Dental implants are today the gold standard for permanent tooth replacement. It has the potential to offer patients a more natural, aesthetic, comfortable and lifestyle friendly solution when compared to removable or fixed dentures. Dental implants are very versatile and can be used to replace a single missing tooth, multiple missing teeth or function as an anchor to stabilize removable full dentures.
What is 'Osseointegration'?
Dental implant treatment is possible because of the ability of bone to heal and grow around Titanium, providing stability and retention. This phenomenon is called Osseointegration and occurs over the first 6 months after implant placement. Besides being inert and biocompatible, Titanium is also strong, yet light in weight.
Advantages of dental implants.
1) Keeps your remaining natural teeth free from dental restorations.
Dental implants eliminates the need for adjacent teeth preparation associated with the use of fixed or removable dentures.
2) Maintain our natural lip support and smile.
As dental implants are embedded in bone, the existing jaw bone height and thickness is maintained. This helps significantly in ensuring long term lip support for the face.
3) Simply more comfortable.
Dental implants are held in place, permanently by the jaw bone, eliminating the inconvenience and discomfort associated with removable dentures.
4) Last longer.
The long term survival rates of dental implants in the presence of adequate bone volume and good oral hygiene is very good. Many long term studies show that dental implants are simply the better option when compared to other forms of teeth replacement.
5) Restores normal function.
Dental implants mimics the natural teeth in daily function. The added stability allows us to chew and speak confidently. This has a direct impact on our professional and social wellbeing.
6) Excellent long term value.
Dental implants are very cost effective in the long term, especially when placed early after tooth loss by an experienced and competent surgeon. While the initial cost is higher than other forms of teeth replacement, the need for remakes in healthy mouths are more infrequent.
Who is suitable for dental implants?
Anyone who is physically well enough to undergo a routine dental extraction will often be fit enough for dental implants. Dental implants are not suitable for the growing child as their jaw bone is still developing. There is however no upper age limit for dental implant treatment in healthy adults.
People with existing gum disease or chronic diseases will need to work with their dentist and physicians to achieve a good level of control prior to embarking on dental implant treatment. Studies show that smoking habits decreased the success rates of dental implant treatment. Smokers may therefore want to consider making a change to their lifestyle to improve the predictability of their care.
What will the dentist do?
Firstly, the attending surgeon will carry out a pre-treatment assessment by doing a visual examination, taking x-ray, CT scans or photos, and making impressions of your teeth and gums. Once the initial assessment is completed, the surgeon will discuss the treatment options, process, risks and cost with you. Treatment often involves 2 stages, a Surgical and Restorative stage.
During the surgical stage, the surgeon will embed the titanium implant into the jaw bone, after careful preparation under local anaesthesia. The incision on the gum is subsequently stitched and allowed to heal. Patients who are anxious can opt to carry out treatment under sedation or general anaesthesia. On average, it takes about 30 minutes per implant.
On some occasions, the surgical stage is carried out on the same visit as the extraction of a tooth. This is possible if there is no active infection affecting the tooth to be extracted. This approach have the benefit of being convenient for the patient as well as reduce treatment time. The cost for immediate placement may be slightly higher due to the need for minor bone grafting.
The restorative stage is conventionally carried out between 3 and 6 months after the surgical stage. The attending dentist will expose the top part of the implant and take an impression of it to facilitate the the fabrication of the dental crown.
What is the experience like?
The surgery itself is pain free as it is done under local anaesthesia. During the preparation of the bone, you may be able to feel some vibration or mild sensitivity.
The impression and fitting of the crown during the restorative stage is also pain free. Your dentist may enlist your help when choosing the colour of the crown. Patients who have high expectations about the colour or shape of their crown may need additional visits and incur additional cost due to the need for additional lab work. The crown is fitted in place once the dentist is satisfied with the way it touches the adjacent and opposing teeth.
What to expect after the surgery?
You should expect some minor bleeding, bruising, swelling and discomfort during the initial healing period. You are encouraged to rest at home during the first day after surgery and to avoid physical exercise or very hot food/beverages over the next 48 hours. Painkillers and antibiotics will be prescribed as needed to reduce discomfort and and avoid infection of the surgery site. It is recommended to avoid the consumption of alcoholic beverages whenever you are on prescribed medication.
The attending surgeon will guide you on how to keep the surgery site clean using antiseptic mouthwashes. Normal brushing of other teeth is important. Your surgeon will often review the healing of the implant site after one week.
The attending dentist will guide you on proper implant care after the final crown has been placed. A follow-up visit with the dentist is usually scheduled three months later to check on the function of your newly restored implant and that you are able to keep it clean.
Are there any risks involved?
Like all other surgeries, the placement of dental implants carries some risks. Common complications include the failure of osseointegration due to infection, injury to adjacent teeth or nearby vital structures that lie within the jaw bone (e.g. blood vessels and nerves).
Your surgeon will explain to you the incidence of such complications and the likelihood of success as it may vary significantly between different individuals and implant site.
Like natural teeth, the longevity of dental implants is dependent on good personal and professional care. The evidence over the last three decades tell us that dental implants is a very predictable treatment option in patients who are conscientious of their long term oral health.