Many years ago, the only options to replace missing teeth were dentures or bridges – or deciding not to replace them at all. Some people refuse to wear dentures because of the discomfort and embarrassment that may be associated with “false teeth,” and others agree to “file down” the adjacent teeth to make a bridge to replace missing teeth.
While these are good options, the downsides can be tremendous.
Dentures are not always stable and have been known to dislodge while eating. They should not be worn overnight and must be replaced every few years because of progressive loss of bone in the upper and lower jaws. Additionally, partial dentures that replace one tooth or a few teeth can weaken the surrounding healthy teeth that support the dentures.
Today, advances in dental technology provide significant restorative opportunities for dental rehabilitation, creating long-lasting solutions that are increasingly popular with patients.
Dental implants replace damaged or missing teeth with artificial teeth – porcelain crowns that are attached to titanium posts anchored to the jaw. They have a sturdy hold and a natural look. In some cases, a bone graft can secure the implant and provide better anchorage to the implant and the new teeth.
Dental implants are convenient and discreet – and unlike dentures, you don’t have to take them out for cleaning or at bedtime. The natural shape and placement of implants can help preserve facial structure while preventing further bone deterioration.
The UT Southwestern Dentistry and Oral and Maxillofacial surgery team combines more than 100 years of experience in the management of a full range of oral health care conditions, from general dentistry to complex, highly specialized reconstructive surgery and lifelong maintenance. Our oral and maxillofacial surgeons are recognized experts in dentistry and in the placement of implant bone grafting. Surgeons from around the U.S. and the world have visited UT Southwestern to observe and learn from the advancements we've made in this area of oral rehabilitation.
Getting dental implants is a significant and lasting commitment to your oral health and personal well-being. It is also a financial commitment. Therefore, our team guides patients through a five-step plan to help ensure their dental implants are safe and last a lifetime.
1. Find out if you are eligible for dental implants
Many people who are missing teeth qualify for dental implants. Some patients have lost teeth due to failed root canals, accidents, aging, or a variety of medical conditions such as cancer. These patients might be unhappy with how their bridges or dentures look and feel and therefore want something that provides a higher level of comfort and functionality.
General oral health is one of the main eligibility criteria. Infections in the mouth can cause the dental implant to fail, which can damage more teeth, facial bones, or overall health.
Patients will be evaluated to determine whether an implant is a viable option for them. Patients who are considered for dental implants are assessed by our staff dental hygienist, who will develop a comprehensive post-implant placement maintenance plan that fosters a favorable prognosis. The plan may include hygiene, periodontal treatment, or other forms of gum therapy.
Some of the pre-existing health conditions we’ll discuss with you include:
- Severe periodontitis (gum disease). Patients with uncontrolled periodontal disease are not candidates for dental implant since it compromises the gums, surrounding bone, and adjacent teeth, whereby causing further damage to the mouth. Patients with diabetes typically have a higher incidence of periodontal disease and will need personalized, expert care.
- Smoking. Tobacco use can be an impediment to successful implant placement because of the potential risk of oral infections. Nicotine limits the flow of blood to the gums and weakens the body’s immune system, making it difficult to heal. Smoking also decreases the progressive healing of the bone around the implant, in some cases resulting in premature failure or loss of the implant. Studies have shown that vaping has a similar negative effect on implants and the surrounding tissues.
- Uncontrolled chronic conditions. Left unmanaged, some conditions can prevent successful integration of the implant in the jaw as a result of slower healing and integration. Some of these chronic conditions include diabetes, heart disease, cancer, long-term steroid therapy, some forms of bone disease, and some neurological conditions such as advanced Parkinson’s disease and multiple sclerosis. Previous radiation therapy to the jaw and some types of medication also can impede the healing process.
Cost of dental implants
Dental implants can be expensive, costing $2,000 to $4,000 per tooth. Some insurance companies cover a portion or the entire cost of dental implants. Talk with your dental insurer and our oral health team – we can help you determine how much is covered and your approximate out-of-pocket costs.
2. Brush up on good oral hygiene habits
Implants are like real teeth and must be cared for like real teeth. Because of this, we want to make sure our patients fully understand the responsibility of caring for their dental implants. For some patients, this requires a significant change in dental hygiene habits.
Our dental hygienists meet with every patient as part of the decision-making process. These experts will talk with you about your dental habits and educate you on best practices, such as:
- Brushing and flossing your teeth regularly.
- Seeing your dentist for checkups twice a year, or more if recommended.
- Calling your dentist immediately if there is pain or something doesn’t feel right. This could indicate an infection that puts your implant at risk.
After you receive dental implants, we will continue to see you regularly to assess your oral health and help you care for your new teeth.
3. Developing your dental implant treatment plan
After a review of your medical history and dental health, the team of providers, which includes the general dentist, surgeons, and hygienist, work to create a comprehensive treatment plan that fits your needs.
Part of that plan may include treatment for gum disease or removal of a few teeth. When teeth are lost or extracted, you also lose jawbone – and you need strong, healthy jawbones to support the implant. Therefore, treatment planning includes taking X-rays to assess how much bone you have in the upper and lower jaws and determining whether a bone graft is required.
Additionally, the radiographic and anatomical location of the nerve in the jaw is very important since it can be injured during implant surgery if you have a low volume of bone in the jaw.
If you have lost substantial jawbone, we may perform a bone graft to help hold the implant in place. To do this, we’ll take molds of your jaw and teeth to find optimal placement areas and make new crowns. We’ll also match the color of your new teeth to your natural teeth for a seamless look.
4. Starting your dental implant procedure
This is a multistep process that can span a few months. The number of procedures and treatment timeline will differ for each person. Talk with the dental team about precautions you should take with medications or supplements before having anesthesia or a procedure.
On the day of the procedure, you will rinse your mouth with chlorhexidine, an antiseptic to decrease bacteria and reduce the risk of infection. Then we will remove the existing teeth and perform a bone graft, if necessary. Bone grafts can come from your own body or a xenograft, which is carefully processed cadaver bone from a human or an animal such as a cow. If we use a graft from your body, we may take bone from your hip, jaw, or chin, depending on how much bone is needed.
In some cases, small grafts can be placed at the time as the implant. Typically, once the graft is placed, it requires four to six months before enough healthy bone can grow to support the implant.
After that period, the surgeon will drill into the newly formed bone where the dental implant post – the equivalent of a tooth’s root – will be placed. A metal spacer called an abutment is placed on the implant to allow easy fabrication and placement of the crown.
The post and abutment are made of titanium, a material that will bond with the bone. Another practical benefit of titanium is that it won’t set off metal detectors. It may take several months for the implant and bone to form into a solid base for your new tooth and for the gum to heal around the abutment. Then, we will attach your new artificial tooth to the abutment.
5. Providing lifelong care for your new teeth
Follow-up care is essential for maintaining the health of your implants and your smile. During regular dental check-ups, we will help you work to prevent potential problems and address issues that crop up before they become serious.
You will be responsible for keeping up with daily oral health care: brushing, flossing, and making an appointment with the dentist right away if you notice changes or pain. Your teeth affect your whole body. When your teeth are healthy, your physical and mental health can improve.
Dental implants can help you smile, talk, eat, and live with more confidence. It’s a big investment – financially and personally – and our expert team will help you reap the dividends of that investment.