Losing a tooth affects more than your smile. It changes how you chew, can alter the shape of your face over time, and often knocks your confidence when speaking or laughing.

A dental implant is a small titanium post placed into the jawbone, where it takes the role of a natural tooth root. Once it has fused with the bone, a custom-made crown is attached on top. The result looks and functions like a natural tooth, and the teeth either side are left untouched.

Why the root matters

The part people overlook is what happens underneath. Jawbone is maintained by the forces of chewing passing through a tooth root. Remove the root and the bone in that area gradually resorbs. Over years this is what gives a sunken look to the lower face after several teeth are lost, and it is why a denture that fitted well can become loose.

An implant is the only replacement that puts a root back, so the bone around it keeps receiving the stimulus that preserves it. That is the main argument for an implant over a bridge, beyond simply not having to prepare the neighbouring teeth.

What the procedure involves

1. Assessment. We examine the site and take imaging to check the volume and quality of bone and the position of nerves and sinuses.
2. Placement. The post is placed into the bone, usually under local anaesthetic. Most patients find it more straightforward than expected and comparable to an extraction.
3. Healing. The bone grows into contact with the implant surface, a process called osseointegration. This takes months rather than weeks and is what gives the implant its stability. A temporary restoration can usually be worn in the meantime.
4. Restoration. Once integration is confirmed, an abutment and the final crown are fitted and the bite adjusted.

Are implants right for you?

Implants suit most adults with healthy gums and enough bone. Some things need managing first or make them less predictable:

• Active gum disease must be treated first, since the same process that destroys bone around teeth will do so around an implant.
• Smoking measurably increases the risk of failure.
• Uncontrolled diabetes affects healing.
• Still-growing jaws mean implants are generally deferred in younger patients.

Where a tooth has been missing for a long time the bone may no longer be adequate to hold an implant. That does not automatically rule you out, and an assessment is the way to find out.

Looking after an implant

An implant cannot decay, but the gum and bone around it can become inflamed and infected in the same way as around a natural tooth. That condition, peri-implantitis, is the most common reason implants fail years later. Brushing, cleaning between the teeth and keeping regular checkups are what protect the investment.

Dr. Marco Caccavella provides implant dentistry at Nest Dental Clinic.