Dental Implants
What are dental implants?
Step-by-Step: Getting a Dental Implant
1. Initial Consultation and Planning: We will evaluate your mouth with an examination and imaging (often a 3D CBCT scan) to ensure you have enough bone for an implant and to plan the precise location. We’ll review your medical history to confirm you’re a good candidate (generally, most healthy adults are). If a tooth is present and needs extraction, that might be done first, sometimes with bone grafting at the same time to preserve bone for the implant.
2. Implant Surgery: On the day of surgery, the area is thoroughly numbed (and sedation options can be used if you are anxious – see Sedation Dentistry section). The dentist or surgeon makes a small incision in the gum to expose the bone. Using special drills, a channel is created in the bone at the predetermined location and angle. The titanium implant is then inserted into this socket and acts as a root. In many cases, we then place a cover screw or healing cap on the implant and stitch the gum tissue back over or around it. You won’t feel pain during this, but you may feel pressure or vibrations. The surgery for a single implant usually takes less than an hour.
3. Healing (Osseointegration) Phase: After implant placement, a healing period is crucial. Over the next 3-6 months, the implant will fuse with your jawbone. During this time, if the implant is in a visible area, we might give you a temporary denture or bridge for appearance. You should avoid chewing directly on the implant site while it heals (especially if it’s supporting a temporary tooth). If the implant was placed at the same time as an extraction with bone graft, healing could be on the longer side (closer to 5-6 months). We will monitor the healing and may take X-rays to ensure the bone is integrating well.
4. Abutment Placement: Once the implant is solidly integrated, a minor procedure is done to expose the implant (if it was covered by gum). We place a small connector called an abutment onto the implant. This may be done under local anesthesia if needed, but often it’s quick and just causes minor pressure. The abutment sticks out above the gum and will hold the crown. Sometimes, the abutment is placed at the same time as the implant (it would be a healing abutment in that case, visible during healing).
5. Impression for Crown: After the gums heal around the abutment (usually 1-2 weeks after abutment placement), we take an impression or digital scan of the implant abutment along with the surrounding teeth. This is used to fabricate your final crown (or bridge or denture, if implants are supporting those). We also match the shade of your other teeth so the crown will be indistinguishable.
6. Crown Placement: When the custom crown is ready (typically 1-2 weeks after the impression), you’ll come in for the restoration. We will test the crown on the abutment for fit, shape, and color. If all is well, we either cement it onto the abutment or screw it into the implant (depending on the type of crown/abutment system). Once secured, the implant crown is now the visible “tooth” part. We check your bite and make sure everything feels natural. At this point, you have a complete tooth replacement.
(Note: In some cases, an immediate temporary crown can be placed on an implant the same day of surgery – this is called immediate loading – but this is only done in ideal conditions and primarily for front teeth for cosmetic reasons. The above outline is for the traditional safe approach of allowing healing before the final tooth.)
Benefits of Gettting a Dental Implant
– Closest Thing to a Natural Tooth: A dental implant with a crown replaces the whole tooth structure – both root and crown. It’s anchored in bone like a real tooth, which gives it stability. You can chew all kinds of foods confidently; implants restore near-natural chewing force. The look is very natural as the crown emerges from the gum like a real tooth. Many patients forget which tooth is the implant because it feels so normal.
– Preserves Jaw Bone and Facial Structure: When a tooth is lost, the jaw bone in that area slowly shrinks (bone resorption). Implants stimulate the bone like natural tooth roots do, preventing or significantly reducing bone loss . This helps maintain your facial structure over time (preventing that “sunken” look that can happen with missing teeth or long-term denture use). By preserving bone, implants also help keep adjacent teeth stable.
– Protects Healthy Teeth: A traditional bridge requires grinding down the adjacent teeth to support it. An implant lets us replace the missing tooth without touching neighboring teeth, thus preserving their natural structure. Implants also don’t rely on other teeth for support, so no extra load or stress is placed on your remaining teeth. Each implant tooth stands independently.
– Long-Term Success: Implants are a well-proven solution with high success rates. Many studies show success rates around 90-95% or higher over 10+ years, making them one of the most predictable treatments in dentistry. With good care, implants can last for decades; some last a lifetime. They don’t get cavities (though gum health is still important). This makes them a cost-effective solution in the long run.
– Improved Comfort and Confidence: Unlike removable dentures, implants are fixed in place. There’s no worry about slipping or clicking, no need for adhesives, and you care for them with regular brushing and flossing. This stability can greatly improve comfort when speaking and eating. Being able to smile broadly and eat what you like (even apples, corn on the cob, steak, etc.) can significantly enhance your quality of life. Many patients report their implant feels so natural they don’t even think about it when they eat or socialize – it’s a big confidence booster after losing a tooth.
Risks of Getting a Dental Implant
– Surgical Risks (During or Immediately After): With any surgery, there are risks like bleeding, swelling, pain, or infection. After implant placement, it’s normal to have mild soreness, possibly minor bruising, and swelling for a few days. Infection at the implant site is uncommon (especially if you follow care instructions and take any prescribed antibiotics), but it can occur and could compromise healing if not addressed. We take sterile precautions and plan carefully to avoid complications. Nerve injury is a rare risk if the implant is placed in the lower jaw near the mandibular nerve – we use imaging and safety margins to prevent this, but if it were to occur, it could cause numbness or tingling in the lip or chin (usually temporary, very rarely permanent). For upper implants near sinuses, there’s a small risk of sinus membrane perforation; if that happens we manage it with grafts and usually it heals without issue. We will review your specific surgical risks based on your case.
– Implant Failure/Non-Integration: In a small percentage of cases, an implant might fail to integrate (the bone does not fuse to it) or it integrates but later becomes loose. This could be due to various factors like infection, excessive stress on the implant too soon, or smoking (which can impair healing). If an implant fails, it will need to be removed. The area can often be grafted and a new implant attempted after a healing period, or alternative options considered. The likelihood of this is low, but it’s a possibility to acknowledge. Following our post-op instructions and maintaining good oral hygiene significantly improves success.
– Adjacent Structure Damage: During drilling or placement, nearby teeth roots could be contacted, or thin bone between teeth could fracture; however, we plan the trajectory to avoid such issues. On rare occasions, an adjacent tooth might become sensitive or need treatment if it was affected by the implant preparation. Additionally, if an implant is replacing a tooth near a nerve or sinus, misplacement could cause nerve irritation or sinus issues (as mentioned above). Again, using 3D imaging and guides helps us avoid these complications.
– Peri-Implantitis (Gum/Bone Infection Around Implant): This is like gum disease around an implant. If oral hygiene is poor or if you are prone to periodontal issues, the tissue around implants can become inflamed and infected, causing bone loss around the implant. In severe cases, this can lead to implant looseness or failure. Regular cleanings and good daily plaque control are key to preventing this. Implants require the same care as natural teeth (actually a bit more vigilance since they lack the ligaments natural teeth have). If caught early, peri-implant inflammation can be treated with deep cleaning and antibiotics; advanced cases might need surgery.
– Mechanical Issues: The implant itself is very strong, but the crown or components can occasionally have issues. For instance, an abutment screw might loosen over time – if you ever feel the implant crown wiggling, come in and we can likely just tighten the screw. Porcelain on the crown can chip if you bite something hard at the wrong angle. These events aren’t common, but if you have habits like teeth grinding, we may recommend a night guard to protect your implant and other teeth. In complex cases (multiple implants, dentures on implants, etc.), there are more components that could wear – we’ll inform you of maintenance if needed (like replacing worn O-rings on implant dentures every year or two). Generally, a single implant crown is very low maintenance beyond good hygiene and check-ups.
Alternatives to Dental Implants
– Bridge or Denture: Instead of an implant, a missing tooth can be replaced with a fixed dental bridge (as described in the previous section) or a removable partial denture. A bridge is a good option if the adjacent teeth also need crowns, but it involves those teeth and doesn’t preserve bone like an implant. A partial denture is a solution if multiple teeth are missing or cost is a concern – it’s less expensive and non-surgical, but not as stable or comfortable as an implant. For a single missing tooth, many patients prefer an implant to avoid altering other teeth. For multiple missing teeth, an implant-supported prosthesis can often give better function than a traditional denture. However, if you cannot or do not want to undergo implant surgery, a well-made bridge or denture is a reasonable alternative.
– No Replacement (Gap): You may choose to leave the space empty. For a back tooth, some patients accept the gap. We will inform you of potential consequences: adjacent teeth can shift, opposing teeth can over-erupt, and you may have reduced chewing efficiency on that side. In the front, most people want something for appearance and function. While living with a missing tooth is an option, it’s generally not ideal for long-term oral health or function. If you do nothing now, you could still pursue an implant or other option later, though delays can sometimes mean bone loss making it more challenging (bone grafts might be needed if you wait years).
– Orthodontic Closure: In certain cases (like a missing tooth towards the back), braces or clear aligners can be used to close the gap by moving other teeth. This is usually only feasible if it doesn’t harm your bite or aesthetics and if the space is small. It’s not common for most missing tooth scenarios, but it is an alternative approach in selective situations (for example, closing a gap from a missing second molar by moving a wisdom tooth forward, or closing a small front tooth gap by bringing teeth together). Orthodontic consultation would be needed to explore this.
Post-Procedure Implant care Instructions
– After Implant Surgery (First Week): You will leave the office with gauze on the surgical site if needed and possibly some stitches (often dissolvable). Bite on gauze for the first hour to control bleeding, changing it as needed until bleeding is minimal. It’s normal to have slight oozing for a day. Use an ice pack on the cheek (20 minutes on, 20 off) for the first 24 hours to reduce swelling. Get plenty of rest and avoid strenuous activity for a couple of days, as increased blood pressure can induce bleeding. We will likely prescribe pain medication or advise on OTC pain relievers – take as directed. Also, if prescribed, take any antibiotics as directed to prevent infection. Do not smoke or use chewing tobacco during the healing period, especially the first week, as it significantly increases the risk of implant failure by impairing healing.
– Oral Hygiene During Healing: Starting the day after surgery, gently rinse your mouth with a warm saltwater solution (1/2 tsp salt in a cup of water) 3-4 times a day, especially after meals. Keep food away from the surgical site as much as possible for the first few days. You can brush your other teeth normally, but be very cautious near the implant area – avoid the implant site with your toothbrush until we say it’s okay, or use a super-soft post-surgical brush if provided. If you have a healing cap visible, you can gently clean around it with a Q-tip or soft brush after about a week when tenderness allows. Good oral hygiene is essential, but avoid disturbing the wound initially.
– Diet: Stick to a soft diet for the first week post-surgery. Cool or lukewarm foods are better initially (avoid very hot foods/drinks on day 1 as they can promote bleeding). Suggested foods: yogurt, smoothies (not using a straw for first 3 days to avoid disturbing clot), mashed potatoes, scrambled eggs, pasta, soups (warm, not hot), applesauce, well-cooked soft vegetables, fish, etc. Avoid hard, crunchy, or chewy foods (nuts, chips, tough meats) for at least a week or two near the surgery site. Also avoid spicy or acidic foods that could irritate the area. As you heal, you can gradually reintroduce normal foods, but use your judgment – if it causes discomfort or requires heavy chewing on the implant area, hold off.
– Managing Discomfort: It’s normal to have discomfort for a few days. Take pain medication as recommended. Usually, implant pain is quite manageable – many people do fine with ibuprofen or Tylenol after day 1. Keep your head slightly elevated when resting to help reduce swelling (sleeping with an extra pillow). If swelling appears on day 2-3, that can be normal; it should start to recede after that. You might have some bruising on the skin – that can happen and will fade in about a week. Numbness beyond the first day (after anesthesia wears off) is not typical – if you experience persistent numbness or severe pain, inform us right away.
– Follow-Up Appointments: We will schedule you for a post-op check (often about 1-2 weeks after surgery) to ensure the site is healing well and remove any sutures if they aren’t dissolvable. Then, during the healing phase, you’ll likely come for periodic checks or impressions as needed. It’s important to keep all these appointments so we can catch any potential issues early. We might take an X-ray at some point to verify integration progress.
– Care for your Temporary Tooth: If you were given a temporary denture (flipper) or retainer with a fake tooth to wear during healing, follow the instructions for its use. Typically, you should avoid wearing it for the first few days or only wear it as instructed, to not put pressure on the implant. When you do wear it, ensure it’s not pressing on the gum where the implant is. If it does, don’t use it until we adjust it. Keep it clean and take it out at night. If you have a temporary bridge or bonded tooth, be gentle with that area.
After Implant Crown Placement: Once your implant crown is in, treat it like a normal tooth in terms of cleaning – brush twice a day and floss around it daily. We’ll show you any special flossing techniques if needed (often normal floss works fine, but sometimes a floss threader is useful if the shape of gum requires it). A low-abrasive toothpaste is best (most regular ones are fine) to keep the crown polished. Continue to see us for regular check-ups every 6 months (or as advised). Implants should be checked and professionally cleaned to ensure the gum stays healthy. If you ever notice bleeding around the implant when brushing (after it’s restored), let us know – it could be a sign of needing a deeper cleaning around it.