Dental Implants
There are many reasons that permanent teeth are lost. They can be broken down from decay and large cavities. They can be weakened from periodontal disease. They can be lost due to falls, sports injuries, and other traumatic impacts to the face. And of course, they can be congenitally missing.
There are several options after a tooth is lost:
No replacement- you can just do nothing, but this may result in the surrounding teeth shifting and may lead to undesirable effects. Best to discuss with your doctor if you are at risk for this.
A removable prosthetic tooth replacement- this is basically a piece that you wear in your mouth that replaces the tooth for cosmetic purposes only. The different types are: flipper, removable partial denture, Essix appliance. Pro- it’s cheaper than fixed options. Also, it’s easily cleansible. The downside: it’s difficult to eat with, because it will loosen with chewing.
A fixed prosthetic tooth replacement- this is what is known as a bridge. It is a bridge of teeth- a crown covering the teeth on either side of the space, and a fake tooth suspended between them. This is for both cosmetics and function. Pro - You can eat with it and it won’t come out. Con- high maintenance. it can be challenging to keep clean, and if you don’t clean it properly, you will shorten its life.
Dental implant- this is a fixed solution. It is a hollow titanium screw that is surgically placed into the jaw. The inside of the screw can accept attachments, which is how the top of the tooth gets connected and anchored. Pro- this option feels the most natural. Con- this option is expensive, involves surgery, and also can be high maintenance in terms of care.
Now, which option is best? Like most things, there is no best. There is the option that is best for you. This depends on your age, which tooth it is, what the rest of your teeth look like, your medical history, and many other factors.
Implant structure
A dental implant is a hollow screw. It is usually made of surface treated titanium. It gets screwed into the bone, and is usually buried for several months before it can be used. During this time, it undergoes a process called osseointegration. This means that the bone actually grows into the little nooks and crannies in the implant surface, and becomes attached to the bone on a microscopic level. When an implant is “integrated” in the bone, if you were to turn it backwards to try to reverse the screw, it would not turn. This is what we want, because you want to be able to chew with this thing.
For an implant to successfully osseointegrate, the bone we place it into needs to be of adequate quality and quantity. This is why you may need a bone graft at the time of tooth extraction, to make sure the site has enough bone for an implant to be placed.
Once the implant is intergrated, it may be used. Your surgeon needs to make sure there is no gum tissue covering the implant, and you may need a procedure to trim the gum tissue, called a stage II implant procedure. Then, your dentist will take an impression of the implant post that is sticking up out of your gums, in order to make a tooth with the right size, shape, anatomy, and color to fit the empty space. The final tooth (called a crown) usually gets screwed into place by the dentist, and the screw head gets covered with tooth covered material, so that only the dentist can access it if and when necessary.
Of course, a dental implant is not susceptible to decay and cavities. For this reason, many patients mistakenly think they do not need to take care of their implants. However, because the implant is implanted into the bone, and is surrounded by gum tissue, it is still very susceptible to gum disease. You must brush and floss the gums diligently around the implant, to remove food, and prevent bacteria from collecting around the implant. If you do not take care of your implants well, they will become infected and need to be removed.
Patients ask which option is best. There is no one solution for everyone, it is different for each person. There is no question that dental implants feel the most like natural teeth. But they still require diligent maintenance and upkeep. For this reason, it is important to discuss with your dentist and oral surgeon what is right for you.