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Family Health Magazine
DENTAL HEALTH

Dental Implants
Are they for you?

Missing teeth can affect how we eat, speak, rest, appear and even behave. Fortunately, many acceptable methods of replacing missing teeth exist. In the last 35 years, the use of dental implants has become a preferred technique.

What is a dental implant?

Dental implants are small screws made out of titanium. Titanium is the only metal that the body will accept, allowing bone to grow in and around the screw. Placing an implant in the jawbone (where the natural tooth root was) anchors the replacement, allowing full use of the mouth and teeth. Restoring comfort, function, and look, and preserving natural anatomy are the main goals in replacing missing teeth with dental implants.

How can dental implants be used to replace missing teeth?

Dental implants can:

• replace one or more missing teeth without affecting adjacent teeth
• support a bridge (where many teeth are joined together to span a larger gap)
• allow the use of, support and stabilize removable partial plates/partials and dentures.

The benefits of dental implants

Dental implants:

• reduce the need to cut down adjacent teeth for bridges
• help preserve remaining natural bone structure
• support face shape and smile
• eliminate the need for removable partials and dentures - and the sores that may go along with them
• reduce the need for the roof of the mouth to be covered by removable partials or complete dentures
• look, feel and work just like natural teeth
• provide confidence when eating, speaking and smiling.

Who makes up your dental implant team?

• The dentist is responsible for diagnosing problems as well as planning and completing restorative treatment. Your dentist may place the implant or a certified dental specialist, experienced in placing implants and working from a surgical suite, can do so. These specialists include oral maxillofacial surgeons and periodontists.
• The dental radiologist reads the special radiographs (x-rays) and provides a report to the dentist placing the implants. This report will describe exactly how much bone is in the areas specified by predetermined markers. Other concerns about your dental anatomy will also be identified at this point.
• Dental assistants assist during each visit, and help the dentist make impressions used to create the teeth.
• A dental laboratory technician makes temporary and permanent teeth based on the impressions.
• The dental hygienist and dentist help you design a customized hygiene program to guide you in taking care of your new teeth.
• The office manager will help prepare insurance forms for preauthorization and submission, as well as work out a payment plan.
• Your family will provide support and amazement as you progress along your personal dental transformation.

What to expect during your visits

The dentist will do a thorough examination to decide whether you are a candidate for dental implants. Each tooth will be examined, and a medical and dental history taken. A record will be made of fillings, tooth positions, gum and bone status, and any other dental requirements needing attention.

Special x-rays (panoramic and tomograms) are taken to evaluate how much bone is available and exactly where it is. This helps assess whether implants can be placed directly, or whether grafting more bone will be necessary. This step is very important. It helps the dentist placing the implant to identify important structures such as nerves, sinuses, and adjacent teeth roots. Mounted diagnostic study casts of the new teeth are made. This helps clarify expectations about the final results.

All treatment options, including leaving the mouth as it is, or making removable prostheses (partials and dentures), fixed prostheses (crowns and bridges), and implants will be discussed. You and your dentist will sit down together to decide your best treatment option.

A comprehensive treatment plan for your whole mouth is necessary. The dentist wants not only to fill in missing holes, but also to eliminate structural problems. As you would build a house on a solid foundation, you want to provide structure when investing in your teeth. Done properly, it should be a one-time job.

Once you have decided on a treatment plan, the next step involves placing the implant in the jaw. Your dentist can do this procedure in the dental office or in a surgical suite. Local anesthetic is usually used to control pain. However, your dentist can also provide you with a prescription for oral pre-medication, inhalation or intravenous sedation for your comfort. You should not feel anything during the procedure, though over-the-counter pain medication may be needed later.

Once the implant is in place, it is usually allowed to heal before permanent teeth are made. Healing may be almost immediate or may take as long as six months, depending on your ability to heal. It is important that healthy bone develop around the implant. This allows a strong bond that holds the implant in place. Once healing is complete, your dentist takes a final impression. A dental laboratory technician then uses it to create the permanent teeth.

If the implant teeth are designed to be fixed, they can be either screw-retained or cemented in place. If the teeth will be removable, they will be on either a bar with clips or other attachments. Your dentist will discuss which option is best for you based on many different factors. Once the permanent teeth are placed, you will receive care and hygiene instructions along with a schedule for future visits. You are now part of the dental implant family!

Caring for implant-retained teeth

Just as with natural teeth, implant-retained teeth need to be cleaned daily and be regularly checked by a dentist. Special plastic cleaning instruments are used to avoid scratching the titanium surface of the implant. Your dentist and hygienist can help you find a daily cleaning technique. Much of your long-term success with the implants depends on keeping your teeth clean. At your check-ups, your hygienist and dentist will evaluate how you are doing. If needed, suggestions will be made to change your cleaning technique.

Frequently Asked Questions

How do I know if implants are right for me?

Once your dentist has done a full examination, you can discuss treatment options. Take the information home and talk it through with those you trust. Do not rush the decision to have this amount of work done. If you are not comfortable with the recommendations, get a second opinion from a certified specialist in prosthodontics.

How much do implants cost?

Everyone has different needs, both in terms of surgery and restoration (teeth placed on top of implants). As a result, it isn't practical to give a flat estimate. Procedures affecting the cost of implants include the number required and the type of teeth used (porcelain and gold or resin). Additional surgical procedures required to place the implants (grafting of tissue or bone) will also affect the final cost. Your dentist can provide a written estimate once the necessary information has been gathered.

How long will the implant last?

Every case is different. Proper planning of treatment, careful surgery and exact prosthetic planning are very important. With these, the odds are pretty good that the implants will last for the rest of your life. See your dentist regularly and clean your teeth carefully to ensure long term success.

Who should not have implants placed?

Patients who have surgical and healing complications may have trouble with implants. If you have cardiac or pulmonary problems that would not allow you to have elective surgical procedures, then implants are not recommended.

People who smoke or have uncontrolled metabolic diseases (severe diabetes) have much less success with implants. It is often necessary to quit smoking beforehand. If in doubt, your dentist will contact your doctor to ensure you are a good candidate for implant placement.

What type of implant should I have placed?

Thousands of different implant types are on the market today. Ask your dentist what type of implant he or she recommends and why. Ensure that the implant company selected has done at least 25 years of research and has published substantial research articles. You may also wish to contact a certified prosthodontist, oral and maxillofacial surgeon, or periodontist. Ask them about the implant company recommended to you. Access promotional material and read the information on the company's web site. You can find patient information and many photographs on these sites that can answer many of your questions directly.