This is a controversial topic, with dentists preferring to use dental implants as an absolute last resort. Is the treatment warranted? Are implants positive for children? Can a child even get dental implants?
This is a topic that has not been studied a lot due to a range of confounding factors. If you think your child may require a dental implant, it’s worth understanding the risks and possibilities for the future.
Generally, removable prosthesis are recommended, but they can lead to increased rate of cavities and other complications. Children don’t like to use them. There is also the risk of the jaw bone being resorbed into the body (a natural process that happens when a tooth is removed from the jaw) which can cause aesthetic and functional issues for children. As a result, parents often push for implants, not understanding the risks.
Children may need dental implants for two main reasons[1]. They could lose a tooth due to an accident or misadventure, or they may have a condition that affects their teeth.
Ectodermal dysplasia: This is a genetic condition that results in abnormal features of hair, nails, sweat glands, facial structure, fingers and teeth. If it affects teeth, it can present as missing teeth, teeth that are pointed, and sometimes enamel is defective.
Anodontia: This is also a genetic defect, and may be related to ectodermal dysplasia. It’s the complete absence of some or all teeth.
Just like in adults, children can be worried about their appearance if they have permanent missing teeth, and gaps in the mouth can cause challenges for speech and eating. But, unlike adults, there are serious risks to their future associated with dental implants.
[1] https://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S1042369905000476/first-page-pdf
If your child’s jaw is growing, the dental implant can seriously affect the natural growth and jaw formations. This is primary concern for children. But is it worth the risk to allow the child to look, sound and eat normally?
The strength of a dental implant lies in the osseointegration—that the titanium screw becomes permanently fused to the bone. While this is perfect for adults, providing unsurpassed strength and durability, for children, it is the risk. The implants act the same as ankylotic teeth—that is, they don’t move with the teeth around it.
While the jaw is developing and moving, the tooth stays in the same place in the jaw. It becomes an unattractive tooth that ends up out of alignment with the other teeth. This can cause an infra-occlusion, where the teeth are out of alignment and pushing on one another.[1] This can create gaps which cause bite problems. Worst case scenario, the implant could lead to permanent jaw disfigurement.
The jaw growing could also mean the implant is no longer supported, or it could overwhelm the implant and submerge it[2].
Once tooth implants are inserted, they must have a certain level of care. Brushing and flossing daily is vital to prevent infection of the gums which may lead to rejection of the implant. There may be limited co-operation from children in maintenance and caring for their teeth.
There are risks every time children have surgery. Due to the nature of tooth implants, the child will likely need full general anaesthetic. The side effects of general anaesthetic can be distressing to children, although not permanent.
In adults, tooth implants are successful more than 90% of the time. With young children, that failure rate is much higher. A Swedish study showed that 64.3% of implants in children between 5 and 12 years old failed before loading[1]. Risk factors were thought to include a small jaw and preoperative conditions.
There is no 100% consensus, but the outcomes are far better when the child is older and the jaw is completely grown. Many dentists will not perform dental implants in young children, and it is for good reason. It also depends where in the mouth the implants are located and how many teeth need to be replaced, with some implants being more successful than others[1]. If you want dental implants in your child, speak to your dentist. They will conduct a full assessment and advise for your specific case.
[1] http://www.jisponline.com/article.asp?issn=0972-124X;year=2013;volume=17;issue=4;spage=546;epage=548;aulast=Shah
