Lost a tooth and want a fixed replacement? This is a dental implant.
An implant is a small titanium root placed in the jawbone where the tooth used to be; the bone knits around it over months, and on top sits a crown made to the shape and colour of your teeth, that you eat with. It suits someone who has lost a tooth, or several, and wants a fixed replacement: nothing leaning on the neighbours, nothing you take out, and whether it suits you right now is decided at the examination and on the x-ray.
Between the root and the crown there is a third piece: a small connector, the abutment, that comes up through the gum and joins them. What matters about the three: the root stays in the bone, and the crown is a separate piece that can be replaced years from now without touching the root.
The word “fixed” is the whole difference: an implant stands on its own in the bone. It does not lean on the teeth beside it the way a bridge does, and it does not come out the way a denture does. That is exactly why people ask for it, and exactly why it is not for everyone right now.
Who it suits
You have lost one tooth. To an extraction, a fall, or decay that was not caught in time.
You have lost several teeth. One tooth is a different job from a row of them, and sometimes a few implants placed well can carry more than one tooth. The layout comes from the examination and the x-ray, not from counting gaps.
A damaged tooth that can no longer be saved. If the examination says it cannot be kept, the implant is discussed before the extraction, not after, because the extraction is done differently when an implant is in the plan.
A denture that moves or rubs. If you are tired of something that comes out, an implant is one of the options discussed at the examination, and it is not the only one.
An implant is not a single visit. It is a course of four stages, and between some of them there is healing time that is not compressed. Here are the stages as they are, with no number of weeks or months attached, because the timeline for your case is something you hear at the examination.
1
The examination and the x-rayThe doctor examines your gum, your bite and the teeth beside the gap, not just the gap. Digital x-rays are taken in the clinic, and whether your case needs a more detailed image is decided at the examination. Because what we need to see before an implant cannot be seen by eye: how dense the bone is, how tall and how wide, and how close it sits to the nerve in the lower jaw or the sinus in the upper jaw. The right image for your case is what shows it.
2
Placing the implantA small operation under local anaesthetic, usually in one visit: the root is placed in the bone through a small opening in the gum, in the position and at the angle planned on the image, and the gum is closed over it or around a small cap. And the pain? It is the first question below.
3
HealingThe bone knits around the root over months, and you live your life as usual. There is some discomfort and mild swelling for the first few days, and they settle; the instructions for those first days you hear from the doctor on the day of the procedure. During this stretch there is no final tooth in the implant's place, and whether your case allows a temporary tooth for appearance is decided at the examination, not here.
4
The crownOnce the root has taken, a small abutment is fitted on it, an impression is taken, and the crown is made in the lab to the shape of your mouth and the colour of your teeth. When it is fitted, your bite is checked so the crown does not carry more than it should and so cleaning around it is possible. From here you eat normally, and the follow-up begins.
Drag and see: the implant, from the gap to the crown
The gapThe crown
An illustration. Between placing the implant and the crown there is a healing period, and you hear how long yours is at the exam.
If the bone is thin, or the gum is inflamed, or a tooth has to come out first, a stage is added before these four, with its own healing time. And anything beyond this course, such as an implant placed at the same visit as the extraction, or a temporary tooth soon after, has conditions and is decided at the examination, sometimes at the moment of extraction itself: Same-day implants: when they work and when they wait.
The downsides and the alternatives, before the advantages
You hear the downsides before the advantages, because an implant is a decision that stays with you. These are the things to know before you book:
Surgery, stages and time. Not one visit and done. A small operation under local anaesthetic, then healing over months, visits along the way, and a stretch without a final tooth or with a temporary one for appearance. If you want a tooth as soon as possible, say so at the first visit, because it changes the order of the plan.
It may not take in the first months. Sometimes the bone does not knit to the implant, and it starts to move. Then it is removed, the site heals, and often a new implant can go in once the bone is ready. Nobody can know in advance whether the bone will take to it. What raises its chances: healthy bone, healthy gum, no smoking, and controlled sugar.
Care and follow-up for as long as you have it. The implant cannot decay, but the gum and bone around it become inflamed when tartar and plaque build up on them, and it usually does not hurt at first. Someone who does not clean along its gum line every day and does not keep their check-ups loses it the way teeth are lost to gum disease: slowly and silently.
Smoking, uncontrolled sugar and grinding. Smoking slows the bond and makes inflammation easier later. High sugar slows healing. Grinding lands a pressure on the implant that it cannot absorb, because it is bonded to the bone with no ligament like a natural tooth has, so a screw can loosen or a crown can chip. Smoking and grinding are not a closed door in most cases, but they change the plan, and high sugar is brought under control first. Say so at the first visit.
A nerve and a sinus. In the lower back jaw a nerve runs close to where the implant goes, and in the upper back jaw the sinus sits above it. That is why the x-ray before the implant is not a formality. Rarely, numbness in the lip or chin can last, and any numbness that stays after the anaesthetic wears off is reported the same day.
The alternatives
An implant is not the only way to replace a tooth, and sometimes not the most suitable one:
A fixed bridge. A false tooth carried on two crowns over the teeth on either side of the gap. It usually finishes in weeks with no surgery, but the two neighbours are trimmed, and trimming does not grow back. If they already carry crowns or large fillings, the comparison changes.
A removable denture. A plate that rests on the gum and holds on to the teeth beside it with small clasps. No surgery, and the one that moves most of the options.
Leaving the gap. The alternative nobody counts. The teeth beside it can lean into it over time, the tooth facing it may drift towards it, and the bone underneath shrinks little by little, which can make replacing the tooth years from now harder. You do not have to decide this week. Just do not leave it for years.
In these cases the answer is usually not “no”. It is “not yet”, and you hear what has to happen for it to become possible:
Thin or shrunken bone. An implant needs enough bone to hold it, and that is seen on the x-ray, not by eye. If there is too little, it may need building up before the implant, which is an extra stage with its own healing time.
Active gum disease. An implant is usually not placed next to an inflamed gum or into a site with an infection or an abscess. It is treated, it heals, and then the implant is decided. And if you lost the tooth to gum disease in the first place, the gum around the implant is more prone to the same thing: not a closed door, but it needs treatment before and closer follow-up after.
Uncontrolled sugar. We do not place an implant on high sugar, because the wound heals more slowly and becomes infected more easily. The first step is with your diabetes doctor: control, a blood test, and then we come back to the implant. Dental implants when you have diabetes.
The tooth is still in place. If the tooth is damaged but still there, the first question is whether it can be saved. If extraction is decided, the implant is planned before the extraction. And if an implant at the same visit as the extraction is a possibility for your case, that is decided at the examination, and sometimes at the moment of extraction, when the doctor sees the bone.
A jaw that is still growing. In a teenager, an implant usually waits until the jaw has finished growing, because it does not grow with the bone the way a natural tooth does. What the option is until then, you hear at the examination.
Medicines for the bones, or radiotherapy. Some medicines given for osteoporosis or alongside cancer treatment, and radiotherapy to the jaw area, change how bone heals. Not necessarily a closed door, but say so in your first sentence, and the doctor may need to speak with your own physician first.
Can a tooth lost twenty years ago still be replaced with an implant?
That is how the question is asked, and the honest answer: yes, in many cases, after the bone has been assessed. What changes over the years is not the implant; it is the bone. When there is no root loading it, it shrinks little by little, at a different speed from one person to the next. So the x-ray decides: enough bone and we place the implant, too little and it may need building up first, and how and where is decided at the examination, and sometimes a bridge or a denture is the more suitable fit if the neighbours allow it. Nobody can say it is too late before the x-ray, not over the phone, and not by email from abroad.
What to do from here
1
Say the three things at the first visit: smoking, diabetes, grindingThese change the whole plan; they are not details for later. How much you smoke, your latest sugar results, and whether you wake with a tired jaw or anyone has told you that you grind in your sleep. Not so you are ruled out, but so the plan is built right from day one, and without a lecture.
2
Have your medicines and your health history readyA list of everything you take, especially blood thinners and medicines for the bones, any past radiotherapy, and any allergy to metals. And do not stop any medicine on your own, before the appointment or after it: anything arranged around your medicine is the doctor's decision, and he may need to speak with your own physician first. If you had dental work done abroad, bring whatever records you have, x-rays included.
3
If the tooth is still in placeSay that an implant is on your mind before the extraction, wherever it is done. The way the tooth comes out helps preserve the bone when an implant is in the plan.
4
If you are in Amman for a whileAn implant takes months, because healing is usually not shortened just because of travel. If you are in Amman for a fixed stretch, a posting, a contract, a semester, or you travel often, say so at the first visit. The stages are planned around your travel before you commit, as far as the healing allows, and whether a temporary tooth is possible between stages is decided at the examination. An implant is usually not squeezed into one short trip, and it is fairer to hear that before you book flights than after.
5
Book an examination and an x-rayThe first visit has no implant in it; it has an x-ray and a conversation. The rest is in the card below.
When to call
If the gap has been there for a long time and nothing hurts, that is not an emergency. Some situations, though, do not wait:
Call today: a broken or loose tooth with swelling, an abscess or a fever. The infection is treated first, and the implant decision comes after.
Call this week: a tooth that is due to be extracted, here or anywhere else, and an implant is on your mind. The planning happens before the extraction, not after.
And after the implant
Most of what happens after an implant is expected: some discomfort and mild swelling for the first few days, and then they settle. These, though, do not wait for the follow-up appointment:
Call today: bleeding that does not stop with pressure on gauze.
Call today: swelling that grows after the second or third day instead of easing.
Call today: numbness in the lip or chin that has stayed after the anaesthetic wore off.
Call today: a fever, or pain that grows over the days instead of easing, or pain that throbs at night.
Call today: a bad taste or smell or discharge from around the implant, or a feeling that the implant or the cap over it has moved.
Call and we will find you the earliest slot, and tell you what to do until you arrive. Before any painkiller, ask the doctor first, so it suits your case. If the swelling has reached your eye, or it has become hard to swallow or breathe, that is a hospital emergency, not an appointment. If the clinic is closed and the bleeding will not stop with pressure, or the swelling is growing, or you have a high fever, go to the nearest hospital emergency department. Let us know as soon as we open. And if the pain is in another tooth, not the implant: Toothache: what to do right now.
And who treats you?
The clinic has a team of dentists, Dr. Adnan Alakhras among them. At the first visit you hear the state of your gum, bone and bite before you hear any plan. His qualifications are on his page: Read about the doctor and the clinic.
Questions people ask
Does it hurt?
The implant is usually placed under local anaesthetic, and the doctor chooses the type and amount for your case at the examination. During the work you usually feel pressure and movement, not pain, and if you feel anything you raise your hand and the anaesthetic is topped up. Once it wears off there is some discomfort and mild swelling for the first few days, and a suitable painkiller the doctor decides on, not something to pick up on your own. What is not normal: pain that grows over the days instead of easing, and that is a reason to call. If fear itself is the problem, say so from the first moment and we go at your pace. For those who need it there is laughing gas alongside the local anaesthetic, not instead of it: a small mask over the nose, you stay awake and can talk. When the visit is hard.
How long does it take?
Stages, not a single visit: an examination and an x-ray, then the implant visit, which is usually one visit, then the bone knits around the implant over months, then the abutment and the final crown. If the bone needs building up, the gum needs treating or a tooth needs extracting first, that comes before. The time between the stages is not compressed, because it is what lets the implant take and stay. And if a same-day implant is done, it saves a visit or a waiting period; it does not save the healing. And if you are flying in, it is rarely one trip: say so at the first visit, and the stages are planned around your travel, as far as the healing allows. The actual timing for your case is discussed at the examination, as an expectation, not a promise.
Are there payment plans?
Not at the moment. The doctor is looking into it and wants a trustworthy partner before he commits to anything. What you can do now: after the examination, talk to him about sequencing the plan in stages, the most important first. And the cost itself is discussed after the examination, not over the phone or by email. The full answer is under Payment and insurance on What decides the cost of your treatment.
Which implant system do you use?
There are many implant systems, and most share the same idea: a titanium root that bonds to the bone. What sets one apart from another is its size, its shape, its surface, the way the crown connects to it, and the system behind it, not the country on the box and not how famous the name is. The doctor chooses the size and the system from your x-ray and the position of the tooth, not from a list, and you hear why at the examination. Implant types: what really differs.
I have diabetes. Can I have an implant?
Often, yes. Diabetes on its own is not a closed door; uncontrolled sugar is, because it slows healing and makes infection easier. If your sugar is controlled, the plan is close to anyone else's, with closer follow-up. If it is not, it is brought under control first with your own doctor, and then we place the implant. The decision is made at the examination, with an x-ray and your blood results. Dental implants when you have diabetes.
How long does an implant last?
There is no fixed number. The implant itself cannot decay, but it lives in bone and gum that react to smoking, uncontrolled sugar, grinding and neglected cleaning. What makes it last longer: cleaning along the gum line every day, check-ups and an x-ray, no smoking, protection from grinding if you grind, and controlled sugar. What shortens it: smoking, neglected gums, and missed check-ups. At the examination the doctor tells you what he expects for your case. How long do dental implants last: what makes one last, and what shortens its life.
My tooth has been missing for years. Is it too late?
In many cases it is not, even after twenty years, once the bone has been assessed. What decides is the bone, and the bone is seen on the x-ray, not over the phone or by email. The full answer is above: When it is not right for now, or should wait.
We suggest only the treatment you need, we tell you why, and we protect your tooth before we think about extraction.
Your next step
An examination and an x-ray. You come in, you are examined, you see your bone on the x-ray, and at the examination your gum, your bite and the teeth beside the gap. Once the right image for your case is in, you hear whether an implant suits you right now or something has to happen first, what the alternatives are, and why. And you decide, in your own time, without pressure, whether you live around the corner or are only in Amman for a while.
Written by: RyanMedical review: Dr. Adnan Alakhras · pending approvalSources: The clinic's services as published: dental implants in a four-stage course · American Dental Association, patient page on dental implants · U.S. Food and Drug Administration, patient page on dental implants: benefits and risks · American Academy of Periodontology, patient page on peri-implant diseases · Questions patients actually ask, in Amman and from abroad
This page explains the procedure in general; it is not a diagnosis of your case. The decision is made at the examination and on the x-ray, and the cost is discussed after the examination.
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