Frequently asked questions - Knowledge base

What are dental implants?
An implant could be likened to an artificial tooth root. If you have a missing tooth it is likely that an implant could replace it. The implant is fitted into the empty socket and then allowed to heal. Once the healing process is complete we can fit a denture or crown to the implant to complete the treatment. A denture fitted to an implant doesn’t move like normal dentures tend to do. Furthermore if you elect to have a crown it will behave as your normal tooth would have done.
Are there different kinds of implants?
Yes there are, but one is used with the highest frequency. This is known as an endosseous implant. These are usually cylindrical in shape. They may have the appearance of the shaft of a screw, with threads visible to the naked eye.

The endosseous implant is most frequently selected by dental surgeons owing to its ability to settle firmly into the jaw bone. It is also most likely to stay firmly in place for many years to come, providing a stable tooth replacement for the patient.

There are restrictions with this type of dental implant. If the tooth was lost a significant period of time ago, the bone in that part of the jaw may have receded. Thus there may not be sufficient bone to perform this procedure. In this case a bone treatment may be offered. This is provided at an additional cost and it enables the dentist to grow sufficient bone for the implant to take at a later date.
How much would I pay for dental implants at Dent1st?
A straightforward single tooth implant which does not require bone treatment would cost £995. Cases where bone treatment is required or where two or more teeth are required to be implanted would cost more.
How many implants are required?
It is dependent on how many teeth are missing. A minimum of one implant is required to replace one tooth. On rare occasions two teeth may be replaced through the use of a single implant. Generally speaking you should require fewer implants than the number of teeth you wish to have replaced. For example six teeth may require five implants, although it depends on the individual situation, where the teeth are located and where the implants are positioned. Expert positioning and placement is vital for the success of any dental implant procedure.

The most important thing to remember is that the new teeth must be able to accommodate the strains of biting and chewing food. The implants are thus distributed evenly so as to take equal strain in this way. This reduces the stresses put onto any individual implant.
What types of metals are commonly used in dentistry?
Metals have been used in dentistry for many centuries. Orthodontic items and even replacement teeth have been connected with healers living in prehistoric times.

Most people are familiar with amalgams which have been used to provide fillings for many years. Indeed they first came into use in the 1800s. An amalgam is a combination of more than one metal. In the case of dental fillings the main ingredient is mercury. It is combined with one or more other metals to provide the required filling. While amalgam fillings are still available, many people opt to have composite resin fillings instead. Not only are they deemed to be safer they are also far less easy to see when placed in the molar or visible regions of the mouth.

Alloys are also frequently used in the world of dentistry. If you are familiar with dental braces to assist in straightening crooked teeth, you may be aware that they are created from titanium or perhaps stainless steel. Combinations of metals including gold and silver are also used to create crowns and bridges.

In every case, the only metals used in dentistry are those with the purest medical grade approval. In the case of dental implants, the most common materials used for their creation were titanium alloys. However in recent times ceramic implants have become the material of choice. These are forged from zirconium dioxide and they are now becoming more popular than the titanium implant options.
Won’t the skin or bone react to the implant since it is made from a foreign substance?
Many thousands of dental implants have been placed with great success in our dental surgery alone. Titanium dental implants do not react to their integration with bone and the soft tissues that surround it. It is for this reason they are known as being biocompatible. When they are created they naturally form a layer of oxidisation. This makes them suitable for placing alongside bone and the soft tissues of the body with great success.

Alloys have also been rigorously tested and approved for use in dental procedures. Created from the highest grades of stainless steel and other alloys, there is no doubt that they provide the best service and outcome for many dental procedures.
What should I expect from the free implant assessment appointment?
When you attend the surgery for your initial assessment, the dentist will perform a thorough examination of your teeth and gums. They will enquire as to how and when you lost any missing teeth. The more information the dentist can acquire during the consultation, the easier it will be to determine the exact course of treatment required. You will be required to complete a questionnaire concerning your full medical history as well, as this will also assist the dentist in determining the best course of action.

The dentist will also take full impressions of your mouth, along with x-rays. These assist in evaluating the position and state of the teeth and the jaw bones. We do not make any charge for x-rays taken before or after your dental implant surgery. The dentist will also take a number of photographs of the mouth prior to treatment commencing. All these items will assist the dentist in pre-planning every detail and stage of your implant treatment.

Occasionally the dentist may require you to have a more detailed 3D scan of your mouth. The Dent1st dental practice has a cone beam CT scanning machine on the premises to assist us in planning dental implant procedures to the highest detail.
What is a CT scan?
Most patients are familiar with the traditional x-ray which provides a two dimensional view of the particular area. In addition to this they are not 100% accurate or easy to see without any degree of distortion.

When dental implants are to be placed in various areas of the jaw bone, the dentist will require precise images in order to avoid damaging vital anatomical structures nearby. The CT scan can provide comprehensive 3D images of all the required sections of the upper and lower jaw as needed. These scans are used to assist with treatment planning and to provide accurate measurements from which to work once the treatment takes place. The CT scan is also far more accurate in providing results of bone treatments if they are required.
Will I be required to see a dental hygienist prior to undergoing implant treatment?
t depends on the general health of your teeth and gums. In order to achieve the best chance of success when opting for one or more dental implants, you must be in the best dental health. If you are suffering from tooth decay in one or more teeth or you have any issues with your gums, these should be treated successfully prior to your implant treatment.

A hygienist can assist with this in a number of ways. They can clean your teeth thoroughly for you and remove any deposits that may have built up on them. They are also able to provide advice on the regular use of floss and tooth picks to keep your teeth in good condition. If you are experiencing gum disease you may be required to see a periodontist to receive further treatment for this.
Why must other dental issues be resolved prior to dental implant treatment commencing?
We should reiterate that dental implant procedures have a very high success rate of more than 95%. In a significant number of the cases where dental implants fail, the cause is down to poor dental hygiene and maintenance on an ongoing basis. Thus if dental implants were placed into a mouth where the teeth and gums are not properly maintained, there is a higher chance of failure.

If any oral infections or issues are discovered during the initial assessment prior to the dental implants taking place, these should be treated and fully resolved. If you undergo a dental implant procedure while suffering from a dental infection, it can inhibit your ability to recover from the surgery and also reduce the chances of long term success with the implant(s).

It has not been proven that an infection in, for example, the upper jaw can affect the healing of an implant in the lower jaw. However we prefer to maximise the chances of success and further reduce the risk of bacterial infection by treating other issues prior to implant surgery.
Is it safe to drink or smoke whilst undergoing the various stages of an implant treatment?
Our dentists will recommend you do not smoke or drink during the period of time you undergo your implant treatment. If you do either or both of these things you will reduce the odds of success. Those who drink and/or smoke may find the life of their dental implants is reduced, even if the implant is initially successful. If you cannot stop completely while the treatment is being performed, you must consider whether to opt for another treatment instead.
Are there likely to be problems with my dental implant(s)?
More than 95% of all dental implants placed meet with great success. They are a safe method for replacing one or more missing teeth and they look very natural when successfully placed in the mouth. However a very small proportion of dental implants may fail at some point. Regular check-ups after the initial treatment are recommended so the implant can be monitored. If the dentist should discover an issue at an early stage, they can plan appropriate treatment to remedy the matter.

It is appropriate for you to keep an eye on your implant after you have had the surgery. If you notice it becomes loose, sore or painful, or you exhibit any other symptoms or issues with your implant, you should contact your dental surgeon at the earliest opportunity so they may examine it.

If you have a porcelain crown and it breaks or cracks, a repair is necessary but relatively easy to perform. If you have a bridge fixed to several implants and you notice it has loosened, see your dentist without delay. They will be able to tighten it for you to limit the possibility of damaging the implants beneath.

In any event if you notice any problems or issues with your implants, seek dental advice from your dentist (or another dentist if you are away from home) as soon as you are able.
How can I seek advice about my dental implants?
Regardless of whether you are partway through your treatment plan or you have just completed it, we would encourage you to contact us immediately if you experience any problems or issues. In many cases we find there is nothing to be concerned about; however we would always wish to put your mind at rest so please do not hesitate to call us for advice.

We recommend you attend the surgery for regular check-ups as part of your maintenance plan for your dental implants. This allows the dentist to assess the condition of your implants, the health of your gums and your overall dental health. Gum problems can lead to the loss of implants just as they can affect the health of real teeth. By attending your appointments when required, you will further increase the odds of keeping healthy dental implants for many years to come. During these check-ups you may mention any issues you have been experiencing and ask for any advice if you wish.
The site of my recent implant surgery is very painful. Does this indicate a problem?
It is normal to expect some pain and discomfort after undergoing implant treatment. Once the implants are in place you can expect some degree of bruising, an aching jaw and a degree of swelling. Generally speaking the fewer implants place and the easier the procedure is, the less painful it is likely to be afterwards. If you undergo bone grafting and require several implants you are likely to feel a greater degree of pain.

Your dentist will recommend suitable painkillers but please do contact the surgery if you are concerned about your level of pain. When the surgery is closed you should consult the emergency dentist for your area. Your A&E department should be the last resort.

It is wise to consider when you should have your dental implant treatments. While it is not usually necessary to miss work on the days immediately following your treatment, you may wish to arrange the treatment for a Friday so you can relax for two days afterwards. In addition it is best to clear your diary for a few days just to be certain you don’t do too much immediately following the treatment.
Is the actual implant surgery painful to go through?
In the majority of cases a local anaesthetic is used while the procedure is performed. This means you will feel no pain. If you are particularly anxious or experience a dental phobia we are able to use conscious sedation while you undergo the procedure. Intravenous sedation vastly reduces the levels of stress you may feel during implant surgery. Many people find they go to sleep or at least are unaware of what occurred once the procedure is completed.
Why am I required to have bone grafting?
Once a tooth is removed it is quite normal for the bone beneath it to reduce in size. This is known as resorption. If the patient experiences gum disease over a long period of time or they have worn dentures that did not fit properly, the degree of bone resorption is higher and occurs at a faster pace. As a consequence it may be revealed during investigation that some patients do not have the required amount of bone to fully support the desired implants. Implants may still be fitted but first a bone treatment must be performed. The dentist will create new bone that will be used to replace that which has previously been lost. The technique is known as bone grafting.

There are several options the dentist may consider when focusing on a bone treatment. Where real bone is used it may come from a donor or possibly taken from the patient if they have an excess of bone in another area of their jaw. Occasionally, particularly when several implants need to be placed and a significant amount of bone grafting must take place bone may be taken from another area. Any bone which is harvested in this way will eventually regrow so there is no lasting effect here.

In situations where bone grafting is not required, the dental implant treatment will typically be completed within 3 and 6 months. However if the patient does require some degree of bone to be added, treatment may take anything up to 12 to 18 months. It will be dependent on whether the bone can be grafted into place and the implants can be positioned simultaneously. This is an easier process, but in some cases the bone treatment must be completed and should mature before the implants are eventually placed.
Why do I need sinus augmentation?
If you require dental implants in the upper molar region of your mouth, you may be required to have sinus augmentation. You may also hear this described or referred to as a sinus lift. The area of bone in this region is typically far shallower than the bone in other sections of the jaw. The solution is to treat the area by grafting new bone onto the jaw in the required area. This may be bone taken from another area of the jaw, a bone substitute material or possibly bone taken from a donor. Once the bone graft has taken place and established itself in the molar region, the implants can go ahead as required.

On some occasions the patient has enough bone to allow the dental surgeon to perform the bone graft and insert the dental implants simultaneously. If there is little bone the dentist will perform the bone graft and then wait for it to mature for several months before inserting the implants. In both cases the patient will not receive the final crown on the implant until several months have passed and the healing process is fully completed. During this time the implant and the bone become solidly attached to one another. Your dentist will be able to advise you on the specific length of time your own augmentation will take; there is always some variation in timings between individual patients and their treatments.
What is the typical lifespan of a Teeth-on-4 acrylic bridge?
The team at Dent1st have carefully monitored the use of acrylic bridges over the 6 year period we have been providing them. The two most common problems to occur – seen in approximately 10%-15% of cases – are for teeth to become worn and for them to fracture.

We provide a guarantee on your acrylic bridge for the first year following completion of your treatment. If you experience a breakage during this period please return to the surgery and we shall resolve the issue at no cost to you. This may involve a repair or a completely new bridge, depending on the specific issue and how severe it is. If you experience any problems after this guarantee period has expired, you may have to pay for the necessary repair.

You may be interested to learn that we offer an implant guarantee scheme. You can cover the cost of any problems, repairs or broken bridges once your guarantee period has expired, for a simple low monthly fee.
If I undergo Teeth-on-4 surgery and it is discovered my implants cannot support a fixed bridge, what will happen next?
Generally we provide a provisional bridge for you to use while the implants are healing. Most patients receive this bridge and experience no problems with it. However on some occasions where multiple implants are inserted into the jaw bone, one of them may not have the same degree of stability as the others. If this were to occur in your case, we would supply a provisional bridge to use in conjunction with the stable implants. It is very rare for none of the implants to be stable following this procedure; however if this were to happen the solution would be to use a removable denture for the short term. This may be for a period of several months; during this time the jaw bone and the implants would fuse together and become stable and strong. Once this is the case the dentures would be removed and replaced with a fixed acrylic bridge.
Is it possible I would need one or more other procedures completed at the same time as having my implants placed?
We adhere to a strict treatment planning procedure that vastly reduces the possibility of any patient requiring additional procedures at the time their implants are placed. However in some cases additional procedures are required. We would ask that if this occurs in your situation, you accept the alteration in your treatment plan as it may need to be performed simultaneously with the rest of your treatment.

On some occasions the fees given can vary. Most of the time, this is due to one of several reasons. Sometimes a patient may require additional or alternative procedures that were not indicated in the treatment plan. If your treatment takes longer than was previously estimated this can also lead to additional fees. A third possibility is that a new and better treatment may become a possibility while you are in the midst of receiving treatment.

If it is not possible to perform the procedure that has been planned on the day of your appointment, an alternative treatment could be considered and performed if it is deemed appropriate to your treatment to do so. If this is not possible, the normal hourly rate for the dentist will be charged for the time they have spent with you.
Is there a possibility the bone that supports the implant could recede?
On some occasions it is possible for bone to recede around an implant. If this should occur we can often find the reason for the occurrence in order to treat it successfully. However if the bone loss is discovered to be progressive, the implant may eventually be lost.
Do you use new materials for implants on a regular basis?
Advances are continually being made in the science of implantology. If we discover new materials or procedures we believe could enhance the outcome of your implant procedure, we may alter your treatment plan to accommodate them. Please be assured that any and all such alterations are only made after careful consideration. Furthermore we shall only make these changes if they are sure to provide you with even better results.
How long should I expect my dental implant treatment take?
It is entirely dependent on how complex your treatment will be. For example a patient requiring no bone grafting and just one implant is likely to complete their treatment far sooner than a patient who does require bone grafting and needs several implants as well.

The initial planning stages alone may last for a month. This covers the initial consultation and the creation of the individualised treatment plan.

Following this stage, you may be required to undergo one or more other treatments. For example any underlying dental problems such as gum disease must be adequately treated. In some cases one or more teeth may be required to be removed. If it has been determined that you require a bone treatment this will also need to be completed prior to the implant surgery taking place.

Once you have received the implants a period of time will be granted for them to heal and settle into the bone. This typically requires three to six months although your dentist will be able to give you a more accurate outlook for your individual situation. Once the crowns, bridges or dentures are ready to be fitted to the implants, a further time period will ensure this is done correctly and with minimal adjustment.

It may seem as if your treatment will take place over many months. However it should be remembered that both the dentist and the patient will want to strive for the best possible outcome. This holds true regardless of whether there is just one implant to be fitted or whether there are several, perhaps involving bone treatments and sinus augmentation as well. The maturation of the bone surrounding the implant(s) and the healthy condition of the soft tissue will take a specific amount of time to be completed. In many cases any required bone treatments will be performed first, with the dental implants added at a later date. While they can sometimes be performed on the same day, it is usually preferable to separate the two in order to achieve the best degree of success in the long term.

If you are in a hurry to achieve the best visual effect in the shortest possible time frame, perhaps you should reconsider having dental implants. The highest level of success is only achievable when the correct amount of time is taken to complete the treatment.

If you do elect to have dental implants we would encourage you to pay close attention to any advice and information given to you by your dental surgeon. They will be able to provide medication for pain relief and also to minimise the chance of infection or discomfort.
May I wear my dentures immediately after my dental implant surgery?
It is unlikely you will be able to wear your existing dentures once your implants have been put in place. This is to prevent them touching your implants and potentially causing pain, discomfort or even movement of the implants.

Consult your dentist about the possibility of receiving a temporary plastic set of dentures during the healing process. These can be adjusted quickly and efficiently in order to assure you of maximum comfort.
Will my treatment be successful?
The degree of success you experience will depend largely on two things:

How your body reacts to your implants
How well you take care of them

We are well aware that natural teeth can fail if the patient experiences gum disease, and the same can occur with implants. It is wise to ensure you follow your dentist’s instructions for cleaning your teeth on a regular basis, using a good brush, toothpaste and also floss. The more you work at looking after your new implants, the longer they are likely to last.