Successful D enta l Im pla nts

Q.

“I heard that dental implants have to be removed sometimes. Does this happen often?”

A.

Today’s dental implants hold one of the highest success rates of all in-bone implant types - nearly 98%. While dental implants are designed to last a lifetime, as with any procedure that involves an implant in human bone, there is an element of risk. In addition to the onset of infection, “bruxing” can be one of the contributing factors to implant failure.

Bruxism is defined as the unconscious gnashing, grinding, or clenching of teeth, usually occurring during sleep. Bruxism and clenching are the most common oral habits and are estimated to occur to some extent in over 80% of the population. Bruxism can involve the teeth, muscles, joints, bone, implants as well as dental prosthetics (partials, crown-&bridge, dentures) in the mouth. While teeth grinding is often attributed to stress and anxiety or as a result of sleep disorders, the act of night-time bruxing also occurs from bite misalignment or missing and crooked teeth. Recently, another source was revealed through a study in the November 2016 issue of the Journal of the American Dental Association. It suggests that people who drink alcohol, heavy coffee drinkers and smokers are more likely to grind their teeth. The odds for grinding during sleep seems to increase more than 2 times for those who are smokers, nearly 2 times for those who drink alcohol, and almost 1.5 times for those who drink more than 8 cups of coffee a day.

The greatest natural forces exerted against teeth, including replacement teeth attached to implants, occurs while eating. These biting and chewing forces range from 5 to 44 pounds of pressure per square inch (psi) for natural teeth. For instance, humans exert a force of 21 psi to chew meat and 28 psi to chew a raw carrot. Fortunately, the average time during which chewing forces are applied to the teeth is only 9 minutes per day.

For a patient who bruxes, these forces can be far greater since the muscles involved in biting and chewing endure more intense and frequent exercise. For patients who brux, the maximum average biting force is 170 psi for adult males and somewhat less for adult females. For some bruxers, pressure loads on the teeth may exceed 500 psi (compare this to a lion who uses 600 psi, on average).

Signs of clenching or grinding are teeth that are worn down, chipped or broken. Dentists can often times determine if patients grind their teeth because “wear facets” are apparent when the teeth are examined. Many patients have no idea they are grinding as they sleep. Sometimes patients wake their partners with their loud grinding and the patient remains clueless. If you suspect you grind or clench, it is important to mention this to your implant doctor prior to treatment so corrective measures can be taken to resolve the problem to protect the restorations placed on top of your implants and of course any other dental work or tooth structure in your mouth.

Although not a frequent occurrence, removing an implant means the patient has lost their investment. Often, they must undergo additional procedures and expenses for removal and replacement. Although the implant doctor has the responsibility to properly diagnose, treatment plan and place the implants, it is the patient who plays the most important role in helping to minimize the risk of implant failure.

- tant factors in any successful medical or dental procedure begins with the doctor who coordinates your care. Your doctor should never be selected based on the lowest fee. The doctor should have specific training and experience in the diagnosis and placement of all implant types in order to select the system most appropriate for your individual needs.

In selecting your doctor, you should also look for a good track record in the placement of implants. Successful placement relies on the ability to assess for adequate bone mass to support an implant without interfering with adjacent structures. In addition to ensuring your doctor is uniquely qualified, keeping risk factors low lies in the patient’s hands once they leave the doctor’s office.

Patients can improve their potential for a successful outcome almost immediately. When the implants are placed, the patient should closely follow their post-op instructions. For most patients, we recommend they eat cool, soft foods for the first few days. This helps to minimize swelling and bleeding and helps the gum tissues around the incision sites to heal faster. With faster healing, infection risk decreases.

Once home, other factors can also put your implants at risk. For smokers, their risk for implant failure is high because the chemicals in cigarette smoke are so drying to oral tissues. This can delay the healing process. The longer the placement sites take to heal, the greater the risk for infection.

Most important of all is the patient’s commitment to maintaining good oral hygiene. Even though dental implants do not experience decay, the gum tissues and bone supporting the implants are as susceptible to oral bacteria as before. When infectious bacteria reach the implant sites, the only option for treatment may involve removal of the implant.

Having dental implants requires a solid commitment to twice-daily athome oral hygiene. Your dental cleanings may also be scheduled to occur every three to four months rather than twice a year. This is so your hygienist can remove accumulated bacteria in your mouth and around implant sites.

Adults with dental implants are able to bite, chew and laugh with confidence. We believe every patient should enjoy a confident smile - for a lifetime. Being an involved patient in your selection of a dentist who placed implants and helping to maintain your implants after placement increases your potential to achieve a lifetime of smiles, without worry! Call 501-262-4010 to schedule or visit