Most adults who have reasonably good general health can have Dental Implants placed. They cannot be placed in children where the mouth is still growing. As a consequence we avoid using Dental Implants with younger patients and provide an alternative treatment until such time as Dental Implants are a suitable treatment.

Smoking has been shown to impact on the success rates. We make patients well aware of this fact. We encourage patients to stop smoking or at least reduce their consumption. Each case, however, is specific and every patient’s needs are assessed carefully and individually. In some situations certain health problems preclude the use of dental implants. These would include (but are not limited to) poorly controlled diabetic patients, patients who are severely immunocompromised and patients receiving certain types of medication.

At your Dental Implant consultation with us we will assess your case for you. We will take a thorough medical and dental history. We will thoroughly examine your mouth and teeth to ascertain the nature and extent of any current dental disease. We will take a CT (computerised tomography) scan, a series of clinical photographs and impressions for casting a set of study models.

All of this information we gather will allow us at The Guild Practice to correctly identify your needs and recommend an appropriate treatment plan that suits your needs and your budget.

With Dental Implant treatments establishing good fundamental dental health is important. At this appointment we will make you aware of any problems that need treatment so as to resolve any active disease processes. Active gum disease MUST be treated and stabilised prior to dental implant treatment. Our Dental Hygienists play an important role in this respect ensuring you maintain a clean mouth and receive good guidance from them to introduce good routines at home for cleaning your mouth.

If you need to enquire about Dental Implants it is normally as a result of or an awareness of ongoing dental problems or the recent loss of a tooth or teeth. The cause of these problems will need to be understood and treated before having any Dental Implant treatment.

If you are conscious of bad breath, loose teeth, or have noticed bleeding when you are brushing your teeth or having your teeth cleaned professionally it is likely you have some ongoing gum disease problems. Gum disease is a major cause of loss of bone. With reduced bone levels Dental Implant treatment may require more preparation treatments initially such as Guided Bone Regeneration or Sinus Grafting.

For many cases, from the implant placement to the final connection of the prosthetic reconstruction the treatment times can vary and be between three to four months. Depending on the bone quality the treatment time may be decreased whilst more time and care may need to be taken with poorer quality bone. In these instances the treatment may extend beyond six months.

At The Guild Practice we will give you a written summary of our treatment planning discussions noting your present situation and any relevance that may have to Dental Implants. This summary may include an overview of the anticipated treatment stages, give you an idea as to the length of time the treatment is likely to take, how many implants will be required and what the fees are expected to be. There may be other issues particular to your situation that will be dealt with accordingly.

A dental implant should last for many years – assuming you are careful in your approach to the maintenance of your dental implant and the overall health of your mouth. Once the Dental Implants and surrounding soft tissues have healed, the new teeth are correctly fitted and adjusted you must maintain good oral hygiene. We recommend that you attend regular maintenance reviews (annually) and visit a dental hygienist at either three-monthly or six-monthly intervals.

If neglected, Dental Implants will develop a covering of plaque and calculus just as your natural teeth do if you neglect them. Untreated, these deposits can lead to subsequent gum infection, bleeding, soreness and general discomfort. Well-maintained implants placed into good bone can be expected to last for many years. However, just as you would expect conventional crowns, bridges and fillings to require occasional repairs or replacements your implant-retained teeth may have similar needs over the years. At The Guild Practice we are still caring for many patients that had Dental Implants placed in our practice over twenty years ago!

Dental implants can be used to support either one single tooth or several missing teeth. Common forms of tooth replacement, such as bridges or dentures can be supported and retained by Dental Implants.

If you are missing one natural tooth then one implant is needed to provide a replacement. However, larger spaces created by two or more missing teeth do not necessarily need one Dental Implant per tooth. The number of Dental Implants needed will depend on a variety of clinical findings made at the assessment and initial consultation with us.

Patients who have a habit of clenching or grinding their teeth (bruxists) could be susceptible to overloading of the implants. For most patients this occurs at night and they are not aware of the habit. The potentially harmful effects of bruxism need to be considered during treatment planning and mitigated against as much as possible. A biteguard, to be worn at night, will be a necessity. Alternatively our treatment planning may include placing additional implants, selecting specific appropriate restorative materials.

We will discuss this in your initial consultation and detail this in your treatment plan.

Routine dental x-rays show good detail but in only two dimensions. Often this may be sufficient to determine the height of bone available for implant placement; however, more advanced imaging techniques are sometimes needed to determine the width of bone available.

Dental CBCT Scans – there are now sophisticated x-ray techniques that allow us to investigate the jawbone in three dimensions. The most widely used of these is the CBCT (cone beam computed tomography) scan. These images can normally show us all the information that is required about your bone; not only the quantity and quality (density) but also the location of important neighbouring anatomical structures.

When you lose your tooth a significant amount of the bone that once surrounded the remaining root will start to disappear (resorb). This bone loss can be very rapid in the first few months following loss of a tooth (bone resorption). Whilst this is highly variable between individuals, it will always occur to a certain extent.

If you have suffered from advanced gum disease (Periodontal Disease), bone loss is one of the characteristics of this condition. There are many occasions where teeth, that have not responded favourably to treatment attempts to treat the Periodontal Disease, demonstrate so much bone loss Dental Implants are only possible once Guided Bone Regeneration procedures have been carried out.

Patients with dentures often report that, after a while, their dentures have become progressively looser and they feel loose in function. Initially, the increased rate of bone loss subsequent to extractions is responsible for this deterioration in denture fit. Over the longer term, the effect of chewing forces being applied directly to the gum surface can cause deterioration of the supporting bone. Hence, the longer dentures are worn, the less bone you will have available for your Dental Implants.

Upper Jaw – provided the implants are placed within the bone that was used to support your own teeth there really are very few restrictions. If you have missing upper back teeth we can show you the maxillary sinus on an x-ray. These sinuses are seen on most x-rays and CBCT scans. The sinuses are air-filled spaces situated in the upper jaw. They can be located on an x-ray or a CT scan and your implant treatment planned accordingly.

Lower Jaw – the inferior alveolar nerve is an important anatomical structure that needs to be carefully protected. If this nerve is disturbed or damaged during the placement of Dental Implants it can lead to temporary or even permanent numbness or altered sensation. This is a rare complication and we take great care to avoid this.

CBCT scans offer the most reliable method for locating this nerve, allowing Dental Implants to be placed safely with greater confidence. Invariably a CBCT scan is taken as this allows us to plan with great accuracy where the implants will be placed. At The Guild Practice we have modern imaging technology such as a CBCT scanner in our practice. This allows our patients to have a CBCT scan taken at much greater convenience and much lower cost than used to be possible. The scan will only take seconds to generate an image and whilst they are more expensive than routine dental x-rays the information they provide is invaluable for Dental Implant cases.

This is an important feature of Dental Implants. When a (restored) Dental Implant begins to function, the everyday forces (talking, smiling, eating) stimulate the surrounding bone, which responds by becoming stronger and denser. As with all things, there are limits to the function that we subject our Dental Implants to. We can discuss this in more detail with you as it relates to your individual case.

When several dental implants are placed they may be joined together. Linking implants creates a physically stronger reconstruction. However, as with every case, this is only done if it is determined a reasonable concept in terms of its cleansability. The resulting prosthetic needs to be cleaned sufficiently well by the patient on a daily basis of course.

The bone quality, the relative position, the number of implants and the opposing dentition (or otherwise) will determine which option is best for your specific case.

Implants can be placed painlessly using the same local anaesthetics we use for routine dental treatment. Depending on the complexity of your individual case, the procedure may take anything from an hour for a single implant to several hours for complex bone grafting and multiple implant placements. You should be prepared to expect some minor swelling and occasionally some bruising however this is much less common. Ordinarily, any of the over-the-counter basic painkillers that you may take, say, for a headache will be adequate for a day or two. If you experience more discomfort than this please contact us and we will look after you.

Healing is generally straightforward and any stitches we place are usually removed after ten days to a fortnight. Over the first few days you must inform us of any unexpected levels of discomfort or swelling so that this can be assessed. If in doubt always seek advice as early detection of a problem will often lead to a simpler solution. We may ask you to take antibiotics and to follow some simple instructions such as rinsing with warm salt water or an antiseptic mouth rinse.

Providing sufficient pain control during Dental Implant treatment is straightforward however some patients suffer from anxiety. We can also provide Intra-Venous Sedation to help alleviate your anxiety.

This is also known as ‘Conscious Sedation’. This is a highly controllable method of keeping you relaxed and comfortable during the Dental Implant placement stage. You are alert enough to respond to simple instructions – however, you will remember almost nothing about the treatment itself. For a routine Intra-Venous Sedation a carefully controlled amount of sedative (Midazolam) is administered through a vein in your arm or the back of your hand. It is a very safe procedure during which your heart rate and oxygen levels are carefully monitored. When Intra-Venous Sedation is provided you will need to arrange to have an adult take you home after your appointment and you will be advised not to drive or operate any machinery for 24-36 hours afterwards.

For some patients, bone loss after removal of a tooth can leave them without enough to secure a Dental Implant. There are procedures that can be carried out if this is the case.

In the upper jaw, above the back teeth, we can increase the height of bone available by creating new bone in the Maxillary Sinus. This is a sinus augmentation. At The Guild Practice we have carried out these procedures for many years with great success enabling patients to have Dental Implants who otherwise would not have been suitable patients, demonstrating previously insufficient bone levels. Without the success of this technique many patients would not have been able to have Dental Implants in an area of the mouth where teeth are so often missing.