Dental implants are an artificial replacement for a tooth’s root. They fit directly into your jawbone and hold crowns or false teeth in place, in the same way that roots support natural teeth.
If you look after your teeth and implants properly, they can last for the rest of your life.
About dental implant surgery
Dental implants are usually made of titanium and have an internal screw called an abutment that holds a false tooth (or teeth) in place.
A single dental implant can support one, or several, replacement teeth – you don’t need to have one implant per replacement tooth. How many you need will depend on how many teeth you need to replace and how strong your jawbone is in these areas. If you need to replace all your teeth, you’ll probably need to have at least six implants in your upper jaw, and between four and six in your lower jaw. It’s possible they can all be fitted in the same procedure. But your dentist will discuss this with you, and whether it’s best to do them in a few different sessions.
Deciding on dental implants
Dental implant surgery involves having at least one operation. You need to have healthy gums and your jawbone needs to be strong enough to hold the implants.
Some dentists won’t insert dental implants if you smoke, as it can affect how well the treatment works. Implants are also less likely to work if you’ve had radiotherapy. Some medical conditions, such as diabetes or osteoporosis, might affect how well implants work but more research is needed to know for sure. It’s possible that your dentist might not recommend you have implants if you have either of these conditions. Your dentist will let you know if implants are an option for you.
Your dentist will talk to you about what will happen before, during, and after the procedure, and any pain you might have. It’s really important that you understand what to expect so you can decide whether to go ahead. Your dentist should go through the risks as well as the benefits. Think about any questions you want to ask – maybe write them down in advance so you don’t forget. If you decide to go ahead with the procedure, you’ll be asked to sign a consent form so you need to know what’s involved.
It’s important that the dentist who does your procedure has training in placing implants. They should reach standards that have been approved by the General Dental Council. Don’t be afraid to ask your dentist how much experience they have.
What are the alternatives to dental implants?
Alternatives to dental implants include:
- removable dentures (false teeth) – plastic or metal frameworks that hold false teeth
- a bridge – false teeth that are fixed onto your adjacent natural teeth
Preparing for dental implant surgery
If you decide to go ahead with implants, you’ll probably be asked to have some X-rays. This is so your dentist can check the shape of your jawbone and where it’s best to place the implant. These will also show the position of other structures in your mouth, such as your nerves. You may need to have a CT scan if the X-rays don’t provide enough information.
Most people have dental implant surgery under local anaesthesia. This completely blocks pain from your mouth and you’ll stay awake during the procedure. You may also have a sedative – this relieves anxiety and helps you to relax. Alternatively, you may need to go into hospital and have treatment under general anaesthesia, which means you’ll be asleep during the procedure. But this is rare.
What happens during dental implant surgery?
How long your procedure will take will depend on how many implants you’re having and how complicated the procedure is. It’s possible to have several implants fitted in the same procedure, and this will naturally take longer. If you’re just having one implant fitted in an immediate implant procedure (see below), it should take about half an hour.
Fitting the implant
Once the anaesthetic has taken effect, your dentist will make a cut in your gum and drill a small hole in your jawbone. The implant will fit into this hole.
There are then a few options on what your dentist can do next.
- Option 1 – fitting immediately. If you’re having any teeth removed before dental implant surgery, your dentist may be able to put an implant straight into your tooth socket.
- Option 2 – fitting after a short period. If it isn’t possible to immediately place the implant, your dentist will fit the implant in a second procedure, after a few weeks.
- Option 3 – fitting after a longer period. Your dentist may fit a dental implant after several months, once your jawbone has had time to heal.
Fitting the abutment
Dental implants have an internal screw called an abutment that holds a false tooth (or teeth) in place. Your dentist can fit the implant and the abutment in one or two stages.
- In one-stage treatment, the implant rod and the abutment that attaches the implant to the false tooth, or teeth, are fitted at the same time.
- In two-stage treatment, the implant rod will be buried under your gum while your bone heals (you won’t see it in your mouth). You’ll have another operation a few months later to attach the abutment.
Attaching replacement teeth to the implant
Your dentist may attach artificial teeth on the same day that you have the implant. But you may need to wait between three and six months to allow your mouth to heal. During this time, you might need to have a temporary bridge or partial dentures so you can’t see the spaces between your teeth. If you usually wear complete dentures, they can be adjusted so that you can wear them during this healing period.
After your mouth has healed, you’ll have another operation to uncover your gum over the top of the implant. Your dentist will then fit your artificial tooth or teeth onto the implant. The teeth may be fixed in place or you may be able to remove them when you need to clean them. Your dentist will make sure that they fit properly, match your other teeth and feel comfortable.
What to expect afterwards
You may need to rest until the effects of the anaesthetic have passed. You can usually go home as soon as you feel ready.
After a local anaesthetic it may take several hours before the feeling comes back into your mouth. You may need to take some pain relief medicines to help with any discomfort as the anaesthetic wears off.
If you have had a general anaesthetic or a sedative, make sure someone can take you home. And ask someone to stay with you for a day or so while it wears off. Having a general anaesthetic or sedative can really take it out of you. You might find that you’re not so coordinated or that it’s difficult to think clearly. This should pass within 24 hours. In the meantime, don’t drive, drink alcohol, operate machinery or sign anything important.
Only eat soft foods for the first week after having dental implant surgery. Be careful if you have any hot food or drinks. It’s probably best to wait until the feeling has returned to your mouth, otherwise you might burn yourself without realising.
It’s really important to keep your mouth clean by brushing and flossing as usual. You might need to use special brushes that make it easier to clean between your teeth.
Recovering from dental implant surgery
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or dentist for advice.
Your dentist may prescribe you antibiotics and an antiseptic mouthwash to reduce the risk of your implant getting infected. Or they might ask you to start taking the antibiotics an hour before you have dental implant surgery.
You’ll need to see your dentist more often after surgery so they can check your progress. The time it takes to make a full recovery from dental implant surgery will vary depending on your treatment plan. Follow your dentist’s advice about what to do during this time.
Once you have made a full recovery, your implants and replacement teeth should work the same as natural teeth. You should be able to eat as normal. It’s really important to brush and floss your teeth at least twice a day to keep them healthy. Go and see your dentist and hygienist regularly. See our FAQ below on caring for dental implants for more information.
If you damage one of the teeth attached to an implant, your dentist can probably remove it and put in a replacement. If the implant itself is damaged, it may be possible to repair it too. If your dentist can’t repair the implant, they will place another one alongside it.
Side-effects of dental implant surgery
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.
You may have some swelling and discomfort around the implant area. You can take an over-the-counter painkiller such as paracetamol or ibuprofen to help with this. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist or dentist for advice.
Complications of dental implant surgery
Complications are when problems occur during or after the procedure. The possible complications of any procedure include an unexpected reaction to the anaesthetic or excessive bleeding.
One potential complication of dental implant surgery involves the nerve that runs to your face, which has branches in your lower jaw. These branches supply the feeling to your lower jaw, lower teeth and gums and your bottom lip. If these nerves are damaged by the implant, you may feel temporary or sometimes permanent tingling or numbness. It may also be painful. You’ll usually have X-rays and CT scans before the procedure to help your dentist see the position of these nerves in your jawbone. This should minimise this risk.
It’s possible your jawbone won’t fuse with the implant properly and the implant can become loose. This isn’t usually painful, but the implant then won’t be able to support false teeth. You may need to have another implant fitted. Your dentist will ask you to attend regular check-ups to make sure your implants are still secure.
FAQ: How do I care for my dental implants?
Good oral hygiene is vital to make sure that your implants last as long as possible. Clean and floss your teeth and gums (including your replacement teeth) every day. You may need special floss or interdental toothbrushes – ask your dentist for advice on caring for your implants.
Although it may take longer to brush your teeth with implants, it’s worth putting the time in. Dental implants can last for your lifetime if you care for them properly. If you don’t clean them every day, they may develop calculus and plaque. This can lead to a gum infection or bleeding and can feel sore, just as would happen with natural teeth. The tissues that support the implant will gradually be destroyed and the implant may fall out.
It’s also important to visit your dentist and dental hygienist regularly. Your dentist may ask to see you more often for the first few months after you have implants to check there aren’t any problems. Your dental care will then be the same as for natural teeth.
FAQ: How long will dental implant treatment take?
Dental implant surgery can take several months to complete. This is because your dentist may want to allow your gums to heal after the first procedure before they carry out the second.
After fitting the implants, your dentist may advise you to wait between anything from three months to a year before having false teeth attached. This is to allow time for your mouth to heal. They will make sure your appearance isn’t affected too much and you can still eat and speak. Your dentist will let you know what your options are, one of which may be to wear temporary dentures.
There’s little scientific evidence to show whether implants are more successful when the false teeth are attached straight away or after a few months. Ask your dentist what’s best for you.
If your treatment is going to take longer than you had hoped, try to be patient. Your dentist will have planned your schedule carefully to try to make sure you have successful implants that last for as long as possible.
FAQ: I grind my teeth at night. Can I have dental implants?
Yes, you’ll probably be able to have dental implants but it depends on how severely you grind your teeth. Let your dentist know so they can account for this when they plan your treatment.
Grinding your teeth, which is called bruxism, is a very common habit. Yet most people do it while they’re asleep so don’t know they’re doing it. Your dentist will be able to pick up signs and symptoms of bruxism.
Grinding your teeth will put extra pressure on implants. Your dentist may recommend placing additional implants to support the artificial tooth or teeth. They will also use materials to make the false teeth that are strong enough to withstand the extra pressure.
Your dentist may also suggest you wear a removable mouthguard – or splint – at night. This is a cover made from hard or soft plastic that fits over your upper or lower teeth to reduce the pressure on your teeth.
FAQ: What is bone grafting and when can it be used?
Bone grafting is surgery to increase the amount of bone in your jaw. Having more bone will mean the dental implant is better supported.
For dental implants to be successful, there must be enough bone to hold and support the implant. There are many reasons why you may not have enough bone in your jaw. These include having gum disease or wearing dentures.
Bone grafting involves taking bone from somewhere else in your body and adding it to your jaw where the implant will go. It’s usually taken from another area of your jaw, but may also come from your hip or shin. Depending on where the bone is taken from, you may be able to have the procedure done under local anaesthesia. If it’s taken from your hip, you’ll need to go into hospital and have a general anaesthetic. Your dentist can also use artificial bone or materials made from the bone of animals if you prefer. But your own bone is usually considered the best method.
If you need to have a bone graft, your dental implant treatment will take longer. You’ll need to wait between three months and a year after your bone graft before you can have an implant fitted.