A common question asked by many patients is, “Just how long will my dental implants last?” The answer to this question may be dodged by some dentists who simply don’t want to over-promise, or confidently answered by others who do over-promise in order to encourage patients to accept the proposed treatment. The truth is probably somewhere in the middle and is something that should be based more on evidence and experience, and less on opinions or self-promoting marketing.
Nothing in life, at least when it comes to material things, lasts forever. Dental implants are placed in the harsh environment of the mouth with bacteria, forces of chewing, and varying hygiene practices, not to mention the possibility of smoking and general dental disease affecting other teeth and the patient’s overall health status. Therefore, the reality is that each patient is unique and has different lifestyle and health factors that will affect the longevity of their dental implants.
So, how does one answer this question in a way that will reassure patients that choosing dental implants is right approach, and yet make them aware of the risk factors and realistic expectations? The success and longevity of dental implants are influenced by so many factors, some completely within our control, some possibly influenced by our behaviors, and yet others that are unpredictable/uncontrollable.
Over the last 22 years, I have enjoyed great success with the implants I have placed for thousands of patients, yet I am humbled by less-than-ideal results on others. My experience has provided me with both confidence and humility.
Here is what I tell my patients when asked how long dental implants last:
There are many factors that can impact the success and longevity of your implants. Some are well within our control, some are possibly influenced by your behavior, and some are beyond our understanding or control.
We can expect long-term and possibly lifetime success if we truly control ALL that we can. This includes:
- Dental professionals who:
- Develop implant sites with abundant and great-quality bone
- Choose a quality dental implant with ideal design, diameter, and length
- Place the dental implants perfectly with ideal angle, tilt, and depth aligned with the planned restoration
- Develop abundant and great-quality gum tissue covering the implant and bone
- Design ideal gum tissue form and health with customized prototype restorations
- Use current techniques and materials at every stage of surgical and restorative treatment
- Create precision-fitting restorations with proper contours
- Establish a physiological occlusion (bite)
- Design and fabricate restorations that mimic nature with ideal aesthetics and function
- Create an implant-restoration complex that promotes easy cleaning and maintenance
- Keep implants healthy using proper implant care protocols
- Patients who:
- Keep their teeth and implants clean with an effective home care regimen
- Avoid smoking
- See their dentist and implant care practitioner or hygienist regularly every 3-4 months for professional care
- Keep in a good state of general health
- Use night guards if recommended
Then there are patient-related factors that, although considered beyond our control, may be influenced to some extent by certain behaviors:
- Physiology of healing – Each person heals differently. Healing physiology is a culmination of many elements guided by the patient’s genetics, immune system, general systemic diseases, and nutrition. Eating healthy is a major factor in improving general health and healing potential and is one that can be easily influenced. Vitamins, particularly Vitamin D, is also an important factor in the health of our bone and is recommended in higher dosage before and after dental implant therapy.
- Emotional state – There is a strong relationship between our emotional state and healing. Stress, anxiety, constant state of overwhelmingness, depression, and negative thoughts diminish our healing potential and can lead to poor healing in general. On the other hand, positive thoughts, calmness, a state of gratitude and happiness, confidence, hope, and meditation greatly promote it. Healthy lifestyles, yoga, exercise, music, connection to family, friends, and the community, and mediation can all help to improve one’s emotional state and optimize the body’s ability to heal.
- Disease – Any systemic disease that affects the patient’s immune system, such as cancer, poorly controlled diabetes, and others that diminish the body’s natural defense mechanism can affect healing and health. Patients should get regular medical check-ups and do their best to stay healthy.
Lastly, there are those factors beyond our understanding or control:
- Complications can happen even with 100% compliance with best practices and following all the treatment guidelines.
- There are circumstances in which an implant may not heal as expected or may undergo gradual bone loss with no known etiology.
- We must respect each person’s biology and accept that we still don’t know everything about the human body and its healing mechanisms. Every experienced clinician will attest to that.
To expect the best, long-term results, we must control every factor that we can and minimize the risks presented by the factors over which we have less or no control. There is no guarantee that, even with controlling all we can, problems won’t happen. We just have to be ready to recognize problems and manage them early. The good news is that research shows that, when placed by an experienced dental professional, dental implants have a long-term (10+ years) survival rate of at least 95% (1). That number should provide most patients with the answer to their question about the longevity of dental implants.
(1) Howe MS1, Keys W2, Richards D3.Long-term (10-year) dental implant survival: A systematic review and sensitivity meta-analysis J Dent. 2019 May;84:9-21. doi: 10.1016/j.jdent.2019.03.008. Epub 2019 Mar 20.
Dr. H. Ryan Kazemi is a board-certified oral and maxillofacial surgeon in Bethesda, MD