When it comes to missing teeth, there are a variety of restorative options to choose from. Dental implants are considered by many to be the best treatment option for achieving an authentic look that offers stability and comfort. They are specially made to look and function like natural teeth.
A dental or tooth implant is a threaded titanium post that is placed into a small hole during surgery in the upper or lower jaw. Implants take the place of natural tooth roots and provide a stable base for the attaching artificial teeth, known as crowns. (1) The implant and crowns are connected by an abutment to support and hold the tooth into place. (2)
If you have a missing tooth or teeth, you cannot simply choose to have a dental implant as your restoration of choice. Dental implant candidacy is determined based on several factors, including: (3)
- Oral health: Oral health issues that must first be treated before an implant can be considered. Gum disease, for example, will affect your candidacy.
- General health: Diabetes and cancer are two examples of health conditions that may prevent implantation.
- Age: Implantation may only be considered after adolescence, once bone growth is complete.
- Bone/gum tissue: An insufficient level of bone and/or gum tissue may prevent implantation without a bone or gum graft.
- Smoking status: If you are a smoker, you will be advised to quit before treatment. Implant failure is considerably higher with smokers.
- Crowded teeth: If your surrounding teeth are too close together, it may not be possible to fit an implant in the space. These cases require alternative considerations.
Dental implants are not for everyone, and some factors may influence your eligibility to receive them such as:
- Children who are still growing may not be eligible to get dental implants until their jaw is fully grown and developed.
- Chronic diseases such as diabetes or cancer may also affect your eligibility for dental implants, as these conditions prevent proper wound healing after surgery. (4)
- Smoking interferes with the healing process. If you are a smoker, your dentist may recommend other alternatives to dental implants.
Your dentist will review your health history and current lifestyle habits to determine if dental implants are right for you.
To start, your dentist will perform a thorough oral exam to ensure your mouth and jawbone are healthy enough for surgery. They may take x-rays, 3D images, and make models of your jaw and teeth. (3)
Before surgery, your dentist may prescribe you antibiotics to help prevent early implant failures and bacterial infections. (5) You may also be required to rinse your mouth with an antibacterial mouthwash (chlorhexidine). (6)
If your jawbone is not healthy enough for dental implants, you may need a bone graft before the procedure. Bone grafts can be used if your jawbone is not thick enough, or if it is too soft to provide a stable base for implants. Several materials can be used to rebuild a jawbone, including natural bone from your body, or a synthetic graft using a bone-substitute material. (7) Your oral surgeon will discuss which option will work best for you.
If you need a bone graft before implantation surgery, you may need to do it several months before placing the implants. In some cases where only minor grafting is needed, the procedure can be done on the same day as implantation surgery.
Dental implantation surgery is typically performed in your dentist’s office using local anesthesia. The process can be broken down into three parts:
- The oral surgeon opens your gum to expose the bone; then, they drill holes into the bone where the dental implant post will be placed. The implant post, made of titanium, will fuse with the bone over the next three to six months in a process called osseointegration. You will still have a gap where teeth are missing during this time. Your dentist may offer you a temporary partial denture to use for aesthetic purposes. The abutment may also be attached to the implant at this step.
- If the abutments are not placed during step 1, then they will be placed after osseointegration is complete. This will be minor surgery performed in an outpatient setting. The oral surgeon will reopen your gums to expose the healed implant; then, they will place the abutment into the implant and close to gum tissue around it. The healing process takes approximately two weeks.
- After the abutments have been placed and healed, the artificial tooth, or crown, can be attached. Your dentist will make molds of your mouth and remaining teeth to construct the crowns. There are two types of crowns to choose from: (7)
- Fixed Crown: This crown is permanently attached to the implant by either screwing into the abutment or being cemented. It cannot be removed for cleaning or sleeping. Typically, in this case, each crown will have its own dental implant.
- Removable Crown: This crown is similar to a conventional denture and can be a partial or full piece. It will be made of artificial white teeth surrounded by a pink plastic gum. The denture is mounted onto a metal frame that attaches to the implant abutment, and snaps securely into place. These can be removed for daily cleaning or repair.
Dentures and dental bridges offer alternatives if dental implants are not for you. These are cheaper, less intensive options to replacing a missing tooth or teeth. They include: (8)
- Removable partial dentures
- Removable complete dentures
- Tooth-supported fixed bridge
- Resin-bonded bridge
As with any surgical treatment, there are risks associated with dental implants. The primary risk associated with dental implantation is implant failure. If osseointegration does not occur, the implant will fail, and alternatives will need consideration.
Additionally, broken implants could lead to infection that requires further surgery. This being said, implants are incredibly safe and very reliable. Dental implants require an intensive process and surgery to place.
Some side effects of most dental surgeries that may occur include: (7)
- Bruising of the skin and gums
- Pain at the implant site
- Swelling of the gums and face
- Bleeding at the implant site
- Infection at the implant site
- Nerve damage, which can cause pain, tingling or numbness in teeth, gums, lips, or chin
- Injury to other teeth or blood vessels in/around the mouth
- Sinus problems if dental implants inserted into the upper jaw jut out into the sinus cavities
Everyone heals at different rates from surgeries, and recovery from dental implants is no exception. On average, patients can expect a two to four-month recovery period following implant placement.
After each surgical session, eat soft foods to help the implant sites heal. You may also have stitches placed that will dissolve on their own; if not, they will be removed after the incision has healed.
It is imperative to practice excellent oral hygiene, visit your dentist regularly, and avoid causing any damage to the crowns. Chewing on hard objects, such as hard candy or ice, may crack or break your crowns – or your natural teeth, even.
Additionally, caffeine and tobacco may stain your crowns. If you grind your teeth, talk to your dentist about getting a mouth guard to prevent any damage from occurring.
The exact cost for dental implants will depend upon many variables. While implants are one of the more expensive treatment options, the long-term benefits may save you money and enhance your quality of life.
The price of a single tooth implants typically costs between $3,000 to $4,500.9 However, the cavity-resistant nature of dental implants means that patients may get a lifetime of use with proper care and follow-up with their dentist.
- American Academy of Implant Dentistry. What are dental implants? https://www.aaid-implant.org/dental-implants/what-are-dental-implants/
- American Dental Association. Dental implants – An option for replacing missing teeth. J Am Dent Assoc. 2005;136:255. https://www.ada.org/~/media/ADA/Publications/Files/patient_47.pdf?la=en
- American Association of Oral and Maxillofacial Surgeons. Dental Implant Surgery. https://myoms.org/wp-content/uploads/2019/09/Ebook_dental_implant_R.pdf
- Mouth Healthy. https://www.mouthhealthy.org/en/az-topics/i/implants
- Romandini M, De tullio I, Congedi F, Kalemaj Z, D’Ambrosio M, et al. Antibiotic prophylaxis at dental implant placement: Which is the best protocol? A systematic review and network meta-analysis. J Clin Periodontol. 2019;46(3):382-395.
- Abraham HM, Philip JM, Kruppa J, Jain AR, Krishnan CJV. Use of Chlorhexidine in Implant Dentistry. Biomed Pharmacol J. 2015;8(October Spl Edition).
- Mayo Clinic. Dental implant surgery. January 29, 2019. https://www.mayoclinic.org/tests-procedures/dental-implant-surgery/about/pac-20384622
- American Academy of Implant Dentistry. Implants versus dentures and bridges. https://www.aaid-implant.org/dental-implants/implants-vs-dentures-and-bridges/
- American Academy of Implant Dentistry. Patient FAQ for Dental Implants. https://www.aaid-implant.org/faq/#265