Modern dental implants not only help you maintain your normal chewing ability and speech patterns after you have lost a tooth or teeth — they also keep you looking younger. How do they do this? Read on.

Do lost teeth cause tooth-supporting bone to “melt” away? Yes. Of course, the bone does not actually melt. Bone is a living tissue, and under normal conditions it constantly dissolves and rebuilds. Stimulation by the small stresses from the contact of upper and lower teeth — something that normally happens hundreds of times each day — keeps these two forces in balance. When a tooth is missing, the bone that normally surrounds and supports the tooth (called alveolar bone) no longer receives the stimulation that causes it to rebuild, and it begins to diminish over time.

What happens if you don't replace missing teeth? The first year after a tooth is lost, the width of the bone that once surrounded the tooth decreases by 25 percent. Over the years, gradually increasing bone loss results in sunken cheeks and lips, making you look older. Gum tissue also decreases, affecting your ability to chew and speak.

What happens if you lose all your teeth? For people who have lost all their teeth, called edentulous, the effects are severe. After the alveolar bone is lost, the bone beneath it, called basal bone, also begins to be resorbed, eventually causing the lower part of the face to partially collapse.

Do partial or full dentures prevent bone loss? Unfortunately, just the contrary is true. A removable denture pressing on a person's gum increases bone loss because the pressures from biting are not transferred into the internal structure of the bone but instead are compressive, which damages the bone over time. This is why dentures begin to fit poorly after they have been worn for a while. This problem can be reduced by anchoring dentures with strategically placed dental implants.

What is a dental implant? A dental implant is a tooth-root replacement that is made of titanium. This metal is able to osseointegrate, or fuse with the bone. For a single tooth replacement, a crown that looks and functions like natural tooth is attached to the titanium implant. As mentioned above, implants can also be used to anchor dentures.

Does an implant prevent bone loss? Yes. When dental implants fuse to the jaw bone, they stabilize the bone. They also provide tooth-to-tooth stimulation that was formerly supplied by the natural tooth.

How long do dental implants last? Dental implants have been shown to last at least 10 years. For most people, implants will last the rest of their lives.

Contact us today to schedule an appointment to discuss your questions about tooth loss and dental implants. You can also learn more by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

The best method for permanently replacing a missing tooth is with a dental implant. But did you know that there are two main techniques for placing implants? Implants can be placed either using a one stage or a two stage surgical technique, and as their names suggests, one is performed in one step while the other requires a second surgery.

With a one-stage procedure, a healing abutment is placed at the time of surgery. An abutment is a connector that attaches the implant from the bone into the mouth and which protrudes through the gum tissues. Following a 3 to 6 month healing period in which the implant fuses to the bone, a crown is then placed on the implant restoring the immediate appearance of a healthy, normal tooth. One-stage implant systems are generally used when the bone quality is good, guaranteeing good initial implant stability. They are also used when cosmetics is not a concern, such as the back areas of the mouth.

Under special conditions an implant can be placed and a crown placed on top of it at the same time. However, this is a very special circumstance requiring ideal conditions and surgical experience as well as crown fabrication know-how. It is generally safer and wiser not to subject an implant to biting forces until it is fully healed and integrated with the supporting bone.

A two-stage procedure is typically used for replacing teeth where there is no immediate need for a cosmetic solution and when more of a margin of safety is required. With this approach, the implant(s) are placed into the jawbone and the gum tissues cover them. They are not exposed to the mouth, but stay buried and left to heal. Once healed, a second surgery is performed to attach an abutment for securing the crown in place. This approach is used when there is poorer bone quality or quantity. This may make it necessary to regenerate bone around the implant at the time of its placement. There may also be other health considerations dictating that a two-stage approach may be indicated.

Depending on your individual situation and medical status, our implant team will determine which approach is best for you. To learn more about these two procedures, read the Dear Doctor article, “Staging Surgery In Implant Dentistry.” You are also welcome to contact us to discuss your questions or to schedule an appointment.

FAQs About This New and Miraculous Procedure

How can sinus surgery contribute to the replacement of missing back teeth with dental implants?
Dental implants must be anchored the in bone to be successful. Maxillary sinus surgery can help regenerate bone that has been lost and is critically needed to anchor dental implants.

What are the maxillary air sinuses?
Inside the upper jaw, or “maxilla,” are structures known as the maxillary air sinuses, one on either side of the upper jaw. Each sinus is an air-filled space lined by a membrane. Upper back teeth are normally encased in the bone of the maxilla, below the sinuses.

Why is it important to replace missing back teeth?
Replacing back teeth restores the ability to eat, chew, and talk properly. The back teeth also provide facial and cheek support.

Why use dental implants?
Dental implants are the state-of-the-art method for replacing missing teeth.

Why does bone loss occur?
Unless special precautions are taken to prevent it, when teeth are lost, the bone supporting them is also lost.

If there is insufficient bone to anchor dental implants, what are the alternatives?
If all the back teeth are lost and dental implants cannot be placed, removable upper dentures may be the only alternative.

How do you determine whether a sinus surgical procedure is necessary?
The size, shape, and remaining bone of the maxillary sinuses influence whether you can have dental implants with or without a sinus surgical procedure.

How does surgery grow bone?
A small window is created in the sinus wall above where implants need to be placed. The sinus membrane is lifted and the space thus created filled with bone grafting and biologically active bone generating materials. The window is then closed and simply heals.

How is the surgery done?
The surgical procedures are performed from inside the mouth in the area just above the missing back teeth. They are generally carried out under local anesthesia (small shots, just like for a filling), sometimes with the addition of sedation or anti-anxiety medication.

How do bone grafts work?
Bone grafts act as scaffolds that the body replaces with its own bone. The most well researched bone substitute grafting material is currently bovine (cow) bone. All grafting materials are approved by the Food and Drug Administration. They are specially treated to render them completely sterile, non-contagious, and free of rejection factors.

What can I expect after surgery?
Moderate swelling and discomfort after surgery generally lasts for a few days to a week, about the same as having an upper impacted wisdom tooth removed. Supportive treatment usually includes a course of antibiotics to prevent infection and prescription strength medication of the aspirin or ibuprofen type. A decongestant may also be prescribed, if necessary. Healing is generally uneventful.

Who performs this surgery?
Maxillary sinus augmentations are usually carried out by oral surgeons, periodontists, or appropriately trained general dentists. Proper assessment of your situation and diagnosis are critical pre-requisites to the right procedure.

If you are missing upper back teeth, contact us today to schedule an appointment and discuss maxillary sinus augmentation. You can also learn more about this procedure by reading the Dear Doctor magazine article “Sinus Surgery: Creating Bone for Dental Implants out of Thin Air.”

There's a lot to like about dental implants, today's state-of-the-art tooth-replacement system. We consider them the best choice for replacing missing teeth because implants are:

Healthy
You may not realize this, but when a tooth is missing, the bone underneath it begins to melt away. That's because bone needs constant stimulation to rebuild itself and stay healthy, and it receives this stimulation from teeth. It's a delicate balance that's disrupted by the loss of even one tooth. Because implants are made of biocompatible titanium, they actually fuse to the bone and prevent bone loss.

Strong
The fusion of implant to bone is an extremely solid connection. Not only does it offer a strong replacement for a missing tooth, but it can also offer support to other tooth-replacement methods such as fixed bridges or dentures. By themselves, these other methods would not preserve bone and might even hasten its loss in the case of dentures. But with implants, bone-loss is prevented — as is embarrassing and uncomfortable slippage of dentures.

Aesthetically Pleasing
When you receive your implant, it is left alone for a few months to complete the fusion process described above. Then it is topped with a crown made of a realistic tooth-like material. The result is so convincing as a tooth replacement, only you and your dentist may be able to tell it's not a natural tooth.

Long-Lasting
Dental implants have an amazing success rate — over 97%. And once they fuse to the jawbone, they should never need replacement. In fact, they will likely outlast the crowns to which they are attached, but this is not a problem. Implant crowns are precision components that detach for easy replacement, should the need arise.

Economical
Implants have a higher initial cost than other forms of tooth replacement, but when you consider how long they last, they are very economical. Consider it an investment in your health, appearance and self-confidence.

If you have any questions about dental implants, contact us today to schedule an appointment for an implant consultation.

You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

Dental implants are in much demand when it comes to replacing missing teeth. And although they have long-term success rates of well over 95% when properly placed, the dental profession's current rule-of-thumb is to not use them as a treatment option for teenagers because jaw and facial growth are not complete.

As with most things in life, timing can be everything. However, having missing teeth as a teen can contribute to significant loss of self-esteem and psychological issues. All this means is that we must review each patient's needs on a case-by-case basis so that we can determine the optimal time to place implants while maintaining your teen's self-esteem. However, the good news is that there are some temporary tooth replacements available until the timing is right for implants.

Unlike natural teeth, which move and change position along with normal growth and jaw development, implants don't. Because implants replace tooth roots by fusing with the jawbone, their position is fixed. If placed before normal jaw growth and maturity are complete, they appear to sink as the jaws grow and leave them behind!

Given the above details, you can clearly see why it is critical for jaw and facial growth to be complete prior to placing a dental implant. To determine this timeline, we will work with our dental team, which include orthodontists (specialist in the study of the growth, development and moving teeth into the right positions). Working together, we will best be able to assess when the time is right to plan and place dental implants — usually around late teens.

To learn more on this subject, continue reading the Dear Doctor magazine article “Teenagers & Dental Implants.” You can also contact us today to schedule an appointment for your teenager or to discuss your questions about dental implants or other treatment options.