Produced by Stephanie Hughes, Bupa Health Information Team, January 2012.

This factsheet is for people who are having dental implants, or who would like information about them.

Dental implants support replacement teeth. They fit directly into your jawbone and hold false teeth in place in the same way that roots support natural teeth.

You will meet the dentist carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs. Details of the procedure may also vary from country to country.
 
About dental implants
What are the alternatives?
Preparing for dental implant surgery
What happens during dental implant surgery?
What to expect afterwards
Recovering from dental implant surgery
What are the risks?

About dental implants

A dental implant is a metal rod that has an internal screw or clip (abutment) that can hold a false tooth (or teeth) in place. Implants are usually made of titanium.

Over several months, your jawbone will fuse with the titanium rod. Dentures, crowns or bridges can be attached to the implant to replace your missing teeth. One implant can support one or more replacement teeth. In your upper jaw you would need at least six implants to replace all your teeth and you would need between four and six implants in your lower jaw.

Having dental implants will involve at least one minor operation. You need to have healthy gums. Some dentists won't offer you dental implants if you smoke as it can affect the outcome of the treatment. Implants are less likely to be successful if you have a medical condition such as diabetes or osteoporosis, or have had chemotherapy. Ask your dentist if implants are an option for you.

What are the alternatives?

Alternatives to dental implants include:

  • removable dentures (false teeth) – plastic or metal frameworks that carry false teeth
  • a bridge – false teeth that are fixed onto adjacent natural teeth

Preparing for dental implant surgery

Your dentist will explain how to prepare for your procedure.

You may need to have an X-ray or a CT scan so your dentist can check the thickness of your jawbone and the position of other structures in your mouth.

Dental implant surgery is usually done under local anaesthesia. This completely blocks pain from your mouth and you will stay awake during the procedure. You may have a sedative – this relieves anxiety and helps you to relax. It’s rare, but you may need to go into hospital and have treatment under general anaesthesia. This means you will be asleep during the operation.

Your dentist will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What happens during dental implant surgery?

Once the anaesthetic has taken effect, your dentist will make a cut in your gum and then drill a small hole in your jawbone. The implant will fit into this hole.

If you need to have teeth removed before dental implant surgery, your dentist may be able to remove a tooth and put an implant straight into your tooth socket – this is called an immediate implant. However, usually your dentist will fit the implant after a few weeks, which is called an immediate-delayed implant. Sometimes he or she will fit it after several months once your tooth is removed and your jawbone has had time to heal – this is called a delayed implant.
Immediate and delayed implants can be done in one or two stages.

  • In one-stage implant treatment, the implant rod and the abutment that pokes through your gums to connect the implant to the false tooth will be fitted at the same time.
  • In two-stage implant treatment, the implant rod will be buried under your gum while your bone heals (you won’t see it in your mouth). Then, a few months later, you will have another small operation to attach the abutment.

Your dentist may attach artificial teeth on the same day you have the implant. Usually, however, you will need to wait between three and eight months to allow your mouth to heal. Your dentist may fit a temporary bridge or partial dentures so you can't see the spaces between your remaining teeth. If you have complete dentures, they can be adjusted so that you can wear them throughout this time.

After your mouth has healed, you will have a second, smaller surgical procedure to uncover the gum over the top of the implant if necessary. Your dentist will then fit your artificial teeth onto the implant. The teeth may be fixed permanently or attached in a way that allows you to remove them for cleaning. Your dentist will ensure that they fit properly, match your other teeth and feel comfortable.

What to expect afterwards

You may need to rest until the effects of the anaesthetic have passed. After a local anaesthetic it may take several hours before the feeling comes back into your mouth.

You may need pain relief to help with any discomfort as the anaesthetic wears off.

You will usually be able to go home when you feel ready.

If you have a general anaesthetic you will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours.

General anaesthesia and sedation temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your dentist’s advice.

It’s important to only eat soft foods for the rest of the day after having dental implant surgery. Try to keep your mouth clean by brushing but don’t directly brush the implant site. Your dentist may advise you to use an antiseptic mouthwash every day during the first week after your operation.

Recovering from dental implant surgery

If you need pain relief, you can take over-the-counter painkillers such as paracetamol (acetaminophen) or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Your dentist may prescribe you antibiotics and an antiseptic mouthwash to reduce the risk of your implant getting infected.

The time it takes to make a full recovery from dental implant surgery will vary depending on your treatment plan, so it's important to follow your dentist's advice.

Once you have recovered, your implants and replacement teeth should function as natural teeth do in terms of eating.

If you damage the implant it may be removed and replaced. If it’s too difficult to remove, it can be safely left in your jaw and another implant will be placed alongside it.

What are the risks?

As with every procedure, there are some risks associated with dental implant surgery. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your dentist to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

You may have some swelling and discomfort around the implant area. If so, you can take an over-the-counter painkiller such as paracetamol (acetaminophen) or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Complications

Complications are when problems occur during or after the procedure.

The possible complications of any operation include an unexpected reaction to the anaesthetic, or excessive bleeding.

Your lower jaw contains nerves that supply the feeling to your tongue, chin, lower lip and lower teeth. If the nerves are damaged by the implant, you may feel temporary or even permanent tingling or numbness. X-rays and CT scans help your dentist to see the position of the nerves in your jawbone to minimise this risk.

Occasionally, the jawbone doesn't fuse with the implant properly and the implant can become loose and fail. This isn't usually painful, but the implant won't be able to support false teeth. Your dentist will ask you to attend regular check-ups to make sure your implants are still secure.

Answers to questions about dental implants.

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
 
Please insert jump links to all H2 headings
 
How long will dental implant treatment take?
What is bone grafting and when can it be used?
If I grind my teeth can I have dental implants?
 

How long will dental implant treatment take?

 

Answer

Dental implant surgery can take some time to complete. However, your dentist will do everything he or she can to ensure that your appearance and ability to eat and speak are affected as little as possible during the treatment. He or she will give you a written summary before your treatment starts, outlining an estimated schedule for your individual treatment plan.

Explanation

After placing the implants, your dentist may recommend waiting between three and eight months for your mouth to heal before attaching the final false teeth. He or she will discuss options for maintaining your appearance and ability to eat and speak during your treatment. This will probably involve temporary dentures.
 
Unfortunately, some people find temporary dentures need frequent adjustments. To address this, some specialists attach the false teeth straight away, speeding up treatment time considerably. But this treatment option isn’t suitable for everyone.
 
If your treatment is going to take longer than you had hoped, try to be patient. Your dentist will have planned your schedule carefully to try and ensure that you have successful implants that last for a long time.

Further information

British Dental Health Foundation
0870 770 4000
www.dentalhealth.org.uk
 
Association of Dental Implantology UK
020 8487 5555
www.adi.org.uk
 
H3 Source
 

  • Esposito M, Grusovin MG, Achille H, et al. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database of Systematic Reviews 2009, Issue 1. DOI: 10.1002/14651858.CD003878.pub4

What is bone grafting and when can it be used?

Answer

Bone grafting is a surgical procedure used to increase the amount of bone in your jaw. It helps to support the dental implant.

Explanation

For dental implants to be successful there needs to be enough bone to hold the implant. If you don't have enough bone in your jaw because of injury, loss of teeth, or a developmental problem, your specialist may recommend a graft to increase the amount of bone.
 
Bone grafting involves re-building the jaw bone by taking bone from somewhere else in your body (autogenous grafts) and adding it to the area where the implant will be placed. If the area is small, then the bone will be taken from another part of your mouth. If the area is large, then the bone will be taken from another area of your body such as your hip or shin. You will need to go into hospital and have this treatment under general anaesthetic.
 
Your dentist may want to avoid taking bone from another part of your body to reduce the amount of surgery you need. In this case, he or she can use synthetic bone (alloplastic grafts), or materials made from the bone of animals (heterografts). However, your own bone is considered the “gold standard” as it fuses with your jaw more quickly.
 
Once the jaw has been re-built it takes between three and 12 months before an implant can be fitted.
 

Further information

Association of Dental Implantology UK
020 8487 5555
www.adi.org.uk
 
H3 Sources

  • Chestnutt IG, Gibson J. Churchill’s pocketbook of clinical dentistry. 3rd ed. Elsevier 2007.
  • If you do not have enough bone what can be done? The Association of Dental Implantology (UK) www.adi.org.uk, accessed 16 October 2009
  • Alternatives to your own bone for grafting. The Association of Dental Implantology (UK) www.adi.org.uk, accessed 16 October 2009

 

I grind my teeth. Can I have dental implants?

 

Answer

Yes, you can still have dental implants if you grind your teeth. But it's important that you discuss this with your dentist so that he or she can plan your treatment accordingly.

Explanation

Grinding your teeth (also called bruxism) is a very common habit, but it often happens during sleep, so many of us are unaware of it. Your dentist will be able to pick up signs and symptoms of bruxism even if you’re not aware that you do it.
 
Grinding your teeth will put extra pressure on implants. Your dentist may recommend placing more implants to support the artificial tooth/teeth. He or she will also make sure that the materials used to make the false teeth are strong enough to withstand the extra pressure.
 
Your dentist may also suggest you wear a removable mouth guard (sometimes called a splint) at night. This is a cover made from hard or soft plastic that fits over your upper or lower teeth. The aim of the splint is to decrease grinding and pressure on your teeth.

Further information

Association of Dental Implantology UK
020 8487 5555
www.adi.org.uk
 

Source

  • Can dental implants preserve bone? The Association of Dental Implantology (UK). www.adi.org.uk, 16 October 2009

Sources

  • Esposito M, Grusovin MG, Polyzos IP, et al. Interventions for replacing missing teeth: dental implants in fresh extraction sockets (immediate, immediate-delayed and delayed implants). Cochrane Database of Systematic Reviews 2010, Issue 9. doi:10.1002/14651858.CD005968.pub3
  • Dental implant information. Association of Dental Implantology UK. www.adi.org.uk, accessed 18 October 2011
  • Dentures and implants. British Dental Association. www.bdasmile.org, accessed 18 October 2011
  • Esposito M, Murray-Curtis L, Grusovin MG, et al. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database of Systematic Reviews 2007, Issue 4. doi:10.1002/14651858.CD003815.pub3
  • Bridges and partial dentures. British Dental Health Foundation. www.dentalhealth.org, accessed 18 October 2011
  • Esposito M, Grusovin MG, Achille H, et al. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database of Systematic Reviews 2009, Issue 1. doi: 10.1002/14651858.CD003878.pub4
  • Implants. British Dental Health Foundation. www.dentalhealth.org, accessed 18 October 2011
  • Esposito M, Worthington HV, Loli V, et al. Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications. Cochrane Database of Systematic Reviews 2010, Issue 7. doi: 10.1002/14651858.CD004152.pub3
  • Grusovin MG, Coulthard P, Worthington HV, et al. Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants. Cochrane Database of Systematic Reviews 2010, Issue 8. doi:10.1002/14651858.CD003069.pub4
  • Dental implants. American Association of Oral and Maxillofacial Surgeons. www.aaoms.org, accessed 21 November 2011

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