A missing tooth can have undesirable consequences. Just a few of these include:
- Possible changes in appearance and speech
- Heightened risk of bacterial buildup, threatening the remaining teeth (and causing bad breath)
- Likelihood of shifting tooth alignment, which can lead to grinding and distressed temporomandibular joint (TMJ)
- Potential bone loss in the jaw
- Greater likelihood of periodontal disease
- Difficulty eating foods, leading to nutrient loss
- Enhanced risk of stroke and heart disease
Given these facts, a dentist will almost always recommend procedures (such as root canals) that might save a damaged tooth. If, however, the tooth is already missing, the dentist will likely recommend replacing it.
A number of options exist for tooth replacement, including dentures or partial dentures, which are often the best option for replacing multiple missing teeth, especially if they are not next to each other. Options also include bridges, which work very well with missing teeth that adjoin. But for a single missing tooth, a dentist will often recommend a dental implant. While nothing is as healthy as a real tooth, an implant comes close. In appearance, function, and overall jaw health, an implant most closely mimics a missing tooth.
A dentist will often warn patients, however, that an implant might not work for people who use tobacco, especially those who smoke. Quitting is recommended, if not required, before an implant is installed. Why?
Dental implant procedure
It first helps to understand the way an implant is placed in the mouth. This occurs in three or four stages:
- Bone graft
The jaw is prepared and strengthened for the implant by a bone graft.
The jawbone is drilled to make a “root” for the replacement tooth, which is the implant proper. Typically made of titanium alloys, it essentially resembles a screw.
At this point, a period of some months needs to elapse to allow the jaw to heal and for the completion of a process called “osseointegration,” in which the implant essentially merges with the bone. In the meantime, a temporary cap is placed over the implant.
Once osseointegration has occurred, the implant is now ready for an abutment. This is essentially a peg-like apparatus over which the crown will be fitted.
Sometimes, oral surgeons place the implant and abutment at the same time, though many prefer to do this as separate procedures. At any rate, the gums need to heal fully before the final stage.
Finally, the crown is attached by means of the abutment, and once it is properly fitted, the procedure is complete.
Tobacco and dental implants
Tobacco use – especially, but not limited to, smoking – increases the risk of periodontal disease and oral lesions. These both create an unhealthy environment in the mouth, especially since the surgery briefly opens the jawbone, usually enclosed by tissue, to whatever is present in the mouth.
Many studies show a connection between nicotine and delayed bone regeneration and healing like what occurs during the bone graft and osseointegration. Medical literature has not concluded that smoking significantly impedes either, but it is better not to take the risk.
There is overwhelming dental and medical consensus that nicotine delays healing. Smoking specifically releases carbon monoxide, which displaces oxygen in the blood’s hemoglobin and thereby reduces the oxygen needed by the tissues of the gum to heal. Furthermore, nicotine in any form constricts the blood vessels, which reduces blood flow and thus the oxygen and blood supply to the tissue healing from surgery.
Dental implantation is a mild surgery, but a surgery nonetheless; the dentist will have to make gum incisions will reach the jawbone, and they will have to open the gums again to install the abutment. Any habit that slows down or prevents healing needs to be avoided.
To underscore this point: while dental implants have a very high success rate (close to 95% of procedures are successful), no surgery is guaranteed to be successful every time. One study concludes that smokers and other tobacco users make up the majority of the 5% that fail.
Successful Dental Implants
At Wall Street Dentistry, Drs. Renfroe and Conley have extensive experience in installing dental implants and want their patients to have the highest possible chance of success. For more information about implants and how to maximize their benefits, set up a consultation by phone or text message: (256) 400-2783. Wall Street Dentistry places its 30 years of experience at the service of the people of Albertville, Gadsden, Boaz and surrounding areas in Alabama and is looking forward to helping them maintain or repair their bright, healthy smiles.