Implants are a complicated branch of dentistry so it is no surprise that there are lots of frequently asked questions. We have answered some of the most common questions here. If you have a question and can’t find the answer, why not get in touch? We are always happy to help.
How many teeth can be supported by implants?
All the common forms of tooth replacement such as crowns, bridges and dentures, can be retained by dental implants.
If you are missing just one natural tooth, then one implant is normally sufficient to provide a replacement.
Larger spaces created by two, three or more missing teeth do not necessarily need one implant per tooth – the number required will depend upon the quality and volume of bone available at each potential implant site. In the upper jaw, bone density is generally poorer than in the lower.
If you have no teeth at all, we would normally need 6 implants to support a complete arch of 10 or more replacement teeth. In the lower jaw, the bone towards the front of the mouth is often very strong and as a direct result, fewer implants are needed. A simple treatment plan to provide 10 or more teeth in the lower jaw might be possible with as few as 4 implants, although it is still more common to use 6.
What else can be done with dental implants?
Denture mobility can be hugely improved. Many patients have had problems with mobile lower dentures. Food can get stuck under them, and they can move around a lot when talking. A lower denture can be stabilised by placing two implants placed towards the front of the mouth, and placing retentive mechanisms onto the denture base, which clip onto the implants. This is called an ‘overdenture’.
The same overdenture concept, when used to treat the upper jaw, would require more implants, as the bone is generally softer. Implant supported overdentures are still removed for daily cleaning. Once back in the mouth the implants virtually eliminate movement, making the denture much more stable, secure and comfortable.
Do you need to have a healthy mouth?
When you first enquire about dental implants it is often in response to an ongoing dental problem or the recent loss of teeth. Each of these problems will need to be diagnosed and treated first before any implants are placed, to ensure they have the best chance of success. Although it is tempting to focus on the more glamorous aspects of teeth supported by implants, basic dental health, which includes the treatment of gum disease, repair of decay and the elimination of abscesses will be just as important for the long-term success of your implant.
What causes bone loss?
Whenever a tooth is lost or extracted a considerable amount of bone that once surrounded the root may disappear. This loss can be particularly rapid during the first few months and is described as ‘bone resorption’.
Gum disease is a major cause of bone loss and patients who suffer from this condition can have a significant reduction in the amount of bone available. This can make dental implant treatment more complicated, as there is less bone available.
Many patients report that after a while their dentures get loose and do not fit as well as they once did. Initially the increased rate of bone loss following extractions is responsible for the worsening fit. Over the long-term, it is the direct effect of chewing forces that causes slow resorption of the supporting bone. Most people who have had dentures for many years will have needed to have them relined to compensate for this bone loss. The longer dentures are worn, the more the amount of bone available for dental implants may have been reduced.
Can dental implants preserve bone?
This is one of the most important features of dental implants. Once in place and supporting teeth, everyday functional forces stimulate the surrounding bone, which responds by becoming stronger and increasing in density. Like all things there are limits to how much work an implant can do. We will be able to discuss this in more detail, if it relates to your case.
What can you do if an implant does not work?
If an implant does not fuse with surrounding bone, it will eventually become loose and no longer be able to support replacement teeth. Commonly the failing implant causes no discomfort and can easily be removed. If there are enough implants remaining it may not be necessary to replace it at all. Failures may not always be so easy to deal with and if you embark upon this type of treatment you have to be prepared to deal with this possibility. If an implant fails, it may be possible to allow it to heal and simply place another.
How long does treatment take?
For routine cases, treatment times can vary from a day to six months. The availability of better quality bone can be used to decrease treatment time, whilst more time and care must be taken with poorer quality bone, which can therefore extend treatment times beyond six months.
How do I look after implants?
For most implant supported teeth you will be able to clean around each supporting implant by brushing and flossing in just the same way that you would work around natural teeth and tooth supported bridges. In some areas inter-dental toothbrushes and other cleaning aids may be needed to maintain good oral hygiene. For the first few months the implants are in function we may ask that you are seen more frequently, however once we are satisfied that your treatment if performing as planned, ongoing care will be similar to any patient with natural teeth.
How long will the implants last?
After the new teeth are fitted, the success of each treatment stage will be the main factor determining how the implants are performing. Once the implants and surrounding soft tissues are seen to be healthy and the new teeth comfortable and correctly adjusted, it is the quality of your home care and willingness to present for regular maintenance reviews that will have the most influence on how long they will last.
If poorly cared for, implants will develop a covering of hard and soft deposits (calculus and plaque), which is very similar to that found on neglected natural teeth. Untreated, these deposits can lead to gum infection, bleeding, soreness and general discomfort, just as can occur around natural teeth.
Well maintained implants placed into adequate bone can be expected to last for many years and probably for your lifetime. However, just as you would expect from conventional crowns, bridges and fillings your implant-supported teeth may also have similar maintenance requirements.
What should I know before treatment?
Before any treatment is started, we will give you a written summary of your treatment planning discussion(s), highlighting your current dental situation and any alternatives there are to dental implants. This summary will also include an overview of the anticipated treatment stages and give you some idea of how long treatment is likely to take, how many implants are required and what the fees are expected to be. There may well be other issues specific to your case and these would be dealt with here accordingly.
Can you wear false teeth during the course of implant treatment?
If the teeth are in a clearly visible part of your mouth, it is most likely that you will want to have some teeth present whilst the treatment is underway. There are a number of ways that this can be done, ranging from simple plastic dentures to removable bridges. If replacement teeth are used during treatment stages it is important that they do not apply uncontrolled pressure to the underlying implants, as this can interfere with their integration.
Is it uncomfortable when the implants are placed?
Most patients will be very familiar with the dental anaesthetics used for routine dentistry and will know how effective they are. Implants are placed using the same anaesthesia.
Depending upon the complexity of your case the operation might take anything from 30 minutes for a single implant to several hours for complex bone grafting and multiple placements. Since the surgery normally involves exposing the bone in the area where the implant and/or bone graft is to be placed you can expect some minor swelling and occasionally bruising afterwards.
For most patients, any of the simple painkillers you might have for a headache would normally be all that is needed for a few days. If you were to experience more discomfort than this we would obviously provide stronger medication for you.
Healing is generally uneventful. Any stitches are normally removed a week or so later. You may also be asked to take a course of antibiotics, some anti-inflammatory painkillers and to follow some simple procedures such as rinsing with salty water. It is important that you carry out these instructions, as they help to promote uneventful and easy healing.