a nose mask. These gases provide pain relief and help you feel relaxed and less aware of discomfort.

What to expect during your dental implant process

The dental implant procedure varies depending on your needs. It includes X-rays and making models, an important part of the process. The process generally includes a combination of following:

  1. Your provider will insert your dental implant post(s) into your jaw. This involves making a cut in your gums in the area of your missing tooth and drilling a hole in your jawbone. Your provider will insert the implants in the jaw then stitch your gums over the implant so that it is not visible.

  2. Your provider may give you a temporary removable false tooth or set of false teeth to wear over the gap in your teeth.

  3. You may then wait several weeks to several months for your new implants to bond strongly with your jawbone. This process is called osseointegration. It helps ensure that the implant is stable and secure enough to chew and function normally.

  4. Your provider will make a cut in your gums, attach a small abutment connector to the top of your implant, and stitch your gums closed around the abutment. Your abutment connector will protrude above the gums and connect your new false tooth (crown) or dentures to the implant post.

  5. Your provider will make a rubber mold (impression) of your abutment connector and the teeth around it. Your provider uses the impression of your teeth to make a customized crown that fits snugly over the abutment connector and between surrounding teeth. For denture wearers, impressions are taken of the jaws without teeth to make a custom-fit denture.

  6. You will return a few weeks later after your gums have healed around your abutment connector. Your provider will then place your permanent crown or dentures.

  7. The crown or dentures are examined and tested for proper fit. This may involve grinding them to ensure a proper bite. You may need to return for painless adjustments to ensure a comfortable bite.

Will I feel pain?

Your comfort and relaxation is very important to you and your care team. You may feel brief sharp pinches when your dentist injects your gums with local anesthetic. Ask your provider if your gums can be partially numbed with a painless topical anesthetic before the injections. 

You may also feel pressure as your provider works on your gums and bone. Take a few long, deep breaths to help yourself relax. Tell your provider if any discomfort does not pass quickly.

What are the risks and potential complications of a dental implant?  

Any dental procedure involves risks and potential complications that may become serious in some cases. Complications can develop during dental implant procedures or your recovery. Risks and potential complications of a dental implant include:

  • Allergic reaction to the materials used in the implant, crown, or implanted dentures

  • Anesthetic complications, such as allergic reaction and nerve or blood vessel injury

  • Chipping, loosening, and loss of crown or dentures

  • Implant failure

  • Infection of the implant site

  • Mouth or tooth injury

  • Nerve damage

  • Sinus injury if an implant in your upper back jaw intrudes into your sinus cavity

Reducing your risk of complications

You can reduce the risk of certain complications by:

  • Following activity, dietary and lifestyle restrictions and recommendations before your implant procedures and during recovery

  • Informing your provider if you are nursing or if there is any possibility of pregnancy

  • Notifying your provider immediately of any concerns after the implant procedures such as pain, fever, and difficulty chewing

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies, especially metal allergies

How do I prepare for my dental implant?

You are an important member of your own dental care team. The steps you take before your dental implant can improve your comfort and outcome. You can prepare for a dental implant by:

  • Answering all questions about your medical and dental history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications and allergies at all times.
  • Taking or stopping medications exactly as directed
  • Telling your provider if you are nursing or there is any possibility of pregnancy

Questions to ask your provider

Having a dental implant can be stressful. It is common for patients to forget some of their questions during an office visit. You may also think of other questions after your appointment. Contact your provider with concerns and questions before your procedure and between appointments.

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • Am I a good candidate for a dental implant?

  • How many and what kind of dental implant procedures will I need?

  • Which dental and medical providers will be involved in my dental implant process and how?

  • How long will each procedure take? When will I go home?

  • What are my options for types of implant and crown/denture materials?

  • What restrictions will I have after the implant procedures? When can I expect to return to eating, work, and other activities?

  • How do I take my regular medications?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my dental implant?

Knowing what to expect can help you get back to your everyday life as soon as possible.

How will I feel after my dental implant?

Your mouth, gums and tongue may feel numb for a few hours after a dental implant procedure if it involved local anesthetic. This is because the local anesthetic will take time to wear off. You may also feel drowsy if general anesthesia or IV sedation are used during your procedure.

You may also feel some pain, tenderness, bruising, swelling and bleeding in the affected area of mouth. Your provider will treat your pain and discomfort as needed. Tell your provider if these symptoms worsen or continue past a few days because they can be a sign of a complication.

When can I go home?

Dental implant procedures are generally done on an outpatient basis. You will probably go home and resume most of your normal activities shortly after a dental implant. 

You may still be a bit drowsy and will need a ride home from your procedure if you had sedation or general anesthesia. You will not be able to drive for about 24 hours, and someone should stay with you during that time. 

Your provider may instruct you to wait to eat and drink until after a local anesthetic has worn off and you can feel your mouth and tongue again. This will help prevent you from accidentally biting your mouth or tongue. 

Your provider may recommend that you consume only liquids or soft foods for a period of time after a dental implant procedure. This can help your bone and gums heal and reduce discomfort. 

When should I call my provider?

You should keep your follow-up appointments after your dental implant procedure. Call your provider if you have any concerns between appointments. Call your provider right if you have:

  • Bleeding or draining from the gums that is heavier than expected

  • Fever

  • Pain in your gums or teeth that is worse than expected or not responding to your pain medication

  • Problems biting or chewing after your implant has healed

  • Swelling that does not go down within a few days

Seek immediate medical care if you have itching, hives, sudden mouth or tongue swelling, or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing. This may be due to a rare allergic reaction to the anesthetic or the dental implant.

How might a dental implant affect my everyday life?

A dental implant will preserve the bone in your jaw and facial structure and is as functional and strong as a healthy natural tooth. 

A dental implant allows you to chew, drink, and speak more normally than conventional dentures. It will also last longer and feel more stable than a dental bridge. It may also help you feel better about your teeth’s appearance. 

A dental implant inserted into your jawbone can last a lifetime with proper care. This includes daily care just like a natural tooth. You should continue to brush twice a day and floss your teeth once a day. Visit your dentist for regular cleanings and checkups as recommended to ensure that your implant and its crown or dentures still fit and work well. 

Crowns and dentures attached to the implants can experience wear and tear and might eventually need replacement, generally after 5 to 15 years. Ask your dentist how long your dental crown that is attached to your implant should last. 

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 11, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Crowns. Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....
  2. Crowns. Mouth Healthy by the American Dental Association. http://www.mouthhealthy.org/en/az-topics/c/Crowns.aspx.
  3. Dental Implants. American Academy of Cosmetic Dentistry. http://www.aacd.com/index.php?module=cms&page=569.
    Dental Implants. American Academy of Periodontology. http://www.perio.org/consumer/dental-implants.
  4. Dental Implants. American Association of Oral and Maxillofacial Surgeons. http://www.aaoms.org/dental_implants.php.
  5. Dental Implants vs. Fixed Dental Bridges. American Academy of Cosmetic Dentistry. http://www.aacd.com/index.php?module=cms&page=570.
  6. Full Mouth Dental Implants. American Academy of Periodontology. http://www.perio.org/consumer/full-mouth-implants.
  7. Multiple Tooth Dental Implants. American Academy of Periodontology. http://www.perio.org/consumer/multiple-tooth-implant.
  8. Ridge Modification. American Academy of Periodontology. http://www.perio.org/consumer/ridge-modification.
  9. Single Tooth Dental Implants. American Academy of Periodontology. http://www.perio.org/consumer/single-tooth-implant.
  10. Sinus Lift Surgery. American Academy of Periodontology. http://www.perio.org/consumer/sinus-augmentation.
  11. Tell Me More About Dental Crowns. Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....
  12. What are Dental Implants? Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....
  13. Oshida, Y, Tuna, EB, Aktoren, O, and Gencay, K. Dental Implant Systems. Int J Mol Sci. 2010; 11(4): 1580–1678. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2871132/.

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