What are dental implants?
Implants are a close approximation of healthy, natural teeth. They stay in place while you to smile, eat, and talk without fear of having them come loose.
These long-lasting tooth replacements are held in place by screws embedded directly into the bone of your jaw. In a short time, the implant bonds with your jawbone, becoming the foundation for new, custom-made dental crowns that have the look, feel, and stability of real teeth. Implants can replace a single tooth or all 28.
Dental implants have a solid track record of success: dentists have been using and perfecting this technique for over 30 years. According to the American Academy of Implant Dentistry, “dental implant surgery is one of the safest and most predictable procedures in dentistry.” Approximately 450,000 implants are placed each year with a 95% success rate.
What are the pros and cons of dental implants?
Pros
- Dental implants look, feel, and function like natural teeth.
- They stay in place and don’t require removal for cleaning or eating—just the same brushing, flossing, and regular dental checkups as natural teeth.
- These replacement teeth are durable enough to last decades, as opposed to dental bridges and dentures that may need to be replaced.
- Implants help stimulate jawbone growth and prevent bone loss.
- They help retain your natural face shape and smile.
Cons
- Even with dental insurance covering part of the cost, dental implants can be very expensive.
- It takes several weeks or even months for new jaw bone growth to occur so you can complete the dental implant procedure.
- Gums may look gray or black where the embedded metal implant shows through thin tissue.
Who’s a good candidate for dental implants?
People typically get a dental implant after extracting a tooth due to infection or decay. If you’ve had a failed root canal or apicoectomy, removing the infected tooth and replacing it with a dental implant can be more effective than trying to save it with additional procedures.
As an alternative to dentures, All-on-4 dental implants can replace an entire top or bottom arch of teeth. For those unwilling or unable to wear removable dentures, implants offer an alternative route.
Ideal candidates are healthy and in generally good oral health, with enough bone in the jaw to support the implant. Heavy smokers, people suffering from heart or gum disease, or patients undergoing radiation therapy to the head and neck area may not be good candidates.
For people who don’t have enough bone in their jaw to support the implant, a dental bone graft can fortify the site. It calls for additional surgery and three to four months of healing time, at which point the bone should be ready for dental implant placement.
Autoimmune diseases like rheumatoid arthritis or diabetes, which can prevent osseointegration (the process by which the implant fuses with the jawbone), could cause dental implant failure. Certain medications for heartburn and depression have also been shown to reduce bone growth, leading to dental implant failure, according to 2016 studies conducted by McGill University and the University at Buffalo. Discuss any medical conditions and disclose all your current medications to your doctor.
How soon after a tooth extraction can you get a dental implant?
An implant should be placed four to six months after an extraction (with or without a bone graft). That gives the bone enough time to heal and strengthen.
Beyond six months, the underlying bone can begin to lose density and surrounding teeth can shift into the gap left by the extracted tooth.
“It is generally recommended to replace a missing tooth within one year of an extraction to prevent teeth from drifting and prevent bone loss in the extraction area,” says Dr. Rachana Vora, a dentist in Arlington, Massachusetts.
Getting your implant sooner rather than later can help you avoid costly orthodontic work or additional bone grafting.
What happens during a dental implant procedure?
Typically, there are two types of dental implants:
- Endosteal implants are placed on the jawbone.
- Subperiosteal implants are placed under the gum, either on or above the jawbone, providing an option for patients who lack a healthy jawbone and don’t want to undergo bone augmentation to rebuild it.
In cases when the jawbone isn’t thick enough or is too soft, bone graft surgery may be required. The bone may be sourced from another location in the body, or a synthetic bone material can provide the necessary support. This can often be done during implant surgery, though it may need to be done a few months before implants are placed, giving the bone time to heal.
The implant dental procedure can take anywhere from one to three hours. Both regular dental x-rays and 3-D scans are taken to measure the site for accurate implantation. Next, you’ll receive a local anesthetic to keep you comfortable and free from pain. Then the doctor will place a screw, usually titanium or zirconia, into your jawbone to serve as the root of your new tooth. Once embedded, the implant looks like a small metal bead sitting on the surface of the gum.
You’ll then need to wait four to six months for the implant to bond with the bone (osseointegration), so the dentist will cover it with a healing cap. (For patients missing all of their teeth, studies have shown high survival rates for prosthetic teeth placed within 48 hours of the implants—known as immediate loading—but allowing several months to heal is still the norm for individually implanted replacement teeth.)
After the implant has bonded with the jawbone, the doctor places an abutment—a small connector that keeps the dental crown secured—onto the implant, just above the gum line.
Your dentist will take impressions of your mouth to create an individual crown or an implant-supported bridge. The new tooth or teeth will be matched to the color and shape of your existing teeth and fixed to the abutment. At that point, the implant teeth should function just like your natural teeth.
Depending on the number and type of implants you get, the entire process can take three to nine months.
Look for a dental specialist, such as an oral surgeon or a periodontist, who has received ongoing training to do the implantation. A general dentist or prosthodontist may do the actual crown and abutment restoration.
What is dental implant recovery like?
“If one does not need bone grafting, getting a dental implant should be no more bothersome than getting a traditional filling, and you won’t need time off work to recover,” says New York City dentist Dr. Steven Davidowitz.
Patients say postsurgical recovery for this first step is similar to any other kind of dental surgery, with swelling, bruising, and tenderness that can be managed with over-the-counter pain medications. Salt water (saline) rinses can help cleanse the mouth and relieve pain and swelling. Avoid mouthwash and hydrogen peroxide, which can irritate the healing gum tissue.
You’ll also want to take it easy on the implant as you heal. “The longer you can go without direct contact on the implant while healing is occurring, the better the chance you have of full integration,” says Dr. Scott Young, a dentist in The Woodlands, Texas.
Your dentist may suggest a soft or liquid diet. If your implant is completely buried under your gums, you can resume eating normally again in one to two weeks, once the gums have healed. However, if you have an abutment or temporary crown above the gums, avoid hard foods (like chips and nuts) and chewing gum for six weeks.
Keep the area clean throughout the healing process by practicing good oral hygiene, but don’t use a sonic toothbrush, which can disturb the implant.
When will you see dental implant results?
It usually takes four to six months for your implants to bond with the bone in your jaw so the abutment and visible crown can placed. That’s when you’ll see your final results.
How long do dental implants last?
Your implants are likely to last 25 years—possibly longer with proper care. Avoid damaging habits, like chewing ice and hard candy, as well as tobacco and tooth-staining drinks like coffee and red wine.
Dental implants are very durable, but there may be some upkeep. Screws that come loose can be tightened and chips in the crowns can be polished. Crowns can also be replaced if they break, get stained, or you want a new one for whatever reason.
If any pieces of your replacement tooth come out of your mouth, save them and see your dentist as soon as possible. Don’t try to put your dental implant back together with a DIY fix.
What are the risks and potential side effects of dental implants?
Dental implantation is one of the most successful procedures in dentistry, with an average success rate of 95%. Even so, stay on the lookout for rare but possible side effects like these:
- Infection: Very rarely, an infection might develop where the implant was placed. Many surgeons will give you an antibiotic prescription to take after the procedure, just in case. A foul odor from the gum line can be a sign of infection.
- Breakage: It’s also rare for one of your implant teeth to break, particularly if the surgeon uses the right size and number of teeth for your mouth, but it’s possible.
- Implant failure: This side effect can affect those whose healing ability has been compromised by heart disease, gum disease, or autoimmune diseases like rheumatoid arthritis or diabetes. Patients undergoing radiation therapy to the head and neck, heavy smokers, and those taking heartburn and antidepressant medications are also at risk.
- Nerve damage: You’ll feel numbness, tingling, or pain in or around your mouth, which can be temporary or permanent. The risk of permanent nerve damage is very low when working with a qualified specialist.
- Bone loss: Keep in mind that it’s not just the implants that have risks. Putting off implants when you need them has risks too. That’s because when you lose teeth, the bone that used to surround the tooth roots starts to break down as well—about a 25% decrease in the first year after you lose the tooth. Getting implants helps stimulate and stabilize the bone that supports your teeth.
- Sinus problems: This can happen when dental implants placed in the upper jawline protrude into the sinus cavity.
How much do dental implants cost?
The average cost of dental implants is about $7,000. This cost includes surgeon and dentist fees, which are typically billed separately. Your price will depend on your dentist’s level of experience and how many implants you need.
Does insurance cover dental implants?
“Dental insurance rarely pays for the surgical implant placement, but it may cover part of the cost of the abutment and crown as well as bone grafting,” says Dr. Davidowitz.
According to the American Academy of Implant Dentistry, many insurers recognize the benefits of dental implants over other artificial tooth options. If your insurance won’t cover it, the AAID recommends asking your insurer if you can receive an allowance toward the implants that’s equal to the cost of a bridge or traditional dentures.
Are there alternatives to dental implants?
If you have all your teeth and none of them need to be pulled, there may be simpler, cheaper options for you than dental implants. Ask your dentist if you might be a good candidate for crowns, bridges, or veneers instead.
Dentures and dental bridges are common alternatives to implants for artificial teeth. They include:
- Tooth-supported fixed bridge: This requires grinding down the healthy teeth next to the one needing treatment to attach and support the bridge.
- Resin-bonded bridge: Also called a Maryland bridge, the approach is often used for front teeth that don’t need to be as resilient as the back teeth. Small wings on each end of the bridge attach to healthy, adjacent teeth. It looks and functions better than dentures, but it isn’t as sturdy as a fixed bridge—nor does it last as long as implants.
- Removable partial dentures: Less expensive but not as natural-looking as an implant-supported crown, these are fitted to the roof of the mouth.
- Removable complete denture: This horseshoe-shaped denture sits on your gums where your teeth used to be. It’s cheaper than implants but can move and chafe, hurt your jawbone, and require replacement every 7 to 15 years.
