10903 Dental Implants

Overview

A dental implant is a small, screw-shaped post that is placed into your jawbone to take the place of a missing tooth root. Once it has settled and joined with the bone, it can hold a replacement tooth, a bridge, or a full or partial denture. Most implants are made of titanium, a strong metal that the body usually accepts well. The implant itself is not the tooth you see — the visible tooth is a cap (called a crown) that is fitted on top later.

Yes, dental implants are very common. They are one of the standard ways to replace missing teeth around the world, and millions are placed every year.

Implants are mostly for adults who have lost one or more teeth because of decay, gum disease, injury or a tooth that could not be saved. They are usually only placed once the jaw has finished growing, so they are not routine for children or teenagers. Older adults can have implants too, as long as their gums and general health are in reasonable shape.

Symptoms

Common symptoms

• A gap where a tooth is missing, which may affect how you bite or speak
• A loose or wobbly denture that slips when you eat or talk
• Sore gums or rubbing from a denture that no longer fits well
• Feeling self-conscious about your smile or avoiding smiling in photos
• Difficulty chewing certain foods, such as crunchy or tough items
• Healthy teeth next to a gap starting to lean or shift out of place

Symptoms in children

• Children and teenagers are rarely given implants because their jaw is still growing
• A child with a missing tooth is usually offered other options first, such as a temporary removable tooth or a bridge
• Your child's dentist will explain the best timing if an implant is planned for later, often in the late teens or early twenties

Symptoms in older adults

• Implant treatment is common in later life, but healing can take a little longer
• Gum health and bone thickness are checked carefully, since bone tends to thin with age
• Some long-term medicines can affect bone healing, so bring a full list of your medicines to your appointment
• Dentures can often be made more secure by anchoring them to implants, which can make eating and speaking easier

Causes

Main causes

• Tooth decay that has gone too deep to repair
• Gum disease that has loosened a tooth
• A tooth knocked out or damaged by injury or an accident
• A tooth that cracked or failed after root canal treatment
• A tooth missing from birth, or lost during other dental treatment

Risk factors

• Smoking or vaping, which slows healing and raises the chance of an implant failing
• Poorly controlled diabetes, which affects healing and gum health
• Gum disease now or in the past
• Not having enough bone in the jaw to hold an implant securely
• Grinding or clenching your teeth heavily
• Certain medicines that affect bone healing, or a history of radiotherapy to the jaw
• Heavy alcohol use and poor nutrition
• Poor oral hygiene and skipping dental check-ups

When to see a doctor

See a doctor urgently if:

• You have severe pain that ordinary pain relief is not helping with
• You have swelling, pus, fever or a bad taste around a tooth or implant
• An implant, crown or denture has become loose or has fallen out
• You have numbness or tingling in your lip, chin or tongue
• Bleeding from the mouth will not stop after firm pressure for 20 minutes

Book a routine appointment if:

• You have a missing tooth and want to talk about replacement options
• Your denture is loose, uncomfortable or rubbing
• You find it hard to chew or speak clearly because of a gap
• You are unhappy with how your smile looks
• You are due a routine dental check-up, even if nothing is bothering you

Diagnosis

Your dentist will start by talking with you about your health, your medicines and what you hope to achieve. They will look inside your mouth, check the health of your gums and nearby teeth, and feel how much bone you have. X-rays or a 3D scan are then used to see the bone in detail and plan where the implant would sit. Sometimes you will be referred to a specialist dentist (a prosthodontist or oral surgeon) for this assessment.

Tests that may be done

• A full mouth examination, including gum health checks
• Dental X-rays to measure bone height and check nearby tooth roots
• A 3D scan (called a CBCT scan) for more detailed planning in some cases
• Photographs, moulds or digital scans of your teeth
• A review of your medical history and current medicines
• Occasionally blood tests or a letter to your GP if you have a health condition that affects healing

What to expect at your appointment

You will usually be given a clear written plan covering what will happen, how long it will take, how many appointments you need, and the cost. Nothing goes ahead without your agreement. It is completely fine to go home, think it over, and come back with more questions.

Treatment

Implant treatment happens in stages, with healing time in between. First the implant post is placed into the jaw. Over the next few months the bone grips it firmly. Then a small connector is fitted, and finally the replacement tooth, bridge or denture is attached on top. Some people need extra steps first, such as a bone graft (adding bone material to build up a thin jaw) or a sinus lift (making room in the upper jaw). Not every missing tooth needs an implant — a bridge or denture may suit you better, and your dentist will go through the pros and cons.

Self-care at home

• Follow the aftercare instructions your dental team gives you closely
• Use any mouth rinse or pain relief exactly as advised by your dentist or pharmacist
• Stick to soft, cool foods for the first few days and avoid very hot drinks
• Do not smoke or vape while healing — it greatly increases the chance of failure
• Keep the area clean but be gentle; use a soft brush as shown by your dental team
• Avoid vigorous rinsing, spitting or straws for the first day or so after surgery
• Attend every review appointment so healing can be checked
• Clean around the implant daily with a small brush or interdental brush once healed

Medical treatments

The procedure is usually done under local anaesthetic, so the area is numb and you stay awake. Some people choose sedation for anxiety, and a full anaesthetic is occasionally used for complex cases. Your dentist or surgeon makes a small opening in the gum, prepares the bone, and places the implant. The gum is then closed with stitches, some of which dissolve on their own. Over the following months, the bone fuses with the implant. After that, impressions or scans are taken and the final tooth is made and fitted. Your dental team will discuss pain relief and any antibiotics only if they are genuinely needed — always ask your dentist or pharmacist rather than using leftover medicines.

When is surgery considered?

Surgery is needed to place the implant itself and sometimes to prepare the bone first. If you have an active gum infection, uncontrolled diabetes or you smoke heavily, your dentist may ask you to get these under control before surgery to give the implant the best chance of lasting.

Living with this condition

Once healed, an implant should feel and work much like a natural tooth. You brush and clean around it every day just like your other teeth, plus a little extra care where the implant meets the gum. Most people forget it is there after a while. Regular dental check-ups and hygiene visits are important, because problems around implants are much easier to fix early.

Lifestyle tips

• Stop smoking or vaping if you can — it is the single biggest thing that protects an implant
• Keep alcohol within recommended limits
• If you grind your teeth, ask your dentist about a night guard to protect the implant
• Avoid using your teeth to open packets or crack nuts
• Keep up regular dental check-ups and cleanings, even when everything feels fine

Diet and exercise

In the first week or two, choose soft, nourishing foods such as soup, yoghurt, mashed vegetables, scrambled eggs and soft fruit. Avoid hard, crunchy or sticky foods and very hot drinks while the area heals. After that, you can normally return to your usual diet, and an implant may let you enjoy foods you had been avoiding. There is no special exercise rule, but avoid strenuous activity and swimming for the first few days after surgery, as your dentist advises.

Mental health and emotional wellbeing

Losing a tooth can affect confidence, and some people feel embarrassed about smiling, eating in public or speaking up. Feeling anxious about dental treatment is also very common. These feelings are understandable and worth mentioning to your dental team — they can adjust how they work with you, and nervous patients are supported every day. If low mood or anxiety about your teeth is affecting your daily life, speak to your GP as well.

Prevention

You cannot always prevent needing a dental implant, but you can lower your chances of losing teeth in the first place. Brush twice a day with a fluoride toothpaste, clean between your teeth daily, keep sugary food and drinks to mealtimes, avoid smoking, and attend regular dental check-ups. Once you have an implant, careful daily cleaning and routine check-ups are the best way to keep it healthy for many years.

Screening programmes

Routine dental check-ups are the main way problems are spotted early. Your dentist will check your gums, existing implants and replacement teeth, and take X-rays when needed. How often you are seen depends on your mouth and health, so ask your dentist what interval suits you.

Complications

If left untreated

• Neighbouring teeth can drift or tilt into the gap, changing your bite
• The jawbone in the empty space can slowly shrink over time
• The gum and bone around remaining teeth may be harder to keep clean
• Chewing may become uneven, which can strain the jaw joint and cause discomfort
• Loose dentures can rub and cause sore spots or ulcers
• Some people avoid smiling or eating with others, which can affect confidence

Long-term outlook

Dental implants have a good track record. In healthy people who do not smoke and who keep their mouth clean, most implants last many years, and many last decades. Some implants do fail, usually early on or when gum problems develop around them, and this can often be treated or replaced. Your dentist will be honest with you about your own chances based on your health and habits — and whatever you decide, there are usually several ways to replace a missing tooth.

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