What is a dental implant?
– A dental implant is a post that is placed into your jawbone to serve as the foundation for a tooth.
Implants in medicine don’t last forever and need to be replaced at regular intervals, however in dentistry people have the belief that things last forever which is just not the case. If I’m replacing a tooth with an implant and that tooth did not last forever, why would you expect an implant which isn’t as good as a natural tooth to last longer? It’s just not going to happen. Implant longevity is usually evaluated at 10 years as the standard. I’ve seen some last for less than 5 years and some still in the mouth 25 years later.
There are many factors that contribute to the long-term success of an implant. These include:
We try to control as many of these variables as we can to make things more predictable but the more factors we have to fight against, the less likely we will win. Along the way, much like a tooth, the implant may need some revision to extend its longevity. This can mean a bone graft, gum graft or changing the crown.
Let’s take a look now at the different stages involved in getting a dental implant. The best and most predictable method is an immediate implant – this occurs when we extract a tooth and place the implant the same day. A bone graft will also be done to cover the gaps where the tooth/roots were because the implant won’t be as large as the roots/socket space. An immediate implant will save you time and money but more importantly, it will preserve as much of the bone and gums as possible.
Sometimes we cannot place an immediate implant for anatomical reasons. In this case, we will graft the area after removing the tooth to maintain as much bone and gum as we can. After the graft heals (3-6 months), we will go back in and place the implant. Once the implant is placed, it will need to heal and integrate with your own bone to become one piece. This healing phase, which typically takes 3-6 months, is crucial to achieve a secure attachment. Now comes the second phase of the procedure. At this appointment, an abutment will be placed on the implant and an impression will be taken to fit for a crown. The final step, which occurs about 2 weeks later, involves securing the crown to the implant.
What if you are missing all of your teeth? Can you do implants for a full mouth? Absolutely!
Full mouth implants refer to any implant procedure that replaces all of your missing teeth in either the upper or lower arch. This is usually done with two to six implants working together to support a full bridge or denture. Four implants is the best option for stability, but six would be even better. Treatment options for the upper and lower arch are basically the same, however additional implants are sometimes needed on the upper to compensate for softer bone.
How do I clean my implants?
Just like natural teeth, plaque can collect on implant crowns and harbour bacteria. Remember that both natural teeth and dental implants rely on healthy supporting gums and bone for support. Proper oral hygiene can be very time consuming and the commitment needs to be there from day one, and if possible, before the implant treatment. Neglected implants develop plaque and tartar which can lead to peri-implantitis, an inflammatory condition that affects both the soft and hard tissues surrounding implants. If left untreated, bone loss can occur and lead to the implant becoming loose. Essentially, there are two parts to implant maintenance and success – regular checkups and cleaning by your dental team and your daily oral hygiene habits. How you care for your implant is critical to its overall health and long-term success.
Oral hygiene doesn’t change all that much for implants but some of the details are different. The gum tissue that forms around an implant is different than the tissue around natural teeth. The connection is not as strong so the gums aren’t as resilient. Even flossing the same way you would floss natural teeth can damage the gums around an implant. Use floss that won’t shred or fray (avoid tufted floss or Superfloss) as floss particles can become stuck under the implant, which can increase the risk of infection or plaque build up around the implant. Flossing around dental implants should be done very gently – never push the floss down into the gum pocket.
A Waterpik® is probably the best tool to use around implants. It loosens and flushes away plaque with a pressurized water stream. You can control the power of the device and use it at a lower setting around implants. Brushing is the same as you would brush natural teeth – use a soft-bristled manual toothbrush or an electric toothbrush.
What to know more or to find if implants are right for you? Call us to make an appointment
Implant surgery is generally very well tolerated especially compared to tooth extractions. You may be a little sore after but most people are fine the next day depending on the surgery. If other procedures were done at the same time like a sinus lift or bone graft then it might be more tender afterwards. However, most people do fine with just over the counter Ibuprofen for pain management.
Although this is rare it can happen. We always recommend to confirm with an allergist. Implants are made of a titanium alloy and most of them will have trace amounts of Nickel which is one of the most common metal that people develop an allergy to. If this is the case then Ceramic implants may be a better option for you. Check out our page on Ceramics to find out more.
Implants can fail unfortunately. They may fail in the healing phase and this can be due to medical history, poor oral hygiene, anatomy, chewing on the implant before healing is complete, poor bone support or a previously grafted site that did not heal, infection in a nearby tooth. If this happens we must remove the implant, clean the site and attempt another surgery after eliminating as many variables as possible. An implant can also fail later on after a tooth has been connected. This can be due to gum disease, oral hygiene, an excessive bite on the implant tooth, premature biting on the implant before it was healed, changing medical history that affects wound healing and bone support.
Sometimes we cannot place an implant right away and we want the body to heal and fill in bone in a defect or the space where a tooth used to occupy. In order to achieve this we must place a bone substitute that acts as physical support and tells the body to fill in that area with its own bone. Otherwise that area can cave in and we can lose up to 50% of the height and width of the space in the first year alone. This makes it much harder to place an implant and we must try to regrow the bone which is more expensive and less predictable.
Don’t worry, implants will not affect your travel plans! Implants are made from titanium and do not set off any metal detectors or alarms.
No, we cannot. Implants only attach to implants and teeth only attach to teeth. The reason is implants don’t move and teeth do. So if we mix the two then we get torqueing on the implant which leads to broken screws, decay on the tooth and fractured bridges.
Depending on the procedure and what is necessary, once we place the implant you can expect to get a tooth 3 months later. If we can’t place the implant and must graft then it’s another 3 months for healing. General rule is bone healing takes 3 months.
Yes! Implants do not do well under grinding/clenching. They cannot adapt like teeth would so they have to be protected under any excessive biting forces.
You cannot get a cavity on an implant tooth however you can still get gum disease as answered below!
Yes, you can. Implants unlike teeth cannot adapt or fight off disease so their response to gum disease is much worse and faster than a tooth. It is very important to maintain your implants with proper oral hygiene and regular check-ups and cleanings so we can identify any issues early on before they become more advanced.