Treatments

Dental Implants

The Problem of Losing a Tooth

Of course, no one wants to lose a tooth, and we try to save a tooth if possible; however, sometimes, they are beyond repair. The body is amazingly designed, and the mouth is no different – each tooth is shaped and positioned for a precise reason. So, even if you can’t see a missing tooth, it still matters. Since our bodies are designed for function only, the physical impact of tooth loss reverberates around the mouth and body. Losing a tooth is more than just an appearance or functional issue. Following tooth extractions, people can also feel a sense of loss, disappointment, shame or guilt.

After a tooth is lost, you may experience the following:

• The bone and gum shrink where the tooth used to be.
• Adjacent teeth can drift out of position into the gap.
• Air escapes through the gap, causing changes in speech.
• The bite changes, and other teeth take on the loads during chewing. Bite changes can cause teeth to wear down or pain in the teeth, facial muscles and jaw joints.
• Eating can become slower and more laborious.
• The face can change shape as the jaw bones shrink, resulting in an aged appearance.

Benefits of Implants

Implants replace missing teeth with substantial additional benefits, including:

• Bite strength – one of the top things that patients look forward to at the end of treatment is enjoying their food again.
• Restoring emotional wellbeing – due to the security of the teeth.
• Improved confidence when smiling.
• Slowing bone shrinkage, which maintains facial appearance and lip support.
• Implanted teeth share the loads when eating, therefore preventing overloading forces on your other teeth so helping them last as long as possible.
• Avoidance of trimming down adjacent teeth.
• Not having to wear a denture so the mouth feels more spacious, theres no denture adhesive or no gag reflex.
• Helping to maintain speech…and gives confidence when kissing!

Benefits of the Gentle Approach

Implant dentistry is a fascinating and fast-developing field. Problems that were impossible to fix even 10 years ago are now tackled effectively.

With 25 years of surgical experience and a focus on continually keeping up to date with the latest methods, equipment and digital technology, we strive to:

• Have the implant treatments look and function as well as possible.
• Make the patient’s implant journey as manageable as possible. The feedback from our patients is that the treatment is often easier than they imagined.
• Plan the implant treatment to reduce potential complications as much as possible.

We realise that implant treatment can be daunting for some patients. Before implant placement we provide medications to make you as comfortable as possible. Then we use double-strength anaesthetic for procedures to ensure adequate numbing. After the implants are placed, patients leave with a goodie bag of medications to make their healing period as successful and manageable as possible. Additionally, conscious sedation is available to take the edge off appointments.

We provide the full range of bone and gum grafting to improve the appearance and longevity of the implants that we place. Moreover, due to our range of implant treatments, we can restore most missing teeth and create treatment options for reduced budgets and individual preferences.

Our style is to work as a multidisciplinary team so that the most suitable dentist performs each treatment. We partner with a superb oral surgeon from London who places advanced Zygomatic implants for people with extensive upper jaw bone loss.

We are passionate about dental education and provide a range of dental courses, including implant training at Gentle.

What is an Implant?

An implant is a titanium post that’s placed under your gum into the jaw bone. Your body grows bone over the implant keeping it well anchored. A new tooth is then designed to connect to the top of the implant so you can eat, speak and smile with confidence.

Bone Grafting

Just like teeth, implants need a certain amount of bone or gum to support them. If you have lost bone or the gum is not sitting in the best position, we can help correct the problem. These advanced treatments, called Bone Grafting or Gum Grafting, can springboard you toward a better-looking and more stable implant result.

Replacing a Few Teeth

Did you know you don’t always need an implant to replace every tooth? For example, if you have a three-tooth gap, sometimes the dentist will advise a three-tooth bridge supported on a platform of two implants. This approach closes your gap, functions better and is more cost-effective than three single implants.

Replacing a Lot of Teeth

If you have more significant gaps, an entire jaw without teeth or complete dentures, there are specific solutions to reconstruct what you have lost and enhance the quality of your life.

The two main approaches are:

• Fixed Bridges – Larger bridges have the teeth joined together and replace the lost teeth, bone and gum. We use strong, beautiful porcelains to create an entire jaw of teeth supported by 4-8 implants. The fixed bridges have less bulk in the mouth than a denture solution, so they are handy for people with a strong gag reflex.
• Click on Dentures supported by Implants – Any implant-supported denture will give you a more stable denture, so you won’t need to use denture adhesive again. We use gold stud and bar attachments on top of implants that connect to new dentures. For top click on dentures, most of the roof of your mouth is exposed so you can taste your food better. With less bulk in your mouth, there is more room for your tongue, so it feels better and is easier to speak with. Lip and face support can be improved with an enhanced denture design. Natural gum work is added for extra naturalness when talking and smiling. A click on denture is an excellent, more affordable option, which is easy to clean and maintain. Your dentist will advise you as to your suitability for each approach.

Faster Implants

Advances in modern dentistry mean faster treatment in some cases.

For example,

• Extract a tooth, place an implant, and put a temporary tooth on top of the implant on the same day.
• Place a few implants and attach a row of temporary teeth on the same day.

Suitability for faster implant treatment depends on a variety of factors. Please call for a consultation to discuss the relevant details.

After Care

At each stage of your implant treatment, we keep in touch with you to ensure your satisfaction. We show you how to clean around our “EasyClean” designed implants, which maximise health and promote treatment longevity. People are encouraged to adopt a healthy lifestyle and daily cleaning routine to make implants last as long as possible. A regular hygiene schedule should be adhered to to keep the implants clean and healthy. A dentist should check the implants, gum and bone health every 6-12 months.

Timescales and Payment

The advanced training, treatment complexity and material processes involved in providing you with implant solutions mean that the investment is higher than in general dentistry.

Implant work typically takes 3-12 months to complete. Temporary teeth are always an option, so you are never left with a gap from the start of treatment. The temporary teeth can be used as a prototype for long-term teeth. This means you are looking better as you proceed.

This time frame and our wide range of finance schemes means more choices regarding your payment options for this investment. All the time, patients tell us how the benefits of implant treatment were worth it in terms of time and money.

Examples

1. Front Tooth Porcelain Crown on Single Implant

This lady was very upset after a dumbbell hit her mouth in the gym and knocked the front tooth out.

A temporary bridge was made to avoid her having to wear a temporary denture during the teatment, which is less comfortable.

A single implant with bone grafting was placed.

Once the implant was bedded into the bone, a new porcelain crown was fitted on the implant, and a new crown was placed on the adjacent tooth to match in better.

2. Front Tooth Porcelain Crown on Single Implant

This lady attended Gentle after a previous implant had not worked. In the left photo below is a temporary bridge that kept falling out, which was frustrating for the patient, so she wanted to try again with implant treatment. Moreover, when she smiled, the adjacent eye tooth had an exposed root, so it looked too long. At the same time as placing gum around the implant, a gum graft was placed to cover the exposed eye tooth root. This improves the overall aesthetic outcome for the patient. Below on the right you can see how we took time to rebuild the bone and gum in the first phase of treatment, which gave the implant a solid foundation to sit in.

The implant was placed into the bone, under the gum, and a white post was chosen to fit into the implant to maximise the final crown’s appearance. The after photo was taken 5 years after the implant was placed and shows how nicely the work is performing.

3. Premolar Tooth Porcelain Crown on Single Implant

When this lady was younger, she had four teeth removed and then braces placed. However, the patient didn’t like her end smile; she felt it looked too narrow, so she sought more treatment.

At the beginning of treatment, the top gaps were too narrow to place the correct size of the premolar tooth. So braces were put on, and the gaps were opened up. When we achieved enough space, we could place the implants on either side of the top jaw. Porcelain crowns were placed on the implants. A while later, we added composite bonding on other teeth to further improve the patient’s bite, bringing additional comfort to her facial muscles and jaws.

4. Molar Tooth Porcelain Crown on Single Implant

This woman had a badly broken down lower molar that had split apart and had been painfully abscessing for months. Unfortunately, it was beyond saving, and it was extracted. Keen to have the space restored, the patient opted to have an implant placed.

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5. Porcelain Bridge on Implant

One New Year’s Eve, we received a phone call from a distressed lady who said her top front bridge had fallen out unexpectedly. Regrettably, the two teeth that supported the bridge had decayed and couldn’t be fixed. The patient wanted to avoid wearing a long-term denture and had always longed for a better smile. She was very self-conscious when smiling, and like many people, having her photo taken was not her favourite event.

The above shows the two rotten teeth that were removed and went on to be replaced by two implants with gold posts.

Below is a temporary bridge worn during the treatment phase.

To achieve smile symmetry, the gum was recontoured around the adjacent teeth while others had gum grafts placed to reduce the speed of gum recession. Both the health and appearance of the smile were addressed.

6. Sinus Grafting for Implants

At the back of everyone’s top jaw, there is an air sinus just above the roots of the back teeth. After removing a top back tooth, the air sinus drops down towards the mouth like an expanding balloon. When we place an implant, we need enough bone width and height to place the implant into. Frequently, there isn’t adequate bone height in the back part of the upper jaw for placing an implant. If this is the situation, we put some bone back in to create more bone height to facilitate placing the implant. This type of procedure is known as a sinus bone graft.

This patient was fed up with her denture and remaining loose upper teeth.

5 upper implants have been placed that support a bridge with 13 teeth in the top jaw.

This is a full arch porcelain bridge which the lady was delighted with.

7. Full Mouth Implants

This lady was embarrassed by her yellow teeth and the gaps. The remaining upper teeth were loose from smoking-related gum disease. The upper front teeth were removed, and a temporary denture was placed to allow healing so that the implants could go into a clean bone environment with higher chances of treatment success. A few months later, six upper implants with bone grafting were placed and then a strong porcelain bridge with 12 teeth was fitted on top of the implants.

This patient was fed up with her denture and remaining loose upper teeth.

5 upper implants have been placed that support a bridge with 13 teeth in the top jaw.

This is a full arch porcelain bridge which the lady was delighted with.

If there is enough bone, now there are new techniques which mean we can do the sinus bone graft and place the implant on the same day. This is easier, quicker, cheaper and more predictable for patients

8. Dentures Fitted to Bars on Implants

This gentleman felt that he had let his mouth go and was ready to get them sorted out. Even though he had most of his teeth, they were heavily decayed, abscessed, split and loose. Regrettably, his upper and lower teeth were past saving and were removed.

We placed eight upper jaw and six lower jaw implants. These were then joined with a bar.

Below left, you can see the inside of his denture with the metal sleeve that fits onto the bar. The custom-made bar is pictured on the right. Although the bars look different initially, patients love the bar’s stability for their dentures. The dentures are simple to remove and place. There’s no movement on eating, and cleaning and maintaining the implants long-term is easier.

9. Partial Dentures Fitted to Studs on Implants

This gentleman came to Gentle as he was concerned that you couldn’t see his teeth when he smiled and that they were continually breaking apart. His upper jaw was sitting way too far back, so his teeth didn’t meet correctly, and the upper lip appeared to collapse inwards.

We removed the hopeless teeth and placed four upper front implants. These were then joined with a bar which is brilliant for supporting a removable partial acrylic denture. The flexibility of a removable denture allowed us to improve his facial appearance by being able to build in the correct lip and facial support while at the same time improving how his teeth bit together and having the right amount of tooth on show when he smiled. In this case, we made the patient two partial dentures so that one would act as a spare.

10. Full Mouth Click On Implant Dentures

This gentleman had been wearing partial dentures for years, and it was only when the last remaining teeth started to loosen that he sought treatment. He was worried that he would have to wear full dentures and that they would move around too much.

There was only one tooth remaining in the top jaw and two teeth in the lower jaw. These gum-diseased teeth were removed, and four upper and four lower implants were placed. New upper and lower dentures were made that clicked onto gold stud attachments on the implants.

On the left is the lower denture as seen from the front, and on the right, you can see the attachments that are fitted inside the lower denture. These allow the lower denture to click onto the four gold studs, in the photo below.