Lost a tooth? What to know about dental implants

Cut-paper illustration of a row of three teeth, illustrating how a dental implant looks on the surface and the internal anatomy of a screw inserted into the gum and the abutment that connects the screw to the implant.

If you've recently lost a tooth, whether to an accident, tooth decay, periodontal disease, or another reason, a dental implant may be a solution to replace your missing tooth.

What are dental implants?

A dental implant is a medical device designed to replace a tooth that has been lost due to injury, genetic predisposition, or dental disease. Unlike dentures, which sit on top of the gums and can be removed, implants are permanent.

Dental implants consist of three parts: a titanium screw (the implant) that is surgically placed into the jawbone to replace the root of the tooth; a small connector (called an abutment) that attaches to the implant above the gumline; and a crown (an artificial tooth) that is placed over the abutment. Surgery is required to insert the titanium screw into the jawbone.

Who can benefit from a dental implant?

Anyone who has lost one or more teeth may benefit from a dental implant. Common causes of tooth loss include:

periodontal disease
injury or accident
smoking
poor nutrition
aging
chronic diseases such as diabetes, COPD, and rheumatoid arthritis
genetic predisposition.

Who is not a good candidate for dental implants?

You may not be a good candidate for a dental implant if you:

are a current smoker
have severe periodontal disease
have certain underlying medical conditions such as bleeding disorders, uncontrolled type 2 diabetes, immune deficiencies, some cardiovascular conditions, and certain bone diseases
are undergoing treatment, such as chemotherapy, which can interfere with the body's ability to heal
are taking a bisphosphonate drug to treat osteoporosis
are unable to maintain good oral hygiene.

Benefits of a dental implant

Missing teeth can cause problems with chewing. This, in turn, can lead to nutritional deficiencies. Missing teeth can also cause trouble with speech, and can lead to worsening oral health problems. In addition, people without a full set of teeth may feel self-conscious about their appearance.

Dental implants can help by:

restoring the ability to chew
preventing bone loss in the jawbone
improving gum health and oral health
stabilizing surrounding teeth
improving cosmetic appearance.

Together, these benefits can help to improve overall health.

The dental implant procedure: What to expect

There are several steps involved in the dental implant procedure. The entire process — from the surgical insertion of the implanted screw to the placement of the crown — can take several months. The timing of the steps in this process varies from person to person.

Here's what to expect:

On the day that your implant is placed you will receive local anesthesia to numb the area, and possibly intravenous (IV) sedation as well. Your dental surgeon will drill a hole into the jaw where the replacement tooth will be set. The titanium screw is inserted into this hole, and the gum tissue is stitched around or over a temporary cap placed over the implant. This is an outpatient procedure, so you will be able to go home the same day.
Over the course of several months, the bone around the implant will grow naturally and fuse with the implant to hold it in place. This process is known as osseointegration.
The dentist will take a mold for the crown.
Once the implant is secure, the dentist will replace the temporary cap with an abutment and attach the custom-made crown to the abutment.

Some people may not have enough natural bone left in their jaw to support an implant. This may be due to a number of reasons, including gum disease, genetics, and aging. In this case, a bone graft may be necessary to replace the lost bone before an implant can be inserted. A bone graft is a surgical procedure in which damaged or diseased bone is replaced with new bone. Bone grafts can be harvested from another bone in your body (your hip or chin, for example), from a human or animal donor, or made from synthetic bone produced in a lab.

In some cases, the implant and bone graft can be completed on the same day. This is known as one-stage implant placement. Candidates for one-stage implant placement must have very good bone density in the jawbone.

Caring for dental implants

Caring for an implant is the same as caring for the rest of your teeth and gums. That means brushing your teeth twice a day, flossing regularly, and visiting your dentist on a regular basis.

While dental implants are not prone to decay, the tissue that surrounds the implant is just as susceptible to periodontal disease as the gums around your natural teeth. Your dental team may recommend special brushes that will help clean around your implants, depending on the design of your crowns.