The Tooth about Dental Implants

If you're missing a tooth and have been to a dentist recently. Chances are your dentist will have recommended having a dental implant. Theres a lot to say about implants but I'll go over the basics that will allow you to make the right decision for you.

DOES GETTING AN IMPLANT HURT? No. The implant placement procedure is about as painful as getting a filling. Very little pressure or sensations. Just lots of water and noises. Sit back and watch a movie. You will be sore after you go home so read my post on extraction to get some tips to help!

WHAT IS A DENTAL IMPLANT: A dental implant an artificial tooth made to be placed in the original spot of a missing tooth. It is made out of 3 pieces:

1. The replacement root or "Fixture". This is the part that involves surgery. After an old tooth is removed. The hole that it leaves is filled in with bone by your body. In order to put a new root in the spot, that bone needs to be removed to make space. The "fixture" is made out of titanium because that is the strongest material that the body does not reject. Most other prostheses in other parts of the body are also made from titanium.

2. The replacement tooth head or "crown" which is the part you will see and chew on. It is very similar to a crown that you get when you get a root canal or when you broke a tooth. It is typically a gold-metal hybrid coated in porcelein but sometimes it is made in all porcelein.

3. The abutment is the piece that connects the pieces 1 and 2. It is hand screwed into the implant. This is the piece that tends to get loose after several years of use. If you find that your implant is loose and moving, this is typically where the problem is. Its not a big problem, the dentist just needs to cut a whole through the crown to find the screw, tighten it with a wrench, and fill the whole. This usually does not have any pain associated with it.

WHY SHOULD I CHOOSE A DENTAL IMPLANT? To answer this question you basically have to understand the drawbacks of the other options. Whenever you need to replace a tooth you have 3 main options:

1) Partial Denture:  This prosthesis is typically bulky. It has clasps to hold onto other teeth and fake teeth to replace your missing ones. Because of its size, it tends to get in the way of your tongue and other tissue. It can generate sores. It can cause your jaw bone to receed from long term stress. It will catch food underneath. Overall its not sometime I would will on any of my friends or family. Its an affordable solution and something is better than nothing, but I would rather save my money for something more comfortable.

2) Bridge:      A bridge is basically putting a crown on the two teeth adjecent to the open space and attaching a fake tooth to them effectively "bridging" the gap. The best things about this solution are a) it feels very similar to having real teeth, since you are using  other teeth to support it, you still have similar chewing and sensations, b) its fast: the dentist can have this back to you in about 2-3 weeks. Whats the problem? Well as you can see, those two adject teeth are ground down quite a bit to what they used to be; and if they were perfectly good teeth, you just ground down about half of each healthy tooth. The other reason is this is a 3 piece unit which means that if any of these pieces fail, the whole thing fails. If you get a cavity on one of these teeth, you have to do it over again. If you lose one of the teeth to periodontal disease, you have to lose the whole bridge. SO its a good solution for the short term, but long term is has problems.

3) Implant: So basically the best thing about the implant is that its a stand alone soluation. No other teeth need be damaged and it relies on no other teeth. If you take care of it, you can take it to your grave. The only real problem with the implant is that it takes time. Usually somewhere between 3-9 months of treatment time. What are the factors that make up the time difference?

- Time to heal: The implant needs time to heal and "integreate" into your body. If you started to chew on it immediately, there is a good chance that it will never form bone around the implant and it would fall out.

- Do you have enough bone? If the tooth is lost for a long time the bone with atrophy away. This means the dentist may need to add some artifical bone around the implant to support it. This requires additional healing time

- Are you in good health? The implant site heals just like any other part of your body. Having health problems like diabetes can impair healing , requiring extra healing time.

-Do you smoke? If you smoke you can cause your gums and bone to not heal during this time. The dentist will tell you not to smoke, but not to say you will definately fail the implant if you do; it just really helps if you dont.

Jeffrey Chung DDS