Are Dental Implants Performed By Orthodontists?
The world of dentistry is filled with specialists, each with a unique and important role. When you are navigating the process of getting a dental implant, you may encounter different types of dental professionals. It is easy to get confused about who does what. One common point of confusion is the role of the orthodontist.
You may know an orthodontist as the person who straightens teeth with braces or aligners. But can they also place your dental implant? The short and definitive answer is no. Orthodontists do not perform dental implant surgery.
This guide will clarify the distinct roles of an orthodontist and the specialists who place implants, explain why orthodontists are actually a crucial part of the implant process for some patients, and help you understand who you need to see for your specific needs.
The Specialists: Understanding the Difference
To understand why an orthodontist doesn’t place implants, you need to understand what they are trained to do.
What is an Orthodontist?
An orthodontist is a dental specialist who focuses on the diagnosis, prevention, and correction of malocclusion—a fancy term for a “bad bite.” This includes teeth that are crowded, too far apart, or jaws that do not align properly.
After completing dental school, an orthodontist spends an additional 2-3 years in a specialized residency program. Their world revolves around moving teeth. They use tools like braces, clear aligners (like Invisalign), retainers, and other appliances to apply gentle, controlled forces to teeth, guiding them into their correct positions. Their focus is on the alignment of the teeth and jaws, not on surgery.
Who Places Dental Implants?
The placement of a dental implant is a surgical procedure. It involves cutting into the gum tissue and drilling into the jawbone. This type of work falls under the purview of surgical specialists and trained restorative dentists.
The professionals who typically place dental implants are:
- Oral and Maxillofacial Surgeons: These are the surgical experts. They complete a 4-6 year hospital-based residency after dental school, focusing on surgery of the mouth, jaw, and face.
- Periodontists: These are specialists in the gums and supporting bone. They complete a 3-year residency focused on treating gum disease and placing implants.
- General Dentists: As we have discussed in a previous article, many general dentists have taken advanced continuing education courses and are highly competent at placing implants for straightforward cases.
Why Orthodontists Are Still Important for Dental Implants
So, if an orthodontist doesn’t place the implant, why are they part of the conversation at all? The answer is that they often play a vital, preparatory role. The best dental outcomes are often achieved through a team approach.
Think of it this way: you wouldn’t build a house on a crooked foundation. Similarly, you don’t want to place a permanent dental implant in a mouth where the surrounding teeth are misaligned or where there is not enough space.
Here is how an orthodontist can help prepare you for a successful dental implant:
1. Creating Space for the Implant
If you have been missing a tooth for a long time, the teeth on either side of the gap may have drifted or tilted into the empty space. This can leave a space that is too small or oddly shaped for a properly sized implant crown.
An orthodontist can use braces or aligners to gently move those teeth back to their correct positions, opening up the ideal amount of space for the future implant. This is a common and critical step for achieving a beautiful, functional result.
2. Correcting the Bite
Before placing an implant, it is often wise to ensure the overall bite is correct. If you have a severe overbite, underbite, or crossbite, the forces of your bite will be unevenly distributed. This could put excessive pressure on the new implant and lead to its failure. Orthodontic treatment can align the bite, creating a stable environment for the implant to thrive.
3. Uprighting a Tipped Tooth
Sometimes, a tooth next to a gap can tip over dramatically. This can make it impossible to place an implant. An orthodontist can upright the tipped tooth, creating the necessary space and a better alignment for the implant.
4. Managing an Impacted Tooth
In some cases, a permanent tooth may be stuck under the gum (impacted), often a canine tooth. An orthodontist can work with an oral surgeon to surgically expose the tooth and use braces to gently pull it into its correct position. If the tooth cannot be saved, the space is then prepared orthodontically for a future implant.
The Typical Sequence: A Team Approach
For a patient who needs both orthodontics and an implant, here is the general sequence of treatment.
- Consultation: You see an orthodontist, who assesses your bite and alignment.
- Orthodontic Treatment: You undergo braces or aligner treatment. This can take from several months to a couple of years, depending on the complexity. During this time, the space for the implant is carefully created and prepared.
- Implant Referral: Once your orthodontist confirms the space and bite are ready, they will refer you to an oral surgeon, periodontist, or general dentist for the implant surgery.
- Implant Placement: The surgical specialist places the implant.
- Healing: The implant heals and integrates with the bone.
- Restoration: A dentist (often your general dentist or a prosthodontist) places the final crown on the implant.
Here is a table comparing the roles:
| Professional | Primary Role | Do They Place Implants? | Their Role in the Implant Process |
|---|---|---|---|
| Orthodontist | Moves teeth, aligns the bite. | No. | Prepares the site by creating space and aligning the bite. |
| Oral Surgeon | Surgery of the mouth, jaw, and face. | Yes. | Performs the surgical placement of the implant, often for complex cases. |
| Periodontist | Treats gums and supporting bone. | Yes. | Places implants, especially in patients with a history of gum disease. |
| General Dentist | Provides overall dental care. | Yes (with training). | Can place implants for straightforward cases and restore the crown. |
| Prosthodontist | Restores and replaces teeth. | Sometimes. | Designs and places the final crown or bridge on the implant. |
When to See an Orthodontist vs. an Implant Surgeon
- See an Orthodontist First if: Your teeth are crowded, you have large gaps, your bite feels uneven, or you know your teeth have shifted after a tooth loss. An orthodontist can tell you if treatment is needed to create the ideal conditions for a future implant.
- See an Implant Surgeon First if: You have a missing tooth, your bite is generally stable, and you have enough space. The surgeon will evaluate your bone and determine if you are ready for an implant.
Important Note: If you are unsure where to start, the best place is often your general dentist. They can evaluate your overall oral health, explain your options, and refer you to the appropriate specialists, whether that is an orthodontist, an oral surgeon, or both.
Conclusion
The roles in dentistry are clearly defined. Orthodontists are the masters of tooth movement, while oral surgeons, periodontists, and trained general dentists are the ones who perform the surgery to place dental implants. An orthodontist will not and cannot place your implant.
However, their role is often indispensable. By straightening your teeth and correcting your bite, an orthodontist can create the perfect foundation for a successful, long-lasting implant. Understanding this team approach will help you navigate your treatment journey with confidence and ensure you are seeing the right specialist at the right time.
Frequently Asked Questions
Can a dentist be both an orthodontist and an implant surgeon?
While a dentist can have multiple areas of interest and advanced training, they are distinct specialties. It is uncommon for a dentist to be a board-certified orthodontist and an oral surgeon, as the residencies are separate and lengthy. It is best to see a specialist for each specific phase of your care.
Do I need braces before getting a dental implant?
Not always. Many people get implants without ever needing orthodontic treatment. You only need orthodontics if there is a problem with space or alignment that would compromise the outcome of the implant. Your dentist or a consulting orthodontist can tell you if it is necessary in your case.
Who puts the tooth on top of the implant?
The final crown (the tooth) is placed by a restorative dentist. This is often a general dentist or a prosthodontist. The surgeon places the implant, and the restorative dentist designs and places the visible tooth.
If I have braces and need an implant, when does the implant get placed?
The implant is almost always placed after the orthodontic treatment is complete or at least in its final stages. The orthodontist needs to finish moving the teeth to ensure the space is the correct size and the bite is stable before the implant is placed.
Additional Resource
For more information on the role of an orthodontist, you can visit the American Association of Orthodontists’ patient education website: https://aaoinfo.org/
