Frequently asked questions

A dental implant is a small titanium screw that takes the place of a missing tooth’s root. It is placed in your jawbone, and over the following weeks the bone bonds to it. Dentists call this bonding osseointegration. Once the implant is secure, a connector called an abutment is fitted, and this holds your new crown, bridge or denture. A denture held by implants doesn’t slip around, and implant crowns and bridges work much like natural teeth. Implants can replace a single tooth, several teeth or all the teeth in a jaw.

Teeth are lost for many reasons: decay, gum disease, accidents, wear with age, a condition you were born with, or a serious infection such as a failing root canal treatment. Whatever the cause, a gap can lead to other changes. Without a tooth to stimulate it, the jawbone underneath slowly shrinks. The teeth either side can tilt and drift into the space, which can upset your bite and change how your smile looks. Over time this can make chewing harder, affect what you eat and leave you feeling self-conscious. We can talk you through the options for filling the gap.

It depends on whether you still have some of your own teeth. If you have no teeth left in a jaw, the options are a removable denture, a denture held in place by implants, or crowns and a bridge supported by implants. If you have some teeth left, you could have crowns or a bridge supported by implants, your own teeth or both; a partial denture secured by implants or by teeth; or a bridge fixed to the teeth either side of the gap. At your consultation we’ll explain which options suit you, and what each involves and costs.

Each option has strengths and drawbacks. Removable dentures cost less, but they often need adhesive, can feel loose or uncomfortable, and can add to decay, gum disease and shrinkage of the bone and gums. An adhesive bridge needs little or no drilling of the teeth next to it, but it can come loose, so it is often seen as temporary. A conventional bridge means filing down the healthy teeth either side of the gap to hold it, and over time these crowns can loosen and lead to decay. An implant isn’t attached to the teeth next to it, so they are left untouched, and it can be combined with bone grafting where needed.

Implants are a well-established, tried-and-tested treatment. Like natural teeth, how long they last depends largely on how well you look after them and whether you keep up your regular hygienist and check-up visits. If they aren’t cleaned well, a coating builds up around them, just as it does on neglected teeth, and this can lead to gum infection, bleeding and soreness. With good care, and strong, healthy bone around them, implants can last for many years. But as with other implants in the body, such as a hip replacement, there is no lifetime guarantee.

Implants are usually placed under a local anaesthetic, which numbs the area while we work. Afterwards, much as after having a tooth out, you may have some discomfort in the week after surgery, such as a dull ache, swelling or slight bruising. How much depends on how many implants you have and how involved the surgery is. If you’re very nervous, or your treatment is complicated, intravenous (IV) sedation is available to help you feel deeply relaxed. General anaesthetic is rarely used for implants, and only for very complicated cases.

The implant itself sits in the jawbone, under the gum, so it can’t be seen. What shows is the crown, bridge or denture fitted on top. This is made for your mouth by dental laboratories we have worked with closely, so that the finished result looks as natural as possible. We’ll talk through how your new teeth will look at your consultation, before any treatment starts.

It depends on the type. Most crowns and bridges fixed to implants can only be fitted and removed by your dentist, so they stay in place from day to day. If you have a denture that clips onto implants, you can take it out yourself to clean it. If you’ve lost all the teeth in one jaw, there is also a removable implant bridge, which you take out to clean. We’ll explain the differences at your consultation.

Sometimes an implant doesn’t fuse with the bone and becomes loose, either while it heals or shortly afterwards. If that happens, it can be removed easily and your jaw heals in the normal way. Once the area has healed, another implant can be placed there. Or, if you have several implants, a bridge can be made using the implants that have bonded. We’ll talk you through what this would mean for you.

It can. Implants can’t decay, but like teeth they can develop gum problems, and bone can sometimes be lost around them. If that bone loss keeps progressing, the implant may be lost. Smoking and heavy drinking both reduce how long implants, and teeth, survive. Your protection is thorough daily cleaning, regular hygienist visits, which reduce the risk, and check-ups, so that any problem is found early, when it’s easier to treat. If an implant is failing, we’ll plan the next step with you.

Implants and the teeth they hold can be damaged in an accident, just like natural teeth. If you play contact sports, or sports with a ball, wear a mouthguard made by your dentist. If only the crown or bridge is damaged, it can usually be removed from the implant and replaced. If the titanium implant itself is damaged beyond repair and is too difficult to remove, it can safely be left in the jaw, and another implant placed alongside it.

We only use established implant brands, such as Straumann^®. Dr Ross Cutts works closely with the Straumann system and has experience with many others. Your crowns, bridges and dentures are made by dental laboratories we work closely with, including Borough Crown & Bridge and TPR Dental Prosthetics, so that they look as natural as possible and suit you. We’ll tell you which system we recommend for you, and why, at your consultation.

Often not. We use an iTero digital scanner, which records your teeth with the tip of a small hand-held wand instead of a tray of impression material. You and your dentist can watch the scan build up on screen, and the computer turns it into a three-dimensional model of your teeth. This is used to make your crowns, bridges and implant teeth, without the mess or taste of traditional moulds.

Your consultation lasts about 30 minutes and includes a thorough examination of your mouth. We’ll talk through your options and answer your questions. Afterwards you’ll receive a fully costed plan for your treatment and a letter explaining the whole procedure. It’s also a good time to mention any social events, travel plans, work commitments or budget limits, so we can plan the stages of your treatment around them. We’ll also ask you to fill in or update a medical history form, which is kept confidential.

An initial implant consultation costs £95, or £150 with Dr Ross Cutts, our principal dentist. Both last 30 minutes and include a full examination, a fully costed treatment plan and a letter explaining the procedure. If you need a CBCT 3D scan to plan your implants, there is an additional charge of £210. The scan is taken at our Cirencester practice.

Yes. Dental implant treatment is available at both our Cirencester and Stow-on-the-Wold practices, so please tell us which you’d prefer when you book. CBCT 3D scans are taken at our Cirencester practice, so if you need one, that appointment will be in Cirencester.

To plan your treatment properly, we usually need photographs, X-rays and models of your teeth and jaws. In some cases we’ll also recommend a CBCT scan, a 3D X-ray that shows the shape of your jaws in much more detail than an ordinary X-ray. The planning stage, up to your written plan, may take a month or so. If you need any treatment first, we’ll explain it in your plan.

It depends on how complex your treatment is. Planning usually takes a month or so. If any treatment is needed first, such as gum treatment, removing teeth that can’t be saved or building up bone, that can take from a few weeks to several months. Once placed, implants are usually left to settle for 6 to 12 weeks before your teeth are fitted. Fitting your final crown, bridge or denture typically takes a couple of weeks.

Sometimes. In some cases implants are suitable for use straight away, with temporary or final teeth fitted at the time the implants are placed, or soon after. Whether this is possible depends on your individual situation, and we’ll tell you at your consultation if it’s an option for you. Otherwise, implants are left to settle for some weeks before your final teeth are fitted.

Time off work isn’t usually necessary. Just to be on the safe side, though, avoid booking important social events or work commitments for at least a week after your implants are placed. If you have IV sedation, you’ll need to rest for a day or two and follow the sedation advice we give you.

Your bone and gums need time to heal fully between each stage. Neither you nor your dentist should try to move on faster than that healing allows: even treatment that is well planned and carried out can fail if it moves too quickly from one stage to the next. We’ll agree a timetable with you at the start, and plan around your commitments where we can.

Guided bone regeneration is a way of encouraging your own bone to grow where there isn’t quite enough to hold an implant. After a tooth is taken out, the socket usually heals well on its own. Where the bone at the planned implant site is less than ideal, a bone-substitute material is placed there to help your own new bone form. Depending on how much bone is needed, this can be done at the same time as your implant is placed or beforehand.

Above your upper back teeth are air spaces called the sinuses. The bone beneath them is often too shallow to hold an implant. A sinus lift, also called sinus augmentation or sinus grafting, builds up bone in this area using your own bone, a bone-substitute material or both. Over time the graft is replaced by new bone that can hold an implant. If there’s already enough bone, implants can sometimes be placed at the same time as the graft; otherwise they’re placed later, once the graft has matured.

Grafting usually adds time, because the new bone has to mature. Without grafting, implants are commonly ready to use after 6 to 12 weeks. If grafting is done at the same time as your implants, it’s more likely to take 9 to 12 weeks. If your implants have to wait until the graft has matured, treatment may take 9 to 18 months overall. After a sinus lift, implants can usually be placed after 3 to 9 months, then heal for a further 3 to 9 months on average before your teeth are fitted. Every graft is different, so these times are a guide.

A CBCT (cone beam computed tomography) scan is a type of 3D X-ray. Ordinary dental X-rays are flat, two-dimensional pictures, which can distort or miss detail. A CBCT scan gives life-sized, three-dimensional images of your upper and lower jaw, so we can take precise measurements and plan where your implants should go, avoiding nerves and other important structures. It can also be used to check a bone graft before implants are placed. Our CBCT scanner is at our Cirencester practice.

A CBCT scan helps us plan treatment in three dimensions. For implants, it’s used to check whether you’re suitable, assess the quality of your bone, find the most suitable place in the jaw for each implant and look at the sinuses, to judge whether a sinus lift is needed. It also shows where nerves and blood vessels lie. Beyond implants, it helps when assessing wisdom teeth before removal, and can show the precise length of a tooth’s root canals for root canal treatment.

Not everyone needs one. Your dentist will recommend a CBCT 3D scan at your consultation if it’s needed to plan your implants. The scan costs £210, in addition to the consultation fee, and is taken at our Cirencester practice. If a written report on the scan from a consultant radiologist is needed, this is from £195.

An OPT, also called a panoramic or panoral X-ray, is a single, clear two-dimensional image of your whole mouth and the bones around it. It shows areas that ordinary dental X-rays can’t, including the whole upper and lower jawbone, the sinuses, the nerve that gives feeling to the lower jaw and gums, and the jaw joints. This helps your dentist pinpoint any problems that need treating. OPT X-rays are taken at our Cirencester practice.

A hygienist removes hidden and hardened plaque that you can’t reach with a toothbrush or interdental brush. They then polish the surfaces of your teeth, which makes it harder for new plaque to build up. They’ll also check how you’re cleaning at home, and show you ways to reach any areas that are difficult to clean around your implants.

Your hygienist starts by asking how your implant feels, and whether you’ve noticed bleeding, pus, a bad taste or pain. Next, they check the gum around each implant for colour, texture, swelling and bleeding, and whether the implant moves. If the gum is healthy, a gentle polish is all that’s needed. If not, they clean around the implant with an ultrasonic instrument designed for implants, and may rinse the area with an antiseptic. They then go through your home care with you, and note even small changes so your dentist can follow them up.