The In’s and Out’s of Dental Implants
Before you decide on replacing a missing tooth, take a minute and get acquainted with the benefits of dental implants.
What Is A Dental Implant?
Did you know that most people, 69% from ages 35 to 44, are missing at least one tooth and 26% of those over the age of 74 have lost all of their permanent teeth ? For these individuals who have lost either a single tooth or multiple teeth, dental implants are a permanent and most likely the best solution for tooth replacement and offer a more durable solution than dentures or a bridge.
A dental implant comes in 3 parts:
• Implant - An implant is similar to a screw which is made of nearly pure titanium and acts like the root of a tooth to which a replacement tooth or structure can be attached. The implant is placed in the jawbone of a patient.
• Abutment - An abutment attaches to the portion of the implant which protrudes above the gum line.
• Crown - Fitted into the abutment, the crown is usually created by a general dentist and looks like the natural tooth.
How is a Dental Implant Placed?
To begin any implant procedure, careful planning is required in order to achieve the best results. The process begins with a consultation with the patient to discuss their options including the possibility of implant and implant type. During the consultation, the patient will usually receive a panoramic x-ray to identify the status of the existing bone and teeth.
To begin the surgery, an incision or “flap” is made at the top of the site where the implant will be placed. The gum is then pulled back to expose the bone. With a precision surgical drill, the oral surgeon drills a small “pilot hole” into the bone. The surgeon may or may not use a “stent”, a guide for drilling the pilot holes, for complicated surgeries. During this process the surgeon is extremely careful to not damage the inferior alveolar nerve which rests in the lower jaw. Drilling the pilot hole is achieved in successive steps, each step widening the pilot hole. During the process, cooling saline or water keeps the bone temperature below 117 degrees Fahrenheit so as to not damage the bone cells by overheating. If significant bone loss has occurred, the Oral Maxillofacial Surgeon may conduct a bone graft prior to drilling and placing and implant.
Once the pilot hole has been drilled, the Oral Maxillofacial Surgeon will insert the titanium, self tapping implant at a precision torque so as not to induce osteonecrosis, or overloading the bone which will cause the bone to die. Upon completion, the surgeon fits a protective cover or “healing cuff” and allows healing for 2 to 8 months, permitting the implant to osseointegrate or anchor into the bone. The special and unique properties of titanium allow the bone to integrate and secure into the titanium implant.
After the appropriate healing time has passed, the healing cuff is removed and an abutment is placed. The abutment is the point at which the new crown or tooth will be placed by a general dentist.
Why is a Dental Implant Better than a Bridge or Denture?
A dental implant is a durable and permanent solution for a missing tooth and can be placed independent of and without damage to other teeth. Thirty years ago the only solution for missing teeth was either a bridge or denture. Thanks to new dental technology, bridges and dentures are being replaced by permanent, superior dental implants.
Implant vs Bridge - A bridge is designed to “bridge” the gap of a missing tooth between two healthy teeth. In order to create a bridge, a general dentist will grind down the two healthy teeth into two posts which surround the missing tooth. The dentist will then create a “crown” or replacement tooth which is connected on each end to the crowns that will be inserted on the ground down posts. A bridge not only devastates two perfectly healthy teeth in order to secure the replacement tooth, but is also not anchored to the actual jaw bone. This means a bridge is less secure than an implant and more prone to wear, to break and to damage. Because of dental decay and gum disease, bridges usually have to be replaced every 15 years. A dental implant does not require the support or destruction of surrounding teeth and since it is secured into the jaw bone, is a more stable and durable option than a bridge and rarely, if never needs replacement.
Implant vs Dentures - Removable dentures have been placed to augment either partial or full tooth loss. But since dentures are not a fixed option, patients who have received dentures can find them frustrating and embarrassing. Removable dentures may slip or cause embarrassing clicking sounds while eating or speaking. They may also limit the kinds of foods patients once enjoyed and alter the manner in which the patient speaks. In general, because of their unsecured nature, dentures lead to embarrassment and frustration. But since implants are secured permanently into the natural bone, implant patients will never experience slipping, clicking or any of the side effects of dentures. Implants are a fixed solution that allows the patient to resume a normal, healthy and confident life.
Dental implants more than bridges and dentures provide patients:
• A Natural and Improved Look - Since implants are placed directly into the bone, they look just like and act just like a natural tooth. Bridges and dentures do not achieve the same natural look as an implant does.
• Better Self Esteem - Get back the great smile you once had without the unnatural look of dentures or bridges. Dental implants look and act like your real teeth and will improve your beautiful smile.
• Convenience - Ditch the adhesives for your dentures and constant removing and replacing them too. Dental implants are permanent and fixed and act like a normal tooth.
• Enhanced Oral Health - Unlike bridges, dental implants don’t require grinding down the other teeth which can lead to increased dental decay.
• Greater Comfort - Dentures can quickly become uncomfortable if not properly fitted or when they become loose. Since dental implants are placed directly into the bone, they are permanent, fixed and more comfortable.
• Improved Speech - A denture that slips into your mouth causes poor speech. With a fixed dental implant, you will never experience the same problems that a poorly secured denture causes.
• Long Term Durability - Durable and stable, dental implants that are properly cared for can last a lifetime.
• Trouble-free Eating - Secure and permanent implants allow you to eat your favorite foods that dentures restrict you from eating.
Am I a Candidate for a Dental Implant?
Dental implants are the solution of choice for patients both young and old in need of replacing one tooth or multiple teeth. Most dental implants in children are postponed until jaw growth is complete. Candidates for dental implants include those with:
• Athletes - Getting a tooth “knocked out” in sports is a common experience. In many cases the tooth may be gone so a permanent implant is the best solution.
• Bone Loss - An oral and maxillofacial surgeon is trained to graft bone where needed in order to support dental implants.
• Dentures or Partials - If you are using a denture or partial, chances are you can have a dental implant and eliminate the hassle of dentures.
• Existing Medical Conditions - Though some chronic diseases may inhibit implants, if you are regularly seeing a dentist there is a good chance you can receive an implant.
• Gum Disease - In most cases where gum disease has led to tooth loss, an implant can be placed with success.
• Missing Tooth/Teeth - Implants are made to be placed where a tooth is missing. Patients with either single or multiple teeth loss are those in need of dental implants.
• Narrow Jaw Bone - In the past those with small or narrow mandibles were not eligible for traditional dental implants. With advancements in narrower “mini” implants, these patients are now candidates for dental implants.
• Smokers - Even though smoking increases the failure rate for dental implants, many smokers experience success with dental implants.
What is the Success Rate for Dental Implants?
On average, dental implants generally boast a 95% success rate. Osseointegration, or the bone anchoring to the titanium implant, is the main component to success or failure. Sometimes the bone recognizes the titanium implant as a foreign object and simply rejects it. Without osseointegration, the implant will fail.
Much like regular teeth, crowns may become loose, implants may become infected or may even break. Though dental implants will are not vulnerable to dental caries (decay), they can develop peri-implantitis which is an inflammation of the bone surrounding the implant. Peri-implantitis can cause bone and implant loss and can be caused by heavy smoking, diabetes, poor oral hygiene, abuse or disregard for proper healing as suggested by the oral surgeon. Since smokers have a higher than average failure rate than non-smokers, oral surgeons suggest quitting smoking prior to receiving an implant.
Will My Insurance Cover Dental Implants?
Some dental and medical insurance plans will cover dental implants, but many will not. Check with your insurance provider for specific details. For those patients where insurance will not cover the treatment, the Smoot Center for Oral Surgery offers payment plans through CareCredit for qualifying customers or a variety of other payment options.
What’s the Difference Between a General Dentist and an Oral Surgeon?
Though both a dentist and oral surgeon have graduated from a 4 year accredited dental school, only an oral surgeon has completed an additional 4 more years of residency at a hospital-based oral and maxillofacial surgery program. Oral Maxillofacial Surgeons specialize in diagnosis and treatment of diseases, injuries and defects, both functional and aesthetic, involving the hard and soft tissues of the oral and maxillofacial region. Oral Maxillofacial Surgeons have been fully trained in administering anesthesia and deep sedation. Though some general dentists choose to perform delicate surgeries such as wisdom teeth extractions, you can trust that a qualified and trained oral surgeon such as Dr. Smoot has completed the additional education to treat both complicated and routine oral surgeries and has been trained in administering anesthesia and deep sedation to make your surgery and recovery as comfortable as possible.
What Are My Sedation Options?
Most patients feel little pain or discomfort when receiving a dental implant. Depending on the preference of the patient, the preference of Dr. Smoot, or depending on a patient’s health condition, a patient can be sedated by either:
• Local Anesthesia - This includes numbing the tooth that will be treated as well as the gum surrounding the tooth. The patient remains awake and alert during this process, but pain in the anesthetized area will be minimized.
• Deep Sedation - Administered intravenously, deep sedation is a sedative and not only helps the patient cope with anxiety, but also affects the patient’s consciousness to minimize the pain. During this process, the patient will be in “deep sleep” during the entire treatment. After deep sedation, patients will not be fully lucid and therefore will not be able to drive home. Patients receiving this treatment will be required to have someone drive them home.
What Can I Expect After the Surgery?
The days and weeks after surgery are critical for proper healing. Every body heals differently and at different rates. As a result of the surgery, conditions may occur all of which a trained oral and maxillofacial surgeon like Dr. Smoot can address and treat.
• Bleeding and Oozing - Most bleeding and oozing after surgery is inevitable and part of the healing process. Both may last up to 4 days. Rinsing immediately after the surgery loosens the blood clot in the wound and can prolong healing which results in bleeding and oozing. After 24 hours, light rinses with lukewarm saltwater can help to ease these symptoms.
• Swelling - Patients should expect some swelling after surgery. The duration varies among patients, but if swelling reappears after a few weeks, this may be an indication of an infection and the patient should contact their surgeon.
• Dry Socket - Caused by a dislodged blood clot at the extraction area, dry socket is a painful inflammation to the alveolar bone. Most dry socket incidents self heal and the pain can be controlled with ibuprofen. For more extreme pain, consult your oral and maxillofacial surgeon.
• Stitches - Some surgeries require stitches and some do not. Stitches can be self-dissolving and will dissolve with time. Non dissolving stitches will require a follow up visit to the oral surgeon to have them removed.
• Parasthesia - Though rare, paresthesia may occur from complicated surgeries within the jawbone and close to the nerves. The resulting bruised or damaged nerves may cause temporary or even permanent numbness in the tongue, lip or chin.
What Are My Payment Options?
The Smoot Center for Oral Surgery not only provides the best oral surgery treatment, but also provides a variety of easy payment options so you can get the care that you need:
• Insurance - At the time of your consultation, please provide the appropriate insurance information as well as your insurance ID number. Prior to treatment, we require the patient to cover the expected co-insurance cost. Please check the list of the insurance providers and plans we accept or call us at (801)264-8504.
• Care Credit - The Smoot Center for Oral Surgery offers another payment option through Care Credit. This is a healthcare credit card that can be used as a payment option for certain expenses not covered by insurance, or to bridge situations when desired care exceeds insurance coverage. It’s an easy and robust option which allows you to get the care you need when you need it. Patients can apply for Care Credit by going to the website at www.carecredit.com or calling (800) 677-0718.
• Check (with valid ID)
• Visa, Mastercard, Discover