When a tooth is lost, the decision may be made to replace it. The choice will depend on whether the loss of the tooth affects the way you function (such as eating and speaking) or the way you look (for example a tooth at the very front of your mouth). Even the way in which the tooth is lost may be relevant; a traumatically avulsed (knocked out) tooth may be best managed by an immediate implant whereas one lost through advanced periodontal (gum) disease would not.
Not every lost tooth needs to be replaced and there are risks associated with the replacement options. One fixed option for some patients is a dental implant. Not everyone is suitable to have a dental implant, therefore a detailed examination is required to work out whether you are able to have one. Some medical conditions and medications will prevent you having a dental implant. Smoking or active gum disease are relative contraindications as the process is less likely to be successful.
Dental implants are metal posts which are screwed in to the jaw bone, they then normally have a false tooth on top of them which can be seen inside the mouth. They are usually made of titanium and sometimes have a coating to improve the way they heal in to the jaw bone. The surgeon will choose the right shape and style of implant to fit the space where it is being inserted before starting the treatment.
Local anaesthetic is used to make the area completely numb before starting. There will be strange sounds and feelings during the treatment, but it shouldn’t be painful.
Normally, a small cut in the gum is made to move it out of the way, to prevent it from tearing. Then, a screw is drilled in to the jaw bone. This forms the new tooth ‘root’. The gum will be stitched back over and left to heal. A few months later, a false tooth can be put on top of the implant screw. In some circumstances the false tooth will be added immediately, other times the healing period is delayed. This is a complex decision in some situations and your surgeon will make this decision with you. Implants can still get infected (peri-implantitis), in the same way as a real tooth, therefore they must be kept extremely clean and regular dental assessments are recommended for maintenance.
Next section: Dental implants