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Dental Implants

Dental Implants FAQs

Should an infected tooth be repaired, or should it be removed and replaced with a dental implant?

Our patients often ask us this question. Our answer to them is the same one we will give you here: It depends on the patient. Let us explain…

Many things can cause a person to lose a tooth. Some reasons include decay, bone loss, infection, abscess, fracture (of the crown and/or root), failing root canal, and impaction, to name a few.

One of the main goals a periodontist should have for his or her patients is to save existing teeth whenever possible. If a tooth can be saved, we believe it is imperative to do so. When saving a tooth is a possibility, but the potential success rate is low, the periodontist and the patient should discuss the options. With today’s technology, dental implant success rates are 90 to 95 percent at the 10-year mark. This success rate is making dental implants a very popular treatment choice.

What happens if I elect not to replace a tooth with an implant?

Once a tooth is removed, a series of events begins to take place. The body starts the process of forming new bone and gum tissue. As discussed previously, if bone grafting is placed in the extraction socket, this helps build a foundation for a future implant. If no grafting is placed, the jawbone begins to atrophy or shrink. A dental implant acts as a tooth root that supports the jawbone, and it also helps support adjacent teeth, preventing bone loss on each side of the implant.

Teeth can begin to shift as a result of not replacing a tooth with an implant. At times, the teeth behind and above the missing tooth drift into the space once occupied by a tooth. This can cause crowding of the teeth, and it changes the way a person bites.

How many implants do I need if I am missing several teeth?

A good rule of thumb is to place one implant per missing tooth. In some instances, two implants can be used as an anchor for a fixed bridge. The patient and the doctor should discuss all options on a case-by-case basis.

If a patient is missing all of his or her teeth, the periodontist should be able to recommend several options. The first question to ask is whether the patient would like a permanent, or fixed, restoration or something that is removable. This is the most important question to ask initially, because more implants are needed to support a fixed restoration versus a removable restoration.

Who benefits from having implants?

  1. Current denture wearers who are fed up with the problems that can be associated with wearing dentures such as:
    • constantly using cream or powder to keep them in place;
    • pain associated with chewing and talking; and
    • possibility of being publicly humiliated if teeth fall out during eating or talking.
  2. Patients who need to have teeth removed due to bone loss.
  3. Patients who need to have teeth removed due to decay or fractures.
  4. Accident or sports injury victims.
  5. Those with otherwise perfect teeth except for one or two missing teeth.

Can I have dental implants if I have/had gum disease?

Even though the goal of every periodontist is to save a person’s teeth, occasionally teeth have to be removed due to bone loss and mobility. If this happens, the teeth can be replaced as long as the gum disease is under control.

For patients who have recently had gum disease treatment, it is wise to wait at least six months before considering replacing teeth with dental implants around previously diseased teeth. The reason is that it can take up to six months before the gum tissue and bone are fully healed and the periodontist can reevaluate them to determine if the disease is under control. We know this may sound confusing, so let us walk you through a typical example:

John is referred to a periodontist to evaluate his gum disease that was recently diagnosed by his general dentist. After a thorough examination, the treatment plan is presented and accepted. John requires the removal of six teeth along with treatment of all of his remaining teeth for gum disease.

After active treatment of his gum disease, John goes to his periodontist’s hygienist for regular cleanings at three- and six-month intervals. During the six-month cleaning, his entire mouth is re-probed (rechecked) for resolution of the gum disease. Dental implants can be considered once this six-month checkup is performed and the gum disease is under control.


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