Dentist in Charlbury, Oxfordshire

Charlbury Dental Practice
The Spendlove Centre, Enstone Road, Charlbury, Oxfordshire OX7 3PQ

dental implant q & a

We listed a number of common, dental implant related questions we get from our patients:

How can I tell if I am healthy enough to have dental implants?

Generally speaking, if a person is well enough to undergo the treatment necessary for fixed bridgework or routine tooth extractions, the same person can undergo dental implant procedures. Also, patients may have general health conditions that would contraindicate implant procedures, although this is unusual. The best form of implant for you is determined after a thorough examination and discussion with your dentist. The amount and location of available bone is usually the major determinant as to which implant system is to be used, or whether you are a good implant candidate.

Where dental implants are concerned, are there risks of the body rejecting them?

When people hear the word "rejection" in connection with implants, they are usually describing conditions that can occur where there has been surgery that involves transplanting a vital organ such as a heart. However, dental implants fall into an entirely different category due to the fact that tissue matching, blood typing, etc., is not a factor as in the other procedures mentioned. The body completely accepts placement of dental implant material within bone; therefore, today's dental implants meet with great success.

Obviously, there are some dental implants that have not been successful. However, success has more to do with proper patient selection, proficiency of the practitioner, and the patient's commitment to proper hygiene and preventative maintenance. Another factor in success involves regular follow-up care, just like other dental treatment. Both soft tissue health and the way the replacement teeth function and bite together must be evaluated periodically to ensure long term success of the dental implant.

How long will implants last?

How long do teeth last? They should last a lifetime. However, we all can sight examples where teeth have not served for a person's lifetime. We know that dental problems mostly stem from improper home care or lack of treatment when needed. The same holds true for implants. With proper care and routine dental check-ups they should last a lifetime. No one can give guarantees because the health of a person is dependent upon many factors which are out of the control of one's dentist, e.g. proper nutritional needs being met, proper hygiene, genetics, disease processes which might occur. So, the answer to this question really is that no one knows how long each individual implant will last... one's success can be influenced by the way you live and the quality of practitioner that you have chosen to do your implants... these things can tip the scales in your favour.

Do implants require special care?

Presume that dental implants are natural teeth and treat them that way. Return for regular check-ups. Do brush and floss. Realize also, that caring for the gums is the best way to care for one's teeth. More teeth are lost as a result of gum disease than any other single cause.

Is the placement of implants painful? How long does it take?

Implant placement usually does not result in much post-operative discomfort -usually the patient takes Ibuprofen or Paracetamol for about 2-5 days. If more extensive treatment is needed, for example bone grafts or many implants, then the post-operative course may require more time and medication. Anaesthesia during the surgery should make the placement procedure pain-free. We are conservative with anaesthetic agents and our philosophy is to utilize the least amount of medication for the patient to comfortably tolerate the procedures. Depending on the complexity and number of implants being placed, the procedure can take between 1 and 4 hours.

How long does the whole dental implant process take? Will I be without teeth or unable to eat for a long time?

The first phase of treatment, after a detailed evaluation and treatment plan, usually is the actual placement of the implants. This procedure is generally done in the surgery during one visit. Most implants will remain covered, underneath the gums, for 3 to 6 months. During this time, osseointegration, the biological bonding of the jawbone to the implant, occurs. Through this healing period, you will probably wear your modified denture or a temporary denture or bridge and maintain normal activities without restriction. You will need to follow a modified, soft diet for the first couple of weeks. There are occasions, one stage implant placements or when extensive bone grafting is to be performed, when patients may be asked not to wear their removable dentures for a period of time. When this is necessary we'll do all we can to help our patient through this transition.

The second phase of the procedure is usually 3-6 months after implant placement. At this time, the top of the implants will be uncovered from under the gums and a small metal post or extension will be attached to the implant(s). Your dentist will make any necessary modifications to your temporary teeth to allow you to continue wearing them after post attachment.

In this phase, your new replacement teeth are created and fitted. This phase involves a series of appointments to make impressions of your mouth and to "try-in" your replacement teeth at key steps in their fabrication. The try-in sessions are necessary to ensure that the size, shape, colour and fit of your new teeth will completely blend with and match your individual facial characteristics and remaining natural teeth (if any).

Total treatment time for most implant cases will usually be 5-8 months. It could be longer if bone or gum procedures are needed.

I've heard that dental implants are experimental - is that true?

Absolutely not! Dental implants have a long history of use and success. Implants are the most thoroughly researched procedure in the history of dentistry and, while no procedure is 100% successful, the current technology has resulted in very high success rates in the hands of well-trained and experienced clinicians. Dental implants are carefully regulated and a number of implant systems have been approved by the BDA.

I must have some teeth extracted and I intend to have implants placed to restore my ability to chew. Can a dental implant be placed at the same visit as the teeth are extracted?

Whether or not the dental implant can be placed immediately after extraction depends on the amount of available bone in the area and presence or absence of active infection. Placing the implant at the same visit helps preserve both width and height of bone and may prevent the need for placing bone grafts when bone naturally shrinks back after teeth are extracted. During the first year after teeth have been removed, as much as 40% of jawbone width can be lost. Sometimes, infection from a tooth or periodontal disease has destroyed the bone to such an extent that it becomes necessary to do a bone grafting procedure prior to implant placement. If it is possible to place the implant at the same visit as the teeth are extracted, this can save at least three months in healing time compared to waiting for an extraction site to heal before the implants can be placed.

Why do dentures lose their fit?

In many cases, the pressure of dentures or partials on the tissues causes gums to get "flabby" and bone to shrink over time. When this occurs, the dentures usually become loose and awkward even when adhesives are applied, much like the way clothes become baggy when one loses weight, and this causes more bone loss and gum problems. With dental implants, bone loss as well as gum erosion are slowed. Unlike dentures, which put pressure and stress on top of the gums and jaw bone, endosseous ("in-the-bone") implants are actually surrounded by bone and the chewing forces transfer pressures into the bone, much like teeth do. This actually can strengthen the bone and increase bone density, reducing the bone shrinkage seen regularly from dentures.

I have a full set of dentures. My uppers are fine, but my lowers are constantly a juggling act when I try to eat. Can I have implants on the lower and keep a full denture on top?

Absolutely. Your situation is a common one. The full lower denture is the most unstable prosthesis fabricated in dental practice. During chewing, the average lower denture moves five times more than an upper denture. The person with advanced bone loss has additional problems of poor muscle coordination, speech difficulties, and inability to keep the denture in place, all of which adversely influence a normal lifestyle. Dental implants can be the solution to all of these problems. Even in cases where a lot of bone loss has occurred there still is a good chance something can be done. In most cases, a thorough oral exam and a panoramic x-ray is all that is needed to determine if you are a good candidate for implants.

I am missing all of my teeth and am now wearing a full upper and lower denture. I can no longer tolerate my lowers. Will I need an implant for every tooth I am replacing in the lower jaw?

It is not necessary to have an implant for every tooth that is being replaced. The number of implants necessary to provide support depends on the type of implants used and the type of teeth (removable vs. non- removable) that will be attached to the implants. For example in this case, if you're a good candidate for endosseous (in-the-bone) implants, you may require between 2-8 implants, depending on the technique used to support a full complement of lower teeth. A thorough oral exam and panoramic x-ray is all that is necessary in most cases, to determine which implant can be used and how many must be used. Sometimes additional x-rays or CT scans are used in more complicated cases.

My husband lost all his teeth from gum disease. He refuses to wear "false teeth". Would implants give him the look and function of natural teeth?

It is possible to replace an entire arch of teeth with non-removable teeth supported by dental implants. Each individual presents a different combination of factors and these factors will determine which type of implant will be best suited for them. The end result is the elimination of the denture as we now know it. The ability to function socially and eat properly is the driving force behind the development of dental implants. These procedures will provide you with stable teeth, in many cases, for the first time in years. A removable denture can be retained and supported by several implants joined by a bar or the missing teeth can be restored with fixed or removable bridges anchored to 5 to 8 implants. Implants are a viable and functional way to help improve one's quality of life and health.

I had a root canal on a tooth that fractured and now it has to be removed. Can it be replaced with an implant or do I have to have a bridge or a partial denture?

Teeth that have root canals can fracture more easily than other teeth because they are weaker and somewhat dehydrated. They can sometimes be as brittle as glass. In the past the best available treatment was to remove the tooth and file down the adjacent teeth and make a bridge - caps on the adjacent teeth with an attached "dummy" tooth in between. Sometimes this still is the only way. However, in many cases an implant can replace the fractured tooth and no teeth need to be ground down at all.