Dental implants are not a new idea: Egyptian mummies have been found with gold-wire implants in their jawbones. Because of improved dental treatments and the fluoridation of water, most Americans under 50 are in less danger of losing teeth than any previous generation. But many older Americans have lost some or all of their teeth. If you’re among them, implants are often a good permanent alternative to bridges or dentures, but at a price.
A modern implant consists of a titanium screw surgically implanted into the jawbone and used as an anchor for a crown, bridge, or full or partial denture. It replaces the roots of a missing tooth. The first step is to get a careful evaluation, usually from your regular dentist. Age is no barrier, but you do need to have healthy gums with adequate bone to support the implant and be in good enough overall health to cope with the oral surgery and heal properly (thus smokers and people with poorly controlled diabetes are poor candidates). Though some regular dentists do implant surgery, it’s best to get a referral to a specialist—a prosthodontist, oral surgeon, or periodontist.
The procedure is usually done in two stages. Shortly after the diseased or damaged tooth has been extracted, the metal implant is surgically inserted into the jawbone and the gum surface closed with sutures. Three to six months later, after the jawbone has fused to the implant, a metal post (abutment) is screwed into the implant so that it projects from the gums. Onto this, your dentist can mold and attach a permanent crown or bridge or else anchor a denture.
There are also one-stage implant procedures, sometimes advertised as “teeth in a day” implants. With these newer procedures, the implant, abutment, and temporary crown (or smaller “healing cap”) are inserted in a single day; you get a permanent crown about three months later, after the bone has fused to the implant. Such procedures have less of a track record and may increase the risk of implant failure. Many experts believe that two-stage implants are superior in terms of long-term success, but some studies have found that one-stage implants can be just as successful when bone quality is good, at least in the lower jaw.
Facts and advice about dental implants
- Implants usually last a lifetime; failure rates are less than 5 percent. Implants in the upper jaw fail more often because the bone there is less dense. If you’ve had bone loss in your jaw, you may need a bone graft or bone regeneration membrane. If bone doesn’t heal securely around the implant or subsequently weakens, the device can loosen and fail.
- Implants are expensive, usually $2,000 to $4,000 for a single tooth, depending on where you live, not counting the crown. Dental insurance typically covers little or none of the cost. Full upper or lower jaw implants can cost $25,000 to $50,000 or more. You might want to compare implants with bridges and dentures in terms of cost, comfort, and durability. Implants almost always win in the last two criteria.
- Be sure the practitioner you choose is experienced. Don’t hesitate to ask about training, how long he or she has been doing implants, and what will be involved.
- Once you have an implant, daily brushing and flossing are a must, as are regular professional cleanings and exams. Tooth grinding may increase the risk that implants will fail. And here’s another reason not to smoke: It’s associated with higher failure rates.
Also see The Truth About Teeth Whitening.