At our office we meet new patients every day and they ask us so many questions about dental implants. Let the following most common questions & answers about dental implants serve as your guide to finding the information you need to make good decisions about your dental health.
- Are Dental Implants Safe?
- How long do they last?
- How much do they cost?
- How do they work?
- What are the various types of teeth components secured to a dental implant?
- How do dental implants feel compared to teeth?
- What is their maintenance schedule?
- Do dental implants have complications or even fail?
- What types of dental work can dental implants be used for?
- Can people with diabetes benefit from dental implants?
- If I smoke will I be able to get dental implants?
- Does Medicare pay for dental implants?
1. Are Dental Implants Safe?
Yes, dental implants are very safe. The body accepts them as if they are natural parts of the body. This concept is called “osseointegration”. Between 97% and 100% of patients receiving dental implant surgery will successfully have success.
2. How long do they last?
Dental implants, when free from infections, will last a lifetime.
3. How much do they cost?
It is impossible to put a flat price on the surgery or the restorative phase. The treatment fee is based on the number of implants placed during the surgery and the specific type, material, size of the project. Most Dental offices will provide an estimate for the work expected to be accomplished. Some offices will also provide this estimate at no charge to the patient.
4. How do they work?
Dental implants basically serve as anchors or posts. They are the replacement of the tooth roots. Dental Implants are made out of medical grade titanium, they have external screw threads of anchoring to the bone, and have an internal screw thread for securing with small screws various teeth components.
5. What are the various types of teeth components secured to a dental implant?
There are a variety of components that can be attached to a dental implant. This is one of the reasons there are no flat fees. The possibilities are too many to have just one outcome and one price. When reading and researching dental implants, it is important to understand the terminology used. Here is a summary of the various parts and components used in Implant Dentistry:
- Dental Implant Crown – single tooth attached permanently to a dental implant.
- Dental Implant Bridge – multiple teeth connected to each other permanently attached to dental implants.
- All-on-4 – complete set of teeth in one arch connected to each other, permanently attached to 4 dental implants. Variations exist, where there might be 5 or 6 dental implants supporting the arch.
- OverDenture – Denture over, supported and retained by dental implants.
- Cover Screw – A flat implant screw that simply covers the top of the implant which allows the gum tissue to grow over the implant. This screw is placed on the implant during surgery for a submerged healing of the implant.
- Abutment – a connecting restorative component attached to the implant. It is the transitional component through the 2-4 mm of gum tissue. It is responsible for shaping the gum tissue and for transferring the forces from the teeth to the implant. There are various types of abutments, each designed specifically for a specific purpose.
- Healing Abutment – A taller implant screw which covers the implant but does not allow the gum tissue to grow over the implant. It is primarily used to shape the gum tissue around the implant. In some cases it is placed at the same time with the implant and in other cases it is placed 3-4 months after initial implant placement surgery.
- Second-stage surgery – The uncovering of the implant several months after initial placement, removal of the flat cover screw and placement of a healing healing abutment. This is the last step of the surgical procedure.
- OverDentures – a denture which snaps to dental implants and gains stability and retention.
- Stability – resistance to lateral movements.
- Retention – resistance to vertical movements.
- Locator Abutment – The most common implant connection to an Overdenture. The component gets installed to the implant after the bone and gum tissue are completely healed and snaps into a receiving “button” or “housing” installed in the tissue-side of a denture. It allows the patient to remove the denture with relative ease for daily hygiene and maintenance. It retains the denture during speaking, function and mastication. There are also several other variations, all accomplishing the same result, notably Locator R-Tx and O-Ball.
- Cementable abutment – The component installed to the implant with the help of a dental implant abutment screw, shaping the gum tissue and supporting and retaining the new teeth with dental cement. Patient is unable to remove teeth. It is difficult or impossible to remove the teeth without damaging the teeth.
- Screw Retained abutment – The component installed to the implant with the help of a dental implant abutment screw. It shapes the gum tissue and supports and retains the new teeth with a secondary dental implant restorative screw. (There are now 2 screws used, one holding the teeth to the abutment and one holding the abutment to the implant). Patients are unable to remove their teeth. The dentist can easily remove the teeth by removing the dental implant restorative screw.
- UCLA or castable abutment – The component connecting the implant directly to the new teeth. The new teeth metal frame is cast directly to this component followed by porcelain fused to the metal structure. The new teeth are attached to the implant with a dental implant abutment screw. There is only one screw, and no cement is used.
- Multi-unit abutment or screw receiving abutment or angle correcting abutment – Similar to a screw-retained abutment, the multi-unit abutment also retained the new teeth with the help of a screw. However, multi-unit abutments are designed to also allow the dentist to change the angle of the restorative screw. This becomes important if the opening of the screw is present on the front side of the teeth. These abutments are used primarily in multiple teeth restorative cases. They were made popular with the advent of the all-on-4 restorative methodology.
- Titanium Bases (Ti Bases) – Similar to an abutment, these titanium bases are the interface between teeth and implants. They are cemented to the teeth or abutments before the teeth or abutments are connected to the implant with a dental implant screw.
- Impression Posts – a special type of abutment used the impression taking technique. It is attached to the implant during a dental visit by the dentist for capturing the location of the dental implant.
- Scan Body – Similar to an impression post, it is used in the digital recording of the location of the implant when an intra-oral scanner records the location of teeth, gums, and implants.
6. How do dental implants feel compared to teeth?
The main difference between dental implants and natural teeth is the connection to the underlying bone. Dental Implants are surrounded intimately by the jaw bone. Teeth are actually surrounded by small attachments called ligaments anchoring the tooth to the bone called periodontal ligaments. The space around tooth roots is several fractions of a millimeter (ranges between 0.15-0.40 mm wide). It is in this space, blood vessels and most importantly nerve endings are present. These nerve endings provide us with sensitivity when biting and chewing. We “feel” through our teeth with the help of these special tiny nerve endings. Dental implants have virtually no movement, no space, no ligaments and have virtually no sensation or perception compared to natural teeth.
7. What is their maintenance schedule?
Dental Implants are maintained much like natural teeth. Patients are encouraged to maintain excellent oral hygiene by brushing and flossing and visit their hygienist for a professional dental cleaning as prescribed by their dentist. Most dentists recommend cleanings be performed every 6 months, unless there has been a history of periodontal infections in which case dental cleanings will be recommended at every 3-4 months.
8. Do dental implants have complications or even fail? How do they fail? Can dental implants be taken out?
Dental Implant can develop complications. Most can be addressed in a successful manner. When complications cannot be managed successfully, the dental implants are removed.
Here is a list of the most common causes of failure:
- Gum disease, similar to natural teeth gum disease.
- Small amounts of dental cement used in attaching teeth to abutments accidentally remaining under the gum tissue attracting and harboring oral bacteria leading to gum and bone infections. Surprisingly, this can happen even many years after the dental cement was used during installation of the new teeth.
- An improper teeth bite which overpowers the ability of the bone to remain healthy around the dental implant
- Dental Implant or Restoration Screw Loosening and screw breaking.
- Cement loosening.
- Bone Atrophy and Gums Recession. A natural process by which bone resorps and shrinks following teeth extractions. The gum tissue follows the bone, pulling away from the original location. This leads to exposed abutments and even exposed areas of the dental implant.
- Restorations Breaking, fracturing or chipping. This is due to either a material failure or/and abnormally strong bite forces.
9. What types of dental work can dental implants be used for?
- Single Tooth Missing
- Fixed Implant Crown (non-removable)
- Several Teeth Missing
- Fixed Implant Partial Denture/Bridge
- Removable Implant Partial Denture/OverPartial
- All Teeth Missing
- Fixed Implant Complete Denture/All on 4 / Hybrid Denture
- Removable Implant Complete Denture/Overdenture
- Multiple Crowns and/or Bridges
10. Can people with diabetes benefit from dental implants?
Yes, diabetic patients could receive dental implants so long the diabetes is well controlled. Diabetes is considered well controlled when the A1c is under 6.5. There is an increase risk of healing failure when the A1c is between 6.5 and 8.0. There is a considerable risk of healing failure when the A1c is above 8.
11. If I smoke will I be able to get dental implants?
Smoking is a risk factor for for implant failure not a strict contra-indication. Smokers are advised and encouraged to cease smoking for a period of time prior to receiving dental implants. Smoking is also a risk factor for getting gum disease around implants, which ultimately leads to implant failure. Smoking is discouraged in patients who have or want to have dental implants. Whether or not your dentist will accept to participate in your treatment is a personal decision between you and your dentist.
12. Does Medicare pay for dental implants?
Medicare does not cover dental implants. Medicare does not cover dental implants as the dental industry and most dental patients think of dental implants. However, there are a very small number of dentists in the US who claim they are able to help patients receive reimbursement from the Medicare system. They claim the necessity of bone grafting and bone anchors (dental implants) as a means to underwrite the dental implant treatment. Since this is not a common practice in the United States and it borders moral and integrity boundaries, our office does not engage in such practices.