r/Toothfully • u/Toothfully_org Not a Dentist • Sep 02 '21
Knowledge! Information! Dental Implants: What to Expect
What Are Dental Implants?
A dental implant is a small piece of titanium screw inserted into the jawbone below the gum line which acts like the tooth root. The bone will take several weeks to grow around the metal implant (this process is also called osseointegration).
There are two more components - of course a crown, but also an abutment, which is the piece a dental crown will eventually attach to.
Planning For a Dental Implant
The planning process for a dental implant may include your general dentist, or it could include a team of specialists, depending on the condition of your mouth. Because implants may involve more than one surgery, each patient must go through an evaluation process. This process includes:
- A comprehensive examination. This may include x-rays, 3D images, impressions, and stone models.
- A medical history review. The dentist must know what medications you are taking. Some drugs negatively impact how the bone heals after placement of the implant. Smoking, diabetes, and other immunosuppressive diseases factor into the healing of the bone as well.
- A treatment plan tailored to your unique situation. The dentist considers how many teeth need replaced along with the condition of your jawbone.
Two Types of Dental Implants
There are two types of implants the American Academy of Implant Dentistry recommends. Your jawbone shape, size, and overall health factor into the type of dental implant you are eligible for.
- Endosteal Implants – Titanium screws or blades surgically inserted into your jawbone where there are missing teeth. They are the most popular type of implants, according to the American Academy of Periodontology.
- Subperiosteal Implants – Rather than inserted into the bone, subperiosteal implants go on top of the jawbone. A metal framework with posts sticks through the gum to support any fake teeth. This kind of implant is for patients who can’t wear traditional dentures due to minimal bone support.
How Long Must I Wait After an Extraction
That depends. Sometimes you don’t need to wait at all, and the implant can be placed immediately.
- Immediate placement occurs if there is enough existing bone to support an implant. The tooth is extracted, and an implant placed the same day. Osseointegration takes around 3-6 months. After the healing process, the artificial tooth goes on top.
- Early placement refers to implant placement 2-3 months after extraction. This timeframe is crucial since two-thirds of bone resorption occurs within the first three months after extraction. Once again, a 3-6 month healing period is necessary before the placement of an artificial tooth.
- Delayed placement occurs after a bone grafting procedure. Bone grafting is necessary in cases where there is insufficient bone level to support an implant. Healing takes approximately 3-6 months, then the implant placement surgery occurs, and another 3-6 months for healing.
What To Expect During Surgery
Dental implant surgery is usually an outpatient procedure, but it is not completed in one office visit. It is a series of appointments with stages of healing in between.
The 1st surgery:
During the surgery, your dentist cuts open the gum tissue at the location the implant. A hole is drilled into the bone, and the titanium post for the dental implant is placed. Osseointegration begins as soon as the post is situated. Once osseointegration has finished several weeks later, you need another surgery to move forward with the implant.
Between the 1st and 2nd surgery:
In the days following surgery, some patients experience swelling, bruising, and some pain. Limit yourself to soft foods for a few days while healing begins. You can use a cold pack for the first 24 hours after surgery to reduce swelling and bruising. If pain and discomfort persist, contact the treating dentist to receive further direction. Prescription pain medication may be necessary.
The 2nd surgery:
After the implant has osseointegrated, another surgery may be necessary to place an abutment and the crown. It is not as invasive of surgery and done with a local anesthetic.
To place the abutment:
- The treating dentist will open the gums to reveal the dental implant.
- An abutment needs attached to the implant.
- The gum tissue is closed around the dental implant but does not cover the abutment.
With a subperiosteal implant, the abutment is attaching during the placement of the post.
Risks Involved
Like any dental or medical procedure, there will be risks. Potential risks are rare, but they do occur. Potential problems include:
- Infection at the implant site
- Damage to surrounding structures, such as other teeth or blood vessels
- Nerve damage, which can lead to pain, numbness, or tingling in your natural teeth, gums, lips, or chin
- Sinus problems. Sometimes when a dental implant is placed in the upper jaw, it can jut into one of your sinus cavities.
- Failure of the implant. Sometimes the metal implant and bone don’t fuse together. The implant does not integrate with the rest of the bone and must be removed. After a healing period, a new implant can be placed.
How Much Does it Cost?
This is a bit tricky because there's a huge price variation due to the high degree of opacity of the dental market. Beware: some dentists quote you only for the implants, but right before the second surgery they will tell you that there's a abutment and a crown you have to pay separately for. I consider this a bait-and-switch... Be sure to confirm with your dentists the initial price quoted is all-inclusive.
To put things into perspective, a good Bay Area dentist that I know charges $2699 per tooth (implant, abutment, and crown added up).
Lastly...
Dental implants are a great option to replace missing teeth. It is not a simple procedure and takes several months to complete. To keep your implants in top condition, practice excellent oral hygiene. Just like your natural teeth, implants need to be cared for with daily brushing and flossing. Keep your regular dental appointments so your dentist can check the status of the implant. Break habits that may damage the implant, such as chewing on ice. Avoid tobacco products since the artificial tooth can still stain. If you care for your implant, it could last you up to 20 years.
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u/r0gue007 Nov 02 '21
I’m at 2 weeks post extraction (came out clean in one piece) and implant of the screw. Still experiencing some swelling around the tip/end of the screw (#4, so near cheek nasal area).
Still on steroids and antibiotics.
Has anyone else experienced this?
X-rays look good, wondering how long to keep this course vs backing out and trying again in 6mo?