Dental implants

A replacement tooth that behaves like a tooth.

A dental implant is a small titanium post placed into the jawbone to take the place of a missing tooth root. Once it has fused with the bone, it carries a crown, bridge or fixed arch that is anchored in place, nothing to remove, nothing resting on the gum.

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The case for implants

Why replace a missing tooth at all?

A gap is rarely just a gap. The teeth either side drift towards it, the opposing tooth over-erupts into the space, the bone that once supported the root begins to resorb, and the bite quietly redistributes itself onto teeth that were not designed to carry it. Left long enough, a single missing tooth becomes a multi-tooth problem.

An implant is the only option that replaces the root as well as the crown. That matters because loading the bone is what keeps the bone. It also leaves the neighbouring teeth untouched, unlike a conventional bridge, which requires cutting down healthy teeth either side to support it.

What implants can replace

A single tooth, one implant, one crown, adjacent teeth left alone
Several teeth, two or more implants supporting a fixed bridge
A whole arch, a fixed, full set of teeth on a planned number of implants (see full-arch rehabilitation)
A loose denture, implants used to lock an existing or new denture firmly in place

Who is a good candidate

Most adults in reasonable general health with stable gums are candidates. What matters more than age is the health of the tissues, the volume of bone available, whether you smoke, whether any grinding habit is controlled, and whether diabetes or other systemic conditions are well managed. Active gum disease is treated and stabilised first, placing implants into an inflamed mouth is a way of losing them.

The process

Six stages, spread over months

Assessment

Examination, photographs, radiographs and a CBCT scan where indicated. The scan shows bone height, width and density in three dimensions, and the position of the nerve and sinus.

Digital planning

The scan is merged with a digital impression so the implant position is planned around the tooth we intend to build, not the other way round. Where useful, a surgical guide is printed from that plan.

Preparation

Any gum disease is treated, failing teeth removed, and grafting or sinus augmentation carried out where the site needs building up. Some sites need healing time before placement.

Placement

The implant is placed under local anaesthetic, usually in under an hour for a single site. Most patients return to normal activity the following day.

Integration

Roughly three to six months while the bone fuses to the implant surface. You wear a temporary throughout, you are not left with a visible gap.

Restoration

The final crown or bridge is made to match the shade, shape and translucency of your own teeth, fitted, and checked against your bite. Reviews and hygiene follow.

Aftercare

Implants are not fit-and-forget

An implant cannot decay, but the tissue around it can become inflamed and the bone that holds it can be lost, peri-implantitis, and it is the commonest reason implants fail years down the line.

Everyone I treat leaves with a maintenance plan: a cleaning routine tailored to the restoration, regular hygiene appointments, and review intervals with radiographs to check the bone level around the implant. Kept up, that is what turns a good result into a long one.

Implant-supported crown replacing a lower molar, restored by Dr Steve Conteh — An implant crown replacing a lower molar, sitting level with the natural teeth beside it.

Questions

Common questions about implants

Does having an implant placed hurt?

Placement is carried out under local anaesthetic and is usually more comfortable than patients expect, most describe it as easier than the extraction that preceded it. Some swelling and tenderness for a few days afterwards is normal and manageable with ordinary painkillers. Sedation is available where anxiety is a factor.

How long does the whole process take?

For a straightforward single implant with good bone, expect roughly three to six months from placement to final crown, most of which is healing time during which you carry on normally with a temporary in place. Cases needing grafting or sinus work take longer.

How long do dental implants last?

Long-term studies report implant survival well above 90% at ten years where patients maintain them properly and do not smoke. That said, an implant is not a permanent guarantee, the crown or bridge on top will need maintenance and, eventually, replacement, and implants can be lost to peri-implant disease if hygiene lapses.

Can I have an implant if I have been told I do not have enough bone?

Frequently, yes. Bone volume can often be augmented with grafting, and in the upper back jaw a sinus lift creates the height required. A CBCT scan tells us definitively what is available and what would be needed.

I smoke, does that rule me out?

It does not rule you out, but it materially raises the risk of early failure and of peri-implantitis later. I will discuss this frankly with you before we plan anything, and I would strongly encourage stopping, at minimum around the surgical and healing phases.

What are the risks?

The main ones are failure of the implant to integrate with the bone, infection, damage to adjacent teeth or nerves, sinus complications in the upper jaw, and peri-implant disease in the longer term if maintenance slips. All of these are discussed with you individually, in writing, as part of consent before anything begins.

Dental implants in Bath, Marlborough, Crewkerne and Bristol

I place and restore dental implants at four practices across the South West: Circus Dental in the centre of Bath, Savernake Dental in Marlborough, Black Swan Dental Spa in Crewkerne and Bristol Dental Suite in north Bristol. Patients travel from Chippenham, Trowbridge, Bradford on Avon, Frome, Devizes, Swindon, Hungerford, Newbury, Yeovil, Sherborne, Taunton and the Dorset border, and longer visits can be grouped for anyone coming further.

Wherever you are seen, the planning is the same: clinical photography, a CBCT scan where indicated, and a written plan with costs before anything begins. Surgery is scheduled into dedicated implant sessions, and your aftercare can take place at whichever practice suits you best.

Next step

Start with a conversation

Every case begins with an unhurried consultation: a proper look, a proper listen, and a written plan you can take away and think about. There is never any pressure to proceed.

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