Saturday, February 10, 2024

Dental Implants

 

Dental Implants: Are They Safe?

Medically Reviewed by Zilpah Sheikh, MD on February 01, 2024
 Written by Lori M. King, PhD
10 min read

Dental implants are titanium or ceramic posts inserted into your jawbone to hold artificial teeth. They act like the roots of your natural teeth to provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth.

Dental implants vs. dentures

Dental implants are usually titanium posts that are permanently inserted into your jaw. They're like artificial roots that make a base onto which your dentist can attach a replacement tooth. On the other hand, dentures are substitutes for your teeth instead of replacements. Dentures are usually made of metal, acrylic, or nylon plates and porcelain teeth. They're removable and generally sit on top of your gums.

There are a couple of different types of implants that differ in how they are attached to your jawbone.

The two types are:

  • Endosteal implant. This is the most common type. It usually looks like a screw, cylinder, or blade that is implanted in your jawbone during surgery. Each of these implants can hold one or more prosthetic teeth. This is a good option for people who already have bridges or removable dentures.
  • Subperiosteal implant. This is placed on top of the jaw, with posts from a metal framework sticking out through your gum to hold your prosthetic teeth. This is a good option for people who can't wear removable dentures or don't have enough bone in their jaw to hold an endosteal implant.

Dental implants have many advantages over dentures, including:

  • Better ability to chew. Dentures can slide around inside your mouth, which may make chewing difficult. Dental implants are fixed in your jaw, like your own natural teeth, which allows you to eat your favorite foods with confidence and without pain.
  • Better ability to talk. Dentures that slip in your mouth may cause you to mumble or slur your words. Dental implants allow you to speak without your teeth slipping around.
  • More comfort. Your gums change shape to fill holes where you had teeth, and they continue to change shape over time, so dentures tend to become loose and shift around. Dentists recommend you get your dentures realigned every once in a while and completely replace your dentures every 5-8 years because of the way your gums change shape over time. Because they become part of you, implants can be more comfortable than dentures that slip around on top of your gums.
  • Improved oral health. Dentures that slip and slide in your mouth can make your gums sore or even make your gums infected. Bacteria and fungi can live in any cracks and crevices of your dentures, which raises your risk of getting an infection. On the other hand, implants allow easier access between your teeth, so you can continue to floss for good gum health. Also, you may need to have some of your teeth shaved down to wear a tooth-supported bridge. With implants, you don't need to have nearby teeth altered, which can improve your long-term oral health.
  • Better appearance. The crown that fits over your implant is made to look like your own teeth. They can give you back your smile and help you feel good about yourself.
  • Durability. With good dental hygiene, your implants can last a lifetime.
  • Protection against bone loss. The roots of your natural teeth are anchored in your jawbone. This stabilizes your jawbone, as a load-bearing wall does inside your house. When you have teeth removed without replacing them, your jawbone can get worse over time. This can change the shape of your face and mouth. Since implants are fixed in your jaw like your natural teeth, they stabilize your jawbone and prevent bone loss.
  • Who Needs Dental Implants?

Most people who are missing one, several, or all of their teeth are candidates for dental implants. In general, if you're healthy enough to have a tooth removed or have a root canal, you can be considered for a dental implant.

The ideal candidate for dental implant

You're an ideal candidate if you:

  • Have good general and oral health
  • Have a fully grown jawbone
  • Have enough bone in your jaw to hold the implant or are able to have a bone graft
  • Have healthy gum tissue with no periodontal disease
  • Don't have a health condition that affects your body's ability to heal bone
  • Don't smoke
  • Are willing to commit several months to the process

Dental implants may not be right for you if you:

  • Are younger than 18
  • Smoke or use other tobacco products
  • Have a lot of bone loss in your jaw
  • Have poor oral hygiene
  • Have a lot of cavities
  • Have gum disease
  • Have some medical conditions, such as bone disorders or some autoimmune conditions (such as diabetes)
  • Does Insurance Cover the Cost of Dental Implants?

Insurance coverage of dental implants often depends on whether your medical or dental insurance applies, or whether both apply. Talk to your oral surgeon's office staff about the extent of your surgery and what your insurance will cover.

Here are some things to keep in mind:

  • If your dental insurance covers implants, make sure you review your annual spending limit because you could have extra out-of-pocket costs.
  • Some insurance plans may cover the implant but not the prosthetic teeth attached to it.
  • Your medical insurance may also cover some parts of the procedure, so ask about that.
  • If you have lost a tooth or need a replacement because of an injury or accident, some insurance policies will cover dental implants as part of that coverage.
  • Make sure you talk to your insurance provider if you don't understand your coverage.

 

How to prepare for dental implant surgery

You will need one or more surgical procedures to get an implant, so it's important that you have a thorough medical evaluation before you start the procedure. You want to make sure you haven't developed any conditions that may prevent you from healing well after the surgery. You will usually have a comprehensive dental exam. Your dentist will take X-rays of your teeth and jaw and make models of them.

You may meet with all the specialists who will be involved in your surgery, such as:

  • An oral and maxillofacial surgeon (a surgeon who specializes in conditions of the jaw, mouth, and face)
  • A periodontist (a dentist who specializes in gums and bones that support the teeth)
  • A prosthodontist (a dentist who designs and fits artificial teeth)
  • An otolaryngologist (an ear, nose, and throat doctor)

In addition:

  • Make sure your dentist has a list of all your medical conditions, medications, and supplements. Your dentist especially needs to know if you are taking a blood thinner. You may need to stop taking some of your medicines before your surgery, but your dentist will talk about this with your primary care doctor. Don't stop taking any medicines without talking to your dentist and doctor about it.
  • Take any medicines your dentist prescribes. People with some conditions or orthopedic implants (such as a hip replacement) may need to take antibiotics before surgery to avoid getting an infection.
  • Talk to your dentist about what kind of sedation you will have during the surgery. You can usually choose between nitrous oxide (laughing gas), oral conscious sedation (sometimes called "twilight sleep"), and IV sedation. 
  • Arrange for a ride after your surgery. If you have oral conscious sedation or IV sedation, you'll need a trusted friend or family member to drive you home afterward.

What to expect during your dental implant procedure

Dental implant surgery is usually an outpatient procedure that's performed in stages to allow you to heal in between. The entire procedure can take months because the bone in your jaw needs to grow and heal around the implant before the dentist can attach your artificial tooth.

Stages of the procedure include:

  • Removal of the damaged tooth, if needed.
  • Bone graft, if needed. If your jawbone is too thin or soft, a bone graft can give you a more solid base to hold the implant. Your dentist may use natural bone from another location in your body or a synthetic bone-substitute material. It may take several months to grow enough new bone to support your implant. Sometimes, you may get a sinus augmentation instead, especially if you need to have a tooth replaced in the upper back of your mouth. A sinus augmentation raises your sinus floor to give you enough bone to place the implant. Many people don't have enough bone to hold an implant in this area because the maxillary sinuses (hollow spots in your head) are right above the back teeth.
  • Placement of the implant. Your surgeon will open your gum to expose your bone. They will then drill holes just large enough to hold your implant deep in your bone and place the post there. They will then stitch your gum closed. If you can see the implant when you talk or smile, your dentist may give you a temporary, removable denture to cover it in the meantime.
  • Healing and bone growth. Your jawbone grows into and around the surface of the implant post. This can take several months and gives you a solid new root for your artificial tooth.
  • Placement of the connector for the artificial tooth. The piece where your artificial tooth will attach is called an abutment. Your surgeon may place this at the same time as they place the implant so you don't need a separate procedure. However, this depends on which tooth or teeth are being replaced. The abutment will be visible above your gum line, so if you can see it when you talk or smile, you may want to wait for a separate procedure.
  • Healing your gums. You usually need to let your gums heal for about 2 weeks before your dentist can place the artificial tooth.
  • Placement of your new tooth. You can generally choose between removable or fixed teeth. Removable teeth look similar to removable dentures, but they snap onto a metal frame attached to the implant abutment. Fixed teeth will be permanently screwed or cemented onto the abutment. Your dentist may be able to replace several teeth onto one implant and abutment using this method if they are all bridged together.
  • How Successful Are Dental Implants?

Success rates of dental implants vary, depending on your overall health and habits. But, for people with good health and oral hygiene habits, implants are successful 90%-95% of the time.

Since getting implants involves having surgery, you should expect a bit of pain. But, according to several studies, most people say that they had less pain and swelling during and after their dental implant surgery than after having a tooth removed.

After the surgery, you can usually manage your pain and swelling with over-the-counter pain medications, such as Tylenol or Motrin.

The risk of complications is minimal if your surgeon has a lot of experience performing implant surgery. But, like all surgical procedures, dental implant surgery does have potential risks:

  • Infection
  • Sinus damage
  • Nerve damage
  • Implant placed in an area that doesn't work long-term
  • Allergic reaction to the implant material (this is very rare)

Recovery times vary after surgery, but most people can get back to their normal activities in about 3 days. Right after surgery, you may have the following:

  • Swelling and bruising in your gums and face
  • Pain where your implant was placed
  • Minor bleeding

Your dentist or surgeon may prescribe you pain medicine and antibiotics. Make sure you take your medicine as prescribed by your doctor.

Any swelling or pain should get better over time, but if it doesn't, talk to your surgeon.

You may want to eat soft foods until your gums heal.

It can take several months for your jawbone to heal and grow around your implant. You'll need to go to your surgeon and dentist for follow-up visits so they can make sure you're healing well.

Long-term dental care

Dental implants require the same care as your real teeth, including brushing, flossing, and regular dental checkups.

Dental implants are permanent replacement roots inserted in your jaw. Your implant will be a base for a replacement tooth, which could be a crown, bridge, or denture. Getting implants can take several dental surgeries with a few months of healing in between. But, in most cases, they're a better option than dentures, as they tend to be more comfortable and can help you chew, speak, and look better.

Dental Implant FAQs

Is there a downside to dental implants?

The most notable downside is that the process takes some time and patience to complete. You will usually need several surgeries with several months of healing before you will have your replacement tooth or teeth. However, it's mostly better for your long-term health and self-esteem than dentures since the implants are more like your natural teeth.

What are the 3 stages of dental implants?

Depending on your situation, your dental implants may take more or fewer stages. Generally, you will have surgery to place the implant, followed by a period of healing to let your bone grow around it. Then, you will have another surgery to place a connector piece called an abutment. Once you have healed from that, your dentist will place your replacement tooth.

What is the best age for dental implants?

If your jaw has stopped growing (generally over age 18), you are at the best age for a dental implant.

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