Unfortunately, sometimes my patients lose a tooth. The tooth either gets lost because of cavities, gum disease, or trauma. The worst teeth that get lost are the ones where the patient has tried to do everything to save the tooth from root canals and crowns to gum surgery and despite all this effort the tooth just does not survive. The wonderful part about teeth and dentistry though is that this is a fixable problem. With good planning, a new tooth can be placed in the same area by using an implant and this tooth with have the same feel as the last tooth. The most important parts of implants is deciding when implants should be used, the placement of the implant and restoration, and maintaining it.
Why are implants good for replacing teeth?
I love implants, and I think that they are a wonderful prosthetic option to keep a person smiling and chew well. I feel that most of the population that has lost a tooth is a good candidate for an implant; however, I would like to focus on when implants are not the best option for a person. A few factors that determine that implants are not indicated are patients who are poorly controlled diabetics or other poorly controlled autoimmune disease patients, people who take drugs to combat osteoporosis such as Fosomax or Prolia, and patients with a lot of dental infections such as gum disease and cavities. The reason that implants are not always the best option in these groups is that the healing can be unpredictable and the body might reject the implant. Especially for patients that have poor dental health, I am hesitant to place implants because they must be kept very clean, and if they get an infection is difficult to treat predictably. The reason that infection is hard to treat is that the implant does not have the same defense mechanisms as a tooth might have to heal itself.
The dental implant process
Placement of the implant requires a bit of planning. Planning for implants is more important than most other aspects of dentistry because it is difficult to replace an implant if it does not go correctly the first time. Equally important is deciding the overall health of the mouth and what future treatment may be necessary. Especially if there is a chance that we may Generally the planning is done in one appointment where the dentist takes models of the upper and lower jaw as well as a 3d x-ray that shows where all the bone is in the mouth. From there the models are scanned into the computer and merged with the 3d x-ray to form an accurate depiction of how the teeth relate to the bone. By merging this data, I can do a digital surgery and placement to make sure that I get the most ideal location for the implant. After I have the most ideal location, I create a surgical guide using special software and a 3d printer. During the surgery and after numbing the patient, I will place the guide in the mouth where it fits to the teeth and has a hole which guides the implant placement. This ensure that implant is placed where I want it to go with minimally invasive surgery. After a few months of healing, I take models of the jaw again and fabricate a tooth that will fit exactly over the implant. Because the surgery has been planned ahead of time though, this process is usually pretty routine. The tooth is then placed onto the implant and held in by a screw. The hole for the screw is covered with white tooth colored filling material so that if the tooth needs to be removed in the future for one reason or another, it is an easy procedure.
Caring for your implants
The final part of having an implant is maintaining it. Maintenance for implants is the same as it is for natural teeth, but there are a couple finer points. Flossing is more important for implants because food can easily get packed around the gums of an implant, and because the gums around an implant aren’t as strong as the gums around a natural tooth, plaque can more easily build up in areas that cannot be cleaned. Also because this plaque can build up more easily, often I will recommend my patients with newly placed implants to have dental cleanings done more often for the first few years to ensure good healing and good hygiene. Lastly, the natural teeth have ligaments present which act as shock absorbers, but implants unfortunately do not have this. This means that clenching and grinding especially at night time can put a lot of destructive forces on implants. For this reason, night guards are made after placing a new tooth on an implant so that these forces will not transfer to the implant directly.
Implants are a great tool for dentists to use to help improve the quality of life of our patients. The process is relatively routine for most implant, and 95% of patients who go through the process are happy with the end results. If you need to have a tooth replaced and think that an implant is the right option for you, please call for a consult with me, Dr. Schafer at 504-392-5104 and my staff and I will take great care of you.