Single-Tooth Implants: What To Expect

Dental implants are titanium cylinders (screws) that are surgically placed into the jawbone where teeth are missing. Once in place, they allow your dentist to mount replacement teeth onto them. Your new tooth, a crown, will look and feel similar to your real teeth.

For some people, ordinary bridges and dentures are simply not comfortable or even possible due to the lack of adequate bone or tooth support, poor oral hygiene, discomfort, or gagging. In addition, standard bridges must attach to the teeth on either side of the space left by the missing tooth. An advantage of implants is that no adjacent teeth need to be prepared or ground down to hold your new replacement tooth/teeth in place.

To receive implants, you need to have:

• Healthy gums
• Adequate bone to support the implant (or be a candidate for bone grafting)
• Excellent oral hygiene habits and regular dental visits to ensure the long-term success and health of the dental implants

Dental implants are usually placed by oral and maxillofacial surgeons, prosthodontists, or periodontists. However, some general dentists may take additional training to learn to place implants. Implants are generally more expensive than other tooth-replacement methods. Most insurance carriers typically cover less than 10 percent of the fees.

According to the American Academy of Implant Dentistry, there are two basic types of implants.

• Endosteal implants — Most commonly placed implants are surgically implanted directly into the jawbone. Once the surrounding gum tissue has healed, a second surgery is needed to connect a post to the original implant. Finally, an artificial tooth (or teeth) is attached to the post —individually or grouped on a bridge or denture.
• Subperiosteal implants — These implants are used with patients who do not have enough healthy bone. A metal frame is fitted onto the jawbone below the gum tissue. As the gums heal, the frame becomes fixed to the jawbone. Posts, which are attached to the frame, protrude through the gums. As with endosteal implants, artificial teeth are then mounted to the posts.

Missing teeth can create oral health problems or make you feel self-conscious when eating, talking, or smiling. Dental implants are an excellent solution for improving your dental health, as well as your confidence.

Dental implants can be used to replace a missing tooth permanently. First, your dentist will surgically place the implant in your jawbone. Once it fuses to the bone, the implant serves as the new "root." A crown also called a cap, is attached to the implant to replace the missing tooth.

To be considered a candidate for dental implants, your jawbone needs to be strong enough to support the implant. The surrounding tissue and nearby teeth have to be in good health. If there is not enough bone to hold it, additional bone can be added through bone grafting.

It's essential the dentist performs a thorough review of your medical history and conducts an exam. Some medical problems could eliminate a candidate for dental implants, such as diabetes, liver disease, or a severe bleeding disorder.

A single-tooth implant consists of several parts:

• The implant — Made of titanium, shaped like a screw or post, is placed into the jawbone.
• The abutment — Made of titanium, gold, or porcelain, is attached to the implant. This part connects the implant to the crown.
• The crown — Made of porcelain fused to metal (PFM), all-metal, or all-porcelain. Your crown will be made to match your other teeth and will be attached to the abutment.

The entire process of getting a single-tooth implant can take months, but the result is worth it! If your dentist determines that your jawbone isn't sturdy enough for the implant, the first step will be bone grafting. Grafting involves taking bone from another source (or using synthetic material) and adding it to your jaw to make it stronger. In this scenario, your jaw will need 4-12 months to heal before getting the implant.

Getting a dental implant requires oral surgery, generally using local anesthesia. Your oral surgeon will cut into your gum to expose the bone. Holes are drilled into the bone where the metal implant will be placed.

After this procedure, you'll still have a gap where your tooth is missing. Your dentist might be able to fabricate a temporary solution to fill in the gap for cosmetic reasons.

Once the implant has properly fused with the bone, your dentist may want to place a healing cap. This helps the gum tissue heal correctly, usually taking around two weeks. After this, the cap is removed, and the abutment is screwed onto the implant. You'll get a temporary crown while the gums finish healing around the abutment.

Your dentist will make a final impression to create your crown, which will either be cemented or screwed to the abutment to secure it in place permanently. You can treat this new "tooth" like any other in your mouth, with regular brushing and flossing to keep the gums healthy.

According to the American Academy of Periodontology, every single-tooth implant is different. Some of these steps may be combined, depending on the situation.

There is the possibility of an implant failing for various reasons — if an infection develops, which is rare, or if the bite (the way the teeth come together) has not been adequately adjusted. In addition, clenching or grinding teeth can put a lot of pressure on the implant. This may cause bone loss and cause the implant to break or fail. Poor oral hygiene and lack of regular preventive professional care can also contribute to implant failure.

When implants are used to replace lower teeth, there is the risk that a nerve in the jawbone could be injured, causing numbness or tingling. It can be temporary until the nerve heals, or it can be permanent. However, x-rays and CT scans help your dentist see where the nerve is located and minimize the possibility of injury. There is also the risk of sinus problems if a dental implant placed in the upper jaw protrudes into one of your sinus cavities. However, these risks are uncommon.

Implants may not be the easiest procedure, but they take time to be healthy and secure. Once you have your new implant and crown, make sure to take care of it — and every other part of your mouth, too! If you have questions about a dental implant procedure — for example, how long does a dental implant procedure take? — be sure to reach out to your dentist.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.