What are dental implants?
A dental implant is used to support one or more false teeth. It is a titanium screw that can replace the root of a tooth when it fails. Just like a tooth root, it is placed into the jawbone.
Are implants safe and how long will they last?
Implants are a safe, well-established, tried-and-tested treatment. It’s probably true to say that implants, much like natural teeth, will last for as long as you care for them.
How well you look after your implants – and whether you go for your regular maintenance appointments – will have the biggest impact on how long they will last.
If you don’t look after your implants they will develop a coating similar to that found on neglected natural teeth. Left untreated, this can lead to gum infection, bleeding, soreness and general discomfort. You could get all these problems with natural teeth.
If your implants are well looked after, and if the bone they are fitted to is strong and healthy, you can expect them to last for many years. However, just as with other surgical implants (such as a hip replacement) there is no lifetime guarantee.
I have some of my own teeth. Can I still have implants?
Yes. You can have any number of teeth replaced with implants – from one single tooth to a complete set.
Can implants always be used to replace missing teeth?
It depends on the condition of the bone in your jaw. Your dentist will arrange for a number of special tests to find out the amount of bone still there. If there is not enough, or if it isn’t healthy enough, it may not be possible to place implants without grafting bone into the area first.
Do implants hurt?
Placing an implant is often easier than taking a tooth out and is usually done using a simple local anaesthetic. You will not feel any pain at the time, but just like after an extraction, you may feel some discomfort during the week after the surgery.
Sometimes your dentist might give you a sedative if you are very nervous or if the case is a complicated one. General anaesthetics are rarely used for implants and are generally only used for very complicated cases.
How long does the treatment take?
a complete or partial denture can be attached to a number of implantsYour dentist will be able to give you a rough timetable before the treatment starts.
Usually the permanent false teeth are fitted 3 to 4 months after the implants are put in. Some teeth can now even be fitted at the same time as the implants (these are called ‘immediate implants’) but you should check with your dentist to see whether these are suitable for you. Sometimes treatment takes longer and your dentist will be able to talk to you about your treatment time.
What about aftercare?
Your dentist will give you instructions on how to look after your implant. They may give you some painkillers after the surgery – or check whether you have them at home – to take over the next few days if you need them.
What happens next?
After your implants have been placed, the bone in your jaw needs to grow onto them and fuse to them. This usually takes a few months. Sometimes the implants may be stable enough when they are fitted for the false teeth to be attached sooner than this.
If you are having one, two or three teeth replaced, you may have a temporary denture in the meantime. If you have full dentures, you can keep wearing these while your implants are healing. Your dentures will need altering, to fit properly after the surgery, and a ‘healing cap’ will usually be placed onto the implant site to protect it.
Are the implant teeth difficult to clean?
No. But aftercare is important if you are going to have a long-lasting, successful implant. Your dentist should give you detailed advice on how to look after your implants. Cleaning around the teeth attached to the implants is no more difficult than cleaning natural teeth. However, there may be areas that are difficult to reach and you’ll be shown methods to help you. You may need to visit your hygienist more often but your dentist will be able to talk to you about this.
If I had gum disease when I had my own teeth, will I get it with the implants?
Yes, if you don’t care for them well enough. If you keep them clean and have them regularly checked by your dentist you should not have any problems. Smoking also affects the health of natural teeth and implants. So, if you smoke, you may need to look after your implants more carefully.
Can I take the teeth out if they are fixed to implants?
Most teeth attached to implants can only be fitted and removed by the dentist. However, if you have removable dentures attached to the implants, then you’ll be able to take them out for cleaning.
Do the implants show?
Most implants look exactly like natural teeth.
Do I have an implant for each missing tooth?
If you have a single tooth missing, you will need an implant to support it. If you have a number of teeth missing, and these are next to each other, you could still have one implant for each tooth. Or you may find that two or more implants may be able to support more than one tooth each. Your dentist will talk to you about the best option for you.
What if I have an accident?
Implants and the teeth they support can be damaged by an accident in the same way that natural teeth can. So it is important that you wear a professionally made mouthguard if you play sports that involve contact or moving objects. If just the teeth are damaged, they can usually be removed from the implant and replaced.
However, if the titanium implant itself is damaged beyond repair, it can be safely left in the jaw if it is too difficult to remove. Another implant may be fitted alongside it to replace the damaged one.
What happens if the implant does not fuse with the bone?
This happens very rarely. If the implant becomes loose during the healing period, or just after, it is easily removed and your jaw will heal in the normal way. Once your jaw has healed, another implant can be placed there. Or the dentist can make a bridge, fitting it to the implanted false teeth that have ‘taken’.
There are other advantages to implants, too. If you have an implant to replace a single tooth, there is no need to cut down the teeth either side of it. If you had a bridge, your dentist would need to do this and fit crowns to these teeth to support the bridge.
Normal dentures often mean you can’t eat or speak well, because the dentures move about. But teeth attached to an implant don’t cause this problem as they are anchored to the bone more firmly than natural teeth.
What is root canal treatment?
Root canal treatment (also called endodontics) is needed when the blood or nerve supply of the tooth (known as the pulp) is infected through decay or injury. You may not feel any pain in the early stages of the infection. In some cases, your tooth could darken in colour, which may mean that the nerve of the tooth has died (or is dying). This would need root canal treatment.
Why is root canal treatment needed?
If the pulp becomes infected, the infection may spread through the root canal system of the tooth. This may eventually lead to an abscess (gumboil). An abscess is an inflamed area in which pus collects and can cause swelling of the tissues around the tooth. The symptoms of an abscess can range from a dull ache to severe pain and the tooth may be tender when you bite. If root canal treatment is not carried out, the infection will spread and the tooth may need to be taken out.
Does root canal treatment hurt?
No. Usually, a local anaesthetic is used and it should feel no different to having an ordinary filling done. There may be some tenderness afterwards but this should gradually get less over time.
What does it involve?
The aim of the treatment is to remove all infection from the root canal. The root is then cleaned and filled to prevent any further infection.
Root canal treatment is a skilled and time-consuming procedure. Most courses of treatment will involve two or more visits to your dentist.
At the first appointment, the infected pulp is removed, and any abscesses can be drained. The root canal is then cleaned and shaped ready for the filling. A temporary filling is put in and the tooth is left to settle.
The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled.
What will my tooth look like after treatment?
In the past, a root-filled tooth would often darken after treatment. However, with modern techniques this does not usually happen. If there is any discolouration, there are several treatments available to restore the natural appearance.
What if it happens again?
Root canal treatment is usually very successful. However, if the infection comes back, the treatment can sometimes be repeated.
What if I don’t have the treatment?
The alternative is to have the tooth out. Once the pulp is destroyed it can’t heal, and it is not recommended to leave an infected tooth in the mouth.
Although some people would prefer to have the tooth out, it is usually best to keep as many natural teeth as possible.
Will the tooth be safe after treatment?
Yes. However, as a dead tooth is more brittle, it may be necessary to restore the tooth with a crown to provide extra support and strength to the tooth.
Where can this treatment be carried out?
Root canal treatment is a routine dental procedure, which your dentist will be happy to do for you. However, sometimes your dentist may refer you to an endodontist, who is a specialist in this type of treatment.
What about aftercare?
Root-treated teeth should be treated just the same as any other tooth. Remember to clean your teeth for two minutes, twice a day with a fluoride toothpaste. Cut down on sugary foods and drinks, and keep them only to mealtimes if possible. See your dentist as often as they recommend for regular check-ups.
Is there anything that can help me with my fear of the dentist?
Yes. Some people are so frightened of the dentist that they will not go for dental treatment. They can overcome their fears with relaxation or sedation. Dentists today are sympathetic about these feelings, and you can ask your dentist about these ways to help.
What is sedation?
Your dentist may recommend an intravenous or ‘IV’ sedation. This is given by injection, either in the back of your hand or in your arm. The dose will depend on the amount of treatment needed and how long it will take to complete.
How will IV sedation affect me?
You become drowsy and unaware of any treatment, but you are still able to co-operate with the dentist. The effects of a sedative medicine take some time to wear off and your dentist will tell you how long the drugs will take to clear from your body. You won’t be able to drink alcohol, drive or work machinery during this time.
What else can help?
You can be helped to feel relaxed by ‘relative analgesia’ sometimes known as inhalation sedation. This means breathing in a mixture of nitrous oxide and oxygen (‘laughing gas’) which quickly leads to a pleasant, relaxed feeling. The dentist puts you at ease at the same time, by talking softly and suggesting what you feel. You remain conscious all the time, although you may be a little drowsy, and any treatment given causes you no discomfort.
You breathe in the mixture through a nosepiece, which is very comfortable. You can’t overdose on the gas, as the mixture quickly leaves the body if you breathe in one or two breaths of ordinary air. There are no after-effects either, and you can drive a car after about 15 minutes. Many dentists use this safe and effective technique.
How does relaxation work?
a woman laying on the sofa relaxed When we are faced with a challenge or something we’re afraid of, such as a visit to the dentist, our bodies produce substances which raise our anxiety. However, we can train our bodies to work against this anxiety, by learning to relax. It’s not possible to be anxious and relaxed at the same time, so learning relaxation helps control our anxiety.
If you are a mother, you may have learned some relaxation techniques in childbirth classes. In fact, almost anyone can learn them. You can practise at home. Some people find that meditation and yoga work well, too.
What about hypnosis?
Hypnosis is a way of relaxing where you concentrate on suggestions of relaxation given by the hypnotist. It’s a bit like daydreaming, although you are awake and in total control.
How do I know which technique is right for me?
Talk to your dentist. Most people can use relaxation techniques, but relative analgesia and sedation may not be suitable for everyone. Your dentist will tell you. You also need to tell your dentist about any medicines you may be taking, whether or not your doctor prescribes them
Are there any other techniques that may help before I get to the dentist?
Some people need something more to help them overcome their fears. The dentist or doctor may give you a sedative medicine, either in tablet or liquid form that you can take before your visit to relax you.
I need a filling – what types are there?
There are a number of different fillings including:
What are amalgam fillings?
Different fillingAmalgam fillings are silver coloured. They are made by combining mercury and a silver alloy (50% mercury, 35% silver, 15% tin, copper and other metals). Amalgam is long lasting and hard wearing and has been used in fillings for at least 150 years. It is economical to use and it is not unusual for an amalgam filling to last 15 to 20 years.
What are composite fillings?
teeth fillingsComposite fillings are strong, but may not be as hard wearing as amalgam fillings. Composite fillings are tooth coloured and are made from powdered glass quartz, silica or other ceramic particles added to a resin base. After the tooth is prepared, the filling is bonded onto the area and a light shone onto it to set it. The dentist will choose a shade to match your existing teeth, although over time staining can happen.
What are glass ionomer fillings?
Glass ionomer fillings form a chemical link with the tooth. They may also release fluoride, which helps to prevent further tooth decay. This type of filling is fairly weak and, because of this, is usually limited to use on baby teeth and non-biting surfaces such as around the necks of the teeth. Little preparation is needed as the filling bonds directly to the tooth.
What are gold inlays and onlays?
These can be used in most areas of the mouth. An inlay is and within the biting surface of the tooth. An onlay can cover a larger area of the tooth. Gold is the most long lasting and hard wearing filling material and will last for many years. An advantage of gold is that it does not tarnish and has great strength.
One of the differences between gold and other filling materials is that the gold filling is made in a laboratory. Your dentist will usually take an impression of the prepared cavity and send it to the laboratory for the technician to make the inlay or onlay. In the meantime a temporary filling will be placed in the cavity. After the gold inlay or onlay has been made, your dentist will fix it in place with dental cement. This type of filling is more expensive.
What are porcelain inlays?
Your dentist can now use digital technology (called CADCAM) to design and prepare perfectly fitted porcelain inlays in just one or two visits. Porcelain inlays can also be made in a laboratory but this will need at least two visits to your dentist. Porcelain can be hard wearing and long lasting and also has the benefit of being able to be coloured to match your natural tooth. Again, this type of filling can be quite expensive.
What is preventive dentistry?
Preventive dentistry is the modern way of helping you keep a healthy mouth. It helps you to keep your teeth, and means you need to have less dental treatment. The two main causes of tooth loss are decay and gum disease. The better we prevent or deal with these two problems, the more chance people have of keeping their teeth for life.
When the dentist, hygienist and patient work together, this can help to prevent the need for treatment and avoid the traditional pattern of fillings and extractions. Your dental team may recommend a course of treatment to get your mouth into good condition, and then work out a ‘maintenance plan’ to help you keep it that way.
Can everybody benefit from preventive dentistry?
Yes. Preventive dentistry will benefit anyone with some of their own teeth. People who don’t have any teeth can also benefit, because conditions such as mouth cancer and denture stomatitis can be spotted during regular visits to the dentist and then treated. It is excellent for children and young people, but it is never too late to start.
What is involved?
Your dentist will first check your teeth and gums, and talk to you about any treatment you need. The main aim is to help you get your mouth really healthy. In a healthy mouth it is unlikely that decay or gum disease will continue to be a problem.
The hygienist or dentist will thoroughly ‘scale and polish’ your teeth.
The dentist or hygienist will show you the best ways to brush and clean in between your teeth using interdental brushes or floss to remove the bacterial ‘plaque’ which forms constantly on your teeth. When you eat or drink something sugary, the bacteria in the plaque turn the sugar into acid, which may cause tooth decay. Plaque can also cause gum inflammation (swelling and soreness) if it is not regularly and thoroughly removed. The hard tartar (or ‘calculus’) which builds up on the teeth also starts off as plaque.
You will be told which oral care products are the best ones for you to use.
The hygienist will probably talk to you about your diet, and any habits such as smoking and drinking.
Your dentist will also make sure that all your fillings are in good repair and there are no rough edges to make cleaning difficult.
Will my dentist recommend treatment?
A ‘preventive dentist’ will often recommend treatment to strengthen a tooth to make sure it does not break. For example, if the dentist sees that a tooth is cracked, or is weak and in danger of breaking, they may advise a new filling or perhaps a crown or ‘onlay’ to protect it. This is always better than waiting until the tooth breaks, and then dealing with it as an emergency.
What else can the dentist and hygienist do to help prevent tooth decay?
Fluoride helps teeth resist decay. If your dentist thinks extra fluoride would be useful, they may recommend applying a fluoride varnish. They may also suggest fluoride rinses, tablets or drops to use at home as an extra help against decay. Children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm (parts per million). Three-year-olds to adults should use a toothpaste that contains 1350ppm to 1500ppm of fluoride.
What are pit and fissure sealants?
The biting surfaces of teeth can be protected by applying ‘sealants’. These make the tooth surface smoother and easier to clean, and stop decay starting in the difficult-to-clean areas. Your dentist will suggest whether this would be right for you. (See our ‘Tell me about’ leaflet Pit and fissure sealants.)
Can diet affect my teeth?
Food and drinks containing sugar cause decay. If you cut down on how often you have sugary snacks and drinks this will help a lot. Foods such as cheese, fruit, nuts and vegetables are better for your teeth.
What is dental erosion?
Dental erosion is the loss of enamel caused by acid attack. When the enamel is worn away it can lead to pain and sensitivity. Foods and drinks that contain acid, such as citrus fruits, fizzy drinks, smoothies, fruit juice and fruit teas, can all cause dental erosion if you have them often.
Can smoking and drinking affect my teeth and gums?
Yes. Smoking can cause tooth staining, tooth loss, mouth cancer and make gum disease worse. If you smoke, you may need to visit the dentist or hygienist more often, but the best advice is to try to give up. Alcoholic drinks can also cause mouth cancer and if you smoke and drink you’re more at risk. Some alcoholic drinks contain a lot of sugar, and some mixed drinks may contain acids. So they can cause decay or erosion if you drink them often and in large amounts.
Can I prevent dental erosion?
Acidic foods and drinks can be harmful if you have them often in large amounts. Try to keep acidic food and drinks to meal times and drink acidic drinks through a straw.
We recommend that you do not brush your teeth for at least one hour after eating or drinking anything. Every time you eat or drink, the enamel on your teeth becomes softer for a short while, and loses some of its mineral content. Waiting for an hour or so will allow your saliva to slowly restore it to its natural balance.
What can I do at home?
It is very important that you keep up a good routine at home to keep your teeth and gums healthy. We recommend that you:
Is there anything else I can do?
The dentist and patient working together Yes. You can take other steps to help prevent tooth loss, decay and the need for treatment.
What oral care products should I use?
There are now many specialised toothpastes, including total care toothpastes and toothpastes made specially to help with plaque and gum disease, sensitive teeth and whitening.
Mouthwashes can help, and there are different types, including ones with anti-bacterial ingredients.
Adults should use a toothbrush with a small- to medium-sized head and soft to medium filaments (bristles).
Tests have shown that electric toothbrushes with an oscillating, rotating action are better than manual toothbrushes at removing plaque and can remove up to twice as much plaque as a manual toothbrush. If you are unsure, ask your dentist or hygienist for advice on the one that best suits your needs
What is a dental hygienist?
Dental hygienists are specially trained to work as part of the dental team, to give care to patients.
They play an important part in dental health care and are mainly concerned with preventive dental health and treating gum disease -showing you correct home care and helping to keep your teeth and gums healthy.
What does the dental hygienist do in the practice?
The hygienist’s main work is to prevent and treat gum disease including professionally cleaning your teeth. This is usually called ‘scaling and polishing’. However, perhaps their most important role is showing you the best way to keep your teeth free of plaque. Plaque is a sticky coating that forms constantly on your teeth. If it is not brushed away properly, this hardens to form tartar which you cannot remove yourself. They also give advice on diet and preventing dental decay. The hygienist will work alongside your dentist to give you care that is tailored to your needs.
Can a dental hygienist do anything else?
Dental hygienists also take dental x-rays. The dentist will use these to help diagnose problems and decide on the possible treatment. All hygienists that take x-rays will have had proper training and will hold a certificate.
If the dentist suggests that you or your child have fissure sealants or fluoride varnishes, they may refer you to the dental hygienist because these are treatments they are trained to carry out.
Tooth whitening is also often carried out by the dental hygienist under the prescription of your dentist.
Why is this dental treatment important?
Regular professional cleaning, combined with looking after your teeth and gums well at home, will help keep your mouth healthy. A clean and healthy mouth will improve your appearance, help you to keep your teeth and give you fresh breath, and help to maintain your general health.
Can a hygienist help prevent dental disease?
patient and hygienist This is what the training of the hygienist is all about. Carefully removing the hard deposits of tartar (or ‘calculus’) that build up on the teeth and teaching you how to prevent them coming back, will go a long way towards slowing the progress of gum disease.
By talking to you about your diet, and recommending other preventive measures, the hygienist can help you keep to a routine that will slow down the rate at which your teeth decay.
Regular visits and advice will help build your confidence in keeping your mouth healthy.
What other help can be given to adults?
Adults who have a lot of decay can benefit from having fluoride applied. They can also have anti-bacterial gels and solutions applied under the gum to kill the bacteria causing gum disease.
Another very important part of the hygienist’s work is showing you and telling you how to look after your mouth at home. The hygienist may also suggest giving up smoking, as this will reduce staining and improve your general health. Research has also shown that smokers have more gum disease and lose more teeth than non-smokers. Your hygienist will be able to advise you on various ways of giving up smoking. They can also give you special advice for home care if you have dental implants or orthodontic appliances.
What help is available for children?
Children can benefit from having their teeth polished. The hygienist can also apply fluoride varnishes to help prevent decay.
The permanent (or ‘adult’) back teeth can also benefit from having the biting surfaces sealed. This is done by applying a special plastic coating to the biting surface soon after the teeth come through. For more information see our ‘Tell me about’ – Pit and fissure sealants.
Why doesn’t the dentist do this work?
Some dentists will do this type of work themselves. However, many now realise that the hygienist has been specially trained to carry out scaling and polishing and can spend longer with you. They are also expert at teaching you how to look after your teeth and gums. Often the hygienist will spend a number of appointments getting the gums healthy ready for the dentist to restore the teeth with crowns and fillings.
Will the treatment hurt?
Scaling and polishing is usually pain free. However, if you do have any discomfort the hygienist can use anaesthetic creams, or give you some local anaesthetic. It is important that you let the hygienist know at the time so they can help with your discomfort.
What can I do to help the hygienist?
You can do a great deal to help yourself and the hygienist, as you are in control of your mouth between visits to the practice. Your hygienist will have shown you how to remove plaque with a toothbrush and fluoride toothpaste.
They will also have shown you how to clean between your teeth with interdental brushes, floss or tape.
There are many oral care products now available including specialist toothpastes, power or electric toothbrushes, and mouthwashes. Your hygienist will recommend those that are best for you.
We recommend you follow three simple steps to help keep your teeth and gums healthy.
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