Frequently Asked Questions

What is a dental implant?

A dental implant is a tooth-root shaped insert made of commercially pure Titanium which is surgically placed into jawbone once occupied by a tooth root. The implant can then be used as a foundation for a restoration replacing a missing tooth.

How is implant treatment carried out?

Phase 1 – Consultation and planning for treatment. This involves a thorough assessment of the mouth as a whole and particularly the area of jaw where it is intended to place the implant(s). This includes the taking of impressions for models of the jaws and x-ray films. Sometimes, more specialised CT scans might be required to provide a very accurate image of the area where implants are to be placed.

Phase 2 - The gum tissue is temporarily lifted up to expose the bone at the site for the procedure and the implant is placed very carefully into the appropriate position. If it appears that there is insufficient bone to fully envelope the implant, a bone augmentation procedure will be required so as to cover the implant and build up the bone volume for the long-term (see FAQ page on bone augmentation and grafting procedures).

The gum tissue is then carefully placed into position to cover the site.

Implant placement can be carried out under local anaesthesia alone or with additional intravenous sedation if required. This is inherently a more pleasant way of having potentially stressful surgical treatment carried out and is especially good if you are apprehensive as the sedative's action actually removes anxiety, making the treatment much more comfortable.

These options can be discussed with you during the consultation appointment.

Phase 3 - Following placement, bone starts to fuse to the implant surface in a process known as "osseointegration". This process can involve a period of three to six months, after which a special post (called an abutment) can be attached to the implant to help shape the adjacent gum tissue.

Usually, one to two weeks after this, impressions can be taken for the construction of a restoration such as a porcelain crown, which will be fixed into position to replace the missing tooth.

How long will the operation take?

This depends on the number of implants being placed and whether the operation is being carried out with local anaesthesia alone or with additional intravenous sedation. An appointment for surgery under local anaesthesia usually lasts 60 minutes. When intravenous sedation is used, an appointment usually lasts 90 minutes. The longer time allows for the recovery period needed before you can be discharged home.

Will there be any stitches?

Stitches are used in the operation to help complete the surgery. A fine size of thread is used to achieve a good cosmetic result. These stitches are dissolvable and so should disappear after about two weeks.

Will I be in any pain afterwards?

You should not feel any pain immediately after the operation, as the area of surgery will be numb from the local anaesthetics that have been used. As the numbness wears off, the area might become uncomfortable and then you should take painkillers. We will advise you about appropriate painkillers, as well as information about doses.

When can I return to work?

This depends on your occupation and how you are after your treatment. It may be possible to return to work the next day. Some people need to take some time off work, especially if the operation has been carried out under intravenous sedation. We will give you appropriate advice for your individual circumstances.

Could there be any complications or after-effects?

After the procedure, there is likely to be some swelling and bruising in the area of the surgery and possibly some discomfort. The bruising is usually most obvious after two to three days and will vary in amount between patients. It normally resolves itself in 10 to 14 days.

If an augmentation procedure has also been carried out, the operation site will now be of a larger volume. The area is likely to feel quite enlarged even after the bruising has subsided and the overlying gum tissue may feel different to that of the adjacent areas.

These changes in sensation generally tend to become less noticeable over time and gradually resolve as the augmented area integrates with the surrounding bone. At the time of implant placement, there is a risk of accidental damage occurring to adjacent anatomical structures (e.g. teeth and nerves), although this should be avoidable with accurate planning. The risk of failure of implants after the first year in function is low as long as general health is maintained and, in particular, that of the bone and gum around the implant. Regular maintenance appointments for the periodic examination of the implant and the surrounding tissues are an essential requirement towards the long-term success of the treatment.

What are the advantages of implant treatments?

The main advantages of dental implant treatment are that it provides a permanent restoration and the adjacent teeth are not involved in any way. Success rates for implant treatment can be in excess of 95% and so, in most cases, can be regarded as the ideal substitute and the first choice for the replacement of missing teeth. A success rate of 95%+ does conversely mean a failure rate of 1-5% and, in most circumstances, if an implant should fail, it can be replaced, although additional surgical procedures may be required.

What are the alternatives to implant treatment?

The alternatives to dental implant treatment to replace a missing tooth/teeth are removable dentures and fixed bridges. The removable denture option has the advantages of avoidance of surgery, a relatively short period of time for provision and, potentially, a lower cost. However, a denture is not a fixed restoration and so can be unstable and consequently difficult to tolerate.

Fixed bridgework can also usually be completed in a short period of time and avoid the need for surgery. However, the adjacent teeth would need to be prepared, which might in turn compromise their health. Once in place, it can be difficult to keep the bridgework adequately clean.

What happens after my operation?

After your surgery, we will give you an information sheet with instructions to help bring about a quick recovery.

We will discuss this with you before you are discharged home to ensure that the information is clear and understood. The main points are as follows.

On the day of the operation:

Get plenty of rest in the first few hours after your operation.
Do not rinse your mouth or drink hot fluids.
Start drinking plenty of cold water, preferably by using a straw. You may use small amount of ice-cold water to hold inside your mouth for 30 seconds. Spit it out and rest for about a minute, then repeat holding cold water in the mouth again for 30 seconds. Repeat this cycle four times in every half hour for the first four hours.
Relieve discomfort by taking the painkillers as directed.
Use ice packs: The immediate use of ice packs outside your face should minimise the swelling. It will also reduce bruising and discomfort at the operation site. An ice pack can be made by filling a small zipped sandwich bag with ice cubes or frozen vegetable (peas). The pack should be applied to the sides of the face where surgery was performed. The ice packs should be held on the face fairly continuously while you are awake.

From the following day:

Keep your mouth as clean as possible by gently brushing your teeth as usual.
Use salt water mouth rinses (one teaspoon of salt in a cup of warm water) every four hours for seven days. This will help to keep the operation site clean and clear of debris.
Avoid smoking. The local action of nicotine in the mouth has been shown to have a detrimental effect on healing after surgery and greatly increases the likelihood of wound infection developing.
Continue to take the painkillers and any other supplied medications as directed and use ice packs for the next day. After 24 hours, ice doesn't provide much beneficial effect.
If bleeding is troublesome, you can usually control it by placing dampened gauze over the wound and applying pressure for 15 to 20 minutes (slight oozing can be expected for a short time following surgery).

If you have any other complications or require advice after treatment, please call 01623 623364 (Mon–Fri 8am-5pm). We will give you a pager number to call in case you need to speak to someone out of hours. Please leave your name and contact details and someone will contact you as soon as possible for appropriate advice and treatment.