Understanding the Tooth Implants Procedure Process

Are you missing one or several teeth? Are you unable to smile or eat properly? Are you unhappy with your dentures? Tooth implants are a popular option to replace what’s missing and get your smile back. ClearChoice Network doctors are specialists who focus on tooth implants, ranging from replacing a single tooth, to replacing a full upper or lower jaw of teeth. The tooth implant procedure at ClearChoice revolves around the patient: the surgeon, the prosthodontist (dentist who restores the implants), and the dental lab are all under one roof, allowing close communication and collaboration without having you travel to multiple locations. With a highly trained team of doctors and staff, precise 3-D imaging equipment, and innovative dental lab facilities in the same center, you will be able to have all your tooth implant treatment in one office.

For your initial consultation, a patient education consultant will explain the tooth implant process and help you navigate your dental needs to make it the best possible experience. You will meet a specialist to help determine whether you are a good candidate for tooth implants. When the process is started, you will have a thorough dental exam with x-rays, discuss different options to finalize a treatment plan, and then help design your new smile by choosing your tooth color, size, and shape. Every patient will have a unique tooth implant process, depending on whether you are replacing a single tooth or a few teeth and keeping most of your natural teeth, or whether you are replacing the entire top and/or bottom jaw of teeth. But with either tooth implant procedure, our team will lead you through it with the utmost care.

Single/Multiple Tooth Implant Replacement(s)

If you still have the decayed/loose tooth/teeth in place, you first need the tooth/teeth removed. A bone graft likely will be placed in the tooth socket to preserve the bony architecture. The bone graft acts as a temporary framework or placeholder for your body to eventually resorb it and fill in with your own bone over 2-6 months of healing. If the tooth/teeth is/are already missing, your body may have resorbed your own bone over time. Therefore, a bone graft may be required to re-create the height and/or width of the bone needed for the tooth implant process.

Once the foundation of bone is set, the first stage of the tooth implant procedure is when a tooth implant is surgically placed in the bone and then buried under the gums. The tooth implant is a metal rod with threads, very similar to a hardware screw, and it acts as the root of the tooth in the bone. The threads give the tooth implant mechanical retention in the bone. Tooth implants are made of a special medical-grade metal called “titanium” that eventually forms chemical bonds to bone. Over an average of 2-6 months of healing, the titanium metal and the bone form chemical bonds to each other that eventually become stronger than natural teeth.

After the tooth implant is healed in the bone, you will return for a smaller second stage surgery, where the top of the tooth implant is uncovered to place a metal cap called a “temporary healing abutment”. This temporary abutment is screwed onto the top of the tooth implant and peeks through the gums. The abutment will heal for about four weeks to help shape/condition the gum tissue for the final crown (prosthetic tooth) that will be attached to the top of the implant. If you are replacing a front tooth, a temporary crown may be made on top of the temporary abutment to help shape the gums in more detail.

Sometimes the above stages of the tooth implant process can be combined. For example, if a tooth is removed and there is enough bone, the tooth implant may be placed on the same day as when the tooth was removed. Another possibility during the first stage of the tooth implant process is if the tooth implant is placed and stable in the bone with minimal-to-no bone grafting needed then the second stage of placing the temporary abutment may be done immediately. Therefore, both the first and second implant stages of the tooth implant process can heal simultaneously.

After healing of both, the tooth implant and the temporary healing abutment, a final impression (mold) of the healed tooth implant and gums is taken . The impression is given to the lab to make the dental implant crown (prosthetic tooth). When you return to the office, the temporary abutment is removed, and the final abutment is screwed onto the top of the implant. The crown (final tooth) then is secured onto the final abutment either with a screw or with dental cement. Any final adjustments are made, and you are ready to enjoy your new tooth!

Whole Top and/or Bottom Jaw of Teeth

The tooth implant process for replacing the whole top and/or bottom jaw is similar, but with a few differences. In general, an average person who receives full arch treatment usually has 12-14 usable natural teeth per jaw. Instead of replacing each single tooth with one implant, the whole top or bottom jaw can be replaced with as few as 2-6 implants. Also, the tooth extraction(s) and the implants can be done on the same day.

One option for the bottom jaw is to place two tooth implants in the bone and secure a bottom denture. The denture is removable, but it can be snapped into place while in use to help prevent the tongue and cheeks from moving the denture around too much. The top jaw requires a minimum of four implants for a snap-in top denture.

Another option for the top and bottom jaws are fixed full-arch dental implants, where a minimum of four implants are placed in one jaw to anchor a whole set of teeth for that jaw. Usually the bone is solid enough for the tooth implants to have good mechanical retention from the screw threads in the bone, so that the temporary set of teeth can be attached to the implants on the same day.

The initial set of teeth that are placed on the tooth implants the day of surgery are temporary. These temporary healing teeth are like training wheels. During the 4-6 months of healing of the tooth implants, these teeth will help you get used to something new in your mouth. You will also be able to evaluate whether you want to change the color, shape, size, and position of the teeth. The temporary healing teeth are made of denture material which is able to be added to, cut, and changed. Once the final custom teeth are made, they cannot be altered. We want to make sure you are happy with the temporary healing teeth design before moving to the final product.

Recovery from surgery

Some bleeding, swelling, and bruising is expected after any tooth implant procedure. Since swelling will peak in 48 hours, you should use ice for those first 48 hours on both the outside and inside your mouth. You can switch to heat after 48 hours to recirculate the blood supply to the area and bring the swelling down. Keep your head elevated above your heart with extra pillows when lying down or sleeping. Light walks are okay, but you should avoid any vigorous physical activity for about a week after surgery to avoid stirring up bleeding. You want to maintain a soft diet and avoid biting, tearing, and chewing to avoid pressure on the area of the bone graft(s)/implant(s). Placing tooth implants are like putting poles in wet cement: it takes an average of 2-6 months for the healing of the bone graft/implants. Any movement could cause them not to heal properly and fail, so the healing process will require 2-6 months of your careful attention.

Post-Op Care

Usually we do not recommend that you do any brushing or rinsing for the first 24 hours after your tooth implant procedure. The following day, you will be able to brush and floss your natural teeth (if any), but your implants will just require rinsing with salt water and the medicated prescription mouth rinse for the first two weeks. At the follow-up appointment, our staff will review detailed instructions on brushing, oral rinses, using the water flosser (if you have a whole jaw replaced by implants), and flossing the natural and/or prosthetic teeth, depending on your surgery. You want to pay close attention to and follow the detailed instructions that will be given at your follow-up appointment, as the same bacteria that can cause bone loss around your teeth can also cause bone loss around your implants. Therefore, you will still need to continue regular daily dental care and professional dental cleanings to protect your remaining teeth (if any) and your tooth implants. Other factors besides detailed oral hygiene that will help optimize your long-term results will be to avoid smoking/nicotine products and maintain good blood sugar control if you have diabetes.

At ClearChoice, we aim to help you achieve optimal dental health and are committed to improving the lives of those suffering with failing teeth by providing the best care possible to transform your life in a positive, meaningful way. If you have additional questions about the tooth implant procedure or want to learn more about permanent teeth replacement options, schedule a free consultation at your local ClearChoice center today.

By Esther Oh, DDS, MD
Oral & Maxillofacial Surgeon, ClearChoice Tampa

Dr. Esther Oh attended Duke University and received her Doctor of Dental Surgery from the Virginia Commonwealth University School of Dentistry in Richmond, VA. She completed her Medical Degree at the University of North Carolina – School of Medicine in Chapel Hill, NC, where she also completed a 6 year oral maxillofacial surgery residency. After her fellowship in oral cancer/reconstruction at the Center for Ear, Nose, Throat, and Allergy (CENTA) at St. Vincent Hospital in Indianapolis, IN she began teaching oral maxillofacial surgery residents and dental students as a clinical assistant professor at the University of Florida. She is board certified by the American Board of Oral Maxillofacial Surgery.