Many people decide to have dental implants over dentures because the result can be easier and more aesthetically appealing than dentures. Depending on the health of your gums and underlying bone, there may be additional treatments you need before you can have implants.
Chronic Disease Management
Since many chronic diseases, such as diabetes or inflammatory disorders can affect the health of your gums and bone, your dentist may advise you to consult with other doctors to gain control over underlying diseases. For example, many people have uncontrolled or poorly controlled diabetes. Since the disease can increase the risk of infection and slow or prevent healing, it is not advised to have dental implants or any other non-urgent dental procedures without gaining control over the disease. Inflammatory disorders will often require certain immunosuppressant medications that are designed to suppress your immune system to prevent the immune system from attacking healthy tissues, such as the salivary glands. Inadequate saliva production will cause chronic dental problems. Immunosuppressant medications do require a balance between treating the underlying disease while not suppressing the immune system so much that it increases your risk of infection from the implant procedure.
The base of a successful dental implant is having healthy bones and gums. If you have extensive periodontal disease, you may need significant treatments to support an implant. Periodontal treatments involve either manual or ultrasonic removal of tartar. If your dentist does manual removal, it may take longer because treatment may be done in quadrants. Manual scaling involves using dental tools to scrape plaque off the surface of the teeth. This includes the visible portion of the teeth and below the gum line. People with periodontal disease have pockets below the gum line where tartar hides. The dentist will gently push the tool into the pocket to remove tartar located in this area. Although the process can sound painful, your dentist will provide a local anesthetic.
The use of an ultrasonic device is different, but accomplishes the same treatment with less time and may be less irritating to the gums. Since the device vibrates rapidly and sprays water, it essentially blasts away tartar on the surface and below the gum line. A suction device will remove the water and debris as the treatment occurs. The use of ultrasonic scaling is faster and your dentist may do it in fewer sessions. Just because you have a periodontal treatment does not mean you are done with the process. The ultimate goal is for the pockets to go away and some people may need several sessions for each quadrant before these pockets go away and the implant process can proceed.
If your dentist already knows you will have an implant, they might place an abutment promptly after extracting a tooth because it can prevent bone loss. Placing the abutment quickly can also give the existing bone a chance to heal around the abutment if there is a fracture, helping to anchor it in place. Early abutment placement also reduces the complexity of the procedure for placing the abutment later because the socket has not filled in with bone. For people who had their extractions a while ago or otherwise do not have enough bone in their jaw to support an implant, bone grafting might be necessary before an implant can be done.
A bone graft means taking bone from elsewhere, whether your own bone or donor's bone, and placing it in the jaw where the implant will go. There are several sources for donor's bone, with your own bone being preferred. Your own bone is more likely to heal successfully and not have signs of rejection. In rare cases, animal, cadaver, or synthetic bone might be used. The ground-up donor bone is placed at the appropriate site and the gum is sutured over it. Bone grafting is a process and it may take many months before the process is complete. Underneath the gum, the transplanted bone melds with the existing bone and acquires a blood supply.
After the initial procedure, it will be critical to follow your dentist's dietary and oral care instructions to minimize the risk of infection, which will compromise the graft. Once the graft is deemed successful, the process of placing the abutment for the implant can begin.
Dental implants are an important option for people who have lost many or all their teeth. In many cases, there must be extensive treatments done before the implant process can begin. Improving the quality of your gums and underlying bone will increase the chances of a successful implant.