Implants are an increasingly popular option for replacing missing teeth. They are placed directly into the jawbone, rather like the roots of natural teeth.
What is a dental implant?
A dental implant is a titanium metal rod which is placed into the jawbone. It is used to support one or more false teeth. In practice, both the false teeth and their supporting rod are known as ‘implants’.
Are implants safe? How long will they last?
Implants are a well-established, tried-and-tested treatment. 95 per cent of modern implants should last for many years with the right care.
I have some of my own teeth. Can I still have implants?
Yes. You can have any number of teeth replaced with implants – from one single tooth to a complete set.
Can implants always be used to replace missing teeth?
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 not be possible to place implants without grafting bone into the area first.
Why have implants?
Because of the following advantages:
– Look, feel and function like natural teeth
– Strong and long lasting
– Restores the chewing ability with confidence
– Over the longer term, implants are usually a more cost-effective and satisfactory option.
– An implant to replace a single tooth avoids the need to cut down the teeth either side for crowns to support a bridge.
– Normal dentures often mean you can’t eat or speak well, due to the dentures moving about. But teeth attached to an implant don’t cause this problem as they are anchored to the bone more firmly than natural teeth.
– When teeth are lost, the jawbone may start to shrink. Implants can help slow this process down.
While increasingly popular, implants are not appropriate for everyone. You need to be medically fit and have healthy gums and a sufficient thickness of jawbone.
What are the alternatives?
The alternatives to implants are dentures or bridges. On the other hand, you may choose to simply accept the space where a tooth is missing.
A denture usually includes a metal and/or plastic base carrying plastic or porcelain artificial teeth. It is a removable replacement for a few missing teeth (partial denture) or a whole set of teeth (complete dentures). Dentures are very common but they can become loose, making it difficult to eat and speak. One or more implants can be fitted to help support and retain a denture.
A bridge consists of artificial teeth cemented onto adjacent natural teeth. When preparing a conventional bridge, the dentist needs to shape the teeth either side of the gap so that they will successfully hold the bridge. The bridge is placed over the gap and the teeth on either side and then cemented into place.
Illustration showing a dental implant
However, implants can also be placed into the jawbone long after a tooth has been removed and the socket has healed.
Once the implant is in place, the gum is stitched over it and the area is left to heal. Stitches are normally removed after about a week. This healing process allows the jawbone to fuse with the surface of the implant. This usually takes between three and six months.2
During the healing period, a temporary bridge or partial denture can be made so that you cannot see the spaces between the remaining teeth. If you have complete dentures they can generally be adjusted so that they can be worn throughout this period.
In some cases, your implants may be stable enough to have a temporary crown or bridge fitted straight after the implant is placed in the jawbone. This avoids having a temporary denture. Your dentist will advise you of the length of time required for your treatment.
After an appropriate healing time, a second, smaller surgical procedure is sometimes needed to uncover the gum over the top of the implant. Once the gum around the implant has healed, your dentist can take impressions to allow the crown, bridge or denture to be made. Your dentist will ensure that they fit properly, match your other teeth and feel comfortable.
Caring for implants
To help maintain your implants you need to thoroughly brush and floss regularly. Your dentist will give you specific advice on caring for your implants. He or she will ask you to attend for regular check-ups, and will usually take X-rays each year to monitor them.
What are the risks?
Implant surgery is generally a safe procedure. However, all surgery carries an element of risk. Before deciding whether or not to have implants, you need to be aware of the possible side-effects and the risk of complications.
Side-effects are the unwanted but mostly temporary effects of a successful procedure. Examples of side-effects include feeling sick as a result of the anaesthesia or sedation and some swelling and discomfort around the implant area.
Complications are problems that can occur during or after the procedure. Most people are not affected. The complications of any surgical procedure can include excessive bleeding, an unexpected reaction to the anaesthetic or infection. It is likely that you will be prescribed antibiotics and an antiseptic mouthwash to reduce the risk of your implant becoming infected.
Your lower jaw contains nerves, which supply feeling to your tongue, chin, lower lip and lower teeth. In a small percentage of cases during implant surgery in the lower jaw the nerves may be bruised and may cause a tingling or numb feeling in your tongue, chin or lip. This is usually temporary, but in a small number of cases this altered sensation may be permanent.
The chance of complications depends on the exact type of procedure you are having and other factors such as your general health.
Implants may not be an option for smokers or people with chronic conditions such as poorly-controlled diabetes or osteoporosis. This is because the implants are more likely to fail due to problems with the healing process.1,3 Ask your dentist if implants are suitable for you. If not, he or she will be able to discuss alternative treatments with you.
It is possible that the jawbone won’t fuse with the implant properly and the implant may become loose. If this happens your dentist will need to remove the failed implant and wait until the bone has healed before attempting to place another implant.
Most implants are very successful, but the crowns, bridges and dentures the implants support can be damaged just like normal teeth, due to an accident, break or chip. The crowns, bridges or dentures are generally easily replaced, providing the implant underneath is not damaged.