Complete & Partial Dental Implants FAQs

Q: I am a diabetic. Are implants a good idea? What are the pros and cons?

A: This is a common concern, since many patients suffer from diabetes. Being diabetic does not rule out getting them. However, there are things to consider. Fixed teeth do involve surgery, like teeth extraction, sinus lift, bone augmentation, or ridge re-shaping. In order for it to be fused  within the bone, the bone needs to be strong and possess enough mass to support it against all impacts like chewing. If the bone is deficient or unhealthy, it may not support osseo-integration, thus causing it to fail. Uncontrolled diabetes will cause the bones to become porous and fragile. In addition, healing of the surgical site will be slower or not possible at all. Long-lasting uncontrolled diabetes will cause the jaw bones to deteriorate.

If you are interested in getting them installed, Dr. Ahmed will be able to see if your jaw bone will support them with a thorough examination. Even with controlled diabetes, it is possible to get them even if the bone is deficient through grafting. The downside is that it may take longer to heal, and cost more if bone grafting is needed. There is also a possibility that the longevity may be affected. By comparing this against the, aesthetic superiority, ability to eat anything, and no need for special care, they have many other advantages.

Q: Can dental implants help fix an overbite?

A: Yes, and no, an overbite is the excessive overlap of the upper front teeth in relation to the lower front teeth. A small overbite is natural. But a severe overbite can cause continuous pain, temp or omandibular displacement (displacement of the jaw joint), or even permanent tooth loss in some cases. Sometimes dentists can fix a certain amount of overbite with a specific treatment plan for replacing missing teeth. This is because they are fixed in the jawbone, and hence, bone orientation can be modified slightly to make slightly improve your bite. Dr. Ahmed will be able to accurately determine whether new permanent teeth can fix your overbite and smile. If the overbite is too severe you need to consider an alternative treatment like braces or orthognathic surgery.

Q: What are the causes of dental implant failure?

A: In 95% of cases, the placement is successful. However, surgery is involved with getting these devices, and like all other surgical procedures there are risk factors. The main causes of failure are:

  • Failed Osseo-integration – A properly installed new tooth will usually fuse well with the jaw bone through a natural procedure called osseo-integration. Bones cells fuse into the face of the post, making a very strong natural bond. Possible causes for failure of osseo-integration are:
    • Lack of bone density or mass
    • Poor positioning
    • Overloading / sudden impact
    • Damage to surrounding tissues
    • Cracked/damaged post
    • Bad reaction to anesthesia
  • Peri-Implantitis – This an infection of the area around the prosthesis. If bacteria was present during surgery, proper hygiene following surgery is not practiced rigorously, it can cause peri-implantitis. It can also be caused if the cement from attaching the crowns to the abutments leaks out into the gum.
  • Nerve and Tissue Damage These cases are very rare, but can happen during surgery.
  • Foreign body rejection This does not occur with materials currently used, but may happen in very rare cases.
  • Allergic Reaction – Titanium is quite bio-compatible, but in extremely rare situations a patient may have an allergic reaction to titanium also.
  • Uncontrolled Type II diabetes may cause the device to fail.
  • Other factors are using bisphosphonates, bruxism, smoking, etc.

Q: What are dental implants made of?

A: They were initially made of pure titanium. However, the pure metal needed to be strengthened, and alloys were made with minor amounts of other metals such as nickel to improve strength and durability. A very small number of people are allergic to these alloys. A titanium post is composed of a specifically fabricated fixture that is screwed into the jawbone, which serves as the root of an artificial tooth. Once it has fully fused itself within the bone, a suitable prosthesis is then placed onto it, which works as the crown of the artificial tooth.

Q: Can older people over 60, 65, 70, also get dental implants?

A: Many people tend to lose teeth with old age. Tooth loss seriously limits a person’s quality of life, and aesthetics. Dentures have been the traditional solution however, they have serious limitations. New fixed teeth are a much better alternative when compared to upper or lower dentures and they are much more durable than a fixed bridge or a partial denture. These look much more natural, do not impose any limitations on what you eat, do not require removal for cleaning and at bedtime, and will not slip or fall off at the wrong moment.

Whether it is just one, multiple teeth, or a complete oral reconstruction, they are a wonderful option as permanent dentures. Before getting them, a patient must receive a thorough medical and dental check-up. The check-up will determine if they are a good solution for you. Chronic, uncontrolled diabetes, and other diseases which reduce the body’s immunity will generally be a factor against the procedure.

Getting new permanent tooth involves surgery, and recovery may be slowed due to reduced immunity. The check-up will determine if they will be a good solution for you. Chronic, uncontrolled diabetes, and other diseases which reduce the body’s immunity will generally be a factor against the surgery. The examination is also necessary in order to assess whether the jaw bone is of sufficient quality to support the new tooth under the expected chewing forces. If bone density is an issue, bone can be grafted although at an additional cost. In short, most ‘healthy’ seniors can get them to regain their quality of life, although the recovery period following the surgery may be relatively slow.

Q: I have lost a front upper tooth. Can it be replaced with an implant? Is it a difficult operation?

A: A permanent fixed tooth is a great solution for your problem. Front teeth, aside from strength, are essential for their aesthetic value. No other kind of tooth replacement can compete with an new permanent tooth. However, esthetic replacement of a front fixed tooth requires expertise and precision. Initially, the broken tooth needs to be removed completely, without damaging the surrounding bone and flesh. Any damage to the socket may cause the procedure to fail.  This is because the empty socket has to receive the titanium root and firmly retain it. The strength is obtained once the surrounding bone grows into the surface of the implant during a natural procedure known as osseo-integration (bone jointing). If there is a gap between the bone and the surface of the new root, osseo-integration will not complete properly, and it may fail.

A special problem with the front teeth is that the sockets are conical, therefore, the post of the exact size needs to be screwed in deep so that no gap is left around the new tooth. This requires precision and expertise. Getting one on a front tooth will provide you with a permanent, problem free restoration with very desirable aesthetic characteristics. You only need to allow time for proper osseo-integration before loading it, and later, the usual regular oral hygiene practice.

Q: Are dental implants covered by dental insurance?

A: Yes, many insurance plans cover some or even all of the cost of new permanent teeth.  However, it depends on the insurance plan you have. A wide range of insurance plans are available. Some will provide immediate coverage, while others may require a qualifying period. Some plans may only offer partial coverage.  You should always confirm with your insurance provider. We can also go over your plan with you to find out if it covers implants and to what extent.

Q: Does a dental implant cause pain?

A: With an expert oral surgeon, an new prosthetic tooth will hurt you just as much as an extraction, that means you should not feel any pain at all! But you should know that installation involves surgery.  First, if any teeth require extraction, those will be extracted, and the gums will be allowed to heal before taking the next steps.

The modern practice is to place the posts in specific areas immediately following the extraction. Implant placement requires drilling specifically placed holes into the jaw bone, and then screwing the post in. After it has been placed, the gums are sutured to cover the post leaving the abutment exposed for placement of the prosthetic teeth. During this surgery, you will experience no pain because a suitable anesthesia will be given.  However, after the procedure, just like after an extraction or any surgery, you may experience slight pain or discomfort around the wounds for a few days until they heal. This pain can be managed easily with suitable pain killers that will be prescribed to you.

Q: How long a healing time can be expected after getting dental implants?

A: The traditional and conservative process takes several stages. A healing time may be needed at more than one stage. Thus, the recovery period can vary greatly depending on the amount of teeth involved, the patient’s health, etc. Here is a list of steps between the procedure and healing, once these steps have been completed successfully, you will have healthy, new teeth.

  • In the first step, if grafting of bone is required, a waiting period of four to six months may be necessary before the next step can be done. Grafting is required only if the patient lacks enough jawbone at the site of the new tooth.
  • In case bone grafting is not necessary, but extractions are needed, healing time will be required for the gum injury. The current practice is to install them right after the extractions so that the patient will not have to wait for a double healing period. A healing cap is screwed onto it before stitching over the gum tissue. Depending on the patient’s health, healing can take about a week.
  • A second surgery is then performed after four to six months once the bone has grown into the surface of the artificial tooth root. The healing cap is exposed and the gum is then stitched around it. The gum heals in the area around the cap, conforming to the shape.
  • Once the gum has healed, and osseo-integration is finished, the healing cap can be removed and an abutment can be placed, so that the artificial tooth or denture may be secured to it.

Q: How should dental implants be cared for?

A: One major benefit they have over other kinds of restorations is that they need no special care once it is installed. You will only need regular hygiene just like your natural teeth. Briefly, the following needs to be done.

  • Brush your teeth at least twice a day with low-abrasive toothpaste. An abrasive toothpaste can wear out the teeth and the artificial root below. You should brush for about two minutes each time, spending equal time on all teeth. In order not to miss any parts, a definite order is preferred, eg:
    • Begin from the outside of right of the upper jaw and keep brushing to the left end.
    • Then brush the insides of these same teeth by brushing from the left end to the right end. Be sure to brush the chewing surfaces of the molars.
    • Now begin from the right of the lower jaw cleaning the outsides of the lower teeth extending to the left end
    • Brush the insides of lower teeth beginning from the left end.
  • Floss your teeth every day to ensure interdental cleaning. For this reason, you can use a tap-floss or a water flosser/water pick. The choice of floss will depend on your personal preference or recommendation.
  • An essential part is to visit your dentist for examinations every six months. If you observe anything out of the ordinary, report it immediately for correction.
  • Avoid tobacco, or your artificial and natural teeth may be stained.

Q: Dental implants are such a convenient thing. Who invented dental implants?

A: Teeth implants are so successful due to osseo-integration, a very successful discovery for modern dentistry. Bothe, Beaton, and Davenport first ‘observed’ Osseo-integration in 1940. They noted the tendency of titanium to integrate with animal tissue and discussed its possibility for use in prostheses for human use. Later in 1951, Gottlieb Leventhal also performed experiments with similar results, and similar comments about potential use. The term “osseointegration” was coined by by Per-Ingvar Brånemark in 1952, as a description for his experiments. In 1965, Prof Branemark was also the first person to place one for a patient named Gosta Larsson.

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Zahid H. Ahmed, DDS, FICOI, FAGD

Dr. Zahid Ahmed combines current advances in dentistry with holistic health to bring patients the best possible dental care. His goal is to provide patients with personalized service, creating lasting relationships based on trust and expertise.

Dr. Ahmed received his DDS from the University of Michigan School of Dentistry. He has worked as an Assistant Clinical Professor at UCSF and maintains a position as Clinical Instructor at Stanford University. He is recognized as a Fellow in both the Academy of General Dentistry (FAGD) and the International Congress of Oral Implantologists (FICOI). He believes continuous learning in dentistry allows him to stay current, and provide the best possible dental care for his patients.

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