Gone are the days when the only options to replace lost teeth would be ill-fitting partial or complete dentures; even fixed crowns or bridges for that matter. Now, you have an option like dental implants which look, feel and work like your natural teeth would, without any damage to neighbouring existing teeth. Our expert Dr Vijay Salvi, a renowned dental implantologist, answers all your queries related to dental implants.
What are dental implants? Why would I need them?
Dental implants are an effective and excellent long-term option to replace missing teeth. They are artificial ‘roots’ (post), usually made of titanium, placed into the upper or lower jaw bone that act like an anchor for the replacement teeth. They can be used to support various dental prostheses like crowns, bridges or dentures. They are an excellent solution for tooth lost due to trauma – patient not only gets a fixed tooth but also there is no need to mutilate the adjacent teeth in any way. The tooth is absolutely life-like and feels natural. Patients who are not happy with the fit of their dentures can opt for implants to anchor their dentures. In a patient with traditional complete dentures the bone resorbs over a period of time and causes the dentures to become loose. In case of implants the denture or artificial tooth/teeth are firmly anchored.
Are there any cases where dental implants cannot be used?
Anybody can get one or any number of teeth replaced with implants provided he/she does not have any major medical illnesses, uncontrolled blood sugar, or has not recently had radiation therapy. It is advisable not to place dental implants till the growth and maturation of a person is over i.e. till the age of 18 years for girls and till 19 to 20 years for boys.
Can all dentists perform implant surgeries? How much would implants cost?
The doctor you chose should have adequate experience in the field of implantology. The centre where the implant is performed should be adequately equipped and have adequate infection control measures. There are various types of implants – less expensive mini implants to very expensive implants sophisticated geometry. The type of implant varies therefore the cost also varies. And also, additional procedures like bone graft may be required if the bone is deficient, which in turn can make the implant procedure costlier. In most cases, a standard implant procedure for replacing a single missing tooth with good bone support would require to be done in two phases. The first phase would cost between Rs 20,000 to Rs 30,000 and the second phase would cost between Rs 10,000 to Rs 20,000.
Are there any precautions to be kept in mind when a dental implant surgery is planned?
Conditions like high blood pressure, diabetes, cholesterol, etc. should be under control before the implant procedure. The parameters of blood tests especially related to platelet count, blood sugar, etc. should be well within normal. It is very important to refrain from smoking for a reasonably long period of time – 3 to 4 weeks before and at least two months after the placement of the implants. The possibility of acceptance of implants in smokers reduces substantially which means there is a possibility of a failure. Gutka or supari chewing exert undue stress and pressure on the recently placed implant causing a failure in the procedure.
How are dental implants placed?
After examining your mouth, your dentist will make a customised treatment plan for placing implants in your jaw bone. If there is not enough bone in your jaw or if it isn’t strong enough, you may be advised bone grafting before your dental implant surgery.
Once your dentist is assured that your jaw bone is healthy to receive an implant, the gum tissue is opened and a channel is created deep into the bone to place the implant with a special drill. The implant is then placed in the channel and the gum is sutured or stitched back.
In the next three to six months the jawbone grows around the implant and anchors it (osseointegration). Once osseointegration occurs a post (abutment) is attached to the implant which will help hold the new artificial tooth. Attaching a post may sometimes also be done at the time of placement of implants in the bone. An artificial tooth (crown) is then cemented over the post.
Typically, to replace a full set of teeth in each jaw, eight to nine implants are required. So, to restore teeth in both the jaws, 16 to 18 implants may be needed which can be done in a single sitting.
The whole procedure is usually done under local anaesthesia. The only pain you experience is the prick of the anaesthesia needle and some amount of pressure.
What are the risks involved in the implant procedure?
There may be discomfort for 48 to 72 hours after implant surgery during which time the pain can be controlled by pain killers. Rarely some patients may develop secondary infection in which case there may be pain and swelling for a week. There may be a few surgical risks involved with this procedure – excessive bleeding or swelling, infection, etc.
In some cases, the implant may not be accepted by the body; this may cause the loss of the implant. In such instances, the channel that was created in the bone to place the implant heals and closes completely.
What kind of care is needed to maintain the health of the implants after the surgery?
The first seven to ten days after placement of implant are extremely critical for the process of healing of the implants. This is the phase that is going to determine how the implant is going to integrate with the surrounding bone. Follow all the instructions given by your doctor – application of cold fomentation in the area of surgery, restrictions in the diet, taking prescribed medicines, maintaining good oral hygiene with brushing and flossing and rinsing your mouth third day onwards with a good antiseptic mouthwash for the first ten days.
Visit your doctor every six months. Any issues with the implants should be reported to your doctor as early as possible. Keep the area around the implants clean. Your doctor might ask you to use proximal brushes to maintain the implants.
How long will the implants last? How ‘permanent’ are they?
It is difficult to predict how long the implants will last because it is very difficult to predict the environment in which they are going to function. But there are cases where the implants have lasted for 14 to 15 years. If maintained well, regularly visit doctor and if your implant survives the first year, then they will last at least 10 to 15 years. And if there is good quality bone around the implant for five years, be sure they are going to last for the rest of your life.
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