Of all the ways modern dentistry has to replace missing teeth, dental implants are by far the best. There is no tooth-replacement option that will give you a longer-lasting result. Implants also help preserve tooth-supporting bone that naturally deteriorates when a tooth is lost. Loss of bone is one of the major hidden consequences of losing teeth.
A dental implant most often takes the form of a small, screw-shaped titanium post that replaces the root-part of a missing tooth. The surgical procedure used to place an implant is actually quite minor and routine, requiring only local anesthesia in most cases. After a healing period, the implant is topped with a lifelike crown custom-made to match your existing natural teeth. Implants have a documented success rate of over 95%, which is significantly higher than any other tooth-replacement option.
How Implants Work
During a minor surgical procedure, your dental implant is inserted directly into the jawbone in the space vacated by the missing tooth. It will then be left to heal for a period of months before the final crown is attached. During this healing period, the implant actually fuses to the bone surrounding it.
Tooth Replacement Options Using Dental Implants
Implants can replace missing teeth in a variety of ways. They can be used to:
Replace One Tooth — When you have one tooth missing, a single implant is inserted into the bone to replace the root part of that tooth; a crown then goes on top to simulate an actual tooth. This treatment choice has the highest success rate, making it the best long-term investment for replacing a single missing tooth. Even if the initial cost is slightly higher than other options, it is the most cost-effective solution over time. An implant will never decay or need root canal treatment, and feels just like the tooth that was there.
Replace Multiple Teeth — When you have more than one tooth missing, implants provide an ideal replacement mechanism. You don't even need one implant for every missing tooth. Instead, implant teeth can act as supports for fixed bridgework. For example, if you are missing three teeth in a row, we can place two implants, one on either side of the gap, and a crown in between that has no implant underneath. That way, you won't need to use any of your remaining natural teeth as bridge supports, which could weaken them and make them more susceptible to decay.
Replace All Teeth Permanently — Implants can support an entire arch of upper or lower replacement teeth that are fixed into the mouth and are never removed. Sometimes the new teeth can be supported by as few as 4 implants. It's comparable to the structure of a table, which only needs 4 legs to hold it up. In cases where jawbone density and volume have deteriorated, 5 or 6 implants might be needed to support a row of 10 to 12 teeth. Dental implant replacement teeth protect your jawbone, won't slip, and should last a lifetime.
Support Removable Dentures — Implants can even make removable dentures more comfortable, effective and healthier to wear. Traditional dentures rest on the gums and put pressure on the underlying bone. This accelerates bone loss so that the jaw shrinks and the dentures slip, particularly on the bottom. But today dentists can attach a removable denture onto implants, transferring that pressure into the bone structure rather than the bone surface. This prevents the dentures from slipping while you eat and speak, and preserves the bone directly beneath them.
Implant Care and Maintenance
There are only two ways an implant can lose attachment to the bone and fail once it has successfully fused: poor oral hygiene or excessive biting forces. Poor oral hygiene and/or a lack of regular cleanings can lead to a destructive bacterial infection called peri-implantitis. Flossing and brushing your teeth on a daily basis, along with regular professional cleanings, can prevent this. Excessive biting forces can come from either a habit of clenching or grinding your teeth, or an insufficient number of implants to handle the forces generated by your bite. You should receive the correct number of implants so this does not happen. And if you have a habit of grinding or clenching your teeth, a nightguard will be recommended to protect your implants. After all, implants are a long-term investment in your smile, your health and your well-being, so it's best to protect your investment.
While you may think that some loss of teeth is inevitable with aging, it is actually possible for all of your teeth to last a lifetime. One of the ways you can achieve this goal is to avoid periodontal disease (“peri” – around; “odont” – tooth), which is caused by bacteria that attack the tissues around the teeth. Unfortunately, you may not even realize you have gum disease as the signs and symptoms are not always as apparent to you as they are to a dental professional.
Nearly all people who do not maintain good daily oral hygiene will develop gingivitis. If left untreated, this bacterial gum infection can progress from gingivitis (“gingival” – gum; “itis” – inflammation) to periodontitis, which results in bone loss around your teeth. As the bone tissue is lost, the gum tissues detach from the teeth and form little pockets that provide an even better place for bacteria to live — where your brush and floss can't reach. As periodontal disease advances leading to more bone loss, tooth loss can result. Part of this has to do with genetics, as periodontal disease tends to run in families. The good news is that periodontal disease can be controlled, even at more advanced stages.
Signs and Symptoms of Periodontal Disease
It's important to understand that you can have periodontal disease with no obvious symptoms, especially if you are a smoker (nicotine reduces blood supply preventing bleeding and swelling of the gum tissues). Still, there are some important things to look for:
- Bleeding gums — Some people think that when their gums bleed, it simply means they're brushing too hard. While brushing too hard is bad for the gums, it should not cause bleeding. Any bleeding of the gums should be considered a warning sign of gum disease.
- Bad breath — It's very easy for plaque to collect in the spaces between the teeth, creating the perfect living conditions for bacteria that produce odorous, sulfur-containing compounds, resulting in bad breath.
- Redness or swelling of the gums — Inflammation of the gums is usually the first visible sign of periodontal disease.
- Receding gums — If you notice that your teeth look longer than they used to, it may be that your gum tissue has receded (away from the enamel), exposing some of your tooth roots.
- Sensitivity — If there is gum recession, the exposed roots may become sensitive to hot or cold.
- Periodontal abscess — Bacteria can become enclosed in a periodontal pocket and the area will fill with pus, becoming swollen and painful.
- Loose teeth — When periodontal disease results in bone loss, teeth can become loose or migrate. Tooth loss can result and may be accelerated if you are applying excessive biting forces from clenching or grinding your teeth.
All periodontal therapy starts with the evaluation of your oral hygiene techniques and instruction for improving them, followed by the mechanical removal of plaque and any calcified deposits (tartar or calculus) that are present on the root surfaces. This is accomplished with a cleaning technique known as scaling, root planing or debridement using hand instruments and/or ultrasonic (high frequency vibrational) instruments. Locally applied antimicrobial products or antibiotics might also be recommended during various parts of periodontal treatment to assist in healing and pocket-depth reduction, hopefully eliminating the need for periodontal surgery. Sometimes surgical procedures may be necessary to remove the deep pockets that form between inflamed gum tissue and teeth. There are many different types of surgery to handle a variety of problems. And many times, combinations of procedures are used to attempt to reduce the number of surgeries as well as the cost of treatment.
Periodontal Disease & Your Overall Health
Periodontal disease starts in your mouth but has actually been linked to more serious conditions, such as cardio-vascular disease (CVD), diabetes and preterm births. Research has suggested two plausible mechanisms for how gum disease and these other serious medical concerns could be related: moderate to severe periodontal disease increases the level of systemic (bodily) inflammation — a characteristic of all chronic inflammatory diseases. Also, the same bacterial strains that are commonly found in periodontal pockets surrounding diseased teeth have been found in blood vessel plaques of individuals with CVD. Therefore, it may be helpful to reduce periodontal inflammation to reduce systemic inflammation.
The best way to prevent periodontal disease is to brush and floss your teeth effectively every day. Regular dental checkups and professional cleanings every 3 or 4 or 6 months are also an important part of maintaining periodontal health; the instruments and techniques used in these cleanings can reach into areas that your toothbrush and floss can't.
It is also possible to detect early forms of gum disease by evaluating your gingival (gum) tissues, both visually and by examining their attachment levels to the teeth. And the health of your tooth-supporting bone can be assessed by taking dental radiographs (x-rays pictures).
There are other steps you can take: Eating right, reducing stress in your life, and giving up unhealthy habits like smoking will also help ensure that you keep your teeth for a lifetime.