In the event you have been required to have a tooth extracted or otherwise have a missing tooth, dental implants are an effective solution because they do not require altering other teeth the way bridges or crowns demand. Additionally, as the top rated Missoula dentist, we are renowned for our remarkably gentle procedures, including dental implants. Dr. David B. Duke has extensive training with oral implants, and he incorporates his knowledge with advanced laser dentistry technology and his gentle care in order to become the premier choice for oral implants.

Oral Implants, Mini Implants, and Implant Overdenture

No matter the type of dental implants your smile requires, we can help. Whether you have been waiting to replace a missing tooth or avoiding wearing your dentures due to having trouble keeping them in place.

Dental Implants In Missoula


Dental implants are usually a permanent and natural solution to replace missing or extracted teeth. They are better than other alternatives such as bridges because no additional teeth need to be altered to place the new tooth.

The entire implant process is performed over the course of a few months. The first part of the process is to install the implant itself, where a screw is placed into the jaw bone. In many cases, the implant can be placed with only a tiny opening in the gum for the implant to be inserted. Your Missoula dentist may choose to use a custom surgical guide to minimize risks in complex cases, though multiple implants can be placed at once if necessary. After the implants are placed the gums may be sutured. If bone grafting is necessary, it will be done during this appointment as well.

The implant must be allowed three to six months to heal, and during this time, the jaw bone will form around the implant in a process called osseointegration. During this healing time you can choose to have temporary crowns installed so that you can eat and speak normally and maintain a proper aesthetic appearance for your smile.

After the implant has healed it is time to place an abutment on the implant. The abutment serves as the base for your new tooth. Once this is placed an impression of the abutment is taken and is used to create your permanent restoration. Three weeks later the restoration is completed and you can return to your dentist’s office to attach the restoration. Your smile will have a beautiful, natural-looking tooth replacement and nobody will know it’s not your original tooth.

Implants can also be utilized to fasten and stabilize a denture in the mouth. As the only general dentist in the greater Missoula area to be awarded the prestigious Fellowship from the International Congress of Oral Implantology, Bitterroot is the best choice for your implant surgery, restoration or maintenance. We’re confident we can offer you the oral care you need while being considerate of your bank account. We have a variety of financial institutions we partner with to make your dental care more manageable for you pocket book.

Mini Implants

Mini dental implants are smaller in diameter than a regular dental implant. They are specially designed to be used in situations where regular implants cannot fit. These small diameter implants (SDI) are perfect for securely fastening a denture. The Locator Overdenture Implant System (LODI) used in our office is the most popular implant overdenture attachment method in the world, because it’s the safest.

To secure a denture, around two to eight mini implants are placed into the jaw bone. These mini implants are slightly above the gum line, allowing a denture to be made to snap onto them. As a general rule, the more implants you have, them more secure and unmovable your denture will be. However, it is not necessary to have a mini implant for every tooth you are replacing. Most often six implants insufficient for a rock solid result.

Another benefit of mini implants is the denture can usually be placed right away or only a short time after. Most often we don’t have to wait for the implant to heal before securing your denture. This is because the Locator Overdenture Implants are designed to be strong and stable the same day they are surgically placed in the mouth.

Mini implants are also significantly less expensive than regular implants. Mini implants are usually not a substitution for regularly sized implants. They are best used to retain dentures, not to replace a single missing tooth, unless a regular dental implant will not fit. If the cost of attaching your dentures to implants was too high previously, mini implants may be the answer you have been looking for.

If you want to get rid of that sloppy, poorly fitting denture so you can eat like you did when you had teeth, give us a call and let us use mini implants to give you the solid denture you’ve always wanted.

Implant Overdenture

Do your dentures move around or fall out?  Do you avoid wearing your dentures because they won’t stay put?

If you found yourself saying yes, you aren’t alone.  More than a third of denture wearers do not regularly wear their dentures, especially lower jaw dentures. Lower dentures are notorious for fitting poorly because there is less suction than an upper denture and tongue movement dislodges them.  Fortunately, we have a solution – the implant overdenture.

Utilizing as few as two dental implants, Dr. Duke can fasten your floppy, movable denture into place.  A few of the advantages are:

  • A better, more comfortable fit
  • Returns your ability to show off your smile
  • No dislodging of the denture when you eat or talk
  • Ability to bite into foods without the denture tipping
  • No more yucky, gooey, expensive denture pastes to hold the denture in place
  • Less loss of bone (atrophy) of the bone under the denture
  • Fewer sore spots from the denture rubbing

By using more than two implants, Dr. Duke is able to slim down your denture, possibly even removing areas such as the roof of the mouth or the denture sides.

If you’re tired of your denture dictating what you can or can’t do, we can help you.  As the only general dentist in the greater Missoula area to be awarded the prestigious Fellowship from the International Congress of Oral Implantology, Dr. Duke is the best choice to provide your implant overdenture.



All on Four/Teeth in a Day

Do you need to have your teeth removed but the fear of a loose, floppy denture scares you? If this is you, we can help you.

Commonly called “Teeth in a Day” or “All on Four,” this treatment concept provides a permanent, screw-retained, same-day replacement for the entire upper and/or lower set of teeth.  This procedure is best for patients with significant tooth loss, severe periodontal disease gum disease or decay.

The procedure involves removing the remaining teeth, providing any necessary bone reshaping or removal of infected bone, necessary bone grafting, placement of at least four dental implants, and fabrication and fastening of your temporary teeth to the implants.  This happens in one appointment, so you are never without stable, fixed teeth.  In most cases, you leave with more teeth than with which you arrived.

This process takes careful planning and coordination to ensure a smooth process.  Before the day of the procedure, we will have many planning visits to begin the process of making your new teeth and planning the surgery.  This includes impressions and a 3D cone beam scan among other things.  The day of your surgery, the lab technician who makes your teeth will be in our office the entire time, so you will leave with a customized, beautiful smile.  Any adjustments to the bite will be made during the healing time.

After appropriate healing of 4-12 months, we will fabricate your final teeth.  Not only will your final teeth be more beautiful than the temporary teeth, but they will be more durable as well.

If you want to improve your smile but can’t stomach the thought of taking your teeth out at night, make an appointment with the premier Missoula dentist to discuss your options for new teeth in a day.


Dental Implant FAQ’s

cbctWhat Is A Dental Implant?

A dental implant is the most natural replacement for a missing tooth. It is a titanium screw that is placed into the jaw bone. An abutment and crown is then placed on the implant to provide a new tooth that is permanent and looks just like a natural tooth. By using as few as two dental implants it is possible to fasten a denture for a tight, secure fit.

How Are Dental Implants Different Than Dentures?

Dentures are a removable set of teeth or partial set of teeth that need to be removed and cared for in a special manner. They can often feel bulky and are difficult to get used to. Dental implants are an unmovable replacement for missing teeth that can be cared for just like natural teeth. Unlike a denture, you don’t ever remove an implant.

What Are The Benefits of Dental Implants?

Dental implants look and feel just like real teeth, they are almost always permanent, you can eat the foods you want without any fear of embarrassment, and the procedure is very successful and fairly inexpensive. Because dental implants are titanium, they cannot get decay.

Who Can Place a Dental Implant?

Any dentist and many specialists can legally place an implant, but no formal training is required by law to do so. However, Dr. Duke has attended extensive and advanced training in bone grafting, surgical implant placement and restoration. In fact, Dr. Duke is one of four general dentists, and the only one in the Missoula area who has been awarded a Fellowship by the International Congress of Oral Implantology for his knowledge and skills in Implantology.

How Much Do Implants Cost?

The price of your dental implants will vary based on how many implants you are having placed, the type of restoration you need, the amount and quality of bone available, if a temporary tooth is required during healing, amount of insurance coverage, and more. Schedule a consultation with us to determine a price for your implants and a financing plan if necessary.

Do Dental Implants Hurt?

No. A local anesthetic will be given before the procedure so that you do not feel any pain. If you have anxiety or fear you should discuss sedation options with your dentist. Due to Dr. Duke’s gentleness and surgical expertise, most patients report no or very little discomfort in the days following the procedure.

How Long Do Implants Last?

When cared for properly and in the absence of systemic disease, implants should last a lifetime. Proper oral hygiene and regular dental visits are essential to the success of your implant. Like teeth, implants must be cleaned regularly by a dental hygienist. Unlike a tooth, they cannot decay.

Computer-Guided Implant Surgery

Another 3D treatment technology that we implore is computer-guided implant surgery. This interactive system is used to determine the best position to place each implant with 100% accuracy. For the patient, this means that the implant will be placed precisely where it needs to go, minimizing discomfort and healing time, reducing surgical risks, avoiding unnecessary bone grafts and give more aesthetic final results.

Using advanced computer software to visualize your 3D cone beam data, Dr. Duke will analyze bone quality, quantity, your bite, nearby anatomical structures, surgical dangers, and adjacent tooth positions. Dr. Duke can then virtually place the perfect implant(s) into a computer-generated 3D model of your jawbone with pinpoint accuracy. This computer plan is then sent to a lab where it is converted into a life-sized model (a replica of your mouth). Using this model, an expert technician will design a surgical guide to fit onto the teeth, gums or bone. After a design consultation with Dr. Duke to ensure 100% accuracy, the technician fabricates the surgical guide and it is sent to our office for your surgery.

While surgical guides add some cost, they speed up the actual surgery (some surgeries last only a few minutes with a guide). While Dr. Duke has extensive experience placing implants without guides, the accuracy and predictability of a guide can never be matched by freehand surgery. In complex cases, a surgical guide is the way to go. These complex cases include:

  • Where anatomical structures are very nearby
  • Minimal bone is present
  • Challenging cosmetic cases
  • Several implants to be placed in one appointment
  • Removal of a tooth and placement of the implant the same day

Not all implants are placed using a surgical guide but you can always choose to have one used.


Contact Your Missoula Dentist

Don’t pass up the opportunity you deserve for affordable, more aesthetic oral health. Contact Bitterroot Dental to give your body the change you need starting with your tooth and gum health.