Teeth – Dental Implants
Dr. Julian Leiner has written the factsheet below to explain what dental implants are, and to answer some of the most frequently asked questions.
What is a dental implant?
An implant is a titanium post that is surgically placed into the jaw bone, essentially providing an artificial root of a tooth. The bone heals around the implant, and you can then place a crown, bridge or even connect dentures (false teeth) to it. Sometimes, treatments are limited due to the amount of bone available, and we need to use artificial bone material or even bone grafts.
Is implant treatment painful?
This is probably the question I get asked the most, and no, it absolutely shouldn’t be. We give you lots of local anaesthetic and wait for the area to be completely numb. Most of my patients say it was no worse than having a tooth taken out, if anything there is less pushing and pulling! Afterwards, it may be a little sore, especially if you have had a lot of implants placed in one go, but we manage this with painkillers and sometimes a low-dose steroid to prevent pain and swelling. My last few patients all said they took some paracetamol on the day of the surgery, and nothing after that.
What if I’m still too anxious to have the treatment?
Admittedly, if you start looking at some of this treatment online it can look quite scary, but you have to remember that the local anaesthetic means you can’t feel it. However, at the practice I work at in Bolton, I also provide intravenous sedation (medication to make you sleepy, that’s given through a vein). This is where we insert a very small cannula (a tiny plastic tube that goes just under the skin) in the arm, hand or foot then use midazolam (similar to diazepam) to make you feel very calm and relaxed. You are still awake but will feel drowsy and time will appear to go very fast, and you likely won’t remember most of the procedure. This is a very safe and pleasant way to have implant work done. We can also give you oral diazepam tablets to help you feel calmer before a procedure. You would need to bring someone with you though.
Who does dental implants?
In the UK there is no such thing as an implant specialist, so they are done by general dentists, or specialists in another area that is linked to implants, such as oral surgery. However, implants are only touched upon in general dentists’ training, and so the dentist should have had further training to become competent at implant work. There is a big range of treatment that these implantologists carry out, from just restoring simple implant crowns, to placing and restoring full mouth cases. I do placements and restorations of most implant cases, but will refer to someone local the ones that need major grafting, sinus lifts or immediate full mouth cases.
How long does it take?
I like to think of all of my patients having an ‘implant journey’, although some are longer than others. You will always start with a detailed consultation, likely followed by a cone beam CT scan (a special type of scan that produces a 3 dimensional image) to show us the bone in 3D. Often when we place an implant we can put a temporary crown on it straight away, and we will always make sure you are not leaving with a gap at the front of your mouth. Then there is a healing period, followed by impressions and the final crown/bridge. Even a simple case will therefore normally take a few months to complete.
How much does it cost?
This depends a lot on which treatment is best for you, so I and many other implantologists offer a free initial consultation to give you a rough idea of the costs and treatment involved, we can then arrange the full consultation if you are interested. We offer 0% interest payment plans through a finance company for up to 18 months, which can be a good way to spread the investment in your new teeth without increasing the cost for you.
What do I need to do during and after treatment?
There are many ways you can help us make your implant treatment successful. Good oral hygiene is essential and we can help you work out a good routine to keep the implants (and teeth) plaque free with healthy gums. Smoking affects the healing of the bone around the implants – the less you smoke the better the success. You will then need regular check ups for life so that we can monitor the implants, as they can be affected by gum disease in the same way that teeth are.
What are the chances of failure/problems?
Sometimes, implants fail to integrate into the body, or are affected by bone loss later. If monitored closely this can normally be managed, but there may be a need for procedures or even replacements down the line. However, most studies show at least 95% of implants to be successful well over 10 years after placement, and most will last a lot longer.
What will it look like afterwards?
In most cases the final porcelain crown or bridge blends in at least as well as a normal tooth-coloured crown. Sometimes, the implant crown may need to be a little longer if there has been some bone loss, but if this would be an issue then we could avoid it through grafting. At the consultation we would discuss the expected outcome and then plan it together accordingly.