Everything you need to know about dental implants

What is a dental implant?   

You can get an implant if you want to replace a lost tooth. A dental implant is a titanium screw, placed into the jawbone. Above the gum line, the titanium screw will have a false tooth made of ceramic. It is possible for one implant to carry 1 or 2 false teeth. This means, you can have for example 2 or 3 implants in one quadrant of your mouth, that support a whole row of false teeth to replace the missing ones. 

How long will dental implants last?

Longevity of implants depends greatly on how well you are taking care of them. This means cleaning the implants, your gums, as well of the rest of your mouth. And having regular (in most cases every 3 months) professional cleanings by the dentist/hygienist. If your implants are well looked after, and if the bone around them, is strong and healthy, you can expect them to last for many years. However, just as with other surgical implants (e.g. hip replacements), there is no lifetime guarantee.

Can you have dental implants if you still have some of your own teeth?                     

You can replace all your teeth or have a single implant amongst your own teeth. You can also have 4 or more implants placed in each arch and have a denture clipped onto the implants. This will give you more stability than an ordinary set of dentures that have very little to hold onto.

Can anyone get dental implants?

No, not everyone is a candidate for implants. One of the considerations is the amount of bone and the quality of bone you have in the site where the implant needs to be. If you are a smoker or have underlying systemic conditions, there will be an increased risk for implant failure. If you have periodontal disease, or lost your teeth because of periodontal disease, you are not a good candidate for implants.

It is important to understand that smoking reduces the body’s immunity. Some dental professionals will not place implants if you are a smoker, because the of the increased risk of implants failure. Other systemic conditions also lower the body’s immunity, and therefore you should always take a holistic approach when you want to have implants done.

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Can children get dental implants?

Yes, children can have implants, but only when the facial bones are fully developed. The bone matures faster in girls than in boys. The latest research indicates that it’s better to wait till the child is around 18 to 20 years old before placing implants.

Implants are a good option to consider for the following two rare genetic conditions: Anodontia and Hypodontia. Anodontia is the absence of all natural teeth and occurs in less than 2-8% of the population regarding permanent teeth (0.1-0.7% regarding primary teeth).

Hypodontia is the absence of six or more teeth and occurs between 2-8% of the general population. For children with one of these genetic conditions, implants are a great way to give them the ability to eat, talk and smile. Until these children are old enough to have implants done, they will need to wear dentures or partial dentures. Of course, cost and accessibility to good dental care can be a great challenge.

Can dental implants always be used to replace missing teeth?

It depends on the condition of the bone in your jaw. A dentist/specialist will take a 3D scan, to determine if there is enough bone and will assess the quality of the bone. If there isn’t enough bone, or the quality of the bone is not good enough, a bone graft can be done first. A bone graft might not always solve the problem. Each case needs to be assessed individually to determine the needs, possibilities, and options.

Is getting dental implants a painful process?

Placing an implant is a routine dental procedure for an experienced clinician and can be done under local anaesthetic, conscious sedation (a drug-induced depression of consciousness) or in hospital under general anaesthetic.

Just like for an extraction or a filling, you will be given local anaesthetic to numb the area where the implant is getting placed. You might feel some discomfort, just like after an extraction, during the week after the procedure was done when healing is taking place. In rare cases, the implant can become infected and there are complications.

How long does the treatment take?

Often, the dental implant will be placed and the get buried underneath the gum. About 3 months later, the implant will be exposed and if the implant has successfully fused with the jawbone (osseointegrated) a healing abutment will be placed onto the implant.

At this stage, the healing abutment will stay visible above the gums. Within the next week or two, an impression will be taken of your mouth and the laboratory will proceed in making the false tooth that will be placed on top of the implant screw. The healing abutment will be taken off and be replaced with the ceramic tooth made in the laboratory. The length of time from start to finish varies from person to person and depending on what implant system and technique is used.

What about aftercare?

Your dentist/dental hygienist will give you detailed aftercare instructions. Just like after an extraction, you will be advised not to eat on the side where the implant is placed. If you had implants placed in more than one side of the mouth, you will be instructed to have a very soft and bland diet.

 A special mouth rinse might be given to you to be used for the next couple of days. You still need to brush the rest of your teeth (if you have some of your own teeth) and make sure your mouth is clean to assist in the healing process.

Do I need to clean my dental implants?

Once you have implants done, your after care and oral hygiene must be impeccable, because bacteria will destroy the bone around the implant, just as it will destroy the bone around a natural tooth. Lots of people think you can simply get your own teeth extracted when they are not good anymore just replace them with implants!

Even more care and maintenance are necessary to maintain your dental implants. The risk of implant failure in an environment where plaque and calculus (calcified plaque) is present, is tenfold! In some cases the reason implants are needed is because the patient didn’t take adequate care of their own teeth. If you do not rectify your oral hygiene habits and/or frequency thereof, the dental implants will follow the same route as your natural teeth did.

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How do I clean my dental implants?

The aim is to remove as much plaque as possible and to have regular (usually every 3 months) professional cleanings with your dentist/hygienist. Because the natural anatomy of the mouth has been altered after extractions, and implant placements, it is sometimes difficult to reach the area around the implants.

Specially designed brushes and floss are available to clean these difficult to reach areas. Speak to your dental hygienist to show your how to use these brushes and floss and show you what your individual needs are. It is important to understand that plaque do not stay in one place. The whole mouth needs thorough cleaning and in doing so, reduce the number of bacteria present in the mouth, not only around the implants.

If I had gum disease when I had my own teeth, will it reoccur when I get dental implants?

Having had gum disease means that you will always be prone to gum disease if you are not taking good care of your mouth. The specific bacteria responsible for gum disease are present in your mouth and needs to be kept under control by trying to remove as much bacteria as possible.

It will never be possible to rid your mouth completely from all bacteria. All that you can do is to try and reduce the number of bacteria as much as possible. This is achieved by brushing, flossing and other forms of interdental cleaning. Like mentioned before, not only around the implant, but throughout the mouth.

Is it possible to remove the false teeth that are placed onto dental implants?

There are two different ways of replacing teeth with implants. One way is where the teeth are screwed onto the implants (or cemented onto the implants). This is mostly done when only one or more teeth need replacement.

When you don’t have any of your natural teeth, a denture like structure is made that clips onto the implants. If the denture clips onto the implants, it is possible to remove it. But the denture can also be cemented/screwed onto the implants, in which case you are not able to remove it.

Will dental implants be visible?

In most cases, the implants will look like natural teeth without the metal pin showing. This depends how well you are maintaining your implants. Good oral hygiene will reduce the risk of bone loss and gum recession so that the implant itself is not visible.

Do I need one dental implant for each missing tooth?

If you have a single tooth missing, you will need one implant to replace that one missing tooth. If you have several teeth missing, one or two implants may support a few teeth. This will be different for everyone, and your dentist/specialist will guide you accordingly.

Can I break a dental implant?

Yes, just like natural teeth, the implant or the implant tooth can be damaged by an accident. If it is only the tooth (implant crown), it is relatively easy to remove it and be replaced with a newly made ceramic false tooth by the laboratory.

If the titanium implant is damaged, it is more complicated. It might be possible to remove the implant and another one can be placed. Alternatively, the broken implant might be buried in the jaw and another one will be placed along side of it and a new implant crown will be made to fit on top of it.

If a dental implant fails, can I get another one?

In some cases, yes, but it depends on the reason for failure. If the bone quality/density has degenerated since the original implant procedure was carried out, or if the bone around the implant is destroyed by bacteria, it might not be an option. In rare cases, someone can have a titanium allergy.

What will cause a dental implant to fail?

Once an implant is placed and fused with the jawbone(osseointegrated), the major reason for failure is poor dental hygiene. This will lead to deterioration of the quality and quantity of bone with the result of implant failure.

What are the signs of dental implant failure?

• Pain in the area of the implant – a dull ache or when biting on the implant.
• Inflamed gum around the implant – the gum will be red and swollen with/without pus.
• Mobility of the implant.

What is the success rate for dental implants?

Studies suggest, when the patient is compliant with good dental hygiene, less than 5% of dental implants fail within 10 years of placement.

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