What exactly are dental implants and what can they do for me?
Implants are substitutes for teeth and they are today's best alternative to your natural teeth. They offer you a permanent or secure solution for replacing one or more teeth. They are made of biocompatible titanium, just the same as hip or knee replacements or similar orthopedic devices, and function as anchors or support for traditional forms of dentistry, such as crowns, bridges or dentures. The body rarely rejects titanium, and bone cells in the areas receiving the implants actually bind to titanium surfaces - a process known as osseointegration.
The main benefits of implants and the restorations built on top of them really depend on how may teeth are being replaced.
Replacement of a single missing tooth with an implant and crown is more conservative, esthetic, and easier to look after because there is no need for a bridge which must use the adjacent teeth on either side for support. Most often, placement of a bridge requires some degree of "shaving" of the support (abutment) teeth, and if these teeth have never had any sort of fillings, then perfectly good tooth structure is being removed: in a sense the tooth is being damaged just to help fill a gap.
Furthermore, dental implants placed into the jawbone can help maintain your bone structure and support your facial tissues. They serve to reduce or eliminate bone atrophy (shrinkage) and facial collapse over time which normally follows tooth loss. Since the facial tissues are supported by the underlying shape of the bones, maintaining the normal contours helps to keep a more youthful appearance.
Replacement of multiple teeth in same area of a dental arch with implants and bridgework can help to restore proper chewing function to a state that most closely resembles the time when you had all of your teeth. You may eat and chew with enjoyment, without pain or irritation, and foods that were difficult may now be eaten again. Furthermore, the annoying and difficult properties of wearing a removable partial denture are avoided.
Replacement of an entire arch of teeth may be accomplished by using implants to support either a removable denture (traditional acrylic base and teeth) or a fixed denture (no denture base, only porcelain over metal structure). The fantastic increase in support and retentiveness provided by the implants under the prosthesis greatly improves quality of life for denture-wearers because they can eat and chew again without pain or irritation - foods that were too difficult are now back in the diet, and better nutrition means better overall health. As well, appearance and speech may be greatly improved due to the fact that dentures are held securely in place and do not move around during function or speech.
Removable: Allows you to remove the prosthesis whenever you wish. The implants under it ensure that the denture is held securely in your mouth. Implants can be used as anchors for your existing dentures, eliminating slippage and enhancing the comfort and confidence you feel.
Fixed: A permanent replacement that can only be removed by the Dentist. The arch of teeth is either cemented or screwed down onto the posts that are attached to the implants. This is the restoration that most closely approaches that of having an entire arch of natural teeth again, because there is no bulky acrylic and there is nothing to remove or take out.
How Successful are Implants, how long do they last, and can they be used for everyone?
Implants, as we know them today, have been in existence for at least twenty-five years. For the last ten years, however, success rates at many treatment centers are consistently over 95% with proper personal and professional care. Few forms of medical, orthopedic or dental treatment have such high success rates. At present, research has shown a reasonable expectation of ten to twenty years. Potentially, implants may last for the rest of your life. As with any dental procedure, expected longevity of treatment depends on the forces that exist in your mouth and the level of oral hygiene maintained.
Various factors affect whether or not you are a candidate for implant treatment: most healthy adults can have implant treatment, while children and teenagers cannot as their bones are still growing. As well, elderly people, diabetics, smokers and heavy drinkers tend to have lower than average success rates and longer healing times. A careful review of your medical history will help to determine if you have any risk factors that may reduce the expected outcome.
What is the procedure like?
There are actually two phases to implant dentistry: placement (and healing) and prosthetic.
1. Placement and healing phase:
Under local anesthetic - just like the kind used for routine dental work - the implant surgeon places one or more implants into the jaw bone with a very gentle surgical procedure involving a small incision in the gums to peel back and expose the bone, followed by careful and very slow drilling to create a small hole into which the implant is pressed or screwed. The implants are small in size, generally the same size and shape as the root of a front tooth. Once the implant is placed to the required depth, the gum tissue is closed over with small stitches. Over the next three to six months, the implant(s) become fused into the jawbone as bone heals around the titanium surfaces.
Routinely, a second procedure is needed to uncover and expose the implants so that healing caps may be attached. Again, this procedure is done using local anesthetic only, and careful incisions are made through the gums to get down to the implant. The healing cap is screwed down tightly to the implant, and the gums are stitched tightly around the cap.
In certain cases where the implant is far back in the mouth and esthetics are not such a concern, a healing cap may be attached to the implant at the time of initial placement, and the gums heal directly around the cap. This allows the second surgical step to be skipped, and you may proceed directly to the next phase once the necessary healing period is over.
2. Prosthetic phase: This is when the final restoration is crafted and placed into the mouth and onto the implant(s). It may take as few as two appointments to complete for more simple restorations like single crowns, or it may take a month or more and numerous appointments if the final prosthesis is more complex.
Will I have missing teeth during the waiting stage?
Generally, No. Usually you will have a temporary denture or bridge made ahead of time and placed at the implant placement appointment. Depending on the type of planned restoration and location of missing tooth/teeth in the mouth, the temporary prosthetic will be worn during the healing period in order to satisfy basic functional and esthetic needs. This could range from an acrylic "flipper denture" with one false tooth to a complete denture with soft reline material to gently rest on the gums where implants have been placed.
Are they expensive...How much do they cost?
Initially, you might feel dental implants are expensive. However, they represent a more permanent and natural solution than bridges, plain dentures and partials. Thus, there is a greater initial investment. They should last for many years, and provide you with the numerous benefits discussed above.
Each case is different, so cost is a function of your particular needs. As part of a complete examination and treatment plan, your dental needs and the best treatment alternative(s) for you will be determined. At that point, you can specifically address the question of cost and be helped with financial arrangements.
Will my insurance cover the procedure?
Some insurance plans may cover a portion of the cost of dental implants, for example, up to an amount equivalent to a tooth-supported bridge or a denture. Very often the cost of the restoration on top of the implant may be a covered benefit, but the implant surgery itself is almost never covered. An appropriate estimate can be prepared and submitted to your insurance carrier in order to find out the exact level of coverage and expected reimbursement.
Is the cost tax-deductible?
Yes, dental implants qualify as a tax-deductible medical expense under current Revenue Canada guidelines. You should speak with your Accountant or Financial Advisor for further details.