Overview/explanation
Front tooth implants aren’t as common as dental implants placed in the posterior areas of the mouth, but in most cases they are the best option for replacing a missing front tooth. A missing front tooth leads to many of the same problems you experience if you are missing back teeth, including:
- Limited chewing function
- Shifting teeth
- Bone loss
- Self-consciousness about having a space between your teeth
If you lose a front tooth due to trauma or an accident, you should visit a dentist immediately. If one of your front teeth becomes loose or falls out due to decay, a failing post, or poor dental hygiene, you should also see a dentist right away. Unaddressed tooth loss can lead to additional dental problems, including further decay and additional loss of teeth.
If you are a good candidate for a front tooth implant procedure, we think you’ll find that the process is not as complex or costly as you might have thought.
What is the process for a front tooth implant?
The first step is tooth extraction, assuming you haven’t already lost the tooth in the question. After the extraction, the resulting space must be allowed to heal for a minimum of three months. This healing period allows the bone to fill in or solidify to the point that an implant can be placed with a high likelihood of success.
An implant is then placed into the space so that the bone can grow around the implant threads and “lock” the implant into the bone. This process—called osseointegration—is the key to the long-term success of the implant. If bone doesn’t have adequate time to heal and densify, there is an increased risk of implant failure.
Typically, the initial surgical procedure is performed with local anesthetic, much like would be used when filling a cavity or receiving a root canal and crown. Recovery and down time are minimal; in many cases, stitches or post-op pain medications aren’t required.
The implant is then covered and protected by a small “button.” Practicing excellent oral hygiene is all that is required for the implant to successfully integrate to the bone and the initial healing time is typically one or two days.
Second phase: abutment and crown
After three or more months of healing time, your implant will have integrated or fused to the bone and will be ready to support the abutment and crown. At this point, your implant dentist will place an abutment or “post” onto the implant and tighten it to a very specific torque value, which ensures that the abutment and crown do not come loose. A master impression or digital scan is then taken and sent to a lab for the fabrication of your porcelain or zirconia crown. Finally, the crown is either cemented or screwed onto the implant for a final result that is akin to a natural tooth in function, aesthetics and long-term maintenance.
How do you determine if you need a front tooth implant?
There are many reasons why you might need a front tooth implant. These include:
- A missing front tooth
- A loose front tooth
- A cracked or broken tooth
- An infected front tooth
While there are alternative treatment options—including a dental bridge or one-tooth removable denture—in most cases the best and most natural choice for replacing a missing front tooth is a dental implant. Patients that choose an implant to replace a missing tooth experience satisfaction rates far higher than patients who choose alternative treatment options.
Cost of a front tooth implant
The cost of a front tooth implant can vary widely, but according to research done by Implant Evolution, the cost ranges from $2,380 to $5,745, with an average of $3,420. The cost of front tooth implants is influenced by the number of teeth that need to be replaced, the number of implants required, and whether preoperative bone grafting is necessary.
To learn more about the cost of dental implants see Implant Evolution’s Guide to Understanding True Dental Implant Cost.
Preoperative advice and tips
Before your front tooth implant procedure, your implant surgeon may prescribe specific medications like an antibiotic, or perhaps vitamin supplements. It may also be necessary for you to stop taking certain medications preoperatively.
Your implant surgeon will give you a list of preoperative requirements that will include a handful of do’s and don’ts. It may look similar to this:
- Do brush your teeth prior to your appointment
- Do wear loose-fitting, comfortable clothing
- Don’t drink alcohol for at least 24 hours prior to your procedure
- Don’t eat or drink anything for at least eight hours prior to surgery if you are scheduled to have any type of sedation or anxiolysis.
You will also be instructed to bring a family member or friend who can sit in the waiting room during your procedure and drive you home afterwards.
Last but not least, if you’re a smoker, you’ll need to stop smoking. Smoking leads to more implant failures than any other activity, in part because nicotine reduces blood flow, which inhibits the healing process.
It’s vital that you follow all preoperative instructions precisely because each directive is designed to increase the chances of successful implant surgery.
Bone density requirements and required preoperative scans
Sufficient bone quantity and quality are required to have a site that is acceptable for implant placement. Additionally, proper diagnosis and preoperative planning are essential to successful implant placements and restorations.
Implant dentists now have amazingly advanced technologies available in the office that aid in preoperative diagnosis and surgical planning. When it comes to surgical planning, the standard of care in implant dentistry is cone beam or CBCT imaging. The 3-D images allow your implant surgeon to investigate all of your internal anatomies located within the surrounding surgical area and produce the best possible surgical plan.
For example, bone quality and quantity can be observed and measured precisely so that the correct implant design can be chosen. Anatomical structures, such as nerves, arteries, and muscles, can be mapped precisely so that they are avoided during the surgical procedure. The use of cone beam imaging or other CT scans leads to safer implant procedures and better outcomes.
Anesthesia: Are you sedated for front tooth implants?
In many cases, the choice of whether or not to be sedated will be up to you. Many front tooth implant procedures are performed using only local anesthetic, which numbs the affected surgical area. Local anesthetic is very safe and predictable and “right” for the majority of front tooth implant procedures.
If your case is complex, conscious sedation or anxiolysis (light sedation) may be used, either of which may also be utilized if you have elevated anxiety levels.
Typically there is an additional cost for sedation that is not included in the implant fee. You should discuss sedation options with your implant dentist during the consultation phase.
Are front tooth implants a same day procedure?
Front tooth implants can sometimes be placed the same day front teeth are extracted, but this is not always the case.
Relatively few people are good candidates for same day front tooth implants, because you need a healthy mouth and gums, plus sufficient bone to support the implants. Many times there is not enough bone present post-extraction or the implant doesn’t fit precisely into the tooth socket after extraction. It is absolutely imperative that an implant has an intimate fit into the bone and cannot exhibit any movement whatsoever after placement. If an implant does not fit intimately into the hole (osteotomy), the chances of failure increase dramatically.
Also, same day—aka “ immediate implant”—placements have a slightly higher failure rate as compared to the conventional implant process. However, immediate implant surgeries are becoming increasingly popular and success rates have been increasing, especially when coupled with bone grafting procedures.
Duration of the process for front tooth implants
The placement of a single front tooth implant typically takes less than an hour using local anesthetic. Then after a three- to four-month healing period, the implant is ready to support an abutment and crown. At that point your implant dentist will place the abutment or “post” onto the implant. Then the crown is either cemented or screwed onto the implant itself and closely resembles a natural tooth. The entire process can typically be completed in a total of three to four appointments.
Complex implant cases that involve replacing multiple teeth, require more implants, or need bone grafting typically involve longer waiting periods. You may need to wear temporaries for an extended period of time to allow proper healing and to make sure your implants have integrated to the bone, a process called osseointegration.
As a general rule, even the most complex dental implant cases can be completed within 10-12 months. It is important to know that additional healing time may be required, depending on the complexity of the case. You should discuss the treatment timetable with your implant dentist early in the planning process; treatment phases and time frames can be outlined in detail based on the specifics of your case.
Proper upkeep and issues with recovery and rejection
On occasion, front tooth implants can fail and this does require additional treatments. Smoking, poor bone quality, and underlying health issues such as diabetes are factors that can contribute to implant failure.
Peri-implantitis—a condition characterized by inflammation and progressive loss of supporting bone in tissues around dental implants—is another concern. The onset of peri-implantitis can occur early during follow-up and often progresses in a non-linear and accelerating pattern of bone loss and implant failure..
If you exhibit poor plaque control skills and are less diligent about maintenance care, you will have an increased risk of developing peri-implantitis. Focused homecare is a must when considering dental implants.
Post-surgery tips and advice for proper healing of front tooth implants
Proper post-operative care is important to ensure successful healing and bone integration of front tooth dental implants.
You will likely be instructed to rinse post surgically with warm saltwater to promote healing. You may also be instructed to use the oral rinse Peridex™, which promotes antimicrobial cleansing of the surgical site and reduces the chance of infection. Also, a natural or holistic rinse from StellaLife® may be used to promote soft tissue healing. Practitioners are using these products more and more often to promote gingival healing with impressive results.
These focused post-surgery exercises promote healing, combat infection, and lead to better outcomes.
How to prevent front tooth implant failure
First and foremost it’s important that you don’t aggravate or chew directly on your front tooth implant for a minimum of eight weeks. Implants that are left undisturbed have the best chance of successful bone integration.
It’s also vital that you avoid behaviors that can contribute to implant failure. Most importantly, don’t smoke. Smoking is far and away the biggest detriment to implant healing and studies indicate that smoking can triple your risk of implant failure.