Honest Answers from Milim Dental, Bursa

This is one of the most common and understandable questions we hear at Milim Dental in Bursa:

“My gums are receding and my bone is melting away.

If my own tooth cannot stay, how will a dental implant hold?”

It sounds like a paradox:

Gum disease → bone loss → tooth becomes loose

And then we say: “We can place an implant into this jaw…”

In this article, we will explain in clear language:

The difference between gum disease around natural teeth and bone around implants

When implants are possible in patients with gum recession and bone loss

How we rebuild or augment bone when needed

What has to be done before and after implant placement to keep it stable

All explanations are based on the clinical approach used by the surgical team at Milim Dental, Bursa (Turkey).

1. Why Teeth Become Loose in Gum Disease

First, let’s understand what is happening when you have:

Gum recession

Bone loss

Loose teeth

In periodontal disease (gum disease):

Bacteria and inflammation damage the supporting tissues of the tooth

Gums pull away from the tooth, forming pockets

The bone that holds the root is slowly resorbed (melted away)

A natural tooth is held in the jaw by:

Its root

Surrounded by a thin periodontal ligament

Embedded in bone

When gum disease is active and not controlled:

The ligament and bone are destroyed

The root has less and less support

Eventually the tooth begins to move and loosen

So the reason your tooth is loose is not that “your jaw is useless”; it is that infection and inflammation have eaten away the support around that particular tooth (and sometimes neighbouring teeth).

2. How an Implant Is Held in the Bone (Different System Than a Tooth)

A dental implant is not held in place the same way as a natural tooth.

A tooth has a root + ligament + bone

An implant is a titanium (or titanium–zirconium) screw that is placed directly into the bone

There is no periodontal ligament around an implant.

Instead, the bone heals directly onto the implant surface in a process called osseointegration.

If:

The bone is healthy and stable, and

The implant is placed in the correct position, and

The patient maintains good oral hygiene,

then the bone can hold the implant very firmly – often more rigidly than it held the original tooth.

So the real question is not:

“If my tooth fell out, how will an implant stay?”

but rather:

“Can we create enough healthy, stable bone to support an implant – and can we keep that bone healthy over time?”

At Milim Dental Bursa, that is exactly what we evaluate and plan.

3. Step One: Stop the Disease Process First

If you currently have active gum disease, the first priority is:

Control the infection and inflammation before thinking about implants.

We never just “pull the tooth and put an implant into infected, unstable tissue”.

Typical first steps:

Detailed periodontal examination

X-rays and often a CBCT scan

Professional deep cleaning (scaling and root planing)

Improvement of home care (brushing technique, interdental cleaning)

Smoking reduction or cessation if possible

In some cases, teeth with advanced bone loss are not savable.

Then the plan becomes:

Treat and stabilise the gums

Remove hopeless teeth

Clean out infection and diseased tissue

Let the area heal and re-evaluate the bone

Only once the disease is under control do we move to the implant stage.

4. “But My Bone Is Already Gone – Where Will You Put the Implant?”

Good question – and this is where 3D imaging and bone regeneration come in.

At Milim Dental in Bursa, we use:

CBCT (Cone Beam CT) to see:

Exactly how much bone is left

The height and width of the ridge

The position of nerves, sinuses and anatomical structures

Based on this, there are several possibilities:

A. Enough Bone Remains – Implants Without Grafting

Sometimes, even with gum recession and some bone loss, there is still:

Sufficient bone in the right areas

Enough height and width for implants

In these cases we can:

Place implants directly into the remaining bone

Choose implant length and diameter to use the most stable regions

Use angulated implants or specific designs to optimise support

B. Borderline Bone – Small or Moderate Bone Grafting

If the bone is not ideal but still workable, we may use bone augmentation, for example:

Local bone grafts (using your own bone or biomaterials)

Guided bone regeneration with special membranes

Sinus lifting in the upper jaw to gain vertical height

These procedures rebuild or add volume to the jaw so that:

A future implant has enough bone to integrate

The final tooth emerges from the gum in a natural position

C. Advanced Bone Loss – Special Solutions

In very advanced cases (for example after long-standing periodontitis, many years without teeth, or several failed treatments), conventional implants may not be enough.

Options can include:

Tilted implants that use remaining bone in the front or side areas

Short implants in selected situations

In extreme cases, zygomatic implants (anchored in the cheekbone) for full-arch rehabilitation

These are complex treatments that must be planned and performed by experienced surgeons.

This is exactly the type of work handled by the surgical team at Milim Dental Bursa.

5. “If My Bone Melts Once, Won’t It Melt Around the Implant Too?”

This is another very important and honest worry.

Patients with a history of gum disease do have a higher risk of developing:

Peri-implant mucositis (inflammation in the gum around the implant)

Peri-implantitis (bone loss around an implant)

However, risk is not the same as destiny.

The main risk factors for future bone loss around implants are:

Poor plaque control (inadequate oral hygiene)

Uncontrolled diabetes

Heavy smoking

Uncontrolled biting forces (e.g., severe bruxism)

Lack of regular professional maintenance

So our approach at Milim Dental Bursa is:

We do not place implants unless we believe the disease can be controlled

We create a maintenance plan from day one

We educate you on cleaning around implants and prosthetics

We schedule regular check-ups and professional cleaning

Many patients with a past history of gum disease enjoy stable implants for years, provided they follow the maintenance programme.

6. What Treatment Might Look Like for a Patient with Gum Recession and Bone Loss

Let’s imagine a patient in exactly your situation:

“My gums have receded, my bone is melting, some teeth are already loose.

I am afraid if you remove them, implants will also not hold.”

A typical treatment sequence at Milim Dental, Bursa might be:

Full Assessment

Medical history, medications, general health

Periodontal charting and photographs

Panoramic X-ray and CBCT scan

Periodontal Phase (Disease Control)

Deep cleaning and debridement

Oral hygiene coaching

Smoking reduction programme if needed

Re-evaluation after healing

Decision: Which Teeth Are Savable?

Teeth with too much bone loss, mobility or poor prognosis: extracted

Teeth with more favourable conditions: treated and kept, sometimes combined with implants

Bone Regeneration / Site Preparation (If Needed)

Bone grafting, sinus lifting, ridge augmentation

Healing time (often several months)

Implant Placement

Guided or freehand surgery depending on case

Possible immediate temporaries in selected situations

Healing / osseointegration phase

Final Restorations

Zirconia or other prosthetic solutions on implants

Optimised bite and smile design

Maintenance Programme

Regular professional cleaning around teeth and implants

Periodic X-rays to monitor bone levels

Night guard if you grind your teeth

This is not a “quick fix” – but it is a path from:

Active disease and bone loss

to

Controlled health and stable implants.

7. Important Truth: Not Every Site Is Suitable for an Implant

Part of being honest is also saying:

In some specific spots, even after treatment, an implant may not be the best option.

In those cases we might:

Combine implants with bridges

Use a removable overdenture on a limited number of implants

Or sometimes choose a non-implant solution for that particular area

The goal is not to place as many implants as possible.

The goal is to create a stable, healthy, functional mouth that you can maintain for many years.

8. What You Can Do to Help Your Implants “Hold”

Your part is just as important as the surgeon’s.

To give your future implants the best chance to stay strong, you can:

Stop or strongly reduce smoking

Control systemic diseases (especially diabetes) with your physician

Brush twice daily with proper technique

Clean between teeth and implants with floss, interdental brushes or special tools recommended by your dentist

Attend all scheduled check-up and hygiene visits

Inform the clinic early if you notice:

Bleeding around implants

Swelling

Bad taste or pain

Implants can last a long time, especially if you and your dental team work together.

9. Key Takeaways – “Will My Implant Hold If I Have Bone Loss?”

Gum recession and bone loss do not automatically mean implants are impossible.

Implants are held in bone by osseointegration, not by the same ligament system as natural teeth.

The disease must be treated and stabilised first before placing implants.

When bone is insufficient, bone grafts, sinus lifts or special implant techniques can often rebuild support.

Patients with past gum disease need strict maintenance, but can still have successful, long-lasting implants.

At Milim Dental in Bursa, our job is to:

Analyse your bone and gum situation in detail

Be realistic – not overly optimistic, not overly pessimistic

Offer you the safest combination of disease control, bone regeneration and implant planning

So if you are thinking,

“My bone is melting – how will an implant ever hold?”

the answer is:

With the right diagnosis, the right surgery and the right maintenance, many patients with bone loss can still enjoy stable, functional implants for years.