Dental Implants are becoming a more common treatment chosen by patients when they loss a tooth. Over the next series of Barron Dental blogs we will discuss all aspects of dental implants from what dental implants are to the long term maintenance of dental implants. All the information below has been taken from the Association of Dental Implantology (ADI) website. The Association of Dental Implantology is a registered charity dedicated to the provision of general information to the public and educating the profession. It is committed to maintaining and improving the standard of implant dentistry within the UK through the dissemination of scientific research and continuing education. For further information, please visit the ADI website on www.consideringdentalimplants.co.uk

What is a dental implant?

A dental implant is an artificial replacement for a tooth root, usually made from titanium. There are many different implant systems available and when competently used they all deliver a highly reliable form of treatment. The main aim during the placement of any implant is to achieve immediate close contact with the surrounding bone. Over time further growth of bone onto the implant surface enhances the stability of the implant.
In order to support replacement teeth, dental implants normally have some form of internal screw thread or post space that allows a variety of components to be fitted. Once fitted, these components provide the foundation for long-term support of crowns, bridges or dentures.

Who is suitable for dental implants?

Dental implants are suitable for most adults with good general health. They can only be used once the jawbone has stopped growing and so generally are not used with younger patients.

Habits such as heavy drinking or smoking can increase the number of problems associated with initial healing and thereafter may be bad for the long-term health of gum and bone surrounding each implant. Some dentists will decline to place implants if smoking cannot be reduced or given up altogether.

However, each case is different and if you do have any medical problems then speak to your doctor or dentist prior to starting any treatment – it is only in some circumstances that health problems prevent the use of dental implants altogether.

How will you know if you are suitable for implants?

At your initial consultation the dentist will assess the feasibility of providing implant treatment. You will be expected to answer detailed questions concerning your medical history and there will be a complete examination of your mouth and remaining teeth to discover the nature and extent of any current dental problems. Usually x-rays will be taken and models of the teeth prepared so that these can be examined after your visit.

These x-rays and models will be used to determine the optimal position for an implant, how many implants can be placed in the gap and the quality and volume of bone that is available.

Establishing good basic dental health is a key stage in any treatment plan. At this first appointment you should be made aware of which problems are urgent, and what treatment is required to stabilise any gum- or tooth-related problems. It would be reasonable to expect a verbal outline of how your particular implant treatment might be approached.

Do you need to have a healthy mouth?

When you first enquire about dental implants it is often in response to an awareness of ongoing dental problems or the recent loss of teeth. The cause of these problems will need to be understood and treated before undertaking implant treatment. If you have a history of gum disease then you have a higher likelihood of having problems with dental implants.

If you are aware of bad breath, loose teeth, or have noticed excessive bleeding, particularly when your teeth are cleaned professionally, you may have gum problems. Gum disease (periodontal disease) is a major cause of bone loss, and with reduced bone dental implant treatment can be more complicated, but not impossible.

How long does treatment take?

For routine cases, from the time of implant placement to the time of placing the first tooth/teeth, treatment times can vary between six weeks and six months.

The availability of better quality bone can be used to decrease treatment time, whilst more time and care must be taken with poorer bone, which can therefore extend treatment times beyond six months.

What should you know before you start treatment?

It is accepted practice that you should be given a written summary of your treatment planning discussion(s), highlighting your current dental situation and any alternatives there are to dental implants.

This summary should also include an overview of the anticipated treatment stages and give you some idea of how long treatment is likely to take, how many implants are required and what the fees are expected to be. There may well be other issues specific to your case and these would be dealt with accordingly.

How long will the implants last?

Once the implants and surrounding soft tissues are seen to be healthy and the new teeth comfortable and correctly adjusted, it is the quality of your personal attention to oral hygiene and willingness to attend regular maintenance reviews that will have most influence on how long they will last. When poorly cared for, implants will develop a covering of hard and soft deposits (calculus and plaque), which is very similar to that found on neglected natural teeth. Untreated, these deposits can lead to gum infection, bleeding, soreness and general discomfort. It could probably be said that implants can last as long as natural teeth.

Well-maintained implants placed into adequate bone can be expected to last for many years and possibly for your lifetime. However, just as you would expect conventional crowns, bridges and fillings to need occasional repairs or replacements, your implant-supported teeth may also have similar maintenance requirements over the years.

How many teeth can be supported by implants?

Dental implants can be used to replace one or several missing teeth. All the common forms of tooth replacement, such as bridges or dentures can be supported by dental implants.

If you are missing just one natural tooth, then one implant is normally all that will be needed to provide a replacement. However, larger spaces created by two, three or more missing teeth do not necessarily need one implant per tooth; the exact number of implants will depend upon the quality and volume of bone at each potential implant site.

Patients who have a habit of clenching or grinding (bruxing) their teeth may be at risk of overloading their implants. For most people, bruxism occurs during sleep, which is why they are generally not aware of it. Heavily worn or flattened teeth, chipped enamel edges and/or regularly breaking pieces of heavily filled teeth are the most common clinical signs of bruxism. The effects of bruxism need to be considered during treatment planning and can be compensated for by placing additional implants, selecting appropriate restorative materials and providing a night time bite guard to protect the new teeth.

This will be discussed in your initial consultation and detailed in your treatment plan.

In Barron Dental’s next blog we will discuss the process and procedure of having a dental implant placed in your mouth.