Overview: Dental Implants & How They Work
A dental implant (artificial tooth root) is a popular tooth replacement option after tooth loss or extraction. Implants are surgically implanted into your jawbone, mirror the shape of a screw, and bond with the natural bone. They create a base to support dental crowns (artificial teeth).
An abutment (supporting tooth) is placed between the implant and crown to connect all of the pieces together. Abutments also connect crowns to dental bridges, removable dentures, and partial dentures.
Implant Body Regions
The body of a dental implant consists of three pieces that serve different functions:
Crest Module
The crest module holds the prosthetic components of the implant.
Body
The body of an implant screw provides surgical ease and prosthetic loading to the jawbone.
Apex
The apex supports the initial placement of the implant into the osteotomy (a removed piece of the jawbone).
Types of Implants
There are two main types of implants:
Endosteal Implant
An endosteal implant (root form implant) is the most common type of implant used today. They are made with titanium, small screws, and alloplastic material, which refers to an artificial tissue graft.
Endosteal implants are surgically inserted into the jawbone. Over time, the implants bond with the natural bone.
Subperiosteal Implant
Subperiosteal implants are extremely rare. However, they may be a better option for patients who do not have enough natural jawbone to support endosteal implants. A subperiosteal implant is placed under the gums (on or above the jawbone). It is not surgically inserted into the jawbone.
Causes of Missing Teeth
There are many causes of tooth loss that may indicate the need for a dental implant. The most common causes of missing teeth include:
Tooth Decay
The leading cause of tooth decay (cavities) is poor nutrition and a lack of proper oral care. Without restorative treatment, a cavitated tooth will continue to deteriorate, eventually resulting in tooth loss.
Regular dentist visits and teeth cleanings (every 6 months) are necessary to catch early signs of decay. If the decay is severe, dental implants may be needed, especially in older adults (65+).
Periodontal Disease
Periodontal disease is a serious form of gum disease. When the gums begin to wear away, plaque and decay-causing bacteria can get underneath the gums, causing inflammation. This eventually leads to bone loss around the jaw and teeth. As a result, teeth may become loose, fall out, or need to be extracted.
Age & Medications
Many implant patients have healthy teeth or only develop minor cavities their entire lives. Although, after 55 years of age, tooth loss is more common.
Those who take medications for high cholesterol, heart disease, or high blood pressure are even more at risk of tooth loss. This is because the long-term use of medication causes dry mouth, which speeds up the tooth decay process.
Trauma
A car accident, injury, or fall can damage your teeth or cause tooth loss. When a tooth cannot be restored to its natural shape and function, a dental implant is necessary.
Who Does Dental Implants?
Two dental specialists perform dental implant surgeries, including:
- Oral and Maxillofacial Surgeons — oral surgeons specialize in the placement of dental implants. Oral surgeons are also qualified to use deeper levels of sedation and understand how to do it safely.
- Periodontists — periodontists focus on the prevention, diagnosis, and treatment of periodontal disease. They have advanced training in dental implant placement and gum inflammation treatment.
Dental Implant Procedure: Step-By-Step
Endosteal implants are a type of outpatient surgery. Patients are able to return home the same day of surgery. However, the process can take many months to complete, especially during the healing process and before artificial tooth (crown) placement.
Dental implant procedures are separated into multiple steps, depending on the number of implants a patient needs:
Step 1 — Remove the Tooth
If the damaged tooth is still in your mouth, the dentist will extract the tooth. This step is not necessary if your tooth is already missing.
Step 2 — Grafting and Jawbone Preparation
Many patients who undergo implant surgery have thin or soft jawbones. Bone grafting, which improves the quantity of bone, ensures the procedure doesn’t fail. Options include a synthetic bone graft, such as a bone-substitute, or a natural graft, which means bone is taken from another area of the patient’s body.
The healing process for bone grafts takes a few months before a dental implant can be placed. Fortunately, grafts are not always necessary.
Step 3 — Implant Placement
During the actual procedure, the oral surgeon exposes the bone by cutting the gums with small instruments. An oral surgeon or periodontist drills holes into the bone. Then they position the implant (a post) deep into the bone, which functions as the tooth’s root.
If a front tooth is being restored, the dentist will fill in the empty space with a temporary removable solution while the implant heals below the gums. If it is a back tooth, they will not place anything over it.
Step 4 — Healing and Growth
Osseointegration begins after the metal implant is placed in your jawbone. This is when the supporting bone begins to bond with the implant. This process can take several months to complete and ensures the base is sturdy enough to support an artificial tooth (dental crown).
Step 5 — Abutment Placement (Crown Preparation)
After the healing process is complete, your dentist will place an abutment on top of the implant post. The abutment extends the implant above the soft tissue (gums). This step allows for easy placement of the dental crown.
Step 6 — Crown Placement (Artificial Tooth)
Once the implant grows into the bone, and it is strong enough to support chewing, your dentist will make new impressions of your mouth. Then a dental technician will create a custom dental crown in a lab. An artificial dental crown looks similar to your natural teeth. The crown sits on top of the abutment (connector) and becomes the only visible part of the implant.
Step 7 — Aftercare
Pain medications and antibiotics are usually prescribed post-op. During the healing process, it is also important to only eat soft foods and practice excellent oral care habits. Restricting the intake of alcohol, caffeine, and tobacco is also essential to see the best results.
Regular check-ups are necessary during the first few months after the implant procedure is complete. You should also keep up with regular dental exams post-surgery.
Risk Factors of Dental Implants
Most implant procedures are successful. Although, in rare cases, implants will fail or heal incorrectly. For example, smoking increases the risk of failure. To reduce this risk, it is crucial to practice good oral health care at home, including proper nutrition, brushing, and flossing.
As with any dental surgery, minor discomfort is normal. Common conditions (that aren’t threatening to the implant) include:
- Gum and face swelling
- Bruises on the skin or gums
- Minor bleeding
- Pain where the implant was placed
More serious risks that can develop after an implant is placed include:
- Damage to your surrounding teeth, gums, and/or blood vessels
- Infection at the implant site
- Prolonged bleeding
- Sinus issues and pressure (if the implant is placed in your upper jaw)
- Fractured jaw and jaw pain
- Nerve damage, which can lead to tingling in the mouth or lips
Common Questions & Concerns
How Much Do Dental Implants Cost?
$1,000 – 4,500 per tooth
Does Insurance Cover Dental Implants?
Some insurance plans cover dental implants, while others do not or only cover part of the procedure. For example, the crown attached to the implant may be covered by some dental insurance plans. And, if the procedure is medically necessary, some medical insurance plans will cover part of the surgery.
Are Dental Implants Painful?
You will most likely experience minor pain after surgery, but over-the-counter pain relievers can help reduce discomfort. The pain should diminish after about a week. However, it can take up to six months for the implant to fully heal.
Are Dental Implants Safe?
Implant dentistry has been practiced for over 50 years. When done correctly and by the right specialists (e.g., periodontists and oral surgeons), dental implants are a safe and successful tooth replacement treatment option. Most people who get implants do not experience any problems and the procedures have a high success rate.
How Long Do They Last?
If you take care of your replacement tooth and practice good oral hygiene, it can last anywhere between 15 and 25 years, sometimes longer. Some people get their implants replaced earlier due to cosmetic concerns.
