Dental Implants

Dental implants are artificial tooth roots made of biocompatible titanium that are surgically placed into the jawbone to support replacement teeth or bridges. This procedure permanently replaces missing teeth with prosthetics that look, feel, and function like natural teeth.

Unlike dentures or bridges that sit on top of the gums, implants fuse with the jawbone through a process called osseointegration, creating a stable foundation for artificial teeth.

Indications Benefits Process Preparation Procedure Recovery Risks FAQ

When to Consider Dental Implants

Dental implants address different types of tooth loss while improving function and appearance.

Single Tooth Loss: A dental implant replaces a missing tooth without altering adjacent healthy teeth. Unlike traditional bridges, this approach preserves natural tooth structure by eliminating the need to grind down neighbouring teeth.
Multiple Teeth Loss: Implants can support multi-tooth bridges when several adjacent teeth are missing. This method requires fewer implants than replacing each tooth individually while still ensuring stable, fixed support.
Complete Tooth Loss: Full-arch implant solutions secure complete dentures or fixed bridges for patients missing all teeth in the upper, lower, or both jaws. As few as four strategically placed implants can support an entire arch of teeth.
Failed Dental Prosthetics: Patients with uncomfortable or ill-fitting dentures and bridges often benefit from implant-supported replacements. Implants eliminate movement, enhance chewing efficiency, and improve overall comfort.

Benefits of Dental Implants

Dental implants provide significant advantages over traditional tooth replacement options. Key benefits include:

Natural Appearance

Implant-supported crowns and bridges closely resemble natural teeth. Each restoration is custom-made to match the colour, shape, and size of surrounding teeth, creating a seamless smile.
Improved Function

The secure bond between the implant and jawbone restores nearly normal biting and chewing ability. Patients can eat hard or crunchy foods without worrying about their replacement teeth shifting or dislodging.
Preservation of Facial Structure

Implants stimulate the jawbone, preventing bone loss and preserving facial contours. This helps maintain a youthful appearance and prevents the sunken look often associated with prolonged tooth loss.
Durability

With proper care, dental implants can last decades or even a lifetime. The titanium components resist decay and deterioration, offering a long-term solution to tooth loss.
Speech Improvement

Unlike removable dentures, which may slip while speaking, implant-supported teeth remain firmly in place. This stability ensures clear pronunciation and eliminates speech difficulties often caused by traditional dentures.
Simplified Oral Hygiene

Implant-supported teeth can be cleaned like natural teeth with regular brushing and flossing. Unlike bridges, implants do not require special cleaning tools for maintaining the area beneath the restoration.

Dental Implant Surgical Process

Implant Placement

The implants are surgically inserted into the jawbone, where they remain beneath the gums for three to six months. During this time, they gradually bond with the bone in a process called osseointegration. Temporary dentures can typically be worn, and a soft diet is recommended while the final replacement teeth are being prepared.

Abutment Attachment

Once the implants have fused with the jawbone, they are uncovered, and small posts called abutments are attached to serve as anchors for the artificial teeth. These posts extend slightly through the gums but will not be visible once the final teeth are placed.

Preparing for the Procedure

Dental Examination

The mouth, teeth, and gums are assessed. X-rays assess bone height and density, while 3D imaging, such as CBCT scans, maps bone volume and nearby anatomical structures.
Medical History Review

Existing conditions, past surgeries, and medications should be disclosed. Certain conditions, such as uncontrolled diabetes or recent cardiac events, may require adjustments or delays. A blood test may be carried out to check overall health, clotting function, and infection risk.
Bone Assessment

Bone measurements determine whether grafting is needed. If required, augmentation may be done before or during implant placement, depending on the extent of bone loss.
Medication Adjustments

Blood-thinning medications may need to be paused under medical guidance. Patients taking anti-resorptive medication for osteoporosis and cancer require special consideration. Antibiotics may be prescribed to reduce infection risk.
Lifestyle Preparations

Smoking slows healing and lowers success rates. Patients should stop at least two weeks before surgery and during recovery. Alcohol intake should be reduced or avoided in the week before surgery.
Pre-Operative Guidelines

Food and liquid restrictions depend on anaesthesia type. For sedation or general anaesthesia, fasting for 6–8 hours is usually required.

Step-by-Step Procedure

Anaesthesia Administration

The procedure begins with anaesthesia to ensure comfort. Local anaesthesia numbs the surgical area, while sedation or general anaesthesia may be used for longer or more complex cases, or for improved patient comfort.

Incision and Bone Preparation

A small incision is made in the gum to expose the underlying jawbone. Using a series of specialised drills, a hole is created in the bone to accommodate the implant. The size and depth of the hole are carefully determined based on the implant type and bone structure.

Implant Placement

The titanium implant is inserted into the prepared site and positioned securely within the jawbone. In some cases, a temporary healing cap is placed over the implant to allow the gum to form around it during the healing process. In other cases, the gum is sutured closed, leaving the implant to integrate with the bone without exposure to the external environment.

Healing and Osseointegration

Over three to six months, the implant bonds with the bone through osseointegration, forming a stable foundation for the replacement tooth. During this period, a temporary prosthetic may be provided for aesthetic and functional purposes.

Abutment Attachment

In cases where the gum is sutured closed, once the implant has fully integrated with the bone, a second minor procedure is performed. The gum tissue is reopened, and a small connector piece called an abutment is attached to the implant. The abutment extends above the gum line and serves as the anchor for the final prosthetic. A short healing period follows to allow the gum tissue to settle around the abutment.

Final Prosthetic Placement

After the gum has healed, impressions are taken to create a custom-made crown, bridge, or denture. The final restoration is carefully fitted and secured to the abutment, restoring function and appearance. Adjustments may be made to ensure proper bite alignment and comfort.

Post-Procedure Care and Recovery

Managing Discomfort and Healing	Mild swelling, discomfort, and minor bleeding are common after surgery. Ice packs reduce swelling, and pain relief medication helps manage discomfort. Biting on gauze pads helps control bleeding. Strenuous activity should be avoided for at least 24 hours.
Oral Hygiene and Diet	Rinsing with warm salt water or an antibacterial mouthwash helps keep the area clean. Brushing should be gentle, avoiding the surgical site for the first few days. A soft diet, including soups, yoghurt, and mashed foods, is recommended, while hard or sticky foods should be avoided.
Lifestyle Considerations	Smoking and alcohol should be avoided, as they can slow healing and increase the risk of implant failure. Staying hydrated and avoiding straws prevents dislodging the blood clot at the surgical site.
Follow-Up and Long-Term Care	Regular check-ups monitor healing and ensure the implant is integrating properly. Once fully healed, daily brushing, flossing, and routine dental visits help maintain long-term implant health.

Potential Risks and Complications

Short-term effects like swelling, bruising, minor bleeding, and temporary discomfort usually subside within days. Infection may develop if oral hygiene is inadequate, and in rare cases, improper placement can cause nerve damage, leading to numbness or tingling. Some implants may fail to integrate with the jawbone, requiring removal or replacement. Upper jaw implants positioned too close to the sinus cavity can result in sinus-related issues. Long-term risks include gum recession, peri-implantitis (inflammation and bone loss), or mechanical problems like implant loosening or fracture. Regular dental check-ups and good oral care help minimise these risks.

Frequently Asked Questions

Can I get dental implants if I have gum disease?

Active gum disease must be treated before implant placement. If left untreated, it can cause ongoing inflammation and bone loss, increasing the likelihood of implant failure.

Will dental implants ever need to be replaced?

Some implants do last a lifetime with proper care, but like natural teeth, they are also subject to biological challenges like infection that may cause bone loss as well as mechanical forces that may cause breakages. The attached crown, bridge, or denture may wear down over time. These prosthetic components typically require replacement every 10–15 years due to normal use.

How long should I wait before returning to work after implant surgery?

Most patients can return to work within 1–3 days, depending on the complexity of the procedure and their individual healing process. Jobs involving heavy lifting or strenuous activity may require a longer recovery period to prevent complications such as swelling or bleeding.

Complimentary eBook

Your Guide to Dental Implants

CT-Guided Dental Implant Surgery

Dr. SL Chan

Singapore Oral Surgeon

BDS | MDS | FRACDS | FAMS |

A Leading Singapore Dental Surgeon specializing in Oral Maxillofacial Surgery, with a special interest in reconstructive & corrective jaw surgery.

Dr Chan has held major leadership position in Singapore Dentistry, including being President of the Association of Oral and Maxillofacial Surgeons (Singapore), Chairman of the Singapore Regional Committee of the Royal Australasian College of Dental Surgeons and President of the College of Dental Surgeons of the Academy of Medicine, Singapore. He has also served in the Singapore Dental Council where he chaired the Credentials Committee and the Aesthetic Facial Procedures Oversight Committee.

Bachelor of Dental Surgery (BDS), National University of Singapore (1989)
Master of Dental Surgery in Oral and Maxillofacial Surgery (Training under Professor H. Tideman), University In Hong Kong
Fellow of the Royal Australasian College of Dental Surgeons
Fellow of the Academy of Medicine, Singapore