PROCEDURES AND EFFECTIVENESS
Dental implants are surgical-grade root devices that support permanent tooth prosthetics that are manufactured to last a lifetime. These artificial roots are anchored in the bone beneath the gums where they become fused into the jaw. A crown is mounted atop the implant for a long-lasting and natural looking smile. Many dentists and patients prefer dental implants because they offer the same function as natural teeth and also help prevent bone atrophy in the jaw. Dental implants may be used to replace a single missing or damaged tooth or to restore an entire smile.
DID YOU KNOW
That approximately 30 million people live with no natural teeth in one or both jaws? But more and more dental patients are opting for dental implants as a means of tooth replacement. The American Academy of Implant Dentistry reports that 3 million people currently have dental implants – a number that is rapidly growing by about 500,000 per year. Modern titanium implants were first developed in the 1950’s, but archeologists have determined that ancient Egyptians and Mayans were the first cultures to implant artificial teeth.
Hi there! This is Dr. Thomas at Integrity Dental in Pueblo, CO. We are back to talk about some dental implants today! We will cover some common questions and explain the process a little bit, so thank you for joining us!
What are Dental Implants and how do they work?
Dental implants are a super cool thing! It used to be that when a patient lost a tooth, there were only a few options to replace that tooth. You could do a partial denture or a denture that comes in and out of your mouth. It is a removable prosthesis, which is always a compromise. You never get as good of a result, you do not chew as well, it is not as comfortable, it just doesn’t feel very natural to have something that is removable and comes out of your mouth. Sometimes you could have a permanent option to do a bridge if you had a tooth on either side of the missing tooth. A bridge is when you put a crown on each tooth on either side and hang a fake one in between. That was the only permanent option. If you had a tooth that was the very back tooth and there was no tooth behind it, you could not do a bridge. Implants have come in and given us a lot more flexibility to be able to replace missing teeth. If you do a bridge, you must drill the teeth on either side which is a big drawback. It can sometimes still be a good option if you need to put crowns on those teeth anyway. But at least now we have a good permanent option that does not require drilling on either side or if you lose a back tooth, we can still do an implant. This way we can get you back to a full set of teeth which is important for overall wellbeing.
Who is a good candidate for Dental Implants?
Most people are. But the younger we are, the better off we are. This is because of changes in how much bone we have to work with, how quickly we heal. But I will also say that we have done implants on 97-year-old patients before! Now, that was under some careful consideration, the individual was very healthy, had a good amount of bone, and had good reason to want these implants. There are a lot of factors that we consider when we do implants for someone of that age. But if you have lots of medical problems, or are not super healthy in general, if you have osteoporosis and take medications for it, that can complicate things. So again, most people are good implant candidates, but we always want to talk about the risks. Some people, because of health or mouth conditions or how many bacteria are in their mouth, are less likely to be good candidates. All of those are good things to bring up with your dentist.
What is the key difference between “Mini Implants” and “Full Implants”?
Mini Implants are traditionally used for denture retention. So, you would put in an implant underneath a denture and then on the underside of the denture there is a little clip that snaps on top of the implant and helps hold it in place. That is the only use for a Mini Implant. There are some systems out there that claim they can do a real tooth on a Mini Implant but that is always a compromise. Mini Implants are very skinny, so there is a place for that, especially if the patient only has skinny bone left. But it needs to be handled very carefully, and the research shows us that they tend to be less successful in the long term.
While mini implants come in one piece and are generally harder to work with and clean, regular implants come in different parts and pieces. They are inserted at bone level and sometimes we even encourage gums to grow completely over the top while they heal. There is an internal screw component that is part of a regular implant that we put an abutment in. That abutment attaches to the bone level implant and comes up through the gums and acts like a stump of a tooth that we can scan and put a crown on top of for a single tooth restoration. Or if we are using regular implants to do an overdenture, or a denture that goes on top of the clip, the clip for that denture is the screw. The research shows that those are just a better long-term solution. They last longer and do better for patients, but there is room for both in certain situations. At Integrity Dental, because of the research and technology we have (some of our full implants are really skinny now!) We have not seen a big advantage in doing Mini Implants, so currently we do not offer them here. We find that we get better results and can accomplish what we want to out of the regular implants with the various size options.
Ultimately, they’re all screws that go into the bone and are made out of titanium and the bone grows around it and it becomes fused to the bone. They all work on the same concept in simply different shapes and forms.
What is the Dental Implant process like from start to finish?
The process can look a few separate ways. Some people will come in and have been missing a tooth for a long time! If they have enough good bone left, it is very simple. We will drill a little hole inside the patient’s bone and insert the implant. Then we will let it heal for about three and a half to four months and then you can come back and put the tooth on top of it after it has had time to integrate into the patient’s bone. A very popular procedure that we do now, a more recent thing, is an immediate implant. Say a patient has a bad tooth that needs to be removed, and they know they want a tooth back in there, they want to go the implant route to get a tooth back in there. If the patient meets certain criteria like having enough bone left to attach the implant to, we can often do it all in one day. We will take the tooth out and where that tooth was inside the bone, there is a hole that we will reshape that hole and insert the implant. Not the new crown, which will come after the three to four months of healing with the implant in. Next, sometimes people come in and they have had their tooth removed previously, but do not have enough bone for an implant. That would require extra bone grafting ahead of time before we can put an implant in so that we can build up the bone to implant into. Those are a little more complicated. Those typically will take three to four months for the bone to heal with the grafting and then another three to four months for the implant to heal. Also, sometimes people are not sure if they want to put an implant in there for a missing tooth, or don’t have enough bone to do an immediate implant, so we will take the tooth out and do some grafting at that time, and then we will let that heal for three or four months and then we can decide on an implant.
Then, the restoration process on top of the implant goes something like this. We will put a healing cap on the implant at about gum level. When we want to put the abutment on the implant, we simply unscrew the healing cap. A lot of times, this phase of the healing process is completely painless, and we do not even have to do an injection. We will then screw in the abutment and make sure that it is the correct shape and size for the patient's mouth, and then we will use our same day crown technology. We will scan the abutment and make a digital impression or model of the abutment and the surrounding teeth and design a crown to go over the implant. We then mill it out and send the patient home with a new same day crown on top of the abutment that was just screwed on to the implant that had healed for three to four months.
How do you care for an Implant and how long is the recovery?
The simple answer is that it usually is far less than what the patient thinks! I can’t lie to you and tell you that an implant is going to be painless, because any time you put a screw in someone’s bone, or have to remove a tooth and then put a screw in, there is going to be a bit of discomfort involved with that. But most of the time, if the procedure goes well and the patient is healthy, the patient will usually tell me afterwards in a follow up appointment that they hardly noticed it was there. Especially if we had to do things like take out a badly infected tooth and graft bone in and do a lot of those things, there may be more discomfort. But we have actually found that by cleaning out the infection, putting an implant in, grafting around it, and disinfecting the area vs just pulling the tooth out and leaving the empty space, there is actually less discomfort than just the regular old extraction. So, there is some discomfort afterwords, but not excruciating pain. I tell people it’s sort of like a bruise, if you leave it alone, it shouldn’t bother you much. But if you push on it or chew on it, yes, you will have some discomfort.
Next, how do you care for implants? Well, you are healing for about three to four months. The first two weeks you want to be very careful not to vibrate it too much. You do not want to use an electric toothbrush on it or anything like that. We would usually use rinses during that time, whether it is a warm saltwater rinse or a prescription rinse. They help keep that area clean, help keep low bacteria, and keep infection from wanting to set in. After a week and a half to two weeks, they can use a regular toothbrush. Again, not an electric one, if you only have an electric one, we recommend that you turn it off and just use it like a regular toothbrush. You’ll gently massage the gums around the gums, and then after 3-4 weeks you should hardly notice that it is there, and you can go back to treating it very normal again. You will then come back after about 3-4 months, and we put the crown on top with our same day crown technology. After that crown is on top of the implant, you treat it just like a regular tooth. One advantage to an implant is that you cannot get a cavity in metal or ceramic! So, we do not have cavity problems on implants. But you can still get gum disease. So, you must clean it, you must take care of it, just like you do with a regular tooth.
How long do Dental Implants last?
This is a loaded question with no simple answer. With all dentistry, there is an expiration date. Nothing will last forever. But implants are one of the longest lasting things that we do. According to the most recent research we have at this time, if an implant is done properly and maintained well, it should last an average of 30-40 years! There are so many factors that can play a role in that. There are cleaning factors, health factors and changes, dry mouth, and so many others! With all those factors, so long as everyone tries to do their job right, there is about a 94-95% chance that your implant will still be present and working well after 30-40 years.
Do check ups affect longevity?
Absolutely, it is the same as anything else in the dental world and even in the medical world. Early detection is so important in trying to get ahead of big problems! If an implant starts to have a problem, it can be fixable if you catch it early. The longer an infection goes undetected and the worse the quality of bone there is around the implant, the harder is to get in to save the implant.
How can I get scheduled?
If you have any other questions, please let us know here at Integrity Dental! We would love to talk with you if you have any interest in implants, they are wonderful and a fantastic addition to what we are able to offer our patients here at Integrity Dental. If you have any interest at all or want to have a consultation to talk about this, we would love to meet you. So, please give us a call at (719)545-2468 or check out our website at letushelpyousmile.com