A good dental implant candidate is usually an adult whose jaw has finished growing, who has enough healthy bone to hold an implant (or can have it rebuilt), healthy gums, reasonably good general health and a commitment to looking after the implant. Factors such as smoking, uncontrolled diabetes and certain medications can increase the risks, but they do not always rule implants out. A full assessment, including 3D imaging, is the only way to know for sure.
What is a dental implant?
A dental implant is a small post, usually made of titanium, that is placed in the jawbone where a tooth is missing. Over a few months, the bone bonds to the surface of the implant in a process called osseointegration. A crown is then attached to replace the visible part of the tooth.
Implants can replace a single tooth, support a bridge for several missing teeth, or anchor a full arch of teeth. Unlike a traditional bridge, an implant does not require the neighbouring teeth to be filed down for support. You can read more on our dental implants page.
What makes someone a good dental implant candidate?
1. Enough healthy bone
An implant needs a solid foundation. After a tooth is lost, the bone in that area gradually shrinks, and the longer a tooth has been missing, the more bone may have been lost. Gum disease and dentures can also contribute to bone loss.
If there is not enough bone, a bone graft may be able to rebuild the area before or at the same time as the implant is placed. In the upper back jaw, a sinus lift may be needed to create room. Grafting adds time, cost and some additional risks, and not every site can be grafted successfully.
2. Healthy gums
Active gum disease needs to be treated and stable before an implant is placed. People who have lost teeth to gum disease can still have implants, but they have a higher risk of inflammation around implants later (peri-implantitis), so ongoing maintenance is especially important.
3. A fully grown jaw
Implants do not move with the growing jaw the way natural teeth do, so they are usually not placed until growth is complete, typically in the late teens or early twenties. There is no upper age limit; many older adults have implants successfully, provided their general health allows.
4. General health
Your overall health affects healing and the long-term success of an implant. Your dentist will want to know about:
- Diabetes: well-controlled diabetes is usually compatible with implants, but poorly controlled blood sugar increases the risk of infection and implant failure.
- Medications for osteoporosis or cancer: some medications that affect bone, such as bisphosphonates and denosumab, carry a rare risk of a serious jaw bone complication after surgery. Your dentist may liaise with your doctor.
- Radiotherapy to the head and neck: this can affect healing in the jaw and needs careful planning.
- Immune conditions and medications that suppress the immune system, which can affect healing.
- Blood thinners, which usually do not prevent treatment but need to be managed with your doctor’s input.
5. Smoking and vaping
Smoking is consistently linked with a higher rate of implant failure and complications, because it reduces blood flow and impairs healing. Your dentist may recommend stopping before and after treatment. Vaping has been studied less, but there are concerns it may also affect healing.
6. Grinding and clenching
Heavy grinding can overload implants and crowns, causing chipping, loosening or, occasionally, failure. If you grind, your dentist may recommend a night guard after treatment.
7. Commitment to oral hygiene
Implants cannot decay, but the gum and bone around them can become inflamed and infected. Daily brushing, cleaning around the implant with floss or interdental brushes, and regular professional maintenance are essential for long-term success.
How suitability is assessed
An implant assessment usually involves a full medical and dental history, an examination of your teeth, gums and bite, and imaging. A 3D CBCT scan shows the height, width and density of the bone, and the position of important structures such as nerves and sinuses, so the implant can be planned accurately. CBCT imaging is available on site at our Macquarie Park practice.
After the assessment, your dentist will explain whether an implant is suitable, whether you would need grafting or other procedures first, the expected timeframe, and alternatives. At North Ryde Dentistry, a dental implant with a CEREC crown is from $5,500 per tooth. A quote is provided after assessment, and bone grafting or other procedures are extra. Health fund rebates depend on your fund and level of extras cover.
What if you are missing many or all of your teeth?
If you are missing most or all teeth in an arch, or your remaining teeth are failing, a full-arch option may be considered. All-on-4 treatment uses four implants to support a fixed bridge of teeth, and in some cases teeth can be attached soon after surgery. It can sometimes avoid the need for extensive bone grafting by angling the back implants to use the available bone.
Full-arch treatment is a major procedure with its own risks, including implant failure, fracture of the bridge and the need for ongoing maintenance and eventual repairs. Not everyone is suitable. The fee depends on the materials, the number of implants and whether extractions or grafting are needed, and a written estimate is given after assessment. Learn more on our All-on-4 dental implants page.
Risks and limitations of dental implants
Dental implants have a long track record and high success rates in suitable patients, but they are surgery and carry risks, including:
- Pain, swelling and bruising after surgery
- Infection
- The implant not integrating with the bone
- Nerve injury causing numbness or tingling, usually temporary but occasionally long-lasting
- Sinus problems with upper implants
- Peri-implantitis, a gum and bone infection around the implant, in the years afterwards
- Mechanical problems such as a loose screw or chipped crown
Treatment also takes time, often several months from start to finish, especially if grafting is needed.
Alternatives to dental implants
- A bridge, which uses the teeth on either side of a gap for support. It is quicker but requires preparing those teeth.
- A removable partial or full denture, which is less invasive and usually lower cost, though some people find dentures less stable.
- Leaving the gap, which may be reasonable for some back teeth, although neighbouring teeth can drift over time.
When to see a dentist
If you have a missing tooth, a tooth that is likely to need removal, or dentures that are loose or uncomfortable, an assessment can help you understand your options. Ideally it is done before bone loss progresses too far, but implants can still be considered years after a tooth has been lost.
Frequently asked questions
Am I too old for dental implants?
There is no upper age limit. What matters more is your general health, bone quality and ability to care for the implant.
Can I get implants if I have bone loss?
Often, yes. A bone graft or sinus lift may be able to rebuild the area, or a technique like All-on-4 may use the available bone. A 3D scan helps determine what is possible.
Can smokers have dental implants?
Smokers can have implants, but the risk of failure and complications is higher. Your dentist may recommend stopping smoking before and after treatment.
Are dental implants suitable for people with diabetes?
Many people with well-controlled diabetes have implants successfully. Poorly controlled diabetes increases the risk of infection and failure.
How long does the implant process take?
Often several months from assessment to the final crown, to allow the bone to heal around the implant. Grafting can add more time.
If you are wondering whether implants could work for you, an assessment is the first step. Call North Ryde Dentistry on (02) 8090 1102 or book an appointment.
This article is general information only and is not a substitute for advice from your own dentist. Any treatment carries risks; your dentist will discuss whether it is suitable for you.
Related at North Ryde Dentistry: our North Ryde dental clinic