Many people have permanent teeth that fail to develop, leaving a space where a tooth should be. The most common missing teeth are wisdom teeth, and when they aren’t there it’s a blessing! However, the next most common congenitally missing tooth is the upper lateral, right next to the centrals. When these teeth are missing it is usually a huge esthetic concern. Parents of these patients usually want to know what the best age for a dental implant would be. Age 18 is the most common reply, but one that can cause a lot of problems later in life.
Traditional thinking is that implants can be placed as soon as growth and development is completed, which is around the age of 16 for females and 18 for males. Also, most dentists learned in dental school that crowns shouldn’t be placed until a patient is 18 years old, so many patients are told that 18 is the perfect age for an implant crown. However, jaw bones grow and teeth drift throughout one’s entire life. Look at old mens’ ears and noses, and you’ll see that jaw bones aren’t alone!
It’s important to note that implants don’t migrate in the jaw with the rest of the teeth and bone; they are anchored in place. Posterior teeth typically drift horizontally toward the front of the mouth. As the natural teeth drift, many posterior implant crowns develop spaces on either side. This can be a little annoying, but many patients aren’t even aware that it has happened. However, upper anterior teeth and bone typically drift vertically, down and away from the nose. An implant crown replacing one of these teeth will appear short and submerged once the surrounding teeth and bone drift downwards. When this happens it’s hard for a patient not to notice.
First, the bad news. Anterior implants will gradually submerge throughout adult life, and there’s nothing that can be done about it. However, the rate of submersion varies with age. One study has shown that the rate of submersion is almost four times greater before the age of 30. After 30, the implant crown only appears to submerge at 0.27% of its length every year, which isn’t very noticeable. Another study has shown that the difference of tooth and bone height after the age of 30 is negligible, as would be expected with such a small rate of submersion.
Another thing to consider is that some people will have more jaw bone growth in their 20’s than others. Those that grow the most have long, narrow faces. It has been shown people with long faces average 5mm of vertical tooth movement between the ages of 15 and 25 years. Someone with this growth pattern whose implant is placed at 18 may have an implant that is much shorter than the surrounding teeth by the age of 25.
So when is the right age for an implant? Depends on the patient, but many people should try to avoid placing anterior implants at the age of 18. These studies show that for some people, the best long term esthetics will be achieved if the patient waits until the age of 25 or 30. The good news is that there are several esthetic options for young patients with missing teeth. If you are looking for a North Scottsdale dentist with esthetic implant experience, please give Enamor Dentistry a call! Dr. Melander would be happy to find the best treatment plan for your individual needs.