Why do I need an implant?

• A tooth that's already missing, from an extraction, an injury, or one that never formed
• A tooth that can't be saved, such as one that's badly broken, cracked down the root, or has severe bone loss around it
• An old bridge that has failed, where an implant may now be an option
• Holding a denture in place, when several or all teeth are missing

An implant usually has three parts:

• The implant itself: a small post, usually titanium, placed in the jawbone. The bone grows tightly around it over a few months.
• The abutment: a connector that attaches to the implant and sticks up through the gum.
• The crown: the tooth you see, attached to the abutment.

Some crowns are made in one piece with the connector and attach directly to the implant, so there are only two parts. Either way works; it depends on the spot and your dentist's preference.

Each part is usually its own line on your treatment plan and bill. See Why are there so many lines on my plan?

The biggest difference from a bridge is that an implant doesn't involve the neighboring teeth. A bridge needs the teeth on either side to be filed down for crowns; an implant stands on its own. Compared with a partial denture, an implant is fixed in place, so there's nothing to take out.

That changes if the neighboring teeth already need crowns. Then a bridge can make more sense, since it repairs those teeth and fills the gap at the same time.

Implants aren't always the best choice, though. They cost more, take longer, involve surgery, and need enough healthy bone. See Are there other options?

Your dentist looks at the bone where the tooth was or will be (often with a 3D X-ray), the health of your gums and nearby teeth, your bite, and your general health. Smoking and poorly controlled diabetes make implants less predictable. Gum disease is usually treated first.

Age matters too. Implants usually wait until the jaw is done growing, typically 18 or older. A teenager missing a tooth often wears a temporary replacement until then.

So do some medicines. Certain bone medicines, used for osteoporosis or for cancer that affects the bone, can change how the jaw heals. Depending on the medicine and how long you've taken it, your dentist may plan around it, talk with your doctor, or suggest another option. Tell your dentist about every medicine you take, even ones you take only once a month or once a year.

Implants are placed by oral surgeons, periodontists (gum specialists), and some general dentists with extra training. The crown on top is usually made by your general dentist or a prosthodontist (a specialist in replacing teeth). It's common for two offices to share the work. If it isn't clear who does which part, ask.