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Dental Implants FAQ's

How can I tell if I am healthy enough to have dental implants?

Generally speaking, if a person is well enough to undergo the treatment necessary for fixed bridgework or routine tooth extractions, the same patient can undergo dental implant procedures.  Also, patients may have general health conditions that would contraindicate implant procedures, although this is unusual.  The best form of implant treatment for you is determined after a thorough examination.  The amount and location of available bone determines whether you are a good implant candidate.

Where dental implants are concerned, are there risks of the body rejecting them?

When people hear the word "rejection" in connection with implants, they are usually describing conditions that can occur where there has been surgery that involves transplanting a vital organ such as a heart.  However, dental implants fall into an entirely different category due to the fact that tissue matching, blood typing.  The body completely accepts placement of dental implant material (like orthopaedic materials such as hips etc which are similar) within bone; therefore, today's dental implants have great success.  However, success has more to do with proper patient selection, proficiency and experience of the dentist, and the patient's commitment to proper hygiene and ongoing maintenance.  Another factor in success involves regular follow-up care, just like any other form of dental treatment.  Both gum health and the way the replacement teeth function and bite together must be evaluated regularly to ensure long-term success of the treatment.

How long will implants last?

How long do teeth last?  They should last a lifetime.  However, we all can name examples where teeth have not served for a patient's lifetime.  We know that dental problems mostly stem from improper home care, lack of treatment when needed or plain and simple poor quality dentistry.  The same holds true for implants.  With proper care and routine dental check-ups they should last a lifetime.  No one can give guarantees because the health of a person is dependent upon many factors which are out of the control of the dentist, e.g., proper nutritional needs being met, proper hygiene, genetics, disease processes which might occur.  So, the answer to this question really is that no one knows how long each individual implant will last... one's success can be influenced by the way you live and the quality of dentist that you have chosen to do your implants... these things can tip the scales in your favour.

Do implants require special care?

Treat dental implants as natural teeth and look after them that way.  Return for regular check-ups.  Brush and floss.  Realize also, that caring for the gums is the best way to care for one's teeth.  More teeth are lost as a result of gum disease than any other cause.

Is the placement of implants painful?  How long does it take?

Implant placement does not usually result in much post-operative pain or discomfort -usually the patient takes Paracetamol or Ibuprofen for a couple of days.  If more extensive treatment is needed, for example bone grafts or many implants, then the post-operative course may require more time and medication. Local anaesthesia during the surgery will make the placement procedure pain-free. 

How long does the whole dental implant process take?  Will I be without teeth or unable to eat for a long time?

The first stage of treatment, after a detailed evaluation and treatment plan, is usually the actual placement of the implants.  This procedure is generally done in the dental practice during one visit.  Most implants will remain covered, underneath the gums, for 3 to 6 months.  During this time, osseointegration --the biological bonding of the jawbone to the implant--occurs.  During this healing period, you will wear your modified denture, a temporary denture or temporary bridge and carry on with normal life.  You will need to follow a modified, soft diet for the first couple of weeks. There are occasions, one-stage implant placements or when extensive bone grafting is to be performed, when patients may be asked not to wear their removable dentures for a period of time. When this is necessary we'll do all we can to help our patient through this transition?

The second phase of the procedure is usually 3-6 months after implant placement.  At this time, the top of the implants will be uncovered from under the gums and a small metal post or extension will be attached to the implant(s). 

In the third phase, which usually starts 2-6 weeks after the second phase, your new replacement teeth are created and fitted.  This phase involves a series of appointments to make impressions of your mouth and to "try-in" your replacement teeth at key steps in their fabrication.  The try-in sessions are necessary to ensure that the size, shape, colour and fit of your new teeth will completely blend with and match your individual facial characteristics and remaining natural teeth (if any).  The third phase is usually completed within 4 to 8 weeks.  Total treatment time for most implant cases will usually be 5-8 months.  It could be longer if bone or gum procedures are needed.

I've heard that dental implants are experimental - is that true?

Absolutely not!  Dental implants have a long history of use and success.  Implants are the most thoroughly researched treatment in the history of dentistry and, while no procedure is 100% successful, the current technology has resulted in very high success rates in the hands of well-trained and experienced clinicians. 

I've heard that dental implants are expensive.  How much do they cost?

The procedure can involve a significant investment, with surgical fees ranging from £2500.00 and up for a single tooth replacement (the cost is about the same as a conventional "3-tooth bridge") and from £5,000 up for replacement of multiple missing teeth.  However, the cost of non-treatment can be considerably more expensive.  Continual bone loss occurs from the wearing of full and partial dentures.  This progressive loss of bone can eventually cause nerve exposure, jaw fracture and a complete inability to function with regular dentures.  Correction at this point may be very expensive and can involve extensive bone grafts, which may require hospitalization and an extended recovery period. Placing implants before the bone loss becomes severe not only saves money in the long run, but also slows the bone loss process, increasing the likelihood of long-term success.

I must have some teeth extracted and I intend to have implants placed to restore my ability to chew.  Can a dental implant be placed at the same visit as the teeth are extracted?

Whether or not the implant can be placed immediately after extraction depends on the amount of available bone in the area and presence or absence of infection.  Placing the implant at the same visit helps preserve both width and height of bone and may prevent the need for placing bone grafts when bone naturally shrinks back after teeth are extracted.  During the first 12 months after teeth have been removed, as much as 40% of the width of the jawbone can be lost.  Sometimes, infection from a tooth or periodontal (gum) disease has destroyed the bone to such an extent that it becomes necessary to do a bone grafting procedure prior to implant placement.  If it is possible to place the implant at the same visit as the teeth are extracted, this can save at least three months in healing time compared to waiting for an extraction site to heal before the implants can be placed.

Why do dentures lose their fit?

In most cases, the pressure of dentures or partials on the tissues causes gums to get "flabby" and bone shrinks over time. When this occurs, the dentures usually become loose and awkward even when adhesives are applied, much like the way clothes become baggy when one loses weight, and this causes more bone loss and gum problems. With dental implants, bone loss as well as gum erosion are slowed. Unlike dentures, which put pressure and stress on top of the gums and jawbone, endosseous ("in-the-bone") implants are actually surrounded by bone and the chewing forces transfer pressures into the bone, much like teeth do. This actually can strengthen the bone and increase bone density, reducing the bone shrinkage seen regularly from dentures.

I have a tooth that is broken and my dentist recommended extraction and a bridge, but I'm not keen about grinding down the perfectly good teeth on each side to make a bridge --could an implant work here?

Most likely an implant could work very well in this situation. Filing down teeth weakens them and makes them more susceptible to decay, gum problems and possible root canals. Sometimes a bridge is still the best alternative, but an implant can often be a better option. An implant will be easier to clean and floss, won't require attachment to or damage other teeth and is as close as we can come to naturally giving you back your missing tooth.

Can any dentist give me an implant?

Under current GDC guidelines, yes!!!! But, with any medical or dental procedure, not all practitioners have equal training or experience with dental implant treatment. Also, for every procedure, there is a "learning curve" and ideally you want practitioners with significant experience to help you with implant treatment so you are likely to get the best possible result.

I need to replace two missing teeth next to each other. Can I just have one implant placed and attach it to one of my natural teeth and make a bridge?

Generally, this is not a good idea-over the years we have learned that it is generally much better not to attach implants to teeth. We frequently attach implants to each other, which can improve strength and works well. So in a case like this, although it may be more expensive in the short term to place two implants instead of one, the long-term success is likely to be much better with the two implants.

I am missing most of my back teeth and do not wish to lose any of my remaining front teeth. I've been through several sets of removable partials and could not wear any of them. Could I have teeth that stay in all the time to replace my teeth missing in the back and keep my remaining teeth in front?

This situation is very common. First of all we will do everything possible to help you keep as many of your remaining natural teeth as long as their supporting structures are sound. Supporting structures means the gum and bone immediately surrounding the tooth. A thorough evaluation must be made to determine if a tooth is healthy enough to keep or not. We do not want remaining unhealthy teeth to compromise the success of any new treatment performed whether it be dental implants or other treatment. We must then decide what is best for your specific needs in order to restore your missing back teeth. If you have had problems with removable partials, then dental implants used to anchor new replacement teeth may be the best answer for you.

I lost my upper back teeth on one side and have gone for years without doing anything about it. My sinuses always seem to bother me more on that side than on the side that I have back teeth. Could these problems be related to one another?

A situation that occurs in a large number of patients who have had their upper back teeth missing for a long period of time is the increasing downward growth of the sinus. At birth it is the size of a pea, and progressively grows as the skull matures. This growth is at the expense of the surrounding bone. If you are considering replacing those upper back teeth with fixed teeth that stay in all the time, it may be necessary to perform a sinus lift procedure to allow room for placement of dental implants into this area to support those teeth. This involves placement of bone and/or bone substitutes into an area, which was previously occupied by the lower part of the maxillary sinus. These bone graft materials act as a matrix or scaffold, which is replaced by the patient's, own new bone. This raises the floor of the sinus, reduces sinus volume and may allow the sinus to drain easier. Most importantly, this procedure increases the available bone use to place implants and restore the missing back teeth.

Both of my parents have worn complete dentures for many years, as have my grandparents. Recently, I lost two of my teeth. Does this mean that I will eventually have to have dentures?

Tradition seems to say that someday we will lose our teeth and then succumb to the inevitable denture. Today the reality is that we can essentially keep all of our teeth throughout our lives... But what about those, such as yourself, who have either already lost some or all of their teeth or are about to? Dental implants could be the answer. We can replace single teeth, several teeth in a section of the jaw, or entire arches of teeth. Some people are more prone to tooth decay or periodontal disease and more apt to lose teeth than others are. If you have a family history of denture use, you should make every effort to save your teeth -and you may never need dentures. If you do lose one or more teeth, implants may be a good option to prevent the need for dentures.

I've had dentures for several years and have lost a lot of jawbone. My lower dentures are floaters and I need help. Is there still hope for me?

In most cases, with the new options available today in the field of dental implants, some form of treatment can be done. We encourage people to get help as soon as possible if they are already having some problems with their current situation. These problems include: excessive use of denture adhesives, chewing only soft food, unable to taste some foods, constant mouth sores, unhappy with the appearance of one's teeth and bite position (in some cases the nose and chin getting closer together). The sooner the problems are corrected with dental implants the more choices one has available for treatment. If you have any or all of the above symptoms, implants could very well be the answer for you.

I have been a denture wearer for many years now and use denture adhesives to hold my teeth in place and am getting tired of the constant bad taste and mess in my mouth. Could dental implants eliminate using adhesives?

A common complaint is having to constantly add adhesives to secure dentures, especially after drinking a cup of coffee or eating a meal. This can really be a nuisance when eating out at a restaurant and having to excuse yourself from the table to go to the rest room because your dentures won't stay in. Laughing, sneezing and coughing can also cause trouble for people who depend on adhesives to hold their teeth in place. It may be funny to see another person having a denture fall out, but it is not funny to the person who has to deal with these embarrassing situations on a daily basis. Denture wearers with problems such as these are not alone. There are 30 million people in the United States with no teeth and 29% in this group chew only soft foods.

I have a full set of dentures. My uppers are fine, but my lowers are constantly a juggling act when I try to eat. Can I have implants on the lower and keep a full denture on top?

Absolutely. Your situation is a common one. The full lower denture is the most unstable prosthesis fabricated in dental practice. During chewing, the average lower denture moves five times more than an upper denture. The person with advanced bone loss has additional problems of poor muscle coordination, speech difficulties, and inability to keep the denture in place, all of which adversely influence a normal lifestyle. Dental implants can be the solution to all of these problems. Even in cases where a lot of bone loss has occurred there still is a good chance something can be done. In most cases, a thorough oral exam and a panoramic x-ray is essential.

I am missing all of my teeth and am now wearing a full upper and lower denture. I can no longer tolerate my lowers. Will I need an implant for every tooth I am replacing on the lower jaw?

It is not necessary to have an implant for every tooth that is being replaced. The number of implants necessary to provide support depends on the type of implants used and the type of teeth (removable vs. non- removable) that will be attached to the implants. For example in this case, if you're a good candidate for endosseous (in-the-bone) implants, you may require between 2-8 implants, depending on the technique used to support a full compliment of lower teeth. A thorough oral exam and panoramic x-ray is all that is necessary in most cases, to determine which implant can be used and how many must be used. Sometimes additional x-rays or CT scans are used in more complicated cases.

My husband lost all his teeth from gum disease. He refuses to wear "false teeth". Would implants give him the look and function of natural teeth?

It is possible to replace an entire arch of teeth with non-removable teeth supported by dental implants. Each individual presents a different combination of factors and these factors will determine which type of implant will be best suited for them. The end result is the elimination of the denture as we now know it. The ability to function socially and eat properly is the driving force behind the development of dental implants. These procedures will provide you with stable teeth, in many cases, for the first time in years. A removable denture can be retained and supported by several implants joined by a bar or the missing teeth can be restored with fixed or removable bridges anchored to 5 to 8 implants. Implants are a viable and functional way to help improve one's quality of life and health.

I consulted a dentist several years ago about using dental implants to replace my lower denture and he told me that I did not have adequate bone available to place enough in-the-bone implants without danger of fracturing my now fragile jawbone. Are there any alternatives?

Because of the advances in the field of dental implantology, there are now more choices and techniques. It's the rare person that cannot receive an implant or a combination of implants. Today we have available many types of implants designed to accommodate multiple problems. As an example, if adequate bone is not available in the front or the back part or the jaw for in-the-bone implants, an over-the-bone type implant can be placed in both areas and non-removable teeth can be made to attach to the implants. Over-the-bone implants have been used successfully in dentistry for over 30 years. An implant of this type also has the added advantage of strengthening a fragile jawbone, which can help prevent a fracture. The ability to utilize multiple implant techniques is an essential ingredient to the successful use of implants. No one design will cover all situations. Bone grafting techniques have improved remarkably and in many instances we can do these procedures in our office. Bone grafts can strengthen the jaw and supply additional bone for implant placement.

I can't keep my upper denture in place for very long without gagging. I also can't taste or feel the temperature or texture of food very well, so eating is not the pleasure it once was -can implants help me?

Probably. Upper dentures cover the roof of the mouth and go back to the soft palate to get support and "seal" so they will stay in place. Unfortunately, this results in covering up the palate and many taste buds. By using implants to anchor or support an upper prosthesis (either removable or nor-removable replacement teeth), the roof of the mouth can be left uncovered so one won't gag, and can feel the texture, temperature, and taste of foods and beverages much better.

I had a root canal on a tooth that fractured and now it has to be removed. Can it be replaced with an implant or do I have to have a bridge or a partial?

Teeth that have root canals can fracture more easily than other teeth because they are weaker and somewhat dehydrated. They can sometimes be as brittle as glass. In the past the best available treatment was to remove the tooth and file down the adjacent teeth and make a bridge - caps on the adjacent teeth with an attached "dummy" tooth in between. Sometimes this still is the only way. However, in many cases an implant can replace the fractured tooth and no teeth need to be ground down at all.

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