There are many blog posts and articles around extolling the virtues of dental implants, on the whole we agree that dental implants are often the treatment of choice to replace missing teeth for the following reasons.
- they prevent further bone loss in the area of the lost tooth
- dental implants support the teeth either side of the gap and prevent those teeth from drifting into the space
- implants support the teeth opposing the gap and prevent them drifting down
- dental implants are often the most cost-effective option when taking into account the length of time they last
However, this information is commonly found around the Internet and so we thought we would write a blog post about some of the problems with dental implants.
Disadvantages of dental implants
The Academy of Osseointegration (1) lists the following disadvantages of dental implants:
- It is a surgical procedure which requires a healing phase.
- Maybe more expensive than other forms of treatment initially.
- Mechanical failure of the dental implant components.
- Fracture of the dental crown.
Let’s look at these disadvantages individually…
Surgical procedure for implants
After the dental implant is placed you will more than likely have stitches, you will need to ensure that you are careful following the placement of the implants. A good rule of thumb is to eat soft and nutritious foods and keep well hydrated directly after the implant placement. It’s also good news that your mouth heals exceptionally quickly. So you will soon be back to normal after the placement of the implant.
In some cases you may not have enough bone to place the dental implant. This may necessitate grafting or bone augmentation. This may be a more invasive procedure which takes longer to heal.
More expensive than other forms of treatment
This is indeed true in the short term, including the surgery, components and final crown manufacture a dental implant can often cost around £2000. However, if you break this down into the lifetime of the dental implant, let’s say 20 years then the cost works out at less than 30p per day!
Many practices also offer credit options including interest-free finance for implants. People will often consider purchasing a car on finance, cars don’t last particularly well and aren’t used 24-hour was a day. Your dental implant should last many years and as it is used all of the time, even when you are sleeping, it’s worth investing in your smile.
Mechanical failure of the dental implant components
Generally speaking the dental implant is made up of the following components:
- the implant itself which is surgically placed into the bone
- the apartment which attaches to it
- the screw which attaches the abutment the dental implant
- the permanent crown which is fixed on top of the abutment
These components are necessary in order to make the implant completely customisable to your own clinical situation but, with the disadvantage that each component may fail. In reality however, the success rate is often over 90%.
Fracture of the dental implant crown
There can be a slightly high incidence of this in dental implants than if a dental crown is placed on a natural tooth. Your natural tooth has natural cushioning via the periodontal ligament but this is missing with the dental implant meaning that the shock of biting is transferred directly to the dental crown rather than absorbed.
If you have a dental implant you need to be aware that this cushioning effect is reduced.
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Dental implant side effects
A dental implant is made from medical grade titanium, amazingly the body does not recognise this as a foreign object which is why the dental implant becomes fully integrated into the jaw. The only negative side effects from having dental implants are either infection of the dental implant site following surgery or failure of the dental implant and/or components after fitted. These have already been discussed.
Your risk of encountering one of these negative side-effects is increased if you smoke, it is therefore highly recommended that you are a non-smoker to increase your chance of dental implant success.
Dental implants infection
Unlike natural teeth, dental implants cannot develop caries. They can however become infected. The dental implant is susceptible to a buildup of plaque, exactly the same as your natural teeth are. If the dental implant crown is not cleaned in the same way that your natural teeth are then this plaque buildup which causes irritation of the gum. This irritation can lead to an inflammation which can then lead to infection of the gum and/or bone. This is known as Peri-implantitis.
If this inflammation is noticed early enough and treated then the loss of the dental implant may not be the result. However, if the information is left to progress any dental implant can become compromised and may have to be removed. For this reason you need to continue to see your dentist regularly (exactly the same as you would with natural teeth) to ensure that your oral hygiene is such that this is unlikely to develop.
Diabetics and smokers have a higher risk of developing Peri-implantitis.
Dental implant problem symptoms
General signs of problems with dental implants can include pain, tenderness, swelling and/or redness of the gum around the dental implant area. In extreme cases you may notice that the implant has become loose.
Research published in the International Journal of oral maxillofacial implants came to the following conclusions:
Patients who were over age 60, smoked, had a history of diabetes or head and neck radiation, or were postmenopausal and on hormone replacement therapy experienced significantly increased implant failure compared with healthy patients.
Overall, dental implant failure is low and there are no absolute contraindications to implant placement. Conditions that were found to be correlated with an increased risk of failure should be considered during treatment planning and factored into the informed consent process.
Do we recommend dental implants?
Yes. However we will always present you with a full treatment plan including all of your options which could also include doing nothing, dentures or dental bridges. Placing dental implants requires a great deal of experience and knowledge in this area, this is why we refer our dental implant cases to a specialist implants surgeon locally to the Euston, London area.
(1) Osseointegration refers to a direct structural and functional connection between ordered, living bone and the surface of a load-carrying implant. Currently, an implant is considered as osseointegrated when there is no progressive relative movement between the implant and the bone with which it has direct contact. http://www.ncbi.nlm.nih.gov/pubmed/19516081 site accessed 02/06/2015