Dental implants

What it is

An implant replaces a missing tooth in three parts:

• The implant. A small post, usually titanium, placed in the jawbone where the root used to be.
• The abutment. A short connector that attaches to the implant and comes up through the gum.
• The crown. The tooth you see, made to match your other teeth. Implants can also hold a bridge or a denture.

Because it’s anchored in bone, an implant doesn’t lean on the teeth beside it the way a bridge does. It also helps slow the shrinking of bone that follows tooth loss.

Who it helps

Implants may be an option if you:

• Are missing one or more teeth
• Have a tooth that can’t be saved and needs to come out
• Would rather not have healthy teeth filed down for a bridge
• Have dentures that slip and want them held more firmly

You need enough healthy bone and healthy gums to support an implant. If the bone has thinned, a bone graft may come first. Smoking, uncontrolled diabetes, and some medicines can slow healing and make an implant more likely to fail. Tell your dentist about your health and anything you take.

What happens

1. Exam and planning. Dr. Minici checks your teeth, gums, and bite, and takes X-rays. A 3D scan is sometimes used to measure the bone. Some cases are referred to an oral surgeon for the surgery itself.
2. Getting the site ready. If the tooth is still there, it’s removed. Some people need a bone graft and a few months of healing before the implant goes in.
3. Placing the implant. We numb the area, which feels like a pinch. A small opening is made in the gum, and the implant is placed in the bone. You’ll feel pressure and vibration, but the area stays numb.
4. Healing. Over the next few months, the bone grows tightly around the implant. If the gap shows when you smile, you may wear a temporary tooth in the meantime.
5. Adding the new tooth. Once the implant is firm, the abutment is attached, sometimes at the same visit the implant went in. A crown is made to match your teeth, and your dentist attaches it and checks your bite.

Recovery and aftercare

After the implant is placed, expect some soreness and swelling for a few days, and sometimes a bruise. Ice on your cheek can help with swelling on the first day.

For the first week or so, eat soft foods and chew on the other side. Keep the area clean the way your dentist shows you. Don’t smoke, since it slows healing and raises the risk of failure.

Once the crown is on, brush and floss around it like a natural tooth, and keep up with cleanings. An implant can’t decay, but the gum and bone around it can get infected, much like gum disease.

Cost and insurance

The cost depends on how many implants you need, what they hold, and the materials. An extraction, a bone graft, or a 3D scan adds to it.

Dental plans vary widely with implants. Some cover part of the cost, some cover only the crown, and some pay what a bridge would cost instead. Check with your plan before you start. Financing can spread the cost over the months of treatment; see insurance and financing.

Alternatives

• A bridge. A bridge fills the gap with a false tooth held by crowns on the teeth beside it. It’s faster and needs no surgery, but those teeth must be filed down.
• A partial denture. A removable partial denture often costs the least. It can feel bulkier and less steady than an implant.
• Dentures held by implants. If you’re missing most or all of your teeth, a few implants can hold a removable denture or a fixed full set of teeth.
• Leaving the gap. This is an option, especially for a back tooth. Over time, though, nearby teeth may drift into the space, and the bone under it slowly shrinks.