FAQ's > Dental Implants


The information presented below is only for informational purposes. Your surgeon will talk to you about details regarding your specific procedure.



Who is a candidate for dental implants?
If you're missing one tooth or all of your teeth, implants may be for you. So long as you have enough bone in the area of the missing tooth to facilitate the anchorage of the implants, this procedure can yield good results. If you don't have enough bone for this purpose, a bone graft may be necessary. If you have a small dental bridge or partial dentures (removable type), implants can be an alternative. Implants are an alternative to a fixed bridge. The implant will last a lifetime, but the crown on top of it will last ten to fifteen years.

How are dental implants attached in your mouth?
Implants are surgically placed in your jaw bone while under anesthesia. It is a very time consuming procedure when having many implants placed. The implant procedure is a surgical placement of the implant or implants in your jaw bone which requires a three to six month healing period before the implant restoration to replace the missing tooth or teeth. During this healing time, the bone grows in and around the titanium implant creating a very strong support. Dental implants can be rejected. Usually they are replaced with another implant of a slightly larger size. The rejection or "failure" rate is minimal; only 1 to 2% of all implant procedures. You must go without wearing your dentures for one day to two weeks after an implant placement. After the implant has "taken" and you have sufficiently healed, a very natural crown is placed on the implant. For some people there are varying degrees discomfort or pain, which subsides in a couple of days. As with similar types of surgery, bruising and minor swelling might also develop shortly after the procedure.

When missing one tooth, your cosmetic dentist may use a Flipper to fill the space. A flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown is placed on the implant. A flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent crown to be placed on your implant(s).

A procedure of building up the bone is known as Bone Grafting. Bone grafting is common with dental implants. The bone that is used is one of three types. The preferred bone to use is taken from other areas of your mouth or collected in a suction device as the drilling of the sites for dental implants occurs. Sometimes bone is taken from areas such as a hip (this requires an orthopedic surgeon and an operating room). The third source for needed bone is a synthetic type. This is the least preferred type of bone to be used for this procedure.

What are some types of dental implant procedures?
Implants rely on titanium fixtures inserted into the jawbone. Most implants are made of titanium, which is very effective at fusing with living bone (osseointegration). There are three main types of dental implants:

Root Form Implant
 - This screw type implant is shaped like the root of a tooth. This is the most commonly used implant and is used where there is plenty of width and depth to your jawbone. If your jawbone is too narrow or short for placement of the root form implants, bone grafting may be needed to allow for their placement. After you've received anesthesia, your cosmetic dentist will expose an area of your jawbone and prepare the bone for the implant. The number of incisions and bone preparations depend on how many implants you need. The implant will be set into place and your gums are closed with stitches. It will take three to six months for healing. After you've fully healed, your implant is uncovered and an abutment is attached.

Plate Form Implant - If your jawbone is too narrow for bone grafting, a plate form implant is placed into your jawbone. The plate form implant is unique for this purpose as it has a flat and long shape for a better fit into a narrow jawbone. After you've received anesthesia, your cosmetic dentist will expose an area of your jawbone and prepare the bone for the implant. The number of incisions and bone preparations depend on how many implants you need. The implant will be set into place and your gums are closed with stitches. It will take three to six months for healing (some plate form implants are immediately ready for restoration without the long healing process).

Subperiosteal Implants - If there's not enough bone width or height for the root form or plate form implants, the subperiosteal implant is recommended. The Subperiosteal implant is custom made to rest on top of your jawbone and under your gums like the plate form implant, but the Subperiosteal implant is placed through one of two special methods. The first method of placement involves your cosmetic dentist making an impression of your jawbone. After you've received anesthesia, your cosmetic dentist exposes your jawbone and takes an impression of it. The impression is used by a dental laboratory to make a custom-fit implant for your jaw. The next procedure, after your custom-fit implant is created, is to again expose your jawbone and place the implant. Your gums are then closed with stitches and replacement teeth are installed. The second method of placement requires a CAT scan of your jawbone. Through computer modeling techniques, a model of your jawbone is made from the CAT information. The next procedure, after your custom-fit subperiosteal implant is created by a dental laboratory, is to again expose your jawbone and place the implant. Your gums are then closed with stitches and replacement teeth are installed.

How often will I need to have my dental implants checked?
The success of your implants will depend greatly on how well you maintain them. They will need to be professionally cleaned by a hygienist and examined by your implant dentist every three to four months. This hygienist should be trained in the specific procedure of maintaining dental implants. Also, brushing and flossing daily is absolutely necessary for long-term success.

What about infection and complications?
During the surgery every attempt is made to maintain a totally sterile field. This tends to minimize any potential for postoperative infection. Once again, your dentist will prescribe the appropriate antibiotics as a precautionary measure. Once the implants have been engaged in your prosthesis, it is imperative for you to maintain scrupulous oral hygiene. Success very often depends on your cooperation and care efforts.

Will I be able to chew and function normally?
Yes. Once your implants have integrated, you will be able to function normally without any unusual sensations. Your chewing ability will really depend upon the type of prosthesis you have chosen.

Q. What is a dental implant?
A. A dental implant is a substitute tooth root that serves the same function as a natural tooth root. It preserves bone and provides a stable foundation for a replacement tooth that looks, feels and functions like a natural tooth. Dental implants are made of titanium, which is a biocompatible material used in orthopedic implants.

Q. Who is a candidate for dental implant treatment?
A. Nearly everyone who is missing one or more teeth and in general good health is a candidate for dental implant treatment. There are a few medical conditions that can undermine the success of implant treatment, such as uncontrolled diabetes. However, there are very few conditions that would keep someone from having implant treatment altogether.

Q. Why are dental implants better than bridges, partials, and dentures?
A. Dental implants can last a lifetime, unlike bridges, partials and dentures that may need to be replaced several times. Since dental implants prevent the bone resorption that occurs when teeth are missing, the natural appearance of the smile is preserved. With implant treatment, there is no compromise to adjacent teeth; they are not cut down to place a bridge, or loosened by the hooks on removable partials. Dentures and partials have the added disadvantage of accelerating the bone resorption process, which causes the appearance of premature aging.

Q. Is anyone ever considered too old for dental
implants?
A. Overall health and a desire to improve the quality of life are much more important considerations than age. When dental implants were first developed, back in the 1950's, implant supported replacement teeth were originally designed as a solution for older patients who were missing all of their teeth. Since then, many patients well into their nineties have had dental implant treatment without a single problem.

Q. How long does it take to complete dental implant treatment?
A. The length of treatment time depends largely upon whether someone is a candidate for Immediate Function procedures. Patients who qualify for this type of treatment receive their replacement teeth the same day implants are placed. For the majority of patients, treatment can take anywhere from several weeks to several months, depending upon the quality of the bone in which the implants are placed. If procedures are needed to augment the bone, the total treatment time is usually somewhere between six to nine months.

Q. Will there be any restrictions to my lifestyle?
A. No. You will be able to undertake any activity that you would with normal teeth. This includes eating and drinking whateveryou choose. Your new replacement teeth will look, feel and function like natural teeth, which will allow you to forget about them and enjoy life as it was meant to be enjoyed.

Q. Will my new teeth look natural?
A. Your new replacement teeth will look, feel and function like natural teeth. And since implant treatment is the only solution that prevents bone resorption, which can cause your smile to look unnatural, the long term esthetics will be superior to any other treatment option.

Q. Is the surgical procedure painful?
A. Most implant patients report that the discomfort is far less than they expected, and is much like having a tooth extracted. And although everyone is different with regard to pain tolerance, most patients are very comfortable simply taking Tylenol afterward.

Q. Is it necessary to have one implant placed for
each missing tooth?
A. No. In fact, it is possible to replace all of the lower teeth with an overdenture that is supported by only 2-4 implants. On the mother hand, some dental specialists feel that it is advantageous to replace missing posterior teeth with individual implants to provide additional strength to withstand the forces of chewing for patients who have most of their natural teeth. Each patient's situation is unique and should be evaluated by a dental specialist to determine the appropriate number of implants required to support the replacement teeth that will meet the patient's functional and esthetic needs.

Q. How long do implants last?

A. Documented clinical research demonstrates that implant supported replacement teeth have been successful for over 50 years. These were some of the first root-form implant cases ever completed and they have been closely monitored from the beginning. It is highly likely that these cases will be successful throughout the lifetime of those patients.

Q. Do dental implants ever fail?
A. Dental implant treatment is one of the most successful procedures in the medical-dental field, with documented success rates over 95%. Although successful treatment is very predictable, there are rare occasions where the bone does not completely bond to the implants. When this occurs, new implants are placed, and the success rates for the replacement implants are even higher. Smoking or putting too much pressure on newly placed implants, as with excessive grinding of the teeth, can cause problems with the bone bonding to the implants and should be avoided.

Q. Does the body ever reject dental implants?

A. Several years ago there was quite a scare about certain types of breast implants, which has caused a number of people to ask if the same thing is possible with dental implants. As indicated above, the success rates for dental implants are extremely high. This is due in part to the fact that root-form implants are made of a biocompatible material, titanium. Because titanium is accepted so well by the human body, it also used for orthopedic implants, such as hip and knee replacements.

Q. Is it possible to use an existing denture with
dental implants?
A. Sometimes it is possible to use a patient's existing denture, as opposed to fabricating a new denture to snap onto dental implants, by altering it to accommodate the necessary attachments. However, there are a number of factors that must be considered. Since each patient's situation is unique, the possibility of using an existing denture can only be determined in consultation with a dentist or dental specialist.

Q. If dental implants preserve bone, why would a
dentist recommend a tooth supported bridge?
A. Naturally, since dental implants preserve bone, if a patient qualifies as a candidate, implant treatment is usually considered the treatment of choice. Now that implants are considered standard of care, it is much less common for dentists to recommend fixed bridges instead of implants. Some dentists recommend bridges for patients who are not candidates for implants, or when patients insist on having the lowest possible fee for tooth replacement. However, even in cases where the teeth adjacent to the missing tooth/teeth have restorations, many dentists do not want to grind these teeth down into peg shapes to fit a bridge, as this compromises the long term health of those teeth. And most dentists abhor the idea of grinding down perfect teeth without restorations to place a traditional bridge, and therefore, will almost always recommend dental implant treatment in these cases.

Q. Are there situations where extracting a tooth and replacing it with an implant would be recommended?
A. There are many situations where natural teeth are either failing, or are about to fail. This includes severe periodontal disease (gum disease) that has eroded the bone that supports teeth. Sometimes in these cases, it is preferable to extract the teeth; eliminate the disease and infection and replace the teeth with implant supported crowns/bridges. There are also situations where a tooth has had a root canal (nerves have been removed from the tooth) leaving the tooth brittle and susceptible to fracture. In cases where the tooth needs to be retreated and the prognosis is not favorable, it is preferable to extract the tooth and replace it with an implant supported crown. Teeth with severe fractures are usually extracted and are ideal candidates for replacement with dental implant treatment.

Q. What is involved with taking care of dental

implants?
A. The home care recommended varies depending upon the type of implant supported replacement teeth. For example, asingle implant supported crown is cleaned like a natural tooth, with regular brushing and flossing. Implant supported bridges that replace a few teeth are cleaned like tooth supported bridges, brushing and flossing with a floss threader. Home care is a little more complicated for people who are missing all of their teeth, in that special brushes and floss are often recommended. With overdentures, it is necessary to clean the implant attachments, as well as the overdenture. Permanently fixed implant supported replacement teeth are cleaned like all other bridges. In all cases, it is recommended that patients see their regular dentist and hygienist at least twice each year unless the routinely see the periodontist, in which case they would continue to alternate visits. It is usually recommended that the patient see the surgical specialist who places the implant(s) at least once each year as well. These visits, combined with proper home care, are essential to the long term success of implant treatment.

FAQ’s about Cosmetic Dentistry
What is cosmetic dentistry, and how is it different from general dentistry?
Cosmetic dentistry is the art and science of designing wonderful smiles. Prosthodontists are skillfully trained at improving the appearance of an individual’s teeth, mouth and smile to look their very best. General dentistry addresses necessary treatment at maintaining the health of your teeth and gums .They provide services such as cleanings, cavity checks, and general monitoring for possible problems that might otherwise go undetected. You should visit your dentist every 6 months to monitor your overall oral health.

Common cosmetic treatments include:

• Teeth Whitening
• Contouring/Tooth reshaping
• Bonding
• Bridges
• Veneers
• Dental implants
• Tooth colored fillings
• Smile makeovers

How long will each cosmetic treatment take?

Every smile is unique; therefore every cosmetic procedure is different. Some treatments can be completed in one office visit while others can take several office visits to complete.

Will my insurance cover cosmetic care?

All insurance coverage and out of pocket expenses can vary. Our office will contact your insurance provider to see if cosmetic coverage is available. We will provide you with your treatment costs up front so we can choose the best payment options for your needs and your budget.

Am I a good candidate for teeth whitening?

Patients who experience the most benefit from having their teeth whitened:
Are in good dental health
Maintain good dental health (i.e. brush two times a day,
floss, receive regular dental checkups every six months, etc.)
May suffer from slightly discolored, or yellow, teeth
Wish to improve the look of their smile for aesthetic purposes
Are in good physical health

Are there any side effects with teeth whitening?
Teeth whitening does not typically include any negative side effects. It is a safe and effective procedure.

Minor side effects may consist of:
Increased tooth sensitivity to hot or cold
White spots on the surface of the teeth
Nighttime whitening trays may cause additional gum sensitivity or irritation

Q: Is a Prosthodontist different from A “COSMETIC
DENTIST”?
A: Prosthodontics is the “dental specialty” pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of oral function, comfort appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. A Prosthodontist has graduated from dental school and has at least three or more years of continuing education afterwards.

Some common procedures will include:
Dentures
Partial dentures
Bridges
Crowns
Implants
Veneers

Q: How can esthetic dentistry help improve the appearance of
my smile?
A: If you dislike your smile, esthetic dentistry may be the answer. This includes dental prevention and having a healthier, whiter, more radiant smile. From restoring a simple tooth or to having a full mouth make-over, your smile can be changed dramatically. Other esthetic procedures

include:
Bleaching
Bonding
Veneers
Crowns
Implants
Orthodontics

Q: How often should I have a dental exam or cleaning?

A: You should visit your dentist at least twice a year to have your teeth cleaned and examined. Depending on your oral health, your dentist will advise you on your recare frequencies for exams and cleanings to monitor, prevent, and maintain your dental health.

Q: How often should I brush and floss?

A: Brushing and flossing helps to control the plaque and bacteria that cause dental disease. Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums. The bacteria change certain food particles into acids that cause tooth decay. Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease. Plaque formation and growth is continuous and can only be controlled by regular brushing and flossing. Tooth brushing should be performed at least twice a day, once in the morning and before bedtime. Also, brushing your tongue to remove bacteria will lead to fresh breath. Flossing daily is strongly advised. It is the best way to clean the teeth under the gum line. It helps disrupt plaque colonies from building up, preventing damage to the gums, teeth and bones.

Q: How can I tell if I have gingivitis or periodontitis (gum
disease)?
A: Many people do not know they have periodontal disease especially when it is in its early stages. Keeping up with regular examinations is very important and will help detect if periodontal problems exist. Having periodontal disease without noticeable symptoms is possible. Periodontal disease is when plaque, a film of bacteria, food debris and saliva is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy bone that supports teeth. Brushing and flossing regularly and properly will decrease the likelihood that plaque will lead to tooth loss.

Other factors that increase the risk of periodontal disease are:
Tobacco use
Certain medications
Pregnancy, oral contraceptives and puberty
Systemic disease- Diabetes, blood cell disorders, HIV/AIDS, etc.

Genetics-patients with family history of tooth loss should pay extra attention to their gums.

Signs and symptoms of Periodontal Disease:

Red, puffy gums
Bleeding gums
Persistent bad breath
Spacing between teeth
Loose teeth
Pus around teeth and gums- indication of an infection.
Receding gums
Tenderness or discomfort of teeth and gums.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

What should I expect at a dental visit?

It depends on your situation, whether you are just coming in for a routine visit or for a specific problem. Our office schedules one hour appointments for routine check ups and cleanings. If you are a new patient to our practice you will be asked to complete a new patient packet that will inform us of your important information, such as your medical history and insurance information if you have dental coverage.

How long will I have to wait in the waiting room?

We do not double book our appointments. We value our patient time as we hope our patients value ours.




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