What are dental implants?
Dental implants are titanium post and/or screws for attaching artificial replacement teeth firmly to the bone. Dental implants act as a replacement for the roots of your teeth. Implants can be used to support a single crown or as anchors for fixed bridges. They are biocompatible substitutes for lost natural teeth, which means that there is no body reaction to the implants. Your immune system will not recognize the implants in your mouth and will not reject them.

Is everyone a candidate for implant treatment?
In general, anyone healthy enough to undergo routine tooth extraction or oral surgery is probably able to receive an implant. There are some health conditions that warrant special consideration. Certain chronic diseases or alcohol abuse may complicate implant treatment. Heavy smoking also has a very detrimental effect on implant treatment. Nicotine has significant effects on the success rate of the treatment, since it causes severe deterioration of the bone around the implant. Another important factor is the amount of available bone to anchor an implant. You should have enough bone volume to support a proper size implant. After careful evaluation of your health history, we will alert you to any conditions that may effect your treatment.

How can dental implants help me?
Dental Implants may offer solutions for the patient who:

• Cannot chew comfortably and efficiently with conventional dentures
• Has lost teeth and doesn't want removable partial dentures
• Has lost a single tooth and wants a single tooth implants rather than a bridge
• Is now wearing a partial or full denture, and would prefer a fixed bridge or fixed-removable appliance
  

What do dental implants offer over conventional dental treatment?

• Maintain healthy natural teeth: To replace a missing tooth by fabricating a bridge, the dentist must shave or file down your natural teeth in the front and back of the missing space. The dentist then cements the bridge over these two teeth. Now, instead of only taking care of the missing tooth, two other healthy teeth have now been irreversibly damaged. Dental implants, on the other hand, do not have a negative effect on any of your natural teeth.
  
  
• Increase chewing efficiency: A patient with all teeth in place will have 100 percent chewing efficiency. If the very same patient lost all of his or her teeth and was provided with a properly fitted upper and lower denture on an adequate ridge, the chewing efficiency would only be between fifteen and eighteen percent. With an implant supported fixed Prosthesis that same person may recover around 85 percent of his or her original chewing efficiency.
  
  
• Prevent bone resorption:
  There is a strong relationship between teeth in function and preservation of alveolar (jaw) bone. If a person maintains his or her teeth well periodontally and is free of any systemic diseases, the alveolar- or ridge bone will be maintained as a response to the load it is subjected to during normal function (chewing). However, when teeth are lost, the alveolar bone will undergo atrophy in the areas where teeth are missing as a response to the lack of direct load. Again, a Bridge will only supply a marginal amount of load to the underlying bone and even less so a Removable Partial Denture or a Full Denture. An implant, on the other hand, will transfer the chewing force directly to the surrounding bone and maintain its volume
  
  
• Maintain healthy teeth:
  Even in some single tooth situations an implant can offer advantages. If teeth adjacent to a toothless area are perfectly healthy and have no fillings, it would be to the patient's advantage to leave them unprepared and deal with the replacement prosthesis as a separate unit, instead of a Bridge, which requires the two adjacent teeth to be shaven down for. Furthermore, especially in the front part of the mouth (the Smile Line), a single tooth implant restoration may offer better long term esthetics, due to the prevention of bone resorption .
  

Are implants always successful?
Modern implant techniques have been in use since the 1960's. Improvements in procedures and materials have given implants a ten year average success rate of 93 percent or better. This enviable success rate is improving every year!

What causes failure of dental implants?
Circumstances that may result in the failure of implants are: local conditions, systemic conditions, and structural overload.

• Local Problems: Bacteria can accumulate around a dental implant just as it can around a tooth. Bacteria can cause inflammation and infection of the gum and bone tissue. This can proceed to bone loss and loss of the implant. For long term success, implants must be kept meticulously clean. Other local damage can result from improper use of cleaning Instruments, grinding of the teeth, smoking, and/or excess use of alcohol.
  
  
• Systemic Problems: Diabetes, metabolic bone disease, steroid therapy, HIV, problems with absorption of nutrients are but a few of the medical problems that may influence the success of implants. Any condition which prevents the body from repairing bone or other supporting tissue can result in the eventual loss of bone and gum support for the implant. Conditions such as osteoporosis, collagen diseases, drug use and addiction, or any debilitating disease can prevent the body from repairing itself. This does not necessarily mean that implants should not be used. Discussion with your physician is sometimes needed to determine whether any medical problems would prohibit implant treatment.
  
  
• Overloading: When the chewing forces which are being applied to the implant(s) are beyond physiological limits. For example, if a very large tooth with a long crown is being supported by a short implant, or a very large prosthesis is supported by an inadequate number of implants.
  

Can failed implants be replaced?
In the unlikely event an implant fails it can usually be replaced by another.

What are the chances of rejection?
The body does not reject a titanium or ceramic dental implant as it might a heart, lung or kidney. . Implants are biocompatible substitutes for lost natural teeth, which means that there is no body reaction to the implants. Your immune system will not recognize the implants in your mouth and will not reject them.

How long will my implants last?
Some implants are still functioning successfully after 25 years. For patients who have a history of trouble with their mouths and whose bone physiology around their roots have been a problem, the prognosis would be less optimistic than for patients who have had fewer dental health problems. Also, if there are many natural teeth remaining, the expected longevity of an implant is greater than if all the teeth are missing. As with any artificial replacement in the human body. no promises or guarantees can be made as to longevity of the implant or of the implant supported appliance.

IT IS IMPOSSIBLE TO KNOW HOW LONG ANY PARTICULAR IMPLANT WILL LAST AND THEREFORE IT IS IMPOSSIBLE TO PREDICT OR GUARANTEE SUCCESS

Who makes up the implant "team"?
The implant team is made up of the Oral and Maxillofacial Surgeon or Periodontist, Prosthodontist(Specialist in prosthetic dentistry) and the Laboratory Technician.

A Prosthodontist is a dentist who specializes in restoring natural looking teeth as well and creating and placing natural-looking substitute or prosthetic teeth.

Will I need to be hospitalized?
Most implant procedures are performed in the dental office under local anesthesia. However, some patients may desire pre-medication or IV sedation to control apprehension. Hospitalization may be necessary for complex surgical procedures or general health reasons.

Is there pain or discomfort?
Many patients report implant surgery less troublesome than having an impacted wisdom tooth removed. With modern anesthesia and close attention to post operative care you can expect minimal discomfort.

How long does complete treatment take?
Depending of the type of implant, the location of the implant and the selected prosthesis, the total time can be as little as three months to six or more months. If bone grafting is necessary, further time may be needed. We will discuss your options with you and advise you of the time requirements.

Will I be without replacement teeth at any time?
Immediately following surgery you may be instructed not to wear replacement teeth in the surgical area. If required, this period is usually short, and temporary teeth are soon provided so you can quickly "get on" with your life. However if your professional or social life style doesn't permit this there are techniques which can be utilized to provide you with a transitional prosthesis same day of the surgery.

Will others know I have dental implants?
Today's implant treatment enables you to have your new teeth look, feel like your own. Even though others will be unaware you have dental implants, many patients are so pleased, they tell everyone they know. Dental implants offer some of the finest restorative results possible in modern dentistry.

Will my implant teeth function as well as my original teeth?
Nothing will function as well as natural teeth. However, implants function better than removable teeth. In most cases patients can eat without being aware of the implants. Most patients are happier with fixed teeth, a single tooth, or dentures that are supported by implants

What about the cost of dental implants?
The cost of implant treatment depends upon the number and type of implants placed and the type of prosthesis needed. Implant procedures, which vary in complexity and extent, depending on the patient's dental condition and requirements, can involve a significant investment. A survey of 350 patients after completion of their implant treatment revealed that not only was it worth the investment, but they would happily do it again.
Oral rehabilitation involving dental implants is generally considered an expensive procedure, especially as the number of implants increases. However, the benefit of having chewing efficiency restored, preserving alveolar bone and not having to prepare sometimes-healthy teeth for a Bridge should be well worth the expense.

Are implants covered by insurance?
Generally, the great majority of dental or medical insurances do not cover oral implants yet, although there are isolated insurances that cover certain modalities of implant reconstruction. Sometimes, certain medical insurances cover a portion of the surgical cost.
One has to understand, however, that most insurance companies do not necessarily look out for the patient's best interest, but rather try to restore the patient's health in an acceptable manner at an acceptable cost. Now this terminology may be very vague, but it usually results in no coverage for state-of-the-art medicine or dentistry. The annual insurance benefit amount or whether procedures are fully covered or not is very poor motivating factor for restoring one's health. Our health is the only precious thing we have and should deserve nothing less than the best that medical and dental sciences have to offer.

Is age a deterrent to implant treatment?
Age is not a deterrent to implant treatment. Health is the determining factor. Many people seventy and eighty years of age are better surgical candidates than someone who is years younger with physical or systemic complications. There is really no preferred age for a hip replacement or a coronary artery bypass, and the same goes for implant surgery. As long as a person is in good health and is important to someone, including him- or herself, one should strive to improve the quality of one's life.

Are there problems associated with smoking?
Smoking is extremely harmful to all oral tissues, especially when implants are present. Heat from smoking is retained in the metal. Irritants from smoking also effect the normal healing of the gum and bone tissues of the mouth. Smoking robs the bone and other tissues of vital nutrients and minerals needed for healing and maintaining the healthy bone connection to the implant. Smoking also decreases blood supply and oxygen to the gums and bone tissues that are next to the implant. To help keep the supporting bone and gum tissues healthy and able to resist infection, the implant patient should not smoke.

What kind of follow-up care is needed?

• Good oral hygiene: Your implants can fail for the same reasons that your natural teeth are lost. Poor oral hygiene is the greatest cause of implant failure. The build-up of dental plaque and debris around teeth and implants cause an increased concentration of bacteria and the destructive consequences of inflammation and infection. This will lead to swollen gums and loss of bone that is needed to support the implant. Excellent oral hygiene is necessary and vital to long-term success of the implant-supported crown, bridge, fixed or removable dental appliances.
  
  
• Frequent visits to our office: Frequent check ups are an important part of your commitment to success of your implant procedure. We will instruct you in the proper use of toothbrush and other oral hygiene aids. In the morning and before bedtime, you must brush and clean around the implants and the supported appliance. We need to clean around the implant(s) and also check the health of the supporting bone tissues by examination and x-rays every six months.