Dental implants
A dental implant is a titanium screw placed in the jawbone to replace the root of a missing tooth. A crown, bridge or denture is then fixed on top.
See the steps- 6 to 12 monthsTypical treatment time, start to finish
- 2 to 6 monthsBone healing before the implant is used
- LocalAnaesthetic for most implant placements
- 96.4%Implants still in place after 10 years
What a dental implant is
A dental implant is a small screw, usually made of titanium alloy, that is placed in the jawbone to replace the root of a missing tooth (Leeds Teaching Hospitals NHS Trust). The implant sits under the gum. What you see is the part fixed to it: a crown for one tooth, a bridge for several, or a denture that clips on.
Implants are used when the teeth either side of a gap are healthy and would otherwise have to be cut down to hold a bridge. They are also used when there are no suitable teeth or gums left to support a bridge or denture (Guy’s and St Thomas’ NHS Foundation Trust).
How long dental implants last
Dental implants have a high survival rate. A 2019 review in the Journal of Dentistry pooled 18 studies and found that 96.4% of implants were still in place after 10 years (Howe, Keys and Richards). When the authors allowed for patients who dropped out of those studies, the estimate fell to 93.2%, and survival was lower in people aged 65 and over.
An implant that fails late usually fails through the gum and bone around it. Inflammation of the gum can progress to bone loss, called peri-implantitis, and in time the implant can be lost. The risk is higher with smoking, poor oral hygiene, a history of gum disease, radiotherapy to the jaws, poorly controlled diabetes and some medicines such as bisphosphonates (Leeds Teaching Hospitals NHS Trust).
Implant, bridge or denture
An implant, a bridge and a denture all replace missing teeth. They differ in what holds them in place and what they ask of the teeth around them.
| Compared on | Dental implant | Bridge | Denture |
|---|---|---|---|
| Held in place by | A screw in the jawbone | Crowns on the teeth either side | The gums, with clasps or implant clips |
| Neighbouring teeth | Left untouched | Cut down to take crowns | Untouched, though clasps may rest on them |
| Fixed or removable | Fixed, or a removable overdenture | Fixed | Removable |
| Surgery | At least one procedure | None | None |
Implant treatment usually takes 6 to 12 months in total (Guy’s and St Thomas’). Leaving the gap is also an option. Leeds Dental Institute notes that it is sometimes better to accept the space, especially when it has little effect on appearance or chewing.
Who is suitable for dental implants
- Finished growing
- Healthy teeth and gums
- Enough bone, or a graft first
- Not smoking, or ready to stop
- Ready for several visits over months
Dental implants are not the right option for everyone with a missing tooth. Suitability depends on your general health and smoking status, the health of your teeth and gums, the amount of bone where the implant would go, and your age, because implants are usually placed only once you have stopped growing (Leeds Teaching Hospitals NHS Trust).
It also depends on how you feel about several appointments over a period of months and at least one surgical procedure. Smoking raises the risk that an implant does not join the bone, so stopping before treatment and staying stopped is strongly recommended (Guy’s and St Thomas’).
Dental implant treatment, step by step
Assessment
Your mouth is examined and X-rayed, and impressions are taken to plan where the new teeth will sit. A cone beam CT scan, a 3D X-ray, is usually used to measure the bone and locate the nerves, sinuses and neighbouring roots.
Bone grafting, if needed
Where there is not enough bone, it can be built up first. A small defect can be grafted at the same visit as the implant, and a larger one is grafted several months beforehand.
Placing the implant
Implant surgery is usually done under local anaesthetic, so you are awake and can go home straight afterwards. The appointment usually takes around 90 minutes.
Healing
The gum usually heals within 1 to 2 weeks. The bone takes longer, and most implants are left for 2 to 6 months to bond to it before they are used.
Fitting your new teeth
Once the implant has bonded, the crown, bridge or denture is made and fitted. A fixed crown or bridge often starts as a temporary that shapes the gum, followed by the final one over several visits a few weeks apart.
Questions about dental implants
Does getting a dental implant hurt?
Dental implant surgery is usually done under local anaesthetic, so the placement itself is felt as pressure rather than pain. Discomfort, swelling and bruising afterwards are common, are usually worst 24 to 48 hours after surgery, and are normally managed with over-the-counter painkillers such as paracetamol or ibuprofen.
How long does dental implant treatment take?
Dental implant treatment usually takes 6 to 12 months from assessment to the final crown, bridge or denture, because the implant needs 2 to 6 months to bond to the bone before it is used. Bone grafting or extractions beforehand add to that time.
Can I have a dental implant if I have lost bone in my jaw?
Often, yes. A small bone defect can be grafted when the implant is placed, and a larger one is built up several months before implant surgery. In the upper jaw, a sinus graft can add the height of bone an implant needs.
Can dental implants replace all of my teeth?
Yes. Several dental implants can hold a fixed bridge that replaces a full arch of teeth, or anchor a removable overdenture that clips on with press-stud attachments and is much more stable than a conventional denture.
How do I look after a dental implant?
A dental implant needs the same daily care as a natural tooth: brushing, flossing and regular dental check-ups. Gum inflammation around an implant can lead to bone loss and, in time, loss of the implant, so the gum around it needs cleaning every day.
What affects the cost of dental implants?
The cost of dental implant treatment depends on how many implants are placed, whether bone grafting or extractions are needed first, and what is fitted on top: a single crown, a bridge or an overdenture. Your dentist should set out each stage and its cost before treatment starts.
Related treatments
A gap left open can let the teeth beside it tilt into the space. An implant, a bridge or a denture fills it, depending on how many teeth are missing and the health of the bone and gums.
Dental bridges
One or more false teeth held in place by crowns on the teeth either side of the gap.
Dentures
Removable replacement teeth for a few gaps or a full arch, made to fit your gums and bite.
A dental implant is planned around your bone, your gums and the teeth beside the gap, so you know every stage before it starts.
Explore all treatments