Prosthodontics, Implants, Cosmetic & Reconstructive Dentistry

Dental Implants

Is your smile suffering from a missing tooth? This not only has the obvious aesthetic ramifications of showing a noticeable gap in your smile, but can hinder you overall bite and effect the neighboring teeth.

Dental implants are the permanent addition of a new tooth.  They involve inserting a titanium screw through your gums and down into the jawbone. This new foundation is then capped with a natural looking, artificial tooth which permanently restores your smile!

Dental implants are metal anchors which are surgically placed into the jawbone and act as tooth root substitutes. Small posts are then attached to the implant, which protrude through the gums. These posts provide stable anchors for artificial replacement teeth. For most patients, placement of dental implants requires two surgical procedures. First, implants are placed within your jawbone. For three to six months following the first surgery, the implants remain beneath the gum surface, gradually bonding with the jawbone. After the implant has bonded to the jawbone, the second phase begins. Dr. Zar will uncover the implants and attach a small healing collar. Posts or attachments are connected to the implants, and then we will take an impression and begin the process of making your new teeth. The replacement teeth are made over the posts or attachments. The entire procedure usually takes six to eight months from start of implant placement in the bone until the final implant crown is complete.

Most patients do not experience any disruption in their daily life.

Bone Grafting for Implants

Do I Have Enough Bone?

After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months. However, when the walls of your socket are very thin (such as in your upper and lower front teeth), this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help your body fill in the empty socket with bone. This step will maintain the width and volume of bone you will need for implant placement several months later.

There may be inadequate bone for implant placement if your tooth was removed many years ago and your bony ridge is extremely thin. In this case, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to your pre-existing bone, the ridge will be re-entered and the implant placed. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including your own bone.

You may also need bone grafting if the sinus cavities in your upper jaw are very large, or very low, and extend into the tooth-bearing areas. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is limited. A “sinus grafting procedure” is then required. Most often, it is performed in the office with local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure often can be performed at the time of implant placement.

Dental Implant FAQ

If I want dental implants how do I start the process?

Getting dental implants begins as every dental procedure does: with a visit to your general dentist. He or she is in the best position to consider your request, examine your current condition and your past records, then help you make an informed decision. Your general dentist can then refer you to a specialist—or several specialists—who are trained to handle your specific dental concerns.

How do I know if my dentist can do dental implants?

Dental implants are a specialty in dentistry and not all general dentists have the background necessary to provide their patients with dental implants. It is up to you to ask your dentist if he or she has the proper education and experience.

What should I know before having dental implant surgery?

Your selected dental professional should thoroughly explain your dental implant surgery to you, from before it begins, through the procedure, and all after-care. You will be given an informed consent form to read and sign prior to surgery. Make sure you read this form thoroughly.

What are “teeth in a day”?

“Teeth in a day” is a common advertising slogan in dental implant centers. This is typically a bit misleading as few people are really able to get a dental implant in a day and even then, it tends to be a two-day affair. Unfortunately, “teeth in a day” is more hype than reality ~ However if planned in advance, it can be arranged where you have extractions and then have a replacement temporary in ½ a day.

Can a general dentist perform dental implant surgery?

Some general dentists have taken the extra training necessary to perform dental implant surgery and some have not. You should ask your dental professional if he or she has had the training and experience required, and even if he or she has, it’s your choice as to whom you use for this procedure, your dental professional or a surgical specialist. Be aware that any dentist can take a course and choose to place implants. There are no regulations that would monitor a dentist from doing so. It is highly recommended that implants are placed by a specialist for example a Periodontist or an Oral Surgeon with many years’ experience. Restoring an implant is a highly technical and involved procedure / process. Implants that a
re placed and restored should be done by an experienced Prosthodontist.

Are dental implants painful?

Most patients do experience some minor discomfort the first day after their dental implant surgery and may still have a little residual pain the second day, but when compared to tooth extraction, dental implants tend to be less painful.

Can I convert my dentures into an implant overdenture?

This is something your dental professional will have to decide, but it is not out of the question, so be sure to ask.

Are overdentures expensive?

Overdentures are more expensive than conventional dentures, so weigh this carefully with the vast benefits overdentures provide. Learn more about dental insurance and financing.

How long does it take to get overdentures?

From beginning to end, the entire process for overdentures takes several months. Expect three to four months for your overdenture fitting and placement.

Do I need two or four implants for overdentures?

Whether you need two or four dental implants is an individual decision. There are several considerations to be thoroughly explored by you and your dental professional before proceeding with two or four implants

Post Op Care for: Dental Implants 

Day of Surgery

FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.

EXERCISE CARE: Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently. Smoking will retard healing, causing increased discomfort and increased chance of dry sockets. We strongly discourage smoking during the healing phase.

ORAL HYGIENE: It is important to keep the mouth clean. You should brush your teeth the night of surgery, but be gentle around the surgical sites. If there is minimal bleeding, saltwater rinses may begin 24 hours after surgery (mix 1 tablespoon of salt with 8 ounces of water.) Swish gently and allow the water to drip into the sink. Rinses should be done 2-3 times a day, especially after eating.

ACTIVITIES: Activities after surgery should be couch or bed rest for the first day. Bending, lifting, or strenuous activity will result in increased bleeding, swelling and pain. You should be careful going from the lying down position to standing. You could get light headed when you stand up suddenly. If you exercise regularly, be aware that your normal fluid and caloric intake is reduced. Exercise in the post-operative period may also result in increased bleeding, swelling and discomfort. Exercise should be avoided for 3-4 days following surgery.

OOZING: Bleeding will occur after surgery, and it is not uncommon to ooze blood for 24-48 hours after surgery. Keep in mind that oral bleeding represents a little blood and a lot of saliva. Placing a gauze pack over the area and biting firmly will control bleeding. If oozing is still active, replace gauze as needed every 30-45 minutes.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or begins again sit upright or in a recliner, avoid physical activity, use ice packs and bite on gauze for 1 hour or on a moistened tea bag for 30 minutes. The tannic acid in the tea leaves helps to promote blood clotting. If bleeding remains uncontrolled, please call our office.

SWELLING: Swelling is a normal occurrence after surgery and will not reach its maximum until 2-3 days after surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

PAIN: Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. Some patients may even require two of the pain pills at one time. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.

DIET: Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.) Avoid chewing food until tongue sensation has returned. It is best to avoid foods like rice, nuts, sunflower seeds, popcorn, etc., which may get lodged in the surgical areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

NAUSEA: Nausea and vomiting can occur as a result of swallowed blood, discomfort, anesthesia or pain medicines. Post-operative nausea is usually self-limiting and sipping on flat cola or ginger ale often helps. Soda crackers also may be used. If nausea persists, stop taking the pain medicine and substitute an over the counter pain medicine for the next dose. If nausea persists, call our office.

Day 2 and 3 post surgery: Dental Implants

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Use 1/4 teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but it is extremely important to clean your teeth within the bounds of comfort. Maintaining a clean environment adjacent to the healing surgical wounds is required for optimum and speedy healing.

HEALING: Normal healing after placement of dental implants should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement, please call our office.

DISCOLORATION OR BRUISING: The development of black, blue, green or yellow discoloration is due to bruising beneath the tissues. This is a normal post-operative occurrence that might appear 2-3 days after surgery. Beginning 36 hours after the surgery, moist heat applied to the area may speed up resolution of the discoloration.

SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.

DRY LIPS: If the corners of your mouth are stretched they may dry out and crack. Keep your lips moist with an ointment such as Vaseline.

SORE THROAT: This is not uncommon after oral surgery. The muscles get swollen and this may make swallowing painful. This should go away on its own in 2-3 days.

STIFF JAW MUSCLES: This may cause a limitation in opening the mouth wide for a few days after surgery. This is a normal post-operative event that usually resolves during the week after surgery. Stretching these muscles may help to speed up resolution of this problem.