Dental Implant FAQ’s

Here are some common questions people ask about dental implants:

What is a dental implant?

implant_drawing_smA dental implant is a small titanium fixture that serves as the replacement for the root portion of a missing natural tooth. It is surgically placed in the bone of either the upper or the lower jaw. The bone grows around it and anchors the implant, and a dental crown is placed over it, so that it becomes a complete tooth replacement. They can be used is you are missing one tooth, missing several teeth, and even if you are missing all your teeth.

How long do they last?

When dental implants were first developed back in the 1970s, they weren’t very long-lasting. It took a lot of research and development to improve the success rate. Now, after more than three decades of clinical experience with over a million patients treated, statistics show that about 95 percent of individual implants are successful. The rate is even higher for bridges supported by implants.

Success is defined as remaining and in function over a five-year period.

How long do dental implants last today? That depends on a couple of factors. One, of course, is how well you take care of them. You need to brush and floss – keep them clean, to prevent inflammation around the implants.

Second, a lot depends on how well they were put in. Because dental implantology is such a new field and isn’t yet a part of the standard dental school curriculum in all dental schools, many dentists are trying to place them when they haven’t had the full education required to do them well. Also, many dentists are trying to cut their costs. For example, there are 200 companies making dental implant fixtures. Only six of these, however, produce fixtures certified by the American Dental Association. To be certified, they have to supply research demonstrating that the fixtures are safe and effective. If you have non-certified fixtures placed, your treatment will likely not last as long, because the chances of developing a loose implant, or infection, or other problem will be greater. Certified fixtures are made to very exacting tolerances, and these standards aren’t followed for the “generic” fixtures.

But the temptation is high for dentists to use non-certified fixtures, because the high-quality certified ones cost about one hundred times as much. One part of the implant, for example, will cost $300-500 if it is a high-quality, carefully sterilized, exacting tolerance, name brand fixture. The same part will cost $3-5 if it is a non-name brand fixture, made in the Philippines. And the patient won’t know the difference until possibly years later.

So how long do the implants last? It depends on you, and on the care and expertise of your dentist. Poor quality treatment can lead to implant failure.

Dr. Chal has an international reputation for excellence, and patients come to him from around the country and even from distant parts of the globe. To learn why, you may want to see his impressive list of credentials, or visit his Phoenix dentist website to read the testimonials of grateful patients and see photographs of some of his amazing work.

Related information:

What is the cost?

Dental implant costs vary over a wide range, depending on the individual case. We’ll try to give you some helpful figures here, to help you budget for this expense. The costs mentioned below include the fee for the actual implant fixture, plus the crown, bridge, or denture attached to it.

Hopefully you understand the world well enough to know that you need to be careful about price shopping for this service. If you look for the cheapest implants, but the placement technique is sloppy and so they only last four years instead of twenty, have you really saved any money? The surgery to place implants is demanding, and if done properly, requires a lot of training, precision, and care, and can’t be rushed. And some dentists try to save money on the very costly implant fixtures, and you won’t notice the difference until months or years down the road. (See our page on implant costs and quality for more information about this.)

At Dr. Chal’s office, the cost of a single dental implant will vary from about $3000 to $5500, depending on the situation. This is the complete cost, which includes the surgery plus the crown. These are two separate procedures, and when we quote you a fee, the surgery fee will be separate from the restorative fee. If bone grafts are required, there would be extra costs for that. If one tooth is missing, only one fixture will be required.

If many teeth are missing, there could be considerable variation in the number of fixtures needed, depending on the situation. The dental implant surgery will cost about $1500 to $2500 for each fixture placed, and then crowns or bridges will be placed on top of those. The price of placing a full set of teeth on these implants could vary from $2000 to $10,000, again depending on the materials used and the difficulty and complexity of the case.

Don’t expect much help for implants from dental insurance. Most insurance plans provide for benefits based on the least expensive option for your case. Often the least expensive option is not very desirable, so be prepared for a stingy response from your insurance company.

Are they covered by insurance?

You could easily become frustrated with insurance coverage for dental implants if you expect too much from the insurance company. But if you remember that the company is in business to make money, you will find the issue easier to deal with.

The dental insurance company needs to compete, and it does this by trying to offer a satisfactory plan to the employer for a competitive price. Since dental implants are not needed by a majority of people, there isn’t much incentive for the company to offer generous coverage. It’s hard to sell that kind of plan to an employer.

What they do is, when you are missing teeth, they will pay benefits for the least expensive treatment option. So, let’s say you’re missing several teeth on the upper arch. The least expensive way to treat that would be with a removable partial denture. Well, you don’t want that because it means you have to wear hardware in your mouth, and it moves when you chew, and it is hard on the teeth it attaches to. You feel they should cover dental implants because that is clearly a superior treatment. But they aren’t a charitable organization and what is “best” for you isn’t their concern. They’re in business to make money for their shareholders, and it doesn’t make sense for them to pay thousands of dollars for a treatment when they can pay a few hundred.

So if you can move away from the entitlement mentality and into the “you get what you pay for” mentality, you’ll be much less frustrated and will be content for any help you can get from your dental insurance for implants.

Plus, be aware that all dental insurance plans will have an annual cap on the amount they will pay, and that this annual cap is set pretty low–around one or two thousand dollars. Again, this is to keep the plan economical for the employer.

Thus, since your dental implant costs will be mostly or all out-of-pocket, you need to be especially careful about your choice of an implant dentist. Since insurance won’t pick up the bill if mistakes are made, make sure your dentist is one who will do it right the first time. See our page about choosing the best implant dentist for tips.

Will they work for me?

Anyone who is missing one or more teeth is a candidate for dental implants. The key limitation is the amount of available bone to hold the implant. And even where there isn’t enough bone, a bone graft can rectify that situation.

Many people fear that age is a limitation—that they may be “too old” for dental implants. But this isn’t a factor. General health can be a factor, but not age.

If you like the idea of getting dental implants, the best way to find out if they will work for you is to schedule a consultation with Dr. Chal. He will explain the benefits and limitations in your situation and will be honest with you in telling you whether or not they will work, or if another treatment option would be better for your situation.

Call his office at 602-957-5000 and schedule a consultation. He’d be happy to talk to you. Be aware that giving you an accurate answer will involve conducting a thorough examination and health history.

Am I too old for Implants?

Sometimes, older patients are concerned that their age may prohibit them from enjoying the benefits of dental implants. However, this is not the case. Health is a key factor, but age isn’t so important. Generally, if you’re healthy enough to have a tooth extracted, you’re healthy enough to receive dental implants.

If you have general health problems, however, that could pose a problem. Certain chronic diseases can contraindicate this treatment. Dr. Chal can determine if you are a candidate. Give our office a call at 602-957-5000, and schedule a consultation. Dr. Chal will conduct a careful evaluation of your dental and health history and tell you honestly whether dental implants will work for you. But you’re not too old for that.

Yes, You Probably Are a Candidate for Implants

Dr. Chal has a high degree of expertise in this field, and he has assembled a team of specialists, such as dual-degree surgeons, technicians, and other professionals, who are accustomed to treating very difficult cases. He has had many patients come to him that were told they weren’t a candidate for dental implants, and almost all of them he and his team have been able to help. If you have questions about this, give us a call.

What are the advantages?

Advantages of Dental Implants

There are several important advantages to this treatment as compared with a bridge or a removable denture:

  • More esthetic. Since an implant uses a root replacement, the tooth looks like it’s growing right out of the gum, so it is very natural looking.
  • No jaw shrinkage. When you lose an entire tooth – crown and root – your jawbone shrinks because there is no root there. When a number of teeth are missing, the shrinkage can be substantial and can give your face a “caved-in” look that makes you look much older. Dental implants can prevent this from happening. A bridge or a removable appliance, even if it is a beautiful cosmetic denture of the kind Dr. Chal is famous for, won’t. (Click here to read more about facial collapse.)
  • No damage to surrounding teeth. To get a dental bridge, the two teeth adjacent to a missing tooth must be ground down to serve as anchors. Dental implants eliminate the need to grind down healthy teeth.
  • With a removable complete denture, the adjacent teeth don’t have to be completely ground down, but they do have to be modified some. Plus, anchoring the denture on existing teeth causes stress and weakens those teeth.
  • Permanent solution. The fixture is placed permanently in your jawbone as a replacement tooth. There are no loose parts to worry about. It is stable and comfortable. It won’t become loose and cause sores. Normally, it will serve you for life.

To help you plan your budget, we have a page about the cost of dental implants.

What do implants feel like?

Implant-supported replacement teeth look, feel and function like natural teeth. This means that you can eat and drink whatever you are used to. You can continue smoking as well, if you must, though we don’t recommend it. But most importantly, dental implants often improve your quality of life in a very concrete way. People who have felt embarrassed and worried because of their tooth problems are often overwhelmed by what new permanent teeth can do for their self-esteem. Since they feel just like having natural teeth again, it is a great boost to your confidence. They aren’t going to come loose at the wrong time. You aren’t going to develop sores that make them hard to wear. You won’t have to worry, if you’re invited to dinner, about being given food that you aren’t able to chew normally.

Related information:

Learn about the cost of dental implants?
Read about a dental implant mistake that Dr. Chal helped rectify.

Are implants esthetically pleasing?

Dental implants, if done right, are very esthetic. When you have a missing tooth, the root form is placed in your jaw, and the crown is attached to it. Therefore, your tooth looks like it is growing out of the gums, exactly like a natural tooth.

Dr. Art Chal is especially expert in this aspect of your treatment. Not only is he an acknowledged expert in implant dentistry (he is a Fellow of the International College of Oral Implantology), but he is also a Past President of the American Academy of Cosmetic Dentistry and is one of their accreditation examiners that helps decide which cosmetic dentists are good enough to be granted accreditation status. The beauty of his work is therefore recognized around the world.

Read Dr. Chal’s long list of credentials. You may also be interested to know how much effort he devotes to continuing education. He attends two hundred hours of continuing education courses a year. To give you an idea of how much that is, that would take about a month and a half if he were to do that in one stretch.

Related information:
What is the cost of dental implants?

Do dental implants function naturally?

People wonder if dental implants are as sturdy as natural teeth. The answer is, yes, they are. Following a brief adaptation period, chewing capacity is the same as natural teeth.

They also feel as secure as natural teeth, since they are anchored in the bone.

It wasn’t too long ago that an extended healing period of up to six months was required before these fixtures could be used. During this healing period, the patient would wear a dental flipper or other temporary tooth replacement to avoid placing stress on the dental implant during the healing period. Dr. Chal, however, has kept up with recent developments and can place implants that function immediately implants. It’s called the teeth-in-an-hour concept, and what it means for you as a patient is that the surgery is much simpler and you can leave the placement appointment with permanent teeth that you can use right away.

Related information:

What is the cost of dental implants?

Is the procedure painful?

Just as with any surgery, there can be some discomfort. Dr. Chal uses local anesthesia and nitrous oxide patient sedation to eliminate any discomfort at the time of the procedure. Most patients report that they were much more comfortable following the procedure than they had anticipated. It may be helpful to talk to another patient who has undergone dental implant treatment to discuss their personal experience.

Dr. Chal uses the teeth-in-an-hour concept to provide dental implants that function immediately. One of the side benefits of this more rapid treatment is that the amount of discomfort after the procedure is greatly reduced.

How long is the process?

Traditionally, the procedure has been performed in two steps. The dentist began by installing the implant, which was left for from three to six months to heal and integrate with the jawbone. During the healing period, the patient was given a temporary prosthesis until the permanent crown could be put in place.

Today, there is an alternative to the two-step method that allows you to have the implant installed in one whole piece in one single session. This new method has simplified the procedure a lot, both for patients and dentists.

The procedure is chosen depends on several factors, such as the patient’s dental health, the number of teeth involved and which teeth are replaced. These factors will also determine the total number of visits to the dentist throughout the treatment period.

Related information:
How can I know if I’m a good candidate for dental implants?

My dental implant fell out. It started out feeling solid, but over time it got loose, and then it just fell out. What would cause this and what can be done?

Is post op discomfort normal?

It is normal to have some small bruises and swelling in the gum and soft tissues. But usually the discomfort, if any, is treated with an ordinary painkiller. You should expect to be able to work the next day.

Dr. Chal works with the teeth-in-an-hour concept that gives you implants that function immediately. With this new technology the surgery required is much less invasive and the amount of post-operative discomfort is greatly reduced over older techniques.

What is the maintenance?

Your new teeth must be cared for and checked regularly, just like your natural teeth. Brush and floss as recommended by your dentist or dental hygienist. Return to Dr. Chal for maintenance visits every six months, or more frequently if so advised.

It’s also important that a dentist trained in maintaining dental implants see you. If you move, ask Dr. Chal for a recommendation for a local dentist with the expertise you need to take care of your investment.

Many people are surprised to learn that, just as natural teeth can succumb to gum disease, dental implants are also subject to gum disease that attacks the attachment between the implant and your jaw. To avoid this gum disease, keep them clean and maintained with faithful brushing and flossing and professional cleanings.

Related information:
How can I know if I’m a good candidate for dental implants?

Implant vs. Bridges

Question: I had a four tooth dental bridge on my front teeth. I had one missing tooth, and the bridge attached to the three other teeth.

Fifteen years later, two of the teeth the bridge was attached to broke. I had to have root canals and posts in those teeth to hold on the bridge. Then the third tooth broke. Today, I am toothless since my dentist can’t attach the old bridge.

Would implants be a better choice for me, or even a possibility?

– Suzanne
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Dear Suzanne,

One of the disadvantages of having teeth replaced with bridges is that you have to have the adjacent teeth ground down and attach the bridge to them. This makes those teeth weaker. If anything happens to those teeth that the bridge is attached to, you have to get a whole new bridge.

Dental implants stand on their own. If you have an implant, and there is trouble with the adjacent tooth, the implant will be unaffected. Your history is a great illustration of one of the advantages of implants. If you had this done at the very beginning, you could have avoided the bridge and your dental care would have been much simpler.

Now for full disclosure we need to say that there are problems you can have with implants down the road–they aren’t a perfect solution. They can be affected by trauma or by gum disease around the implants. But they aren’t affected by any problems with your other teeth, so in your case it appears that they would be a much better solution for you.

What is this black space?

Hello! I have an implant on my top right front tooth and a root canal on my top left front tooth. Both are now crowned, but between the two crowns right under my gum there’s a tiny black space. It’s very unsightly and I’m a singer, so when I say “f” or “s” sounds air escapes. It’s very annoying and I don’t think I have the confidence to sing on a microphone. Any advice or help would be deeply appreciated. Thank you very much.

– Randy
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Randy,

This space between your teeth is called a “black triangle, and is actually a difficult problem and there may not be an easy fix. And I can’t give you a complete answer without seeing exactly what it looks like and doing a close examination.

The position of the gum is determined by the positions of the implant and the natural tooth, and by the shapes of the crowns. It’s not a situation where you can have a little gum surgery and re-position the gum.

Sometimes this problem occurs because the general dentist who initially plans the implant doesn’t know how to tell the surgeon exactly where to place the implant, and the surgeon may not have any expertise in that area. It’s an issue of teamwork, and the surgeon and general dentist need to have excellent communication and a great working relationship.

You could come in to our office and let us take a look, and we could give you a better idea of what could be done, if you’d be willing. It’s possible that some simple procedures to clean or maintain the area would help the gum be more healthy and this would be all that would be required. On the other hand, the problem could be fundamental and require a new implant and/or new crowns on the front teeth.

Complete Denture Question?

I have five implants–two eye teeth with crowns, and three that are about six years old that I never had crowned. I am now missing the rest of my upper teeth and wonder how difficult it will be to remove them and get a complete denture or if you have any other suggestions.

–Susan
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Susan,
It sounds like money must be an issue, because you never had these other implants crowned. I’ll try to be helpful.

I don’t know that the implants you have need to be removed unless they are loose. Usually, especially with older implants, the exposed part of the implant is fastened in with a screw. So you should be able to have the exposed part of the implant unscrewed and removed, and then you could have a removable implant overdenture placed over that.

You need to understand, however, that this will be a removable denture that will be able to slide around and may be uncomfortable and hard to get used to. With the implants still in the bone, though, that will help prevent your bone from shrinking and will give a stronger foundation for the denture.

Another course would be to have more implants placed to take the place of your other missing teeth. This would be much more comfortable and functional for you, though it would cost more money and might be beyond your budget. Read our page about complete dentures for more information about what can be done.

Tooth Replacement Question?

Dr. Chal,
I have a Root Canal and cap on a front tooth. My dentist believes it is fractured and suggests an implant. The procedure takes about 4 months of healing before another cap can be “installed” and an upper plate will hold a tooth in place until that can happen. Is there any other way to fix the tooth, and how much would that cost?

– Susan
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Susan,
There are two good options for replacing a front tooth. One is a dental implant, as your dentist has suggested. The other would be to place a dental bridge.

If the teeth on either side of this front tooth are in good condition and don’t already have crowns or large fillings, I would tend to agree with your dentist that the implant would be best. You do have that delay with the implant, though, so if that matters, you may want to lean toward the bridge. The implant needs healing time for the bone to grow back around it.

As far as the cost, the implant costs a little more but not a lot more. I would make the decision on the other factors. Long-term cost of the implant would be less because the maintenance is simpler and less risky.
– Dr. Chal

What about dental implant centers?

Question:

I recently visited the Clear Choice Phoenix Arizona Dental Implant Center. I was considering having an implant-retained denture using the All-On-Four technique that they promote. I asked the doctor about the long-term stability of the results using this technique, and then I asked different of the staff that were helping me, and everyone gave me a different answer. What is the long-term success rate of this technique?
– Eileen
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Eileen – I’m sure that the doctors and staff at Clear Choice Phoenix are all well-trained. It appears to me that what you are seeing in the different answers you are getting is some confusion in the dental profession itself about whether or not this All-On-Four technique is stable, long-term. There has been a higher than average failure rate with this technique. And one of the complications we are seeing with it is that if any one of the four implants placed with this technique fails, the entire case fails and has to be re-done.

In our office, we will certainly use this technique for you, if that’s what you wanted. I have training in all of these techniques. But you need to make these decisions about All-On-Four, or Teeth-in-an-Hour, or any other system, with complete and accurate information. Timing issues, the number of implants used, and other convenience issues all have risks associated with them. If you want to assume the risks, then that is your right. Our responsibility as professionals is to give you complete, accurate, and unbiased information so that you can make an intelligent choice.