What to know before you get a dental implant

Two parts, and a wait in between

An implant solution has two parts. The first is the implant (a post) that sits in the jawbone where the root of the tooth used to be. The second is the replacement crown that attaches to it.

The implant (post) goes in first, and then the bone has to heal around it before the crown can go on. How long that takes differs from person to person. An implant is never a one-appointment job, and nobody can give you an honest timeline before they have seen your radiographs and completed an in person assessment.

What a gap does over time

A missing tooth changes the mouth slowly, for mechanical reasons. The bone that held the root has nothing to do once the root has gone, and it gradually shrinks. The teeth on either side can tilt into the space of the missing tooth. The tooth above or below the gap can drift toward it, because nothing meets it any more. Most people start chewing on the other side without noticing.

The majority of the bone loss around a missing tooth occurs within the first year, so it’s important to think about whether you want an implant early before you’ve lost the bone needed to support the implant.

What has to be under the gum

An implant needs enough bone to hold the post, and the bone has to be of reasonable quality. The gum around it has to be healthy. The teeth beside the gap matter too.

General health plays a part. Smoking, and diabetes that is not well controlled, can both slow the way bone heals around an implant, so expect to be asked about both. Where there is not enough bone, it sometimes has to be built up before an implant can go in.

None of this shows up in a photograph or from the outside of your mouth. It takes radiographs and a full examination, and that is also why an implant cannot be quoted over the phone.

An implant is one of three ways to replace a tooth

A bridge anchors a replacement tooth to the teeth on either side of the gap, which means preparing those teeth for crowns. A bridge is cemented permanently in your mouth. An implant stands on its own and leaves the neighbouring teeth alone. A denture replaces one or more teeth and comes out at night.

Bridges and dentures both cost less than an implant, and for plenty of people one of them is the sensible choice. Which suits you depends on how many teeth are missing and the condition of the ones still there. Ask to have all three options explained, with what each involves, before you decide.

Living with an implant

An implant cannot decay, but the gum around it can become inflamed in the same way gum around a natural tooth can. Brush and floss around it as you would a natural tooth, and keep up your cleanings so it is checked.

Cost

The cost depends on what your mouth needs before and around the implant. Some cases are straightforward. Some need work done first. At our office you get the number at the examination, in writing, before you commit to anything.

If an implant you already have feels wrong

Get it looked at. Email us a photo and tell us what is happening: when it started, what it feels like, and whether anything moves. Dr. Fenn will look and tell you what she thinks it might be, whether or not you are a patient here. If there is pain or swelling, call instead.

Dr. Fenn places and restores implants at 1411 Danforth Avenue, and she is a Fellow of the International Congress of Oral Implantologists. Book an examination and she will go through every option open to you, including the ones that are not implants.

FAQ: Addressing Common Concerns