Photo by Dr. Ramsey A. Amin I recently had the privilege of speaking with Dr. Ramsey A. Amin, D.D.S., an acclaimed dental implant dentist practicing out of Burbank, Calif. He…

dental implant by Dr. Ramsey A. Amin
Photo by Dr. Ramsey A. Amin

Dental Implants 101 – An Interview with Dr. Ramsey Amin

dental implant by Dr. Ramsey A. AminPhoto by Dr. Ramsey A. Amin

I recently had the privilege of speaking with Dr. Ramsey A. Amin, D.D.S., an acclaimed dental implant dentist practicing out of Burbank, Calif. He is a Diplomate of the American Board of Oral Implantology / Implant Dentistry and also runs the Dental Implant Dentistry Blog, where he posts information and case studies on actual implant procedures to help others learn more about the fascinating field. Implants are becoming more and more common, but you still may have questions. We asked them for you, so you can learn a little bit more about the procedure and what to expect. Dr. Amin graciously gave up some of his time to share a little of what he knows:

What exactly is a dental implant?

A dental implant is an artificial tooth root that’s made out of titanium that replaces a missing tooth. It’s really that simple – an artificial tooth root. Dental implants are placed directly into the jawbone. They usually are shaped to look like screws, and they are threaded into the bone. You have to have enough bone to put them into in order to have an implant. If you don’t have the proper amount of bone, you’re going to have to make the proper amount of bone, to build it back.

How often do you need to perform a bone graft in order to do the implant?

It’s quite variable. Bone grafts are going to be more common in patients that have been missing teeth longer. As soon as you lose a tooth, your bone begins to shrink. So the longer a tooth is gone, the more the bone shrinks, and the more likely you are to have a bone graft, whereas the sooner you have an implant after having a tooth extracted, the less of a chance of needing a bone graft. It really is more of a time question than a percentage. Many times implants are placed on the same day of the extraction if they’re in the front of the mouth, and that can reduce the incidence of needing a bone graft. But if you need a bone graft, it’s far better to have the bone graft than it is to cut corners and try to do something without it if it’s necessary.

How long does an implant procedure typically take?

For a single tooth implant, which is probably the most common, if it’s in the back of the mouth you can expect to be in and out of the office within, oh, I would say an hour. In my office that’s what it is – an hour, an hour and a half at the most.

What kind of anesthesia do you have with an implant?

It varies from patient to patient. For most of my patients, the thought of having a screw put in their head is often disconcerting, so many patients opt to be sedated for the procedure. Many times they heal faster and have less pain not only during but after the procedure, because you’re able to administer certain anti-inflammatories by IV (I’m talking about IV sedation) that help the healing process and help you have less pain and less swelling. It’s really variable, but most people are just kind of scared at whole thought of, “I’m going to have a screw put in my head.” Implants on average are about an inch long. Some people are scared of a needle going in their arm that’s skinny and long; Try taking that same long thing and making it 5 millimeters diameter. Most of my patients I suggest to have sedation. It keeps them more relaxed, and if they’re relaxed, they’re safer having the procedure done.

In what cases are implants a better option than bridges or dentures?

Almost 100% of the time dental implants are better than bridges or dentures. 100% for dentures, and almost 100% for bridges. If you’re going to have a bridge, you have to grind down other teeth in order to have a bridge, so if you’re missing one tooth, you have to grind down the tooth on either side in order to have a bridge. So why create a 3-tooth problem when you only have a 1-tooth problem? Or why use a 3-tooth solution for a 1-tooth problem? You’re grinding down other healthy teeth for bridges. Bridges also have a lifespan on average of 7-10 years, then they re-decay, they get cavities around the bridge, and the bridge is subsequently replaced. If you’re getting a bridge replaced every 10 years versus having an implant once, financially it makes a whole lot more sense, and for the health of your teeth it makes a lot more sense. When a bridge fails, often the cavity under the bridge is so big that one of the teeth that the bridge was anchored to needs to be extracted, or needs a root canal, and then you have to grind down another tooth and make a new bridge big enough to fill the gap now. For dentures? I would say that dental implants are the best denture adhesive. Dentures are loose, they wiggle, they don’t hold in very well, but the main reason why implants were brought into the picture in the mid-60s and 70s is because they preserve your jawbone. When you wear dentures, your jawbone shrinks naturally because of disuse atrophy. If you don’t use it, you lose it, so if you’re not using the bone in your mouth –and the only way you can use the bone in your mouth is by chewing with teeth or chewing with implants – if your bone isn’t being stimulated by either your natural teeth or by implants, your bone is going to shrink away. As your bone shrinks away, your denture has to be made bigger and bigger in order to fill the gap till you don’t have enough bone, and then dentures don’t hold.

When did you first know you wanted to work with dental implants?

Definitely early in my days in dental school is when I made that decision, and ever since I’ve been out of dental school it’s been a passion of mine. My practice is very focused around dental implants, and I’m a Diplomate of the American Board of Oral Implantology. It’s very much been my life. I teach on the topic, I enjoy it, and I really think it’s the best service you can provide for a patient.

What is your favorite part about being an implant dentist?

Honestly, you’re helping people make the right decisions in doing things right the first time and avoiding making permanent mistakes by having a bridge and grinding down other teeth. Helping people make the right decisions, and the best decisions for their mouth. Really it often makes a big difference in their self-confidence and their social life, and honestly in their financial success. If a patient has self-esteem and has a confident, secure, handsome or beautiful smile, they’re just going to do better in the world.

What is a mini implant? Are they any easier or better?

Mini implants have a lot of advertising clout. They have some use for patients who are wearing dentures, but they’re only meant for people who have dentures. They are useful, but because they’re mini, they are small and they bend or break, so oftentimes they’re really more intended for a temporary situation, like temporary implants until a person can afford to have real implants made. [How would it bend or break in the jaw? How does that typically happen?] It’s just because the metal is so thin and the jaw is so strong that they just break off and bend, they’re so small. It’s like taking a credit card, you can bend it back and forth until it snaps. A real implant cannot bend or break, or it’s very, very uncommon. They can’t bend, but mini implants can bend or break. Mini implants can only be used for one purpose only, and that’s only for an overdenture, whereas a person that had a denture and they had implants and eventually they wanted to have real teeth attached to their implants, they could reuse their existing implants to be turned into a fixed bridge. The person who has mini implants is going to be stuck having the mini implants and dentures over top. So mini implants are really only used for overdentures and for people that are wearing dentures, but they can’t be used typically to replace a single tooth or any of the other indications for implants.

Does age matter when getting an implant?

Age is not a factor. A few weeks ago I had a 91-year-old patient who I placed 8 implants on. He came to me when he was 88 years old originally, 3 years ago, to talk about it. He came back 3 years later and said, ‘I can’t believe I waited all this time. My brother is beyond 100 and still going strong.” So age is not a factor. On the upper end of age, it’s your health. As long as you’re healthy – if you’re healthy enough to have a tooth extracted, then you’re healthy enough to have an implant. On the opposite end, for young patients, typically you have to be done growing in order to have an implant. Your jaws have to be done growing. Oftentimes for girls that may be 16 years of age and for boys it may be 18 years of age. It varies though. There are ways to confirm that a patient is done growing by taking an X-ray of their wrist. There are ways to tell by how the bone looks in their wrist that they are pretty much done growing.

Do you ever run into situations where people are trying to work around braces?

Yeah, as a matter of fact I was just working with a patient 10 or 20 minutes ago. Some ppl are missing teeth – let’s say they lost a tooth and they waited too long, so their other teeth are tilted or moved into the space where they want to have the implant, and we have to use braces to tilt the teeth back into position or to move teeth out of the way or into better positions to have the implants in the right spots. Orthodontists often use implants as anchors to move other teeth too. Implants can remove the need for headgear in the younger population. Now we put a couple “mini implants,” what we call a TAD (transitional anchorage device), which would be screwed into the jaw from the side. The orthodontist hooks some rubber bands onto the TAD, or “mini implant” that goes into the jaw, and they move the teeth around that way without having to wear headgear.

What is the most difficult or unusual procedure you have done?

The most difficult or unusual procedure I do is called a nerve repositioning or nerve lateralization. It’s for somebody who is missing their lower molars and the main nerve that goes through the jaw which is usually deep inside the jaw is near the surface, so you can’t put implants in the lower jaw because their anatomy pushed the nerve toward the surface or their bone loss brought the nerve toward the surface. There’s no way to put implants in there because the nerve is too shallow. If you were to put it in you would drill into the nerve. So the procedure I do, called a nerve reposition or nerve lateralization, is where the nerve is removed from the bone in its entirety and moved to the side, moved out of the way, and implants are put in where the nerve used to be. That procedure is not done too often, because many patients don’t want to do that procedure because of the risk involved of having a permanent or temporary numbness from the procedure. It’s not for everybody. It’s really for the person who is missing their lower teeth, they can’t wear removable dentures anymore, but they really want their teeth at all costs and are willing to take some extra surgical risks in order to move the nerve out of the way. It’s become more safe with some recent medical devices that allow moving the nerve or cutting bone without using a drill or using mechanical devices

What is the most interesting new technology in the implant world?

It’s a toss-up, really. I would probably say the ability to take a CAT Scan of a person and to simulate the surgery of their mouth on the computer before ever doing it in their mouth. Simulated 3D CAT Scan surgery. [Is that something you would show the patient?] I do go over it with the patient, it’s kinda cool on the screen, it looks like a video game of their skull on the screen. It gives them some understanding because they can see their jaw in 3 dimensions, I can show them ‘Here you have bone, here you don’t.’ That is definitely what I would say is the most interesting technology. It is useful on more advanced cases; it’s not needed for every single person.

Final comments

I would say just do your research on who is going to be doing your implant surgery, because dentists who place implants are not created equal. There are dentists who do this all the time and are really well-versed in this, and there are people who just dabble in it. So do your research and make sure you’re working with somebody really good. That’s ultimately what you’re paying for.

We really appreciate getting a chance to talk with Dr. Amin and learning so much about tooth implants. Visit Dr. Amin’s dental implant blog to learn more!

Would you ever consider tooth implants?

Let us know in the comments section!

60 Comments
  1. please let me no what i can do i really want implants get back with by email or phone. Waiting for your call.

    • Implants can be a costly procedure. However, our discount dental plans can cut the cost for you significantly. Give us a call at 1-855-760-4154. One of our representatives will be able to give you some more information about the cost of dental implants with our plan and where you can find a dentist that can help you.

  2. A Bend implant dentist can perform procedures that replace missing teeth and help create a beautiful smile. The problem with missing teeth is that the mouth can’t function properly to chew, and sometimes pain, discomfort and swelling can result.

  3. I recently had FOUR implants, some had bone grafted. For that part I already paid a reasonable amount, but, it is paid. I HAD to SIGN that I would pay for the same dentist to do the total imbutment and crown in 3-4 months. I am going out of the country and know a dentist who WANTS to do the final special crowns for me for a MUCH CHEAPER price. Am I legally held to pay for this by dentist number one here in the USA? Or–can I NOT pay for this–or ask to pay a small amount for his inconvience and get this done abroad by my friend, who is a dentist and knows an implant specialist? I have had work done abroad in the past with absolute success, so that part is not a problem. Thank you for your response.

    • You will probably want to read the paperwork you signed more closely. You may be legally bound to pay your dentist because of the paperwork you signed. If that’s the case, you may need to have the work done here. Talk to your dentist about the situation. He may be able to help lower the cost for you or create a more suitable payment plan.

  4. I have had full dentures, upper and lower since I was 16. I am now 71. I had new dentures made about 10 years ago. I looked like a rabbit at the time. Now they are so worn down it is hard to eat hard things and salads. Before these I had the harder almost like metal teeth. It was suggested I use this type of dentures. They are much softer so don’t last as long. I do not want to get more and look like a rabbit again and not be able to talk either. What can i do?

    • Hi Carolyn, I suggest you talk to a dentist that you trust and see what they recommend. A dentist who knows your dental history would be able to offer the most helpful advice to you in this situation. Thanks for reading!

  5. Thanks for the info, my question : can I use my old bridge once I do the implant instead of having a new bridge fixed in.

    • Hi Zeyad, that is a good question. Because everyone’s case is different, your dentist would be able to give you the best answer to that. Thanks for reading!

    • Hi Jerry, the cost of implants will largely depend on your dentist and the area you are located in. However, the typical cost of implants will typically run around $1500-$2000.

      • I just had an implant done for a molar. The periodontist charged $1800 for the graft and the implant screw, now my dentist is charging $2000 for the crown part. I live in NJ. Where do you find implants that typically cost only $2000?

        • Thank you for your patience. The typical fee for an implant is about $1,800 (with our discount dental plans you can get about 20% off that price) and crowns typically run from $1,150 to $1,250, where we can also get you a significant amount off. [That does not include the cost of the graft, which can typically cost anywhere from $200 to $3,000. I sincerely apologize for not being more clear on that in our earlier comment.] However, if your dentist is wanting to charge $2,000 for one crown, I would recommend trying to find another dentist in the area and see how much they charge. It’s possible your dentist is charging more than he should for the crown, if that price is just for the one crown and nothing else.

          I hope this was helpful for you! You can also get a better idea of prices for this procedure by looking at our fee schedule. You’ll see what you can typically expect to pay at the dentist without insurance and what you can expect to pay for this procedure using one of our discount dental plans. Hopefully that can be a help to you if you haven’t already bought your crown or if you need another procedure like this in the future.

          I did want to note that our discounted prices are only accepted at general dentists in our network. If you find a specialist in our network, you can receive 20% off his/her prices, which may not save you as much on the crown as you would at a general dentist in our network.

  6. I’m in the process now of having 2 Dental Implants done, in fact I’ve had the pins put in but have to wait 4 months for the pins to take to the bone then the Crowns will be able to be placed over the pins or screws as they refer to. I’ve had Crowns, Bridges and you name it and have had problems with all of them. Looking back, I wish I would have gone with the Implants in the first place. So if you skeptical about having it done, I say don’t hesitate do it…..

  7. I’m scheduled to get dental implants on May 23 and have been a bit nervous about it but this article helped answer a lot of my questions and I feel better about it now. Thanks for the excellent info!

    -Lance

  8. Just to know about dental implant people will not have to visit near any dentist. After reading this post people will directly visit the dentist to have an dental implant surgery. Thanks for sharing these information.

  9. Thanks foe sharing such a wonderful interview with everyone. there is no doubt to the question that Dental Implants is one of the best known dental treatment procedure now and more and more people are relying on this procedure for resolving their dental problems.
    thanks again

  10. Great blog, and i’m glad that you provide a “question/answer” type blog for the most common types of questions about dental implants. Only 1 hour average for a tooth implant? that’s great.

  11. Thjank you so very much for your infomation and the explanation of what we need for our tooth that is missing and what to expect and what to look for in a good oral dr. God bless and keep up the good work. From Tenn.

  12. I also had very little bone there to support the tooth due to not having teeth there for too long. I got a bone graph done and it came out well now im just waiting for everything to heal.

  13. I am 16 and I got implants yesterday because I was born without 2 teeth in the front of the mouth. I had bracees before that to open up spaces for the implants and when all is said I done and Im glad I got them. I was really hesitant at first to have it done because it was kind of a big decision but I am extremely happy I wentt through with it.

  14. Our teeth are originally designed to last a lifetime. But, there are instances wherein our teeth have to be removed. Usually these reasons would involve anatomical problems, diseases of the gums, and incorrect positioning. Fortunately, dental implants are now made available in most dental clinics.

  15. Wow that was very informative, I would so love to have implants but can’t afford it, thank you for sheering your knowledge.

  16. That was a great interview!!! Got lots to know about dental implants, its procedures and how people feel when they go for an implant. It is true then that dental implants are far better than dentures and dental bridges. But one thing that I found confusing was the CAT scan surgery process. I heard about dental implants and dentures but CAT scan surgery is a relatively new term for me. Could you please give us some more details about this new technology?

  17. With the development of dentistry, many new ways have been introduced as effective restorative options for the treatment of tooth loss. However, not every treatment procedure is effective for treating all issues in relation with missing teeth. Hence, if you are looking for a durable and stable option in dentistry, considering dental implants will be the only way out. In many cases, dental implants have proved to be the best solution for the restoration of the necessary functionality of the teeth and supporting structures.

  18. I had both of my baby lateral’s extracted when I was in the 6th grade and I do not naturally have my adult teeth. I was going to have a temporary anchorage device(TAD) put in but it turns out I don’t have the density because the doctor waited 3 years after the extraction to have it done. I have a bridge in but it has popped out close to 5 times in the year i’ve had it. I’m now 18 and I’m going away to college. My biggest concern is going away to college, having it pop out and being unable to run to my dentist to put it back in. Am I too young to get a bone graft done? I would love an implant before I go away to school.

    • Hi Caitlyn, I’m sorry that you’ve had such an ordeal! The best advice we can give is for you to see a dentist (or specialist) to seek their advice. Going away to college is the best time to make sure you get a cleaning, so you can ask about the implant then. Good luck!

  19. Thanks for sharing such an informative and helpful post with us. It is really very useful for all to gain knowledge about dental implants technology. The Dental Implants techniques are the latest solutions which offer simple, reliable and long-lasting results for patients of any age who are missing teeth or experiencing the frustrations of loose, decayed and broken teeth. In one day, patients can get a new, natural-looking smile that feels like permanent teeth, works like permanent teeth, is cared for like permanent teeth and may last even longer.

  20. I had fixed bridges and it is so sad to think how many teeth I had drilled down to fix the bridge in place. Then when they become loose because of decay – more teeth are drilled. I’m so sorry I ever had this done.

    I have a full denture on the bottom anchored by 4 implants. I love them. Four teeth had to be pulled. So it meant having no teeth on the bottom. It was quite expensive but the end result is wonderful. I was sedated. No problems at all.

    I used most of my retirement funds but I am glad I did this. To know that at least my bottom teeth will not decay – what a relief. I went to Clear Choice and it was a great experience. Just expert work. It’s nice when you go in for a medical procedure and you can say – “No, I have no dentures”.

  21. What a helpful interview! I would be one of those patients who would need to be sedated! But I’m very excited about the prospect of never having to get dentures when I get older. That’s a hassle I’d rather not deal with!

  22. Would there be any benefits to just having all of my teeth removed and getting a mouth full of implants so I never had to worry about cavities?

  23. Implants are an extremely popular topic to search online these days. With such an invasive procedure, have to echo Dr Ramsey: critical to find someone competent and capable. And kudos on the nerve lateralization procedure – not one you hear about every day!

  24. Wow, thank you so much for sharing this helpful information! I didn’t know very much about implants before reading this. This is great–thanks to Dr. Amin!

  25. That was really interesting! Based on that information, if the need arose, I would definitely get an implant over a bridge or dentures! Thanks for posting :)

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