Questions and Answers

Here are all the questions that have been previously put to our surgeons. Some are more general and others are specific to the individual posing the question. Click on a question to reveal its answer.

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I have two missing teeth in the upper jaw - my second premolar and first molar. These have been missing for a number of years. Given this, are implants suitable for this area?

We can easily tell you what is involved in replacing these two missing teeth with implants after we take some x-rays, which we would do as part of your initial assessment. Without first taking x-rays, there is no way of telling how much bone you have in these regions and what would be involved in implant treatment, i.e. whether you have enough bone to place implants or whether you need some bone-grafting first.

How painful is the dental implant procedure?

It is one of the most common concerns for people thinking about having an implant. When carried out by an experienced clinician, most dental implants are very straightforward to place, taking only about ten to fifteen minutes to complete the surgical part of the treatment (though clearly more complex cases may take longer).

The majority of implants are placed under a normal dental local anaesthetic. Although the local anaesthetic injections can sting a little (most of us have experienced dental injections in our mouth at some time), once you are numb, you will not feel anything sharp or painful at all throughout your treatment. You will feel some pressing and pushing during the procedure, as well as some vibration during the drilling stage, but this will not be sharp or painful in any way and your dentist can check to make sure you are completely numb before they start the surgery.

For bigger procedures, such as multiple implants or cases that require large bone grafts, sedation can be provided. Sedation is not a general anaesthetic, but makes patients feel very comfortable and relaxed, and they rarely remember much about the procedure afterwards (an advantage for many nervous patients!)

Obviously, the more training and experience the clinician carrying out your dental implant treatment has, the quicker and more comfortable you are going to be, so make sure you check out your implant surgeon thoroughly before starting treatment.

I got my back molar pulled three years ago. I decided to have it pulled because it is completely decayed as I have observed. Is it possible to "implant" a tooth or undergo any dental procedure to have the empty space occupied?

It is a very simple procedure to replace a molar tooth with a dental implant – far easier than an extraction, and far less uncomfortable.  It is truly the only long-term solution to losing a tooth – whatever you do, do not let anyone put in a bridge which will ruin the adjacent teeth.

Can you get a dental implant put in at the time a tooth is removed?

Skilled implant surgeons are able to place implants immediately into the extraction socket and then build up a temporary tooth on top of the implant. This depends on a lot of factors – the main one is that, if there is any sign of infection, then the implant has to wait.

Do not worry because you need never have a gap – there are all sorts of temporary solutions to make sure there is no embarrassment at any stage throughout the implant process.

What are the issues with travelling from the UK to a foreign country to have dental work done?

We have had to resolve many of the issues caused by treatment that has been done overseas to patients trying to save money. Sadly, in the long run, this costs far more to the patient. The only winner is the overseas clinic, as patients with complications never travel back to have them resolved.

It is very easy to offer cut-price treatments when using low-cost and poorly researched implants and components, and when you do not need to offer the reassurance of back-up and maintenance. While some clinics and treatment will be perfectly adequate, some will not, and we have seen a growing level of this in recent years. Do not forget that you need to factor in travel to these low costs – if treated in the UK you would expect three to four visits. You could only do this in one to two visits by cutting corners in many cases. A complication of any sort, requiring further travel, or remedial treatment in the UK will soon push the fee past the UK standard fees.

Please consider discussing alternative dental treatments with your dentist rather than trying to get something that is highly valuable at a cut price.

What is the difference between mini-implants and traditional dental implants?

Mini-implants can only be used to hold a lower denture in place, so keeping it stable and much more comfortable. This is a life-transforming procedure for many patients with loose lower dentures. The cost for this is around £1,500 for the four mini-implants needed for this procedure.

Although some dentists try to use these for other reasons (including trying to cut costs and corners), they will fail and cause issues after a few years, so please avoid this at all costs.

Will the implants activate Airport Security Devices and, if so, will I need to carry x-rays with me when I travel?

That is a great question and one that many patients are concerned about. Fortunately, the answer is ‘no’.

Just as a patient’s metal fillings do not set off the detectors, neither will your dental implants.

Can I not use my existing crown on the tooth I am about to have removed to go on the implant?

Unfortunately not – the crown we use on your implant is very different to the one you have on your tooth. We are able to screw the special custom-made implant crown directly into the implant which ensures the most secure fit – no more risk of your crown coming off. As you will see at your assessment, the implant crown therefore is very different to the hollow shell that relies on cement fixing it to the tooth.

How long does the treatment take?

If the treatment is straightforward, it can be a little as eight to ten weeks from placement of the implant to fit of the final crown. However, sometimes treatment can take longer, depending on the level of complexity of your case, with some patients not finishing for up to a year. The exact time frame will be ascertained from your assessment at The Implant Centre.

How long will an implant last?

If well cared for and maintained, with reviews to monitor, an implant should last a lifetime.

It is possible to chip a crown or bridge on implants in the same way that it is possible to chip a tooth, and we recommend annual reviews with x-rays to check the bone levels around the implants in addition to your regular check-ups with your dentist. We offer an annual review and we will cover the cost of any damage to the crown or bridge for a monthly fee on our Implant Care Plan.

When can I eat once a crown goes onto the implant?

If you have had the final crown fitted on your implant, then it is perfectly possible for you to eat straightaway. However, as it is often the case that the tooth or teeth have been missing for a while, then it often takes some time getting used to and it is best to start gently.

Occasionally, patients find they accidentally bite their cheek or tongue in the first few days, but this soon settles.

What material is used for dental implants?

Titanium is the material almost all implants are made from (other materials just do not work as well). This is completely ‘biocompatible’ – i.e. The body sees it as part of its own and will grow bone directly onto the surface rather than reject it, as would happen with a bit of steel for example. Because of this, there is no harmful side effect and there is no issue with people who have other metal allergies (such as nickel for example).

It is certainly the right decision for you, just make sure the person carrying out the work is well trained, specifically in implant surgery, and that they use well known and well researched implants – not cheap copies that are available on the market.

I am having three tooth implants, and I am so scared of the dentist. When it is being done, is it a painful procedure and can you feel it when they are doing it? Also, is it possible to do under general anaesthesia?

Dental implants should not be painful if carried out by experienced surgeons. Standard local anaesthetics are used in the majority of cases, so you should feel no discomfort at all throughout the procedure. You will be aware of the treatment being carried out, but this should be very gentle in skilled hands. You can consider sedation if you are nervous. I expect my patients to have little or no pain following treatment, if using simple pain medications.

If you are this scared, then consider sedation – this will make everything so much easier for you, and there is no benefit in learning how to cope with having dental implants. General anaesthetics are not available in general dental practice and should never be used anyway for this type of treatment, as the risks are higher than simple sedation.

What bone is used when having implants?

We use a couple of different bone substitutes at The Implant Centre, depending on the clinical situation – i.e. What is required from the bone? The majority of the time we do not need to add any bone at all, so if you have been told by someone that you need a graft please check with us as we specialise in working with people who have minimal bone.

The most common is BioOss which is Bovine (Cow) bone, and has the longest and best research. We also have a number of other bone substitutes that we will use if people do not want an animal product.

We very rarely use the patient’s own bone, as this causes marked pain, so is best avoided to allow for a pain-free recovery.

Can I have dental implants if I am a smoker?

We now know that smoking does affect both natural teeth and implants. For natural teeth, smoking increases the risks of gum disease. For implants, smoking very slightly increases the risks of complications at every stage of implant treatment.

The good news is that this increased risk is very slight and we successfully treat patients who are smokers every day at The Implant Centre.

From your website I note you do not use Straumann at all, but my research indicates that it is one of the best systems. I therefore wondered why?

There are over six hundred different makes of implants currently available and each one has its advocates.  Straumann is a great implant system that has been around for a long while. However, there are many other great implant systems that have also been around for a long while.

No single implant system can do everything – there is no single “Best Implant System”.

We use a number of implant systems at The Implant Centre, choosing the one which we feel is most suitable for the case being treated. Generally, we use Ankylos and Bicon implants, both of which, like Straumann, have also been around for well over twenty years and have outstanding research to back them up.

We place a phenomenal number of implants each year and the simple fact is that, if we had problems with the implants we use, we would stop using them – but we do not.

I have two missing teeth in the upper jaw - my second premolar and first molar. These have been missing for a number of years. Given this, are implants suitable for this area?

We can easily tell you what is involved in replacing these two missing teeth with implants after we take some x-rays, which we would do as part of your initial assessment. Without first taking x-rays, there is no way of telling how much bone you have in these regions and what would be involved in implant treatment, i.e. whether you have enough bone to place implants or whether you need some bone grafting first.

I am considering having all my remaining teeth removed and have them replaced with implants. Is this is a common procedure and what is the maximum I can have done?

It really depends on whether you really need all of the remaining teeth to be removed, or if some can be maintained depending on the health of the teeth. Of course, if they are not viable on a long-term basis, we would agree and consider replacement of all of the teeth with implants that have an exceptional level of stability.

We treat a surprising number of patients who need this level of treatment on a regular basis (four to five patients a month). We usually replace twenty-four teeth on the implants when treating the whole mouth and have very well-developed protocols to make this as easy as possible for you. We expect to be able to remove the remaining teeth and roots, place the implants and make a temporary set of teeth for you to go away with, all at the same time – the pinnacle of dental implant treatment and truly life-transforming.

I had bone grafting done on the lower right jaw five months ago for possibly three implants. Would you take on a case where the bone graft has been carried out by someone else?

We would have no concerns about placing implants where grafting has been done elsewhere, but of course would need to assess the area and the rest of your mouth before considering this.

Is there any risk of any infection due to metal under the implants and is there any risk of chipping the implant?

There is no risk of infection or allergy from the metal in the implants as this is surgical grade Titanium, which is completely bio-compatible. This means your body sees the metal as part of its own and will heal the bone onto the surface.

With regard to chipping, the crown of the implant is made of ceramics or exceptionally strong zirconia materials.  While you will never chip the zirconia, it is possible to chip the ceramics as with any crown. As long as highly-skilled dentists are fitting crowns of the highest quality, without cutting corners on costs, this is very unlikely. If it does happen, we guarantee our crowns anyway and would always replace at no additional cost.

My dentist has mentioned the idea of tooth-whitening alongside the restoration of my missing upper incisor tooth with an implant crown. Is this a good idea?

Yes, we highly recommend you consider tooth-whitening, especially if the implant crown is for a missing front tooth. Tooth whitening is a simple non-invasive process which will enhance and bring life to your smile.

Impressions are taken to make the trays you wear during the whitening process. They are worn up to three hours at a time, either while you sleep or during the day. After two to three weeks you will start to see the results.

It is sensible to undertake tooth-whitening after the implant has been placed and you are waiting for the bone to bond to the titanium, before placing the new implant crown to match the new brighter, whiter teeth.

Can you explain the procedure for lateral sinus-grafting?

A lateral sinus graft is needed when a patient does not have enough bone for an implant at the back of the upper jaw (the region of the upper molar teeth). The sinus sits above our upper molar teeth and, when these teeth are lost, there can sometimes be very little bone beneath the sinus in which to place dental implants. A lateral sinus graft builds back this missing bone to allow implants to be placed and the missing upper molar teeth to be replaced.  There are many different graft materials that can be used, and you should discuss this when you meet with the dentist who will be carrying out your graft.

With modern short implants, lateral sinus grafts are needed much less often than in the past (when longer implants were required). A careful examination of your mouth and special x-rays (such as CT scans) can determine both whether the lateral sinus graft is required and if your sinus is healthy enough for it (chronic sinusitis would need to be cleared up before a lateral sinus graft could be performed). Often these x-rays reveal sufficient bone to enable other less invasive techniques than a lateral sinus graft to be used.

Your dentist would give you written advice and instructions on how to look after your mouth when a graft is carried out, and you would be provided with all the medication necessary to make the procedure safe and your recovery smooth.

Most lateral sinus grafts are carried out under a normal dental anaesthetic, although some patients prefer to be sedated for the procedure to make it even more comfortable.

I would like to know the procedure for Overdenture on 2 Implants for the lower and upper complete arch.

For the lower jaw, implant overdentures are commonly held in place by either two conventional implants or 4 mini implants.  The procedures for these are very similar though the costs are very different as conventional implants cost much more to manufacture than mini implants and the components that attach them to the denture are also more expensive.

What the treatment would cost you will depend on whether your current lower denture can be used to clip onto the implants or not.  The lower denture needs to be almost perfect, so if you’ve had it for a long time, or if it is poorly extended, then a new denture will need to be made.

For your upper jaw the implant options for a full-arch treatment are either a fixed or a removable bridge.  Although most patients initially think that a fixed bridge is preferable, a removable bridge stays in all the time except for the two times each day when you take the bridge out to clean it and the underlying implants.

If a bone graft fails is there an optimum time to wait before a second attempt is made?

The answer depends on what exactly has gone on before;  What type of graft?  What material was used?  How did it fail?  What’s been done since?

We can find out at your assessment exactly what your particular situation is and then can advise on what can be done and when the best time for that would be.

I am thinking of getting a single tooth implant. Are the implants you use pure titanium or do they contain trace elements of other metals and if so what metals as I have had problems in the past with some metal sensitivity.

There are a few implant systems we use and some do have a mix of titanium and other metal s as an alloy (aluminium etc).   We also use Ankylos as a major excellent system and this is surgically pure titanium so would suit your situation.

We also have to be careful to look at the components that fit onto the implant including the crown but our onsite laboratory utilises the latest in CADCAM milling techniques from metal free materials such as Zirconia.  We have dealt with a number of patients who have such sensitivities and are well practiced in this to reassure you.

I don’t have any teeth in my upper jaw and the CT scan shows very little bone to do implants. Can I have implants without going for bone grafting or sinus lift?

This area is indeed our expertise and we help patients in exactly your situation on a daily basis.

While there are cases that we have to resort to sinus grafting, in the absolute majority of cases we can place implants as you say avoiding this need.