A dental implant is something artificial that is placed in the area where a tooth was extracted. There are different types of implants, but basically it is replacing a tooth that was removed from the body.
2. How is dental implant technology changing?
I think the most exciting thing is that there is something available called zirconia. It is a ceramic material; it is more bio-compatible to the body versus titanium. The other exciting thing is that we can now place implants the same day as you do the extraction, so the whole process is much faster.
3. Why do people get dental implants?
It is important anytime you lose a tooth to replace that tooth, first and foremost to prevent teeth from shifting. To improve function as you chew because when you lose a tooth you lose some of that function. Also it puts stress on the other teeth if you do not replace that tooth. The main reason why you would want to do an implant versus the other options which are a removable partial denture or a fixed bridge is that one, it preserves the bone. Two, it does not affect the teeth adjacent to it. Three it does not get cavities and so it is not going to need to be replaced and rarely does it ever develop any gum inflammation around it.
4. What are the advantages of dental implants?
The reason why you would want to do an implant versus a partial denture or a bridge is, first, the partial denture is something that has to be taken in and out. It does not preserve the bone and at some point in time it will need to be replaced throughout your lifetime, maybe several times. So from a cost perspective it is going to end up costing more. A bridge is something that is cemented in but requires treatment of the teeth adjacent to it. So in some cases you might have to drill down perfectly good teeth. The bridge can get decay; it can develop gum inflammation around it. With an implant you are not affecting the adjacent teeth, it does not come out, and it restores function better than an actual natural tooth. As I said it does not have to be replaced or repaired over time. There is no decay, no inflammation.
5. Are dental implants as strong as natural teeth?
Yes, actually stronger. If you have any experience as a dentist if you have ever taken a tooth out versus trying to take an implant out, it is sort of like taking a post that has been placed in the ground with just dirt versus one that has been placed in the ground with concrete. They are very stable; they integrate with the bone itself. The main anatomical difference is that with a tooth there is a ligament that attaches the tooth to the bone; that ligament is soft tissue. So when you are removing a tooth you just have to create enough movement to cause some expansion of the ligament to allow the tooth to pop out. With a implant because there is threads, the threads actually integrate into the bone. So in essence it is actually going to give you more strength and be stronger than your natural tooth.
6. How many visits are necessary?
It could vary from three visits to as many ten, depending on where you got involved. If you came in to have the tooth extracted and there was sufficient bone and there was not a lot of infection, you could probably place the implant that day, then wait for that to heal. You can even put a temporary crown on there so that you might have as few as three or four appointments. However, if there was significant bone loss, we would have to do some bone grafting. We would have to wait for that to heal and then come back and do the implant. It could be as many as ten appointments; it really depends on the individual.
7. Will it hurt?
That is a good question. We use a local anaesthetic like any other dental procedure. For anxiety we have a program here at the Julian Centre for patients that are anxious. So after the implant is placed you will have some soreness some tenderness, but a lot less discomfort than having your tooth extracted.
8. What are the advantages of going to a general dentist instead of an oral surgeon?
The biggest advantage is that you are staying with the dentist that you have built a relationship with and you trust, rather than being referred out to someone you have never met before. Two, is that the general dentist is always going to restore the implant that was placed by the surgeon. So the typical scenario is the patient has a problem, they go the surgeon to have the tooth extracted, they wait for it to heal, they go back to the surgeon maybe to place the implant and then once the implant heals they go back to the general dentist. If the general dentist does extractions, they may send the patient out for the implant and then come back and do the crown or the restoration. That is never done by the oral surgeon. So the surgeon, as good as they might be, they do not really understand how important placement is as much as the general dentist. The general dentist has to sort of make up if the implant is not placed properly in a position parallel to the other teeth. They then have to make a restoration crown to fit in an ill-placed or poorly placed implant. So the general dentist is less likely to do that because they are the ones that have to restore it.
9. Will insurance pay for my implants?
That is a difficult question because every insurance is different. I can tell you this; there are some insurance companies that will pay for the reimbursement. More than likely if you have dental insurance, if they do not pay for the implant, they will more or likely at least pay for the crown that goes over the top of the implant.
10. Am I a candidate for dental implants?
Everyone is a candidate for implants, unless you do not have any teeth missing, then I would not necessarily recommend it. But yes, there are certainly some medically compromised patients that would be contraindicated for any surgical procedure. If you have severe bone loss and certain areas of the jaw that are difficult to replace that bone and would require a hospital visit where you would actually take maybe a part of the hip or bone from elsewhere in the body and replace that into the jaw bone and if you are medically compromised, you are probably not going to be a candidate for that. But otherwise almost everyone would be a good candidate.
11. What are the newest advances in bone grafting?
Well those are procedures in which we draw the patient’s blood, we spin it down in the centrifuge and we take off the red and white blood cells and use the platelet rich growth factors that are left. It is in a gelatinous form and we can actually use that to place around the implant. We can place it into a socket from an immediately extracted tooth; it speeds up the healing. From what I have experienced, the healing occurs probably at four or five times faster than it would without this material. And this is all from your own body, so it is called autogenous, which means it is from your body. It is not synthetic, it is not from some other manufacturer. If you are not using that and you have not in years you can still get results but it is going to be a much slower process.
12. Will it be necessary to graft bone from other parts of my body?
Most of the time, no. The exception is someone who has been missing their teeth for an extended period of time, and especially if it is multiple teeth because you are going to get some re-absorption with one tooth. When you are missing two, three, four, five teeth you are going to get a lot more re-absorption. And if it has been over twenty, thirty, forty years, there is just not going to be sufficient bone. If that person wanted an implant you are probably going to have to do some kind of bone replacement – take some bone off the hip and actually reconstruct the jaw bone itself. That is probably a little more than most eighty year olds want to go through.
13. Is age a factor for dental implants?
I do not think so. I certainly hear from patients “Why would I want to deal with this now? I am seventy years old and I do not know how much longer I am going to live.” But I would say, even if you are only going to live two or three years, wouldn’t it be worth being able to chew your food and digest it properly. Plus, you do not know how long you are going to live because most of the studies show that those people who lose teeth early tend to die younger. There is even a study now that says that Alzheimer incidents is higher in people that are missing teeth. So I think it would be crazy not to get it. I think it might be difficult to really recommend that for someone who is in a nursing home, who is debilitated at that point it is probably not worth it.
14. What is the minimum age for dental implants?
Well we do not recommend typically much younger than sixteen. Simply because the patient is still growing, the bone is still growing. You could do it younger, but I think with zirconia we are going to see that occur more often and that would be a great way to replace a front tooth that got knocked out say in a sport injury.
15. Can smokers get dental implants?
They can. We would certainly encourage them to stop smoking. If you were going to have some complications with the healing process that would certainly be one of the factors that would cause that. But there is no direct contra-indication for that. But, expect that your failure rate may be increased with smokers than non-smokers for sure.
16. Will anyone know I have dental implants?
No one will know, other than your dentist. Now if you have a titanium implant and the gum recedes, people will know that you have an implant. If they even know what it is. There is metal showing. But for the most part, no one is going to know that you have implants. If it is done properly and restored properly, no one is going to know.
17. How long is the dental implant recovery period?
That varies from individual to individual depending on the extent of the treatment necessary to place that implant with any bone grafting. What is the overall medical health of the patient? What is their diet and nutrition? So it could vary from three months to nine months to a year depending on the type of implant, the extensiveness of the treatment for the implant and the overall health of the patient.
18. What can I expect after the anaesthesia wears off?
Well you are going to feel a little sore and obviously everyone’s pain thresh hold is different. I would say some patients will require maybe a prescription drug for anti-inflammatory or pain reliever. I have seen many patients who even get prescriptions filled and never use them. The level of discomfort is going to be far, far less than having a tooth extracted. So if you have had a tooth extracted, which is why you are getting the implant, it is going to be less traumatic.
19. What about eating after implant surgery?
You do not want to place force on the implant immediately after. What is happening after the implant is placed is the body is now growing new bone around the implant. And the one reason why it would not build strong bone is if there is excessive force being put on the implant. So biting into something is certainly going to put force on it that is not conducive to the healing process. So you would want to stay away from that. Your dentist can make you a splint that can go over it so you bite into the splint. You can eat on the other side or away from it so there are other options. You do not want to put pressure directly on it.
20. Can my body reject a dental implant and if so what happens then?
It could reject it. First when we were doing mostly titanium, we always recommended a test called MELISA. It tests for hypersensitivity to titanium. If you are hypersensitive, I would recommend you not have titanium implants. But now that we have zirconia we do not have the same problem. The other reason for rejecting it would be just poor case selection. If you are trying to put an implant into poorly healing bone or infected bone, or someone who has advanced gum disease without addressing and getting that under control, then you are sort of asking for trouble for failure.
21. How long do dental implants last?
If they are done properly, if you have a healthy patient, if they carry a good oral hygiene, they have good nutrition there is no reason it would not last a lifetime.
22. Will I be smiling more with my dental implants?
Of course you will, why wouldn’t you? You have all your teeth and no-one knows, that is why you are smiling, because no-one knows.