Article 1 : Dental Implants
Q What are dental implants?
A A dental implant is a precision made titanium metal post which is placed into the jawbone. It is used to support one or more crown units. In practice, both the crowns and their supporting post are known as ‘implants’.
Q Are implants safe? How long will they last?
A Implants are a well established, tried and tested treatment. Modern implants often last for at least 15 years – possibly for life. Implants are a relatively new treatment alternative, and there is now research covering 20 years.
Q What are the options for replacing a gap where a tooth has been lost?
A The three main options are dentures, bridges (conventional or adhesive), and implants.
Q What are the advantages and disadvantages of each?
A The advantage of a denture is that it is cheap. The disadvantages are that they can move when eating, speaking, laughing or smiling. There is the possibility of damage to the gums. The gums and bone often continue to shrink, and the life expectancy of high-quality dentures is 5 – 12 years.
A The advantage of a bridge is that it is fixed. The disadvantages include an average life expectancy of high quality conventional bridgework of 7 – 15 years. For conventional bridgework the adjacent teeth usually have to be drilled and cut down, this is not so for adhesive bridgework, but this type can become de- bonded and fall out. Gums and bone level usually continue to shrink, and the bridge margins can become unsightly due to recession.
A The advantages of an implant are that it is fixed, it stops the shrinkage of gum and bone, & there is no damage to adjacent teeth. An implant is the most cost-effective long-term solution with a life expectancy of at least 15 years if not for life. The disadvantages are that the initial investment is higher, and there is a possibility of a longer treatment timeframe.
Q I have some of my own teeth. Can I still have implants?
A Yes. You can have any number of teeth replaced with implants – from one single tooth to a complete set.
Q Can implants always be used to replace missing teeth?
A It depends on the state of the bone in your jaw. Your dentist will arrange for a number of special tests to assess the amount of bone still there. If there is not enough, or if it isn’t healthy enough, it may only be possible to place implants with grafting bone into the area first.
Q Do implants hurt?
A Placing the implants requires a small operation. This can be carried out under local anaesthetic alone(dental injection), with sedation or with a general anaesthetic. You will not feel any pain at the time, but you may feel some discomfort during the week following the surgery. This is usually due to having stitches in place, and the normal healing process.
Q Can I have the new teeth straight away?
A Yes, sometimes this is possible, but usually the implants need to bond (integrate) with the bone after they have been placed. This takes from 3 – 6 months. If you are having one, two or three teeth replaced, you will have a temporary restoration in the meantime. If you have complete dentures, you can wear them throughout the healing period once they have been adjusted after the surgery.
Q How long does treatment take?
A It takes about 9 months from the initial assessment to the time when the artificial teeth or dentures are finally attached to the implants. However, if only the lower jaw is involved then it may only take around 5 months. A lot depends on how complicated your treatment is. Your dentist will be able to give you a timetable.
Q Are the teeth difficult to clean?
A Cleaning around the teeth attached to the implants is no more difficult than cleaning natural teeth. However, there may be areas that give you problems and you’ll be shown methods to help.
Q If I had gum disease when I had my own teeth, will I get it with the teeth attached to the implants?
A No, gum disease is the disease of the ligament that holds teeth in place, there is no such ligament with implants. It is possible for implants to become infected but this is a very rare occurrence, and if it is going to occur, then it usually happens in the first year.
Q Can I take the teeth out if they are fixed to implants?
A Most artificial teeth attached to implants can only be placed and removed by the dentist. However, if you have complete dentures fixed to the implants by bars, then you’ll be able to take them out for cleaning.
Q Do the implants show?
A Your dentist will make sure that the implants won’t show during all normal movements of the mouth and lips. You will need to be able to see them, so that you can clean them properly.
Q Do I have an implant for each missing tooth?
A No, unless you’re only having a single tooth replaced. Normally, five or six implants are used to replace all the teeth in one jaw, as each implant can usually support two teeth. For a few missing teeth, two or three implants may be used.
Q What if I get hit in the face?
A Implants and the teeth they support can be damaged by an accident in the same way that natural teeth can. However, if the false teeth are damaged and the remnants are left in the bone then they may be more difficult to remove than natural teeth would be. After healing, new implants can be placed alongside the fragments.
Q What happens if the implant does not bond (integrate) with the bone?
A This happens very rarely but is more likely to occur in a patient who smokes. If the implant becomes loose during the healing period or just after, then it should be removed and healing takes place in the normal way. Once the jaw has healed, another implant can usually be placed there. You should always ask to make sure that there will be no additional charge if integration fails and has to be redone. Or, the dentist can make a bridge, using the implanted false teeth that have ‘taken’.
Q Can I become allergic to implants.
A No. There is no known allergy published to date in medical research.
Q How do I know if I can have implant treatment?
A Nearly everyone at any age (except children and growing adolescents) can have implant treatment, and medical conditions are rarely a problem.
Q Where do I get this treatment?
A Talk to your dentist, so you can be referred to a specialist for assessment and treatment at our practice. Your dentist may already carry out some or all of this type of treatment and will give you the advice you need. Remember to ask exactly what treatment is proposed, the total cost of the treatment and what the alternatives are. If you are unhappy with any of the answers then do ask for a second opinion. You will be spending a lot of time, effort and money so you must be sure that you know what you are getting at the end of treatment.
Remember! there are now various implant systems on the market of varying quality and price. Remember also that you are paying for the experience and qualifications of the clinician who you are seeing. If you have a difficult case then we can always bring in a consultant from Guy’s or we occasionally refer to a more experienced colleague or Implant Clinic.
