Dental implants are artificial teeth that are implanted into the mouth and jaw, often used when adults lose their permanent teeth as they age. Most dental implants are made to look, feel and act like natural teeth and are the closest thing you can get to natural, healthy teeth. Not only does this help preserve the aesthetic view of the mouth, but dental implants also preserve the overall structure of the mouth by keeping the other teeth from moving out of their normal positions in unnatural or painful ways.
A dental implant is made of a metal post topped by an artificial tooth.
This implant is installed into the gum line to keep the structure of the remaining teeth and to keep natural chewing and biting intact. Dental implant surgery replaces the root area of the missing tooth with metal, screw-like posts in which the artificial tooth can be implemented. The artificial teeth look and act just like real ones, so this type of surgery can be a great alternative to wearing dentures or having ill-fitting bridgework done.
Dental implant surgery may be performed in several steps depending on the kind of implant you’re getting and the health of your jawbone. The process requires the jawbone to heal tightly around the dental implant area (called osseointegration), effectively assimilating it into the gum line as if it were a natural tooth. The implants are surgically placed within the jawbone and serve as the “root” of the artificial tooth being implemented. Titanium is often used for this procedure because it fuses the implant with the jawbone, remains firmly in place, and won’t decay like some kinds of bridgework.
Why Should You Get Dental Implants?
There are many reasons to have dental implants: you have one or more missing teeth; your jawbone is strong enough to have the procedure; you’re unable (or unwilling) to wear dentures; or you have a speech impediment that could be improved by adding one or more dental implants to your gum line.
Like with any medical procedure, there are risks involved with dental implant surgery. While issues or complications are rare, there is still a risk of infection at the implant site, which can lead to other issues later on.
Other possible complications from dental implant surgery include damage to the surrounding teeth or nerve damage to adjacent teeth, lips or gums. If you’re discussing the possibility of dental implants with your dentist or oral surgeon, they will discuss these risks and address your concerns ahead of the procedure.
Dental Implant Surgery Procedure
Because several surgical procedures are required for dental implants, your dentist or oral surgeon will do a full and thorough evaluation, including X-rays and teeth models, to ensure the dental implants will closely match your natural teeth. Next, the condition of your jawbone will be judged in relation to how many teeth you plan on having replaced with implants. This planning process could involve several types of dental specialists (including a maxillofacial surgeon and a periodontist), so don’t expect it to be a quick process.
Your dentist will also want to know about any medical conditions you may have and any medications you are taking, including those bought over the counter. Do you have any heart conditions or orthopaedic implants? If so, your dental specialist may prescribe certain antibiotics before the surgery to help prevent infection. Your dentist will know and discuss the three surgical anaesthesia options and which will be best for you during the procedure. Your surgical team will also have a list of “dos and don’ts” you should adhere to leading up to the surgery.
If you haven’t already, arrange for a friend or family member to drive you to and from the surgery because you’ll be in no condition to drive yourself after the procedure. Expect to be in “full rest” mode for the rest of the day following the surgery.
During the Surgery
Dental implant surgery is often done in several stages, requiring the jawbone to heal completely around the implant before more work is done.
- The damaged tooth is removed (if it hasn’t already come out in some other way).
- The jawbone is prepped for surgery; this may include some measure of bone grafting.
- Once the jawbone heals, the implant is inserted into the gum line.
- The jaw will be given time to heal again, and then the surgeon places the abutment (the piece that screws into the implant) and attaches the artificial tooth on top, completing the full implant.
This process could take up to several months to allow your jaw time to heal and prepare for the final installation of the implant. Without a strong jawbone in place, the implant won’t take, so it’s important to be patient during the healing process.
Dental Implant Surgery and Bone Grafting
The current jawbone site for your implant may not be thick enough or it could be too soft. Because your jaw creates so much pressure while chewing, the bone needs to be extra strong to handle both the chewing and protecting of the dental implant once it’s been surgically added to the gum line.
Depending on the structure of your jawbone, you may need a little extra bone added to give the implant site a more solid foundation. This is done through a process called bone grafting, a procedure in which a small bit of bone is transplanted to help solidify the implant base within the jawbone. This bone transplant typically comes from another area in the upper or lower jawbone away from the dental implant area, but it could also potentially come from another part of the body. The condition of your jaw determines whether you’ll need to have the bone heal first or whether the extra bone structure can be added at the same time as the implant (which would be the ideal situation in terms of time).
While the implant heals, you’ll be given a temporary denture to keep the appearance of a full tooth. The denture will be removable and should be kept clean at all times. During this time, osseointegration will be occurring. Osseointegration is when the bone begins growing into and uniting with the surface of the implant, making it a part of the natural gum line. The process can take anywhere from three to nine months and will operate the way the roots of a natural tooth would.
Placing the Abutment
When the healing and osseointegration processes are complete, the abutment is installed. An abutment is a piece that screws into the dental implant and to which the artificial tooth will attach later. This is a minor outpatient procedure and will most likely be done under local anaesthesia. The abutment can be attached to the implant during the initial implantation phase, but many people don’t care for the visibility of the post and thus elect for a second procedure to install it later.
To place the abutment, the oral surgeon will reopen your gums so that the dental implant is exposed. Once exposed, the abutment is attached to the dental implant. The gum tissue is then closed back around the abutment and left to heal for one to two weeks.
Choosing Your New Artificial Teeth
Once your gums have healed, more impressions will be made of your mouth and the remaining teeth so they can be used to make the artificial tooth, or crown, for your dental implant. There are two main types of artificial teeth you’ll be able to choose from — a removable implant prosthesis or a fixed implant prosthesis.
Going the removable route is similar to a removable denture mounted on a metal frame that snaps securely onto the implant abutment.This is a great choice because it can be removed easily for cleaning or replacing, especially when several teeth have been removed and required dental implant replacements. It’s also a more secure and affordable option.
If you choose to get a fixed implant, understand that the tooth cannot be removed for cleaning or easy replacement. It’s either permanently screwed on to the abutment or cemented down. Should you have several teeth that require implants and money isn’t a concern, you can have all of them replaced in this manner with each crown attached to its own separate dental implant.
Discomfort is natural and normal after dental implant surgery. Here’s what you can expect:
- Swelling of the face and gums
- Bruising of the gums or skin
- Pain at the site of your implant surgery
- Minor bleeding
If any of these symptoms get worse several days after the surgery, contact your dentist or oral surgeon immediately because they may indicate larger issues that need to be addressed by a professional. To help you heal post-surgery, your dentist or oral surgeon may advise a post-surgery diet of soft foods, compressing ice packs (to help the swelling) and patience while the surgical site heals.
While the majority of dental implants are routine procedures and the majority of dental implant surgeries are successful, there may be complications, including issues with the bone fusing to the implant. This can usually be prevented by doing the following things:
- Avoid using tobacco products — they can stain your teeth and may increase infections.
- Practise proper oral hygiene by brushing twice a day and flossing at least once a day.
- Attend regular dental office visits and examinations to stay on top of your oral health.
- Avoid bad oral habits, like chewing on ice or hard sweets — these can damage both your real teeth and implants.
If you think you may be a candidate for dental implants, talk to your dentist or oral surgeon about dental implant surgery.