Tooth Implants

Tooth loss is a real part of life that can happen at any age; missing teeth can seriously impact everything from your eating habits to your self- esteem. If you are reading this, you are probably considering a tooth implant. I have had three, so you’ve come to a great place to get the real chew on what the dental implant procedure is like from a patient’s perspective.

First, STOP googling. A lot of what you read online is outdated and scary. Dental implants have come a long way and they are constantly getting better and improving (as with all medical and dental treatments). Whether you knocked out a tooth in an accident, experienced a failed restoration, or have other dental and/or health issues that resulted in a missing tooth, even a back tooth, you should consider having the tooth replaced. A single missing tooth can impact your chewing, your bite, your jaw, the shape of your face (over time, the bone loss can cause sagging or an appearance change) and what kind of foods you can eat.

There is no need for the inconvenience of missing a tooth or teeth because there are a few options worth mentioning:

I’m sure you’ve thought about a dental bridge. I have six. Bridges are like crowns but with two (or three) teeth in one snuggly little crown. They look like regular teeth. But my bridges do bother me sometimes and there is a good chance they will need replacing  some day. Bridges require a lot of upkeep, there’s no skimping on the flossing and you’re going to wish for the days when you could just pop some floss between those choppers. Now you need a threader and thinner floss.
A clip in is another option; it is removable and fits around two teeth. It has a plastic base and it’s simple to snap in. It costs a few hundred dollars and you can talk, eat, and use it as you would a normal tooth. You have to take it out at the end of the day, clean it well, and get it refitted sometimes. Sticky or gooey foods tend to pull it out of place, but it is an affordable option to cover a missing hole and to help you chew.

That brings us the the third option (and the reason you are reading this): A tooth implant. I have had three tooth implant procedures, each were entirely unique experiences. The first was a very back bottom tooth about 15 years ago. I had the tooth pulled, waited 3 months and had the implant placed, then waited 6 months and had the crown put in. The permanent crown feels and works as a regular tooth. You cannot tell it is an implant by sight or as a wearer. My second implant failed. I had a tooth pulled, the implant done the same day, and a few days before I had the crown placed, it failed. While my new periodontist says it is possible to retry that spot, right now I am happy with the clip. My recent implant is a top molar. I had the tooth pulled seven weeks ago and was told it was probably going to be a simple implant with no sinus lift or bone graft necessary. The thing is, until he actually gets in there, he can’t know 100%. Ultimately, in order to give this the best shot at taking, he said he wanted to do the bone graft and sinus lift. This would give the implant more room and a better chance of taking. The sinus lift also allowed him to use a longer post- and hey, longer is definitely better!

Okay stop! Don’t panic. I know this sounds scary, but it was nothing. Sinus lifts, especially for implants, have come a long way. It’s basically just like slightly nudging the sinuses up and putting in a little support. It doesn’t take long at all and it does not hurt. The entire implant procedure was less painful than a filling and took much less time than a root canal. I know your brain is spiraling with questions because mine went down that same path (and yes, I made the mistake of googling, but since I had already had two, I knew some of the untruths and sensationalizations to ignore):

1- How much time does it take to actually do the implant procedure?
The “Drilling” took less than 7 minutes. It was so fast and not anything like a filling drilling. It’s just a little vibration as they shape the bone There is very little blood (unlike what you have probably read online) in a tooth implant, especially if the surgeon can use the “punch” technique. You may bleed a little more if he has to cut your gums but it still is not like what you probably read in the online articles. The entire procedure (including the time it took to let the anesthesia take effect and the 5 minutes the bone graft had to set) took 37 minutes. That’s right yall, 12-15 minutes worth of letting the anesthesia set in, 5 minutes for the bone graft, 7 for the drilling, a few minutes to take xrays, and a few extra minutes for the sinus lift. No stitches (because he could use the punch technique) and then a minute to put in the healing abutment (it screws in just like a regular screw would).

2- Why a sinus lift? What is that?
The sinus lift was nothing (for me, a little extra work for him, though). They do a sinus lift if your sinuses hang low or if they need to use a longer post. There was a little pressure at one point but never pain or discomfort.

3- What did it feel like?

There was NEVER pain. Not even a little big. There was a little vibration while he was shaping the bone and a little pressure when he was packing the bone graft. Pressure is not painful, it’s just like pressing a spot on your leg or arm. You feel it but it doesn’t hurt. There was also a little pressure when he was actually screwing the healing abutment into place (which you would expect, just like you have to make sure you screw a regular screw in all the way). When he told me he was done, my mouth dropped open (well, it would have, except that it was already open) in shock. I thought that was the first step or that we had just gotten the party started. Nope. All done.

3- How did you feel after the procedure?
Five hours post-op, I realized the local probably wore off hours ago. I felt fine. My dentist is in a mall so I did my daily walk, browsed a shop or two, came home and ate lunch. I waited for the pain to kick in but I never felt it (they did warn me that I might feel some pain). I do not do pain medicine, my body cannot tolerate Tylenol or Advil, I can’t even take baby asprin so what you are reading is my actual feeling without any anti-inflammatory or pain soothing medicine. It was fine. Honest. And I’m a baby about pain.

4- Do I have to take an antibiotic?
Only 5% of tooth implants will get infected and if it does, yes, you do need to take an antibiotic. I have a prescription in case I fall into this category, but you do not need an antibiotic except out of an abundance of caution. Some people want one, others try not to take antibiotics unless absolutely necessary. Talk to your perio or oral surgeon before your procedure.

5- Do I have to change my diet?
Nope. You do not have to live on soup or soft foods for a week. You should try to avoid chewing on that side for a few days and now probably isn’t the best time to go for that overstuffed po-boy or that triple decker burger, steer clear of pointy potato chips with jaggered edges, but otherwise you eat whatever you want.

6- Do I have to sleep in a certain position?
No. Sleep however you want (except in the bat position, hanging upside down right now isn’t a good idea).

7- Is it expensive?
A tooth implant is a permanent solution and prices vary greatly between professionals. Sometimes it can be covered (at least partially) by insurance. You can expect to pay $2000-5000 mid range, depending on what procedures you need and how many teeth you are getting. You can shop around but it is better to go on a person’s experience rather than his rates. My perio charges along the lower end but is up on the newest techniques (he is part of a franchise so he works steadily and securely, therefore he doesn’t have to change an arm, leg, and your first born).

8- Who does this procedure?
While many general dentists have started doing implants, your best bet is to find a periodontist or oral surgeon who specializes in these procedures. These guys know the nuances it takes to give that tooth implant the best shot at taking, healing, and not getting infected. They can quickly adapt (sinus lift! Bone Graft! Complication!) and are usually more up-to-date on the newest techniques and have the newest or best kits. It’s like going to your GP for a GYN exam. They can do it, but are you really in the best hands?

9- How do I know whether I should get my tooth implant the same day I get the tooth pulled or whether I should wait?
A good perio or oral surgeon can look at the xrays and the post-extraction site and tell you what is best for you, whether you will need a bone graft or sinus lift, and will be able to tell you how much your full procedure will cost. You aren’t out of anything by getting a consult.

10- I had a tooth pulled 10 years ago, so I can’t get a tooth implant?
YES! You can get an implant anytime, you can even try the same place an implant failed years later. But you may need some pre-op procedures, rebuilding that bone and grafting or bone shaping.

11- How much will it bleed? How much blood will I lose?
Contrary to what you read online, you don’t have to bite sponges or gauze pads all afternoon. As my perio said, if you lose a teaspoon of blood you’ve lost more than most.

12- How will I know if it is going to fail?
Meh. Here’s the thing, a tooth implant can fail anytime from the day it’s put in until.. well, forever. I have had so much dental work, I get my choppers cleaned every 3-4 months and I make sure they check it for any signs (swelling, inflammation, gingivitis, and all of the subtleties they know to look for). When my second implant failed, I had a lot of pain from the jawbone pretty much from the get-go, I thought it was just the healing but then it started feeling mobile and within two days it was done. I suspect the tooth that was pulled was infected and I should have waited to have the screw placed until the infection healed, but I will never know for sure. There are endless reasons why it can fail (your body can even reject it, just like it can reject a knee replacement).

13- What happens if it fails?
There are options if it fails. First, find out from the perio/oral surgeon what his/her policy is. Mine will replace it for free and if it fails again, will refund my money.  If yours fails, you can have it replaced or you can opt for a bridge (if possible) or a clip. You can also leave a hole there if you are comfortable with it and it doesn’t bother you. New options are on the horizon (including being able to regrow teeth) so stay tuned because yours truly will likely experience those things some day too.

14- Is there anything special I have to do to take care of a tooth implant?
Unlike a bridge, you can use regular dental floss in the regular way, but you do want to floss well after it is healed and you are given the okay to do so. Brush, don’t chew ice or crunch hard candies (like any crown). It is a permanent fixture in your mouth so you don’t need denture brushes or any other special tools.

15- Is it safe?
As far as they know, titanium is safe (limb replacements use titanium too). It bonds well with bone and it seems to be fine. I always recommend you inform medical staff if you are having an Xray, MRI, CT scan, or anywhere magnets are used but I’ve always been told it’s fine (I still would rather be safe than sorry, I don’t fancy having my jaw ripped off in an MRI machine or something crazy like that).

 

If you have a question, please feel free to ask in a comment or message me. I am not a dentist, I just have gobs of experience on the other end of the drill and if there is a burning question, I can ask my perio, endo, or general dentist because they all rock like that.

Shameless referral and recommendation: If you are in the New Orleans area, I highly recommend Louisiana Dental Center in Lakeside mall. Dr. Cummings is a wonderful General dentist (who has saved so many of my teeth and did a painless job of pulling this one) and Dr. Snitzer is a fabulous periodontist (the one who did my implant)