If you have any problems with your teeth, a dentist is always there to help you. There are many dental procedures that can aid you in sporting healthy teeth. Getting dental implants is one of many such procedures. Not many people are aware of what exactly a dental implant is or if they really need one. To clear the air and help people take a more informed decision, we spoke to Dr Reiyal Goveas, Bds, Dip. Oral Oncology and Radiation Biology, MSc (Maxillofacial Prosthetics), Fellow Maxillofacial Prosthetics Service, Mahidol University. He answered many pertinent questions dental implants and dental prosthetics.
What is a dental implant?
A dental implant is an artificial tooth root that is surgically positioned into the jawbone beneath your gums. Once in place, it allows the dentist to mount a replacement tooth or teeth on to it. Since implants fuse with your jawbone, they provide a stable support for artificial teeth. Dentures and/or bridges mounted to implants won't slip or shift in your mouth, an especially important benefit when eating and speaking. This secure fit helps the dentures, bridges, as well as individual crowns placed over implants feel more natural than conventional bridges or dentures.
How is a dental implant advantageous over a bridge?
Unlike a bridge where it is necessary to cut off natural teeth to prepare them for a crown, an Implant causes no damage to your adjacent teeth. Moreover, if maintained properly, a dental implant can last for a lifetime proving to be a good option in the long run.
Are dental implants right for me?
You may qualify for dental implants (teeth implants) if you desire to replace your missing, broken or severely decayed teeth and if you're in relatively good overall health. The only way of determining your eligibility for dental implants is to consult with an implant dentist, to identify whether you have adequate bone support and healthy gums that will support the new tooth structure.
If I am medically compromised, can I still get dental implants?
This depends on what your ailment is and its severity. Patients with mild blood pressure or diabetes, which is under control, can still get implants. If you are on blood thinners then your physician's consent should be taken as the blood thinners will need to be stopped prior to the procedure. Severely compromised patients or those who have been advised against surgical procedures may not be good candidates. However, it is always better to consult an implantologist prior to taking any decisions regarding implant placement.
Is there any additional information that my dentist needs for implant planning?
The placement of dental implants is a multi-step process that typically takes between 3-4 months to complete. It begins with a full diagnostic check-up to rule out any medical conditions which may contraindicate implant placement. X-rays of individual teeth and a full mouth (OPG) X-ray along with a special three-dimensional scan known as a CBCT scan to determine bone condition will be required. Photos both inside the mouth and of the face along with videos of the patient while taking, smiling, etc. will be taken. Sometimes models of the upper and lower jaw may also be made to aid in the implant placement planning.
Will the implant surgery/treatment be very painful?
This is one of the most common concerns for people thinking about receiving a dental implant. The majority of dental implants are placed under a normal dental local anaesthetic. Though the local anaesthetic injections can sting a little, there are systems in place to reduce the pain by numbing the area first with a mild numbing gel/spray, using very thin needles and warm anaesthetic agents. Once the anaesthetic agent takes effect, you will not feel anything sharp or painful throughout your treatment. You will feel some pressure and pushing during the procedure as well as some vibration during the drilling stage, but this will not be painful in any way. Once the anaesthetic has worn off, you may need to take over-the-counter medications. It is not unusual to have a very minimal level of pain or even no pain whatsoever. During the first few days after surgery, it's possible the gum may feel a little sore as it heals and you might wish to stick to soft foods that are easy to eat. With a single dental implant, you should be fine to go back to work the next day.
Can I get my implant put in at the time when my tooth is removed?
Yes, in some cases, the dental surgeon can place an implant immediately after tooth extraction in the tooth socket (known as immediate implant placement), provided there is no infection around the area and if it meets with all the suitable criteria gone through the assessment by the dentist. It can then be covered with a temporary tooth (known as immediate implant loading) till the healing takes place. However, it is better to wait for the healing to take place before placing teeth.
If I am not a candidate for immediate implant loading, will I be left with a gap?
There are a few factors which make it necessary to wait for healing after tooth removal before a dental implant can be placed; the main factor being the presence of infection. If infection is present prior to implant placement, we need to allow a healing phase of 8-12 weeks before we can place the dental implants. There are some cases where we can go for Immediate dental implants and then cover the implant with dental crowns (teeth), but that will depend on the suitability assessment done in the planning stage by the implant dentist.
Don't worry because you never need to have a gap, there are all sorts of temporary solutions, both fixed and removable, to make sure there is no embarrassment at any stage through the dental implant process.
My teeth have been missing for a long time, can I still get dental implants?
Long standing areas of the mouth without teeth tend to lose bone. If this is the case, an additional procedure known as an "alveolar bone graft" is required to achieve a solid base of bone for the implant. In the upper jaw, the available amount of bone may be limited by the presence of the sinus. "Sinus augmentation" or "sinus lift" is performed by the implant dentist to raise the sinus floor and graft more synthetic bone into the sinus. This will make more bone available to support a dental implant.
Can I replace all my teeth with dental implants?
Yes. You do not need one implant per tooth and can actually have as few as four implants to replace all of the upper or lower teeth. These will be strategically placed by the implant dentist. There are a variety of options for the type of bridgework supplied, which can either be removed by you or remain fixed in place and can be removed by the dentist only.
Can implants help with dentures?
Absolutely yes. Dentures are usually a nightmare for patients due to difficulty in wearing them and the effect on all aspects of life. Partial dentures can be replaced with just a few teeth implants. Complete (full) dentures can either be held in position with dental implants or replaced with implants all together giving you a fixed set of teeth surely the most amazing dental transformation available. Implant supported dentures provide the much-needed stability and confidence that you need to eat and smile with ease.
How do I maintain my dental implants?
To ensure the longevity of dental implants, it is essential to keep it clean and to prevent bacteria and plaque from forming around it. Just like your natural teeth, an implant is also supposed to be brushed and flossed. In areas that are difficult to clean, interdental brushes may be used. For those having removable dentures over the implants, kindly rinse the denture after use and soak it in denture cleansing solution. It is recommended to visit your dentist to check for any potential issues that may arise with your implant.
How long will dental implants last?
If the dental implant integration is successful and the area is well cared for and maintained with regular reviews and monitoring by the dentist, a dental implant should last a lifetime. It is possible to chip a crown or bridge on implants in the same way that it is possible to chip a tooth. Sometimes the outer screw over the implants may become loose which can be easily corrected by the dentist. Annual reviews with x-rays to check the bone levels around the implants in addition to your regular check-ups with your implant dentist are recommended.
Can I have dental implants if I am a smoker?
Smoking affects both natural teeth and implants. For natural teeth, smoking increases the risks of gum disease. For dental implants, smoking increases the risks of complications at every stage of implant treatment. Cessation of smoking to reduce any chances of implant failure in the long run is always highly recommended.
What are the potential risks, complications and problems with a dental implant?
With any surgery, there are always some risks and potential complications to you or to the success of a dental implant. Careful planning is important to ensure that you are healthy enough to undergo oral surgery and heal properly. Just like any oral surgery procedure, bleeding disorders, infections, allergies, existing medical conditions, and medications need careful review prior to proceeding with treatment. Fortunately, the success rate is quite high and failures usually occur in the unlikely event of infection, fracture of the dental implant, overloading of the dental implant, damage to the surrounding area (nerves, blood vessels, teeth), poor positioning of the dental implant, or poor bone quantity or quality. Again, careful planning with an implant dentist can help avoid these problems. In many cases, another attempt can be made to replace a failed dental implant after the requisite time for healing has taken place.