What to Expect From Dental Implant Treatment

By Brian J. Gray, DDS, MAGD, FICOI

Dental implant treatment requires a "team approach," with the surgeon that is going to place the implant and the restorative dentist who is going to place the crown on the implant working together. The key to a successful dental implant restoration is the development of a comprehensive treatment plan that considers the overall oral condition. Both the surgeon and restorative dentist must make sure that there is no uncontrolled infection in the mouth that could jeopardize the implant success. In addition, the entire dentition needs to be evaluated to design how the teeth are going to come together after treatment.

Planning dental implant treatment begins with the collection of diagnostic data. After reviewing your medical and dental history, the implant surgeon is going to need certain X-rays to plan the location and size of the implants. To start with, dental X-rays are helpful to see if you are a candidate for implants. If you are, your dentist may refer you for a DentaScan -- a CT scan of the jaw. This X-ray gives the surgeon a three-dimensional view of the jawbone and information about the width and location of the bone. By reviewing the DentaScan, the surgeon will be able to plan the size and location of the implants and whether bone grafting or other procedures will also be required. For better treatment planning, other measurements and molds of the teeth may also be needed.

Dental implant treatment is done in four stages:

  1. Dental implants can be placed at the dentist's office. The procedure is similar to other dental procedures in which the gum is numbed with local anesthesia. After numbing, the gum is pushed back to expose the bone. The bone is then prepared with a series of instruments to make it ready to fit the implant. After the implant is placed, the gum is placed back with sutures (stitches). Although all this sounds painful, with proper anesthesia, dental implant treatment is mostly painless. After the numbness wears off, you can expect some mild discomfort that can be controlled with commonly available over-the-counter medications such as ibuprofen or acetaminophen. The dental surgeon will remove the stitches a week later and may see you for a few evaluations after that.

    After the surgical placement of the dental implants, the bone needs to heal and bond to the implants. During the time that implants are healing, they are under the gum and you may not be able to see them. Traditionally, six months of healing is allowed for the upper jaw (where the bone is softer) and four months on the lower jaw. Recent developments have allowed a shorter healing time, which is dependent on very specific criteria that need to be evaluated by the implant surgeon and restorative dentist.

  2. Once the implants have healed and bonded to the bone, a second surgery may be required to expose them. Again, the gum needs to be numbed with local anesthesia and pushed back. The implant can then be exposed and a connecting piece (abutment) placed on top. A few stitches that can be removed a week later may be required after this procedure.

  3. The third phase of implant treatment involves the construction of the crowns, bridges, or dentures that will be fitted to the implant through the abutment. The restorative dentist will require several appointments to take impressions, fabricate temporary restorations, and fit the final replacement teeth.

  4. Poor oral hygiene can jeopardize implant success. Although implants don't get cavities, they are susceptible to peri-implantitis, an infection of the supporting bone that can lead to bone loss and eventual implant failure. Meticulous oral hygiene, periodic exams, and professional cleanings around implants are just as important as around teeth.

The success of implant treatment is dependent on the expertise of the dental team and the patient's ability to control plaque. With proper implant design and follow-up maintenance, you can enjoy the benefits of dental implant treatment for a lifetime. They can look and feel like natural teeth, adding comfort and improving the smile of people of all ages.