We often have patients coming into our Forest Hills, Queens office that know beyond a shadow of a doubt that they want dental implants. That's great by us -- in most cases, dental implants are the best way to restore an area where teeth have been lost. The only problem is that sometimes even those very same patients that KNOW they want implants ... aren't exactly sure what implants are.
We can't blame them -- most of us weren't clear on the details until we became dentists. So we created this list of frequently asked questions about dental implants.
-What is an implant?
A dental implant is a man-made tooth root. The x-ray image below shows a patient who lost a tooth in a car accident. It shows the roots of a few natural teeth, with a dental implant in the center of them.
-So what good is a root? I want a tooth!
Once the implant is placed, it can be used to support a crown, a bridge, or even a denture or partial. If you look carefully at the x-ray, you can see a small grey area at the bottom of the implant. That grey area is a channel inside the implant where a special screw will fit. Using that screw channel, we can attach the implant to whatever you need to restore your mouth.
-So how do I go from an implant to the tooth I need?
Sometimes when teeth fracture badly, they need to have a post placed inside them. The x-ray below is the same one as above, but it indicates a post inside a neighboring tooth and a crown on top of it. We use this same type of process with an implant. Just like on a root where the chewing portion of the tooth has broken, we place a screw inside of the implant that allows us to secure a crown.
-So how does that look and feel?
Implants look, feel, and function more like natural teeth than any other type of tooth replacement. Like with the natural teeth, the foundation is below the gums, which means that all you will see is the final crown. Because we have an experienced dental laboratory technician right here in our office, we can custom match an ideal crown that fits in perfectly with your natural teeth. In the x-ray below, you can see an implant crown that we placed on top of an implant placed by another doctor.
-How long do implants last?
Implants have only existed in their current form for a little more than thirty years, but most of the original patients in the original treatment trials either still have their implants, or they took them to the grave. According to published studies, dental implants have the highest success rates of any treatment in dentistry, and implant designs and techniques are getting better all the time. Still, implant treatment is extremely complex, and if the dentist that handles it isn't highly knowledgeable, it can be unpredictable. The case above wasn't an easy one to treat because of the way that the patient's previous dentist placed the implant at a difficult angle. In fact, the patient originally came in because the previous dentist's crown had been loose from very soon after it was made. On the other hand, we were able to create a perfectly stable crown because of our knowledge of all the different methods of impressioning and restoring an implant crown, and because of our focus on the mouth as a whole. Patients have problems with implant crowns when they aren't planned to work harmoniously with the teeth around them, when dentists treat implants exactly like they do teeth, or they aren't meticulous about all the details of the treatment. We have patients in our office that have had their implants and the restorations on them for decades without problems.
-Will I be able to eat normally with implants?
Implant-supported teeth are secured to the jaw even more firmly than natural teeth, allowing you to eat anything you could with natural teeth. One of the most amazing uses of implants is for securing a loose denture or partial. By adding just a few implants, it's possible to make precision-fitting attachments inside of a denture or partial, allowing it to snap into place, and giving you the ability to bite into fresh fruits and vegetables, hard foods like nuts, and tough meats without worrying about the denture shifting, rubbing painfully, or moving out of the mouth.
-How much do implants cost?
The most common implant treatment is a replacement of a single tooth, like in the images shown above. These are cases where the only options in the past were either a fixed bridge attached to the teeth on either side of the space, or a partial denture that the patient would have to take out at night, The price for implant treatment varies from case to case and from one area to another, but in most cases in our Forest Hills, Queens dental office, the cost of the implant and crown is very similar to the cost of a traditional fixed bridge. There are some cases where the teeth on both sides of a missing space are already structurally compromised and can benefit from the reinforcement that a bridge can offer. In cases like the one in the first x-ray though, if neither tooth on either side of the space has ever had so much as a filling, there's a big benefit to not cutting down the teeth on either side for a bridge.
-Do patients ever have problems with implants?
Like most things in dentistry, it's very important to follow up after the implant has been placed, and after the crown on top is finished. The most common problems with implants are minor, and can be prevented by carefully following up with the patient early in the process. Because implants don't decay, people who lost their teeth to decay often say that their implants are better than their natural teeth were. People who lost their teeth because of gum disease or because they cracked and broke them often need to be checked out every few months after the implant crown is finished, but they also do extremely well when their risk factors are well understood and managed from the start. With all dental concerns, small problems eventually become large problems, so it's important to regularly come in for check-ups to make sure that any small problems are caught before they get any bigger.
-So implants are placed in bone? Does that hurt?
Patients are always worried about this, but they routinely tell us that it was nowhere near as bad as they feared. Obviously, all patients are completely numb for the procedure, and most of them don't need to take any time off of work afterward. Essentially all of our patients say that the implant procedure was more comfortable than having the tooth extracted in the first place, and often times, they say that they had no pain that Advil didn't take care of. Of course, this is no coincidence. In addition to using the most minimally-invasive surgical protocols possible, we use a combination of medications and over-the-counter methods to minimize the inflammation and ensure that any soreness afterward is as minimal as possible. If you're highly fearful of dental treatment, it's also possible to give you some medication to allieviate your anxiety and make the procedure easier.
-How long does the whole process take?
One of the biggest advantages we offer our patients is the ability to perform what are called "immediate" implant treatments. This means that the implant can usually be placed at the same time that the tooth is removed, and it's often possible to place a temporary crown at the same time that the implant is placed. When the current design of implants was first designed, the protocol was to remove the tooth, place bone grafting material (at an additional expense), wait four to six months for healing, place an implant and possibly more bone stimulating material (another expense), wait another four to six months, and then begin the process of making the final crown. Some dentists still follow this protocol in all cases. In fact, more than eighty percent of dentists in this country don't even place dental implants. By keeping up with the latest techniques and research, we are often able to replace a hopeless tooth the same day, saving you up to twelve months, several appointments and multiple surgical procedures in the process, which obviously saves you significant money and hassle in the meantime.
-How do I know if I'm a candidate for implants?
The one issue that most decides whether implants are a good fit for the patient is the amount of bone remaining in the area slated to have an implant. Implants are anchored in bone, and there has to be plenty of volume of high-quality bone to house them. In the past, implant positions and outcomes were often compromised because traditional x-rays could be misleading about the amount and quality of bone available. We've eliminated all the guesswork by investing in a 3-D x-ray machine. This technology is extremely unusual in general dentist's offices because of the extreme expense involved, but it allows us to plan the implants and restorations so precisely that it's worth every penny to us. The video below shows the computer program we use to plan the implant and restoration virtually long before we ever touch the patient.
-What if I need to replace more than one tooth?
Dental implants are an ideal solution whether you need to replace one tooth or a whole mouthful of teeth. The great thing about implants is that because they're so versatile, the same implant can be used to support one tooth or used as one support for a whole jaw restoration. In other words, dental implants are "upgradeable." For example, if a patient has one implant placed, it can be used to replace a single tooth, but if he needs more teeth replaced over time, the implants can be connected together to hold a bridge or retain a denture. And because they don't decay, their long-term outlook can be even better than teeth.
These are the most common questions we hear about implants, but if you made it to the bottom of this list, you're obviously interested in as much information as you can get. To get more information, or if you're ready to look and feel better and to chew like you used to, Call us today at (718) 268-1561, or request a consultation.