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Dental Implants

This is a subject that we get A LOT of questions about.  Totally understandable – it’s confusing and for some people it’s also very scary.  With a little explanation, though, I think you will begin to understand what implants are, why they benefit you, and how and when dentists decide to use them.  You will also understand some of the costs involved and be able to better make decisions for your own mouth.

A secure and lasting solution.

Replacing your missing teeth with dental implants offers you the chance to live your life as if you had never suffered from missing teeth. When your dental implant treatment is complete, you should be able to chew, speak and socialize without experiencing the negative emotions that having missing teeth can sometimes cause.

Each implant features an artificial root, the post and a crown. A few implant posts can secure a bridge, partial or denture. Cared for properly, dental implants can last a lifetime.

How we can help: Implant roots (the posts) are made of biocompatible material, such as titanium. Surgically inserted into the sockets left by missing teeth, these man-made tooth roots are accepted by the body. The jaw bone integrates with the roots to create replacements for natural teeth roots. On top of a dental implant post, your dentist can secure a single restoration (crown) or a prosthetic appliance.

Often, denture patients who suffer from slipping or loose appliances turn to dental implants for optimal stability. Dental implants require no adhesives, suction, clasps, or crowned support teeth to stay in place. They are a lasting solution that improves quality of life through rejuvenated oral function and appearance. Dental implants also maintain jaw bone that would otherwise deteriorate if dental implants were not placed.

All about dental implants

As we get started down this road, I’m going to be careful not to start talking in language that’s too clinical.  If I do, I’ll make sure that to include diagrams.  Also – there won’t be any bloody pics on this page.  I want this to be informative, not scary.  If detailed clinical photography is what you’re after, send me an email, and I’ll happily share any clinical photos you’d like.
We work with dental implants every day.  They are a wonderful treatment option when teeth are lost, and in our practice they have helped hundreds of people.  Seriously.  In fact, they are so prevalent, I’m sure you know somebody who has one.
In the profession of dentistry, we have been using them since 1965.  Over time, the designs have improved as have the results.

What are dental implants used for?

There are 3 main reasons to use a dental implant.
  1. To replace a missing tooth or teeth
  2. To hold on to a denture
  3. To help move teeth [or re-position]
The first purpose is pretty straight forward.  We have a space where a tooth should be [but isn’t].  We can place an implant in that space, and attach a new tooth to it.  We can even use implants to replace groups of teeth that are missing.
Secondly – we can use dental implants to hold onto a whole or partial denture.  Depending on the case we can use as little as 2 implants to stabilize a denture.  In my opinion, this is one of the biggest life changes for denture wearers.  After dealing with a poor fit, and needing denture adhesive to hold everything securely – implants in situations like these are amazing!   If you know anyone who complains about their dentures they need a consultation – and soon!
Lastly – mini-implants are used in many orthodontic offices to help in cases where some extra stabilization is required.  Remember all of that head gear?  With mini implants, called ‘temporary anchorage devices’ or ‘TADs’ We can totally avoid head-gear, and move teeth we otherwise wouldn’t be able to re-position.

What are dental implants?

Dental Implants are essentially small bolts made from titanium or zirconia.  They usually are about the size and shape of the root of a tooth, have threads on the outside, and also have internal threads for dentists to attach things to.  Sometimes they have special features – coatings, special holes, extra threads – but most all have those few basic components.

How do dental implants work?

Dental implants work because of a process called “integration”.  The bone heals right up to the dental implant so that there is nothing between them.  Because of the density of bone, and the rigidity of the implant, it is very stable and strong.  The gum tissue also heals very well around dental implants, and creates a nice seal.  This prevents bacteria from getting places we don’t want them.

Will my dental insurance cover a dental implant?

The world of “dental insurance” or dental benefits is changing as we speak.  The short answer is – maybe.  If you have had the same benefits package from the same company for a long time, you might be surprised to find out that much of it has changed.  Or, it hasn’t.
Many dental insurance companies have what they call a ‘missing tooth clause’.  This means that if the tooth was missing prior to you having them as your dental insurance company, they will not cover any replacement for that tooth – including implants.
The only way to know for sure is to call them and ask.  The ADA codes for these types of services are D5000-D6999.

How much do dental implants cost?

This question comes up at our office a lot.  And the short answer is, “it depends”.
To find a better answer, we have to dive a little deeper into some specifics.  Where is it being placed? What kind of implant is it? What will the implant be used for? What was there before?  How healthy is the patient?  Who is placing the implant?  The answers to these questions, among others, will better shape the question around cost and get us a better answer.

How do you put a tooth on a dental implant?

When the implant is finished healing, we can put a crown on it.  Usually, the surgeon who placed the implant has evaluated your healing, exposed the implant if necessary, and placed a healing cap on top of the implant.  This healing cap sticks out slightly from your gums, and is something that a dentist can easily unscrew and remove to access the internal parts of the implant.
Once you are at the dental office that will be designing and placing the crown, the dentist will remove that healing cap, and place a post designed for making an impression.  Once the impression is made [either analog with a mouth-full of goop or digital with a scanner] then that post is removed and the healing cap is replaced.
At this point, your impressions are evaluated.  We care about things like the height of the gums around the implant, the angle of the implant, what do the teeth around the implant look like, etc.
Once the evaluation is complete, we can begin the design of the crown.
When the crown is finished, you will have a second appointment to deliver and install the crown on the implant.
At this appointment, the healing cap is removed again, and the internal features of the implant are cleaned and disinfected.  If your crown required a custom designed abutment, that gets installed first.  It is precision fit, and screwed into the dental implant.  then, an xray is made to confirm that the abutment is seated all the way.  At this point, we can try in the crown on top of the abutment, and confirm the fit.  After any needed adjustments are made, the crown is polished outside of your mouth.  We then finalize the placement of the abutment by using a special wrench to tighten the screw to a very specific amount of force.  then this abutment is cleaned and disinfected and the screw access is packed with cotton or Teflon tape [my preferred method].  Now, your implant crown is cemented on the abutment just as if if was your tooth – with the exception of the cement.  In the case of cemented implant crowns, I prefer to use a soft cement that is easy to clean.  If your crown is attached to the abutment directly [this is always my first choice], there is no cement needed.  The access is through the chewing surface of the crown, which is where we put the Teflon and seal the top with a filling material.
That’s it!  The whole process is divided into two appointments in our office, and each one usually takes only 30 minutes or so.

How long does it take to get a dental implant?

It takes between 3-8 months for a dental implant to heal.
This answer is slightly simplistic though.  So let me explain in a little more detail.  I will assume that this question really is, “how long does it take to replace a tooth with a dental implant?” and provide you with that answer.
Sometimes, it is possible to have a tooth removed and an implant placed in the same surgical appointment.  It is also possible in some cases to also place a provisional replacement tooth on that same implant, in the same appointment.  In this case – it would only take the time of the appointmetn to have your replacement tooth – about 2 hours.
If a provisional replacement tooth isn’t possible at the time of your implant surgery, then we need to wait for the implant to fully integrate before we put any tooth on it.  That healing process can take between 3-5 months.
It is also possible that we can’t place the implant when the tooth is removed.  This can be due to many different factors – including how the surgeon was feeling about it at the moment.  If this is the case, then we need to wait for your bone to heal and place the implant in a second stage.  From beginning to end, this can take 6-9 months [3-4 months for each stage].
Once the implant is fully integrated and healed we can put a final crown to function on the implant.  The process of doing this is detailed above and can take 3-4 weeks.

What Are The Different Types of Dental Implants?

Dental implants come in many different forms.  Many of them are rarely used in today’s dental procedures, but they were cutting edge at one point in time.

  1. Blade Implants – Are exactly what they sound like.  They are shaped like the blade of a pocket knife, with holes placed in them.  The idea was that with more surface area, the implant would be more stable and would allow more bone to heal around it and through it.
  2. Transosteal Implants – These are implants that are designed to help people with little to no lower jawbone.  The implant system is made up of three different parts.  Two plates that are placed under and on top of the lower jaw bone, and then screwed together with two bolts that then serve as the location of the attachments to support a denture or other prosthetic.
  3. Periosteal implants – These are dental implants that rest on top of the jaw bone and under the gums.  They are also used for patients that don’t have adequate bone for a traditional endosteal implant – not very common.
  4. Endosteal Implants – Endosteal implants are what you probably think of when you hear the term, “dental implants”.  They are shaped like a barrel, or a tapered cylinder, that has been threaded just like a bolt.  They are placed into the jaw bone, and are made of titanium or zirconia which allows the bone to heal right up to the surface of the implant.  When this happens, we call it “integrated” or “oseointegrated”, meaning that at a microscopic cellular level, there is nothing between the bone and the implant.

Will my dental implant set off the TSA alarm at the airport?

No.  Dental implants are made of either titanium or zirconia, and neither of those materials contain any iron.  Metal detectors work because of magnetic fields – and dental implants are non-magnetic.

Do dental implants hurt?

This is another ‘it depends’ answer.  Nine times out of ten, both the procedure and the recovery are painless.  Occasionally a patient will experience mild discomfort that is easily resolved with a little ibuprofen or Tylenol.  If we are placing an implant or removing a tooth in the presence of infection it can be more likely that there will be some pain after the procedure.

Will people be able to tell that I have a dental implant?

Who are the people that are looking?  If they are dentists, hygienists, or dental assistants – i.e. people who look at these things all day every day – then yes, probably.  If you are asking if the person on the street can tell, in passing, that you have a tooth in your mouth that is an implant – no way.  Sometimes the results are less aesthetic than we we would like to see.  If that’s a concern and you haven’t had the implant placed yet – go get some second opinions and make sure that you have confidence in the person who is placing the dental implant for you.  If you are disappointed with the look of an implant that is already placed, there are probably things that we can do to help.  I would encourage you to also get a second opinion and find out what options you actually have to fix it.  With today’s dentistry, amazing things are possible.

Are there people who shouldn’t get dental implants?

Absolutely!  Dental implants are not for everyone.  Here is a list [not comprehensive] of the most common contraindications:
  1. Active Cancer
  2. Auto-immune Disorders [RA, Leukemia]
  3. Uncontrolled Diabetes
  4. Osteoporosis Treatment [Bisphosphonates]
  5. Radiation Therapy [Recent]
  6. Pregnancy
  7. Smokers
  8. Younger than 20 years old [due to facial growth and development]
If you have any of these conditions and need a dental implant, make sure that you are working with an experienced surgeon.  Many patients with these conditions are able to work with a specialist and have an implant successfully placed.

What is the best brand of dental implant?

There are sooooo many brands of dental implants!  This is an impossible question to answer.  Some brands make many styles of implants – and not all implants from that manufacturer would be great for one individual case.  Instead, I’ll share the brands that I have the most experience with.
Nobel, Strauman, and Zimmer.
I have also worked with Astra, Implant Direct, and 3i.  There are so many other companies out there, and there are new and wonderful solutions coming to the market everyday.
I suppose the BEST answer to this question is, “the implant your dentist has the most confidence in for your individual situation.”
Find a great dentist, and I’m sure they will do their absolute best for you!

Can dental implants fail?

Yes, dental implants fail.  Not all the time, but often enough.  If you can save your tooth – save it.  Many people feel that dental implants are a cure-all and you’ll never have any problems ever again.  Not true.  If you are ever presented a treatment plan like that – run away.  A good dentist will tell it to you straight.  Yes there are problems with dental implants.  No, they don’t happen often, but they do happen and you should be aware of all of the risks and benefits of treatment.  Somethimes, there isn’t a choice.  Most of the time there is.  If I could save my own tooth, even if it means getting a root canal and a crown, I am doing just that.  But I wouldn’t do it if it meant putting my other teeth at risk.
If you have an implant, take care of it.  See a dentist regularly, wear your occlusal guard, make sure your home care is exemplary.  That’s all.

Can dental implants get infected?

Yes.  And at any stage of the placement, even years after surgery.

Can I get a cavity on my dental implant?

No.  The bacteria that cause cavities need teeth to live.  You can get gum disease around your implant, though.

What are dental implants made of?

Most dental implants are made of titanium.  Some are being made using zirconia.

Other Dental Implant Questions – Answers to Come Soon!

How long do dental implants last?

What is an abutment and why do I need one?
Will my dental implants look natural?
Will dental implants stop bone loss?
Will dental implants cause bone loss?
Why are dental implants important?

Laguna Niguel Smiles Dentistry wants to help you with all your dental needs. For more information, please schedule an appointment with your dentist, and we will be in touch with you shortly.