Dental implants are the go-to solution for missing teeth. They are fitted in place of the root of the tooth, giving an solid anchor for an artificial tooth to attach to. Once installed, they are just as effective as all of your other teeth, giving you a secure tooth to bite, chew and smile with.
Losing a tooth can be traumatic experience, whether it is due to prior tooth decay, gum disease or an accident. Our modern implants can replace everything from a single missing tooth to a full mouth of teeth. A long-lasting solution that looks great and functions as if it has always been a part of your mouth, implants are the best option for replacing damaged or missing teeth.
What is a dental implant?
Dental implants are replacements for missing teeth, they are fixed in placed and supported by your jawbone. The implant itself is an artificial replacement for a tooth root and is placed under the gums. Implants is used to support an artificial tooth or multiple teeth. Another word sometimes used to describe an implant is a fixture.
If the implant is supporting only one tooth then a crown is placed on top of it – this is the visible part of the tooth replacement in the mouth, above the gum. Implants can also be used to support multiple teeth. They can support fixed bridges – similar to crowns joined together and removable dentures – false teeth which can be removed from the mouth for cleaning, but are supported in the mouth by implants, much more securely than without any implants.
To attach your implant (under your gum), to your crown, bridge or denture (on top of your gum), many implants use a connector, called an abutment.
What are tooth implants made from?
Most modern implants are made from titanium. Titanium is a very biocompatible material which is both strong a durable. On a microscopic level, new bone cells can actually grow onto the surface of titanium implants during a process called osseointegration, which basically means your implants securely integrate with to your jawbone.
Some implants may also be made from zirconia, although this is not as widely used as titanium.
Am I suitable for Dental Implant Treatment?
Most adults with good overall health are suitable for treatment. In general implants are not suitable for children and adolescents as they are usually only used when the jaws have stopped growing.
Smoking or excessive alcohol intake may increase the risk of problems with both the initial healing of implants and their long term maintenance. A few medical issues can increase the risk of complications from dental implants such as poorly controlled diabetes and certain drugs used for the treatment of cancer and heart disease. Every case is individual and there are very few absolute contraindications to the placement of implants so don’t be put off if you are concerned about any lifestyle or medical issues, the vast majority of people are still suitable for treatment.
It is important that your gums and any remaining teeth you may have are as healthy as possible so professional cleaning of your gums and teeth may be required prior to treatment.
An overview of the implant dentistry process
There are a few different stages to dental implant treatment. It is important not to rush things to get a successful and long lasting result, so from start to finish treatment can usually take anywhere between three to nine months. In some rarer cases, overall treatment time may be shorter or even sometimes longer than this.
There are a number of approaches to treatment and a lot will depend on your individual circumstances, but the typical process usually involves the following:
1. Your implant consultation – You will be given an initial consultation to discuss implants. Your teeth and gums will be examined and some initial X-rays may be taken. It is usually possible to make and assessment on your suitability for implant treatment at this point. Often, an estimate of how many implants you will need, how long treatment will take and the overall treatment cost can also be given.
2. Records and treatment planning – To properly plan your treatment it is important to take records of the condition of your teeth, your gums and your jawbones. This way implants can be placed in the optimum positions in your mouth and avoid accidentally placing them in an awkward or potentially harmful position. Moulds or scans of your teeth and gums will be taken and x-rays or CT scans (which is similar to an x-ray but in 3D) can be taken of your jawbones. Proper positioning for the implants and replacement teeth can then be planned, and an accurate written plan detailing the sequence and cost of treatment can be formulated.
3. Implant placement – Implant placement surgery is a relatively straightforward procedure that can be performed in a dentist’s surgery. A local anaesthetic similar to that used for a tooth filling is most commonly used during placement. You don’t need to be put to sleep, although some patients prefer to have sedation for the treatment. If during the treatment planning phase it was deemed you did not have enough bone for placement of implants, there are a number of ways that the volume of bone can be increased or augmented. Bone augmentation if usually performed either before or at the same time as implant placement depending on your specific case.
4. Integration period – The time it takes for an implant to fuse with your bone can vary anywhere between six weeks and six months. During this time it may be possible to place temporary teeth in your mouth to hide the gap. These usually takes the form of a removable denture or fixed bridges, but sometimes temporary teeth may be fitted onto the implants themselves. In some circumstances you may not need any temporary replacement, such as where teeth are towards the back of the mouth and cannot be seen easily.
5. The restorative phase – After the implants have integrated with your jawbone, the process of making the definitive replacement teeth can begin. A number of factors affect what type of final teeth are made. These include, but are not limited to, how many teeth are missing, the amount of teeth and gum remaining in your mouth, the way you bite together and your budget. Usually a mould, scan or series of moulds or scans of the implants in your mouth will need to be made for the production of your final teeth. This process can take anywhere from a few days to a few months, depending on your specific case, but for many cases takes a few weeks. At the end of treatment your new replacement teeth will be checked in your mouth to make sure that the fit and appearance is correct before they are either screwed or cemented securely into place.
6. Maintenance – Having invested time and money into your dental implants it is important that you look after them. It is very important to regularly clean your new replacement teeth on your implants, any remaining natural teeth you may have and your gums. Regular visits to your dentist are important so that your implant teeth and gums can be checked, and any minor issues dealt with quickly before they become bigger problems. Regular trips to a dental hygienist to have your teeth, implants and gums cleaned are also advisable.
How do you know if you have enough bone for dental implants?
While a routine dental x-ray can give some information on how much bone is available for dental implant placement. Unfortunately traditional x-rays only provide 2D images and therefore only give an estimate of bone height and width, but not on bone thickness or depth. A CBCT scan of your jawbone can give more information. It provides a three dimensional image of your jawbone and also gives information on the strength or density of the bone available. The other advantage of CBCT scans is that they can highlight areas where important anatomical structures such as nerves and blood vessels are so that these can be avoided during surgery. We use CBCT technology for the vast majority of implant treatments.
What can cause bone loss in the first place?
If you are a little low on bone in your jaws, you may be wondering why this has happened. Whenever you lose a tooth or have one taken out some bone around where the tooth root was is lost. The amount of bone lost varies from person to person and can be quite high initially, then tends to slow down over time. While the rate bone loss may slow down, bone loss can continue without a tooth in place as the bone is no longer needed to support a tooth. Having your teeth replaced with removable dentures without implants to support them can actually increase the amount of bone that is lost over time.
Can dental implants preserve bone?
This is one of the big functional advantages of dental implants over other methods of replacing missing teeth. Unlike bridges and dentures not supported by implants, once a dental implant is in place, supporting teeth and subject to everyday functional forces during eating, smiling and talking they can actually stimulate the surrounding bone to become stronger and thicker. However, it is important to remember that everyone is different and the amount of bone preservation you can expect will vary depending on your individual case.
What can be done if there is not enough bone?
A reduced amount of bone does not necessarily mean you cannot have dental implant treatment. It is often possible to replace missing bone or to encourage new bone to grow. Procedures intended to increase the amount of bone available are often referred to as bone augmentation, bone regeneration or bone grafting procedures. The details of the procedure you require will depend on your specific case. Some common procedures used to increase the amount of bone available include the following:
1. Onlay Grafting – Also known as block grafting is where a piece or block of your own bone is taken from somewhere else and laid on top of the of the deficient area (hence the term onlay). The block of bone may be taken from another area of your mouth such as near your chin or the back of your mouth or if a larger amount of bone is needed can also be taken from another part of your body such as your leg or hip. The new piece of bone is then left to heal and join with the underlying deficient area to increase the amount of bone available.
2. Guided bone regeneration – Your own bone or bone substitute can be placed in a deficient area to bulk up the amount of bone available. The bone placed will usually be in small particles or grains with the aim of new bone filling in the space between these grains. Sometimes a sheet or membrane may be placed over these particles to keep them in place. Occasionally the membrane is placed on its own to promote new bone to grow. Guided bone regeneration often removes the need to have a second surgery to take a block of bone from another part of your mouth or body.
3. Sinus lift – A sinus lift sinus augmentation is used to increase the bone height around the back of your upper jaw. Over time the height of the bone in this area can reduce and your sinuses – air filled spaces in your jaw bone can increase in size further reducing the amount of bone available. It is possible to lift your sinuses up and either graft bone in the space created by lifting your sinuses or promote new bone to grow in this area.
What is bone substitute?
As an alternative to a second surgery to harvest your own bone from another area of your mouth or body, several bone substitutes are available. Special synthetic bone substitutes have been manufactured and bone products have also been produced from bovine (derived from cow), porcine (derived from pig) or other human sources. These materials have all been specially prepared to make them safe for use in people.
When is bone grafting performed?
If a relatively small amount of bone needs to be added then it is often possible to add this at the same time that the implants are placed. As the implant is integrating new bone can grow around it and grow into the scaffold created by the bone grafting procedure. This has the advantage that it does not slow down the overall treatment time.
When a larger amount of bone is needed it is often better to graft bone before placing the implants. A larger amount of bone takes longer to mature than a smaller amount and it may be between 3 and 12 months before the grafted area is suitable to receive an implant. While you will be keen to get your new teeth as soon as possible it is important not to rush things to ensure a successful outcome in the long term.
Dental Implant Surgery
The implant surgery itself usually involves making a small nick in the gum and then gently lifting the gum away from your jawbone. This allows the bone to be properly visualised. A small channel is then created to allow the implant to be inserted. After the implant is inserted, the gum may be replaced to completely cover the implant. Alternatively, a special cover called a healing cap may be placed over the implant or a temporary replacement tooth may be placed immediately on the same day as the surgery. The exact details of the surgery will vary on a case by case basis.
Do you have to have a gap during implant treatment?
It is possible to wear replacement teeth during implant treatment. This is most common where the teeth due to be replaced are towards the front of the mouth where they are more visible. Teeth can be replaced on a temporary basis by removable dentures or fixed bridges and in some cumstances a temporary tooth may be placed on the implant itself.
Can dental implants be placed next to natural teeth?
Dental implants are routinely placed next to natural teeth and it is usually very safe to do so. Where the roots of adjacent teeth are very curved and lie in the path where an implant may go it is usually still possible to place implants with a few tweaks to the treatment. Implants can be tilted to stay clear of the roots or a shorter implant may be used.
Do dental implants hurt?
Implant surgery is a relatively straightforward procedure which can be completed with a local anaesthetic similar to that used for a routine dental filling. Depending on how complex your case is, placing implants can take anywhere from half an hour for one or two to several hours for multiple implants and major bone grafting.
Like any surgery, you can expect a bit of discomfort afterwards. Many patients are surprised as the amount of discomfort is often less than expected. If required, you can take painkillers similar to those you might take for a headache such as ibuprofen or paracetamol.
Stitches are often used to secure the gum around the implants following the surgery. Sometimes dissolvable stitches may be used however if non-dissolvable stitches they may pull a little afterwards. Stitches are used they are usually removed a week or two later. In initial days after the surgery you should report any unexpected pain, swelling or prolonged bleeding or bruising.
Can I be put to sleep for the implant surgery?
Many implants are completed with a simple local anaesthetic (injection) alone. If you prefer you can have the implants placed with conscious sedation. When sedation is used, the patient is still awake but is in a relaxed state, many people compare it to being a little tipsy. Often patients don’t remember having the treatment done. For larger treatments, such as those that involve major bone grafting, you can be given a general anaesthetic. This will usually require hospital admission.
Do Implants always work? Can anything go wrong?
Where the human body is involved unfortunately nothing is 100% guaranteed to work first time. A number of factors may lead to implants being rejected by your body including smoking and excessive alcohol intake so you will be encouraged to quit smoking and reduce your alcohol intake if these apply to you. Sometimes if implants are not placed correctly in the first place problems can arise. Some of the problems we see in implants NOT placed by us include:
1. Implants being rejected by your body – If your implant is not placed in the correct position in the bone it may fail to integrate, be rejected and could fall out.
2. Ugly looking teeth – The implant essentially replaces the root of the tooth, then artificial teeth are placed on top of this. Implants placed in the wrong position or at the wrong angulation can mean that the tooth on top of it is also wrong, giving an unpleasant appearance.
3. Damage to important nerves and blood vessels – Your jaws are not only made of bone. They also have important nerves and blood vessels running through them. If an implant is accidentally placed into a nerve or blood vessel it could have serious negative consequences.
We use advanced digital technology to place our implants in the correct position to help avoid these problems.
How we use the advanced digital technology for successful dental implants in London
We have invested in advanced 3D scanning and printing technology to help ensure your implant treatment is a success. Our workflow for successful dental implant treatment planning is as follows:
1. We scan your jawbone – We use a CBCT scan to provide information on the strength of your bone and highlights the location of nerves and blood vessels so we can avoid placing implants there.
2. We scan your teeth and your gums – To make sure that your new implants fit in with your remaining teeth and gums and don’t look ugly. Don’t worry, if you are missing all your teeth we can take a scan of only your gums so that your new teeth fit properly and look natural.
3. We combine your jawbone scan with your teeth and gum scan – Very few dentists do this and it is actually one of the most important aspects of planning your treatment. To get teeth that both look natural and are long lasting it is important that they fit with your remaining teeth, gums and bone. If you don’t consider all three, you risk problems in the future.
4. We plan exactly where we want your new teeth to go – This part is crucial. It may seem crazy, but many treatments are planned with the teeth as an afterthought. We think this is wrong. We plan the teeth first and then work backwards.
5. Then we plan the position of the implants to match the final teeth – Ultimately you want new teeth, not new screws in your jaw. Failing to consider the final result from the outset can leave implants being placed where teeth won’t fit properly, leaving an ugly appearance and risking problems in the future. After planning the position of the teeth we then plan the position of the implants so they are placed in the optimum location to support the teeth you want.
6. Time to turn plan into reality – It’s all good having a plan but we then need to be able to execute it. Using the information gained from our advanced 3D scanning procedures, we use 3D printing technology to manufacture a guide that is used in surgery to place the implants in the position that we planned. We can also use the 3D plan to make new teeth ahead of your surgery to deliver immediately to you the same day.
Looking after your dental implants
Having invested your time and money in implant treatment, it is important that you look after them. Like natural teeth, implant teeth can suffer from issues such as gum recession and gum disease, and fractures.
One key element of maintaining your implants is to practice good oral hygiene. Gum disease around implants is one of the major long term causes of implant failure and is largely a result of implants not being cleaned properly. Like cleaning your teeth, cleaning your implants is not difficult.
The vast majority of patients will be able to clean around their implant teeth just like they should around natural teeth, by brushing and flossing. In some cases special floss and brushes for in between teeth and implants may be required.
It is likely that cleaning will take a little longer initially. However, once you are into a good routine the process will become much easier. It is also important to see your dentist and hygienist for regular check-ups to keep an eye on your implant teeth. This way, if any problems do arise they can be dealt with at the earliest opportunity.
London Dental Implant FAQ
What is the cost of dental implants?
The cost of treatment can vary depending on the amount of treatment required and its complexity. Often records such as a CBCT scan of your jawbone will need to be taken to properly assess your case before an accurate treatment cost can be given. This will help avoid any unforeseen additional treatment and extra costs you may need.
Is the treatment painful?
You will be given a local anaesthetic for the implant placement itself and therefore you should not feel any pain. Afterwards, like any surgical procedure you can expect a degree of discomfort. Most patients are surprised at how little discomfort they experience after implant placement. Some patients experience discomfort similar to having a tooth out. Any discomfort experience can usually be managed by simple painkillers like those you would take for a headache.
Am I too old for implant treatment?
You cannot be too old for implant treatment. As long as you are in reasonably good health, implants can still be placed. There is no upper age limit for treatment.
Will I be able to eat whatever I want?
The aim of any implant treatment is to restore both the function and aesthetics of your teeth. In this way we don’t only want your teeth to look good but we want you to be able to eat whatever you want as well. During treatment, there may be some times when it will be easier for you to stick to a soft diet and you may be advised to avoid certain foods for short periods of time. However, once treatment is completed, patients should be able to eat a wide range of foods without any issues.
How long will the treatment take?
Treatment usually takes multiple appointments over anywhere from weeks to several months. over a period of months. Treatment time varies on a case by case basis and is usually shorter for simpler treatments and longer for more complicated cases. In general, treatment takes between three and nine months, with the majority taking less than six months.
How long will the implants last?
The aim of every treatment is to provide a result that will last as long as possible. If properly cared for dental implants can last a lifetime. It is important to attend the dentist and hygienist on a regular basis for check-ups on your implants.