What is a dental implant?
The best way to describe a dental implant is to compare it to a real tooth. A natural tooth consists of a root and a crown. The part of the tooth that you see and eat with is called the crown. Beneath the crown is a root, which anchors the tooth through the gum tissue to the jawbone. When you lose a tooth, you lose both the root and the crown. To replace a tooth, we first have to replace the root. Essentially, a dental implant is a new root. This titanium root is fitted into a socket that is created in your jaw, replacing the lost root of your natural tooth.
Dental implants come in various shapes and sizes and have different types of surfaces. The actual implant selection will depend on a variety of factors related to your specific treatment needs and the most appropriate one(s) will be used. Once an implant has been placed in the jaw, the bone around implant will need to heal for six weeks to six months, depending upon how hard the bone is. When this initial phase of healing is completed, a support post called an abutment will be placed into the implant itself and then a new crown, or replacement tooth will be placed on top. If all your teeth are missing, a variety of treatment options are available to support the replacement teeth.
How are dental implants placed?
Usually, the office procedure to place a dental implant takes about an hour for one implant and no more than two or three hours for multiple implants. The placement process consists of the following steps:
- We will discuss anesthesia options at your consultation appointment. On the following
day of implant placement, you will be given local anesthesia and sedation, if desired, to make you comfortable.
- A small incision is made into the gum tissue, revealing the bone into which the implant will be placed.
- Using special instruments, a space (socket) is created for the implant.
- The titanium implant is then inserted into the socket.
- Finally, if necessary, sutures will be used.
After the implant is placed, the area will need to heal for six weeks to six months. The length of time is determined by a variety of factors, including how hard your bone is.
Follow-up care (one to four appointments) is usually needed to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment.
Is there another way I can have a tooth replaced other than a bridge?
Yes. Dental implants can provide artificial teeth that look natural and feel secure. Dental implants can also be used to attach full or partial dentures. Implants, however, are not an option for everyone. Because implants require surgery, patients must be in good health, have healthy gums, have adequate bone to support the implant and be committed to meticulous oral hygiene and regular dental visits. If you are considering implants, a thorough evaluation by your dentist will help determine if you would be a good candidate.
What is involved in placing implants?
First, surgery is performed to place the anchor. Surgery can take up to several hours, and up to six months may be required for the bone to grow around the anchor and firmly hold it in place. Some implants require a second surgery in which a post is attached to connect the anchor to the replacement teeth. With other implants, the anchor and post are already attached and are placed at the same time.
After the gums have had several weeks to heal, the next step begins. The artificial teeth are made and fitted to the post portion of the anchor. Because several fittings may be required, this step can take one to two months to complete.
Implant surgery can be done either in a dental office or in a hospital, depending upon a number of factors. A local or general anesthetic may be used. Usually pain medications and, when necessary, antibiotics are prescribed. Your dentist will give you instructions on diet and oral hygiene.
What type of maintenance do dental implants require?
Implant crowns and other prosthetic (false) tooth replacements are made to be remarkably failsafe systems. They are removable and replaceable (only by your dentist), so that if damage or wear necessitates replacement, this can be accomplished without affecting the implant(s) or attachment to the bone.
Nevertheless, implants do require maintenance. It is important to practice good daily oral hygiene, including brushing and flossing to control bacterial biofilm. It is also important to see your dentist and dental hygienist. Special instruments are necessary to clean dental implants that will not damage their metal surface beneath the gum tissues. Your dentist will need to monitor your implants to make sure the integrity of the osseointegration is stable, and that the implant crowns, bridgework or dentures are functioning adequately.
POST Placement Instructions
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will be a metal healing abutment protruding through the gingival (gum) tissue.
Some bleeding or redness in the saliva is normal for 24 hours. If bleeding continues please call for further instructions.
Swelling is very minimal but a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 36 hours.
Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.
You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, 1 or 2 Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, bought over the counter comes in 200 mg tablets: 2 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.
Be sure to take the prescribed antibiotics as directed to help prevent infection.
Good oral hygiene is essential to good healing. The night of surgery, use the prescribed Peridex Oral Rinse before bed. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas.
Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.
Wearing your Prosthesis
The use of partial dentures, removable temporaries, or full dentures may usually be used immediately after the surgery. However, each case is different and your dentist will go over instructions for your specific case.