Dental implants are suitable for most adults with good general health. They can only be used once the jawbone has stopped growing and so generally are not used with younger patients. Habits such as heavy drinking or smoking can increase the number of problems associated with initial healing and thereafter may be bad for the long-term health of the gum and bone surrounding each implant. Some Dentists will decline to place implants if smoking cannot be reduced or given up altogether. However, each case is different and if you do have any medical problems then speak to the dentist prior to starting any treatment – it is only in some circumstances that health problems prevent the use of dental implants altogether.

When you first enquire about dental implants it is often in response to an awareness of ongoing dental problems or the recent loss of teeth. The cause of these problems will need to be understood and treated before undertaking implant treatment. If you are aware of bad breath, loose teeth, or have noticed excessive bleeding, particularly when your teeth are cleaned professionally, you may have gum problems. Gum disease (periodontal disease) is a major cause of bone loss, and with reduced bone dental implant treatment can be more complicated but not impossible.

It is accepted practice that you should be given a written summary of your treatment planning discussion(s), highlighting your current dental situation and any alternatives there are to dental implants. This summary should also include an overview of the anticipated treatment stages and give you some idea of how long treatment is likely to take, how many implants are required and what the fees are expected to be, There may well be other issues specific to your case and these would be dealt with accordingly.

Dental implants can be used to replace one or several missing teeth. All the common forms of tooth replacement, such as bridges or dentures can be supported by dental implants. If you are missing just one natural tooth, then one implant is normally all that will be needed to provide a replacement.

However, larger spaces created by two, three or more missing teeth do not necessarily needed one implant per tooth; the exact number of implants will depend upon the quality and volume of bone at each potential implant site. Patients who have a habit of clenching or grinding (bruxing) their teeth may be at risk of overloading their implants. For most people bruxism occurs during sleep, which is why they are generally not aware of it. Heavily worn or flattened teeth, chipped enamel edges and/or regularly breaking pieces of heavily filled teeth are the most common clinical signs of bruxism.

The effects of bruxism need to be considered during treatment planning and can be compensated for by placing additional implants, selecting appropriate restorative materials and providing a night time bite guard to protect the new teeth. This will be discussed in your initial consultation and detailed in your treatment plan.

Although it is quite straightforward to provide good pain control during surgery, most people will be quite anxious. There is no need to suffer in silence, as there are several very effective means by which you can achieve a relaxed state.

Oral sedation – simple way to aid relaxation is to be given a dose of a short acting medication such as Temazepam (normally used to help with sleeping difficulties). This will reduce anxiety for most patients and provides a very good effect for uncomplicated surgical stages taking less than an hour.

Conscious sedation – For treatment of greater complexity it may be suggested that you have a more controlled way of keeping relaxed and comfortable during the surgical stages. This is known as a ‘conscious sedation’ and is distinctly different from a general anaesthetic, because you remain alert enough to respond to simple instructions that may be helpful to the surgeon – however, you will remember almost nothing about the treatment stage. It is particularly beneficial for procedures taking more than an hour where a hospital admission is not required – this is probably true for the majority of treatments related to dental implants. For a routine ‘conscious sedation’ a carefully controlled amount of sedative is delivered through a vein in your arm or hand for as long as the treatments takes. It is a very safe procedure during which your heart rate and oxygen levels are monitored throughout by an anaesthetist. With conscious sedation, a normal dental local anaesthetic is injected around the proposed implant sites. Most people do not remember this stage because the sedation has already taken effect by the time the dental anaesthetic is given. For procedures involving oral or conscious sedation you may be asked not to eat or drink for at least four hours prior to the surgery and you will need to arrange for an adult to take your home. You will also be advised not to operate any machinery for at least 24 to 36 hours afterward.

Alternatives to you own bone for grafting. For those who would prefer an easier but slightly slower, solution there are other sources of bone such as bovine (derived from cow), porcine (derived from pig) or synthetic materials that have been specially prepared to make them safe for use in humans. All of these materials, including your own bone, simply provide a scaffold into which new bone will grow in order to be ready to receive dental implants a few month later. New bone can take anywhere between 3-12 months before it is ready to receive dental implants.

Do not be in a hurry to move to the next stage. If you need a large volume of bone it will take longer to mature than a small amount. Each surgeon will have his or her preferred way of creating new bone. Many of them will also use a supplementary technique called ‘guided tissue regeneration’. Using this technique, slow-moving bone cells given time to fill a space by placing a barrier materials between them and the fast moving cells of the soft tissue s lining the mouth. This is a ‘resorb-able barrier’ that will disappear naturally in a few months after it has done its work