How Long Can I Wait on Getting Dental Implants?

Dental implants are the best modern dentistry can offer when it comes to replacing a tooth, and, in a previous article, we talked to a number of dentists to get a general idea of what having implants done might cost.

We realized that some people may be concerned about the expense of having this done, and may put it off until “the right time” when they can afford it. However, is it wise to put the procedure off for too long? Are there risks in not having a dental implant placed soon after a tooth is lost?

We checked back with the professionals for their answers.

While modern dentistry has many ways to help save teeth, there are some times that a tooth must be removed. While wisdom teeth are usually removed because there isn’t enough room for them, other teeth are important to replace. If they are not replaced, then the teeth surrounding them and above or below the missing tooth will tilt or continue to drift, causing a collapse in the bite. This change in bite can begin to occur within months of the loss, so prompt replacement will protect the bite.

After a tooth is lost, the jaw bone that held the bone in place no longer has any stimulation and begins to shrink and the surrounding area narrows. In order to place a dental implant, which is the best replacement that modern dentistry can offer at this time, there must be sufficient healthy bone to place the implant in both in height and width. In some cases, a dental implant can be placed immediately after extraction, which minimizes bone loss and can keep the gum contour ideal. In other cases, a bone graft to preserve the bone so that an implant can be placed after 4-6 months of healing must be done.

It is not wise to delay the placement of the dental implant because the bone will continue to narrow and shrink, and then, if an implant can be done, more extensive, costly bone augmentation procedures would need to be done first to be able to place the implant. If the teeth have shifted, there may not be enough room to do an implant unless orthodontic treatment would be done first, which would also add to the time and cost of the replacement.

If a dental implant is not done in a timely manner, and it is not possible to place the implant because of the lack of bone or space, the other replacement options could include a removable partial denture which people can find bulky or awkward, or possibly a fixed partial denture or bridge. This second option isn’t very conservative, as the healthy teeth on either side of the missing tooth would need to be prepared. The investment for the bridge is probably close to the investment for the dental implant; however, the bridge may need replaced in the future even every 7-10 years and the implant is about 97% effective for long term without additional replacements.

Tamara L. Clauson, DDS – Lodi, CA

Although restoring the implant right away is the best, I think waiting six months to a year is okay. The implant will not move but the teeth around it do, therefore, if you wait too long the teeth above it could move down, creating another problem. Or the tooth behind it could move forward, crowding your final crown so that the result is not as good.

Cynthia M. Sachs, DDS – Rockford, IL

If you need a tooth extracted, when should you have a dental implant placed? Most dentists will remove the tooth and graft the socket. Wait 6 months, then place the implant. After 6 more months of healing, they will uncover the dental implant and you will then be sent for the crown.

To summarize, after one year and 3 different surgeries you will have your dentist make the final crown.

This is the traditional and costly treatment still practiced today. Of this one year period, you lose bone, have numerous surgeries and post-surgical appointments. But what if you could skip these many surgeries and have your implant placed immediately and a temporary crown inserted the day you have your tooth removed? Wow, that would save an immense amount of time, stress and eliminate the bone loss that comes from waiting over a year.

Ask your dentist if he or she can refer you to a dental implant surgeon who can do these procedures in this manner. Avoid having to wear a partial denture for over a year and walk out with a temporary tooth attached to your dental implant the day you have your tooth removed.

This will save you time, money and provide better esthetic results. Why wait?!

Robert Schroering DMD – Marion, IN

It depends… If there is uncontrolled disease in the mouth, such as periodontitis (gum disease) or tooth decay, or if any medical condition is unstable, then it is wise to wait until all disease is under control. It is important to consider that implants are not fail-safe and depend on a healthy patient and healthy mouth for the best prognosis.

Implants fill a hole that was created due to a failed tooth. Why was the tooth lost in the first place? That reason could also be the reason for implant failure. Therefore, in my opinion, implants are an option for treatment in the right situation; they are not the only option. The decision for implant therapy, and when it should be done, depends on many factors and is not always a simple one.

Kevin D. Huff, DDS, LLC – Dover, OH

We hope you found these answers enlightening. With bone loss from the lack of stimulation and other teeth shifting due to the space a missing tooth leaves behind, if your dentist has recommended a dental implant procedure, it may be best not to put it off for too long—and the good news is that, in some cases, implants can be placed at the same appointment as the extraction.

That said, Dr. Huff makes a good point: As dental implants behave just like natural teeth do, they are susceptible to the same problems that may have caused the missing tooth in the first place. If this was due to poor oral hygiene or gum disease, those issues will need to be addressed first, or the dental implant may not be the permanent solution it’s intended to be.