How long does an implant last?

What you call an 'implant' in your mouth is made up of three parts. At the bottom is the implant, which sits in the bone and takes the place of the tooth's root. Above it is a connecting part that passes through the gum into the mouth (the intermediate part dentists call an abutment). At the top is the tooth you see and chew with, in other words the bridgework. Because the three are subject to different forces and face different risks, they do not last the same length of time either.

The implant in the bone does not decay or wear out. What causes it to be lost is not the passing of time but the tissue around it losing its health. The implant stays where it has locked into the bone; if the gum becomes inflamed and the inflammation reaches the bone, the anchorage weakens. In short, the lifespan of an implant is the lifespan of the bone around it.

The tooth on top, by contrast, carries the chewing load directly. Its surface wears over the years, its edge chips when it hits something hard, and the screw holding it comes loose. None of these is a failure of the implant; it is wear and tear on the part that carries the load. The bridgework is removed and replaced without the implant underneath being touched.

In practice this means that when you come in years later saying 'my tooth has broken', what we are talking about is not taking the implant out but repairing the bridgework. When you say 'my implant is moving', the first thing we check is whether the screw has come loose; a loose screw is tightened and that is the end of it. An implant that moves inside the bone is a completely different matter.

We talk about an implant's lifespan not in years but in conditions. Of two patients who have implants on the same day with the same materials, one uses them for years without problems while the other has trouble early on. Five things make the difference: daily oral hygiene, smoking, having diabetes under control, grinding your teeth at night (bruxism) and coming for check-ups. All five are in your hands.

The strategic implants we use lock mechanically into the hard outer layer of the jaw, the cortical bone, which is the densest layer of the bone. Conventional implants take their anchorage mainly from the softer, spongy bone inside, and you have to wait for osseointegration. This difference changes how long the start of treatment takes: a graft and months of waiting do not come into it. The rule that applies in the long term, however, is the same for both: what keeps an implant in place is the health of the tissue around it.

This is not a list of who is accepted and who is turned away. If you see yourself in the second list, it does not mean you cannot have implants; it means there is something to sort out first. Every one of these points can be sorted out.

Looking after an implant is no harder than looking after a natural tooth, but it is different. When treatment is finished, we explain the routine below by showing you in your own mouth; reading about it is not enough.

1. 1

   Brush twice a day

   With a soft brush, and so that the gum line is included. The border area around an implant is not as resistant as it is around a natural tooth; what you need to do is not brush harder but widen the area the brush reaches.

2. 2

   Clean between the teeth every day

   A brush cannot reach between the teeth or under the bridge on the implants. For these areas we use an interdental brush or special floss that is threaded under the bridge; we try out at the clinic which size suits you. A water flosser does not replace these, but it is a good addition.

3. 3

   Keep up with professional cleaning

   Cleaning at the clinic is done with tips that do not scratch the implant surface. That is why you should tell every practice you visit that you have implants; a standard scaling instrument damages the implant surface.

4. 4

   Have a check-up X-ray at least once a year

   Whether the level of the surrounding bone has changed can only be seen on an X-ray. Taken when you have no symptoms at all, this X-ray catches a problem while it is still at the stage where it is easy to resolve.

5. 5

   Wear a night guard if you grind your teeth

   The guard takes the chewing force onto itself instead of the bridgework. In patients who come to us with a broken bridge or a loose screw, this habit is the cause we come across.

Almost all problems are resolved without touching the implant. The items below are listed from mildest to most serious; an examination and X-ray show which step you are on.

We are not writing this to frighten you, but so you can recognise the signs early. The most important feature of this condition is that it is painless at the start; that is why noticing it depends not on what you feel but on your check-ups.

The course below is for after treatment is finished. These are stages, not a timetable; we wrote them to show what to pay attention to at each point.

1. The first months

   A period of getting used to a new routine. We check at the clinic how you are using the interdental cleaner, because mistakes that set in during the first weeks turn into habits later. If anything in your bite feels uncomfortable, we adjust it during this period.

2. The first year

   We take a baseline image of the level of the surrounding bone. This image becomes the point of comparison for the years that follow; without it, the question 'has it changed?' has no measurable answer.

3. The years that follow

   Regular examinations, professional cleaning and a check-up X-ray. If anything has changed regarding smoking, blood sugar control or teeth grinding, we adjust the interval between check-ups.

4. Replacing the bridgework

   At some point, replacing the bridge comes up. This is not a failure but the replacement of the part that carries the load. The implants underneath stay in place, and the procedure goes ahead without surgery.

We do not give figures on this page; we give you the price in writing after we have seen your mouth and your X-rays. But the factors that change the sums for the years after treatment can be known from the start:

The bridgework material

The material used for the bridge determines both how it wears and how often it needs replacing. We state the material we use and its manufacturer in writing in the treatment plan.

Removable bridgework

Because the bridge is designed so that it can be removed without touching the implants underneath, replacing it years later becomes a small procedure. This choice is made on the first day.

Check-ups and professional cleaning

A small but recurring item. When it is skipped, what takes its place is more extensive treatment, which does not work out cheaper overall.

Number of implants and teeth

How many teeth are carried on how many implants determines both the initial scope and the extent of later maintenance work. A full-mouth plan is costed differently from solutions added one at a time.