Dental implants and jawbone health

If you are about to lose some of your teeth through decay or advanced gum disease, you are probably wondering about having dental implants as a brilliant way to replace teeth as they are embedded into the jawbone and no one can tell they’re not your real teeth.

However, being able to have dental implants is dependent upon how healthy and strong your jawbone is.

Sinus Lifts in MaryleboneIf you have been missing teeth for some time, or you are a smoker or have had advanced gum disease, your jawbone may not be in as good condition as you would like. As soon as you lose teeth, the bone in the area of the lost tooth understands that it is no longer being used and begins to dissolve itself, releasing the nutrients from the bone back into the bloodstream for use elsewhere in the body.

It used to be that if your jawbone had deteriorated, due to one of the above reasons, your dentist would not be able to fit dental implants. However, at David Madruga in Marylebone, London, we use various techniques to rectify bone density issues.

Over the last decade or so, experimental dentists have come up with some brilliant ways to get around the thorny issue of the jawbone that can no longer support dental implants.

Sinus lifts in Marylebone

If you have been without teeth in your upper back jaw for some time, what tends to happen is that the sinus cavity starts extending downwards. The layer of bone becomes too thin to hold the entire length of the dental implant, which would not be able to cope with the pressures exerted during chewing, which can be up to 97kg or 220lbs.

The solution is to go into the large sinus cavity, gently push the lining upwards and then insert bone material into the gap between the lining and the bone. Bone material can either come from you as the patient, or from an animal source.

You then have to wait several weeks for the bone material to integrate with your jawbone and once it has done so, we can proceed with placing dental implants into the back of your jaw.

Stress-free oral surgery with conscious sedation in Marylebone

If you are feeling anxious about visiting the dentist, you are not alone. Dental phobia is a very common occurrence, affecting almost half of all UK adults. Patients suffering from dental phobia tend to cancel dental appointments and visit the dentist only when it is absolutely necessary to be treated. Unfortunately, this can create a lot of problems in the long run.

Nervous Patients in MaryleboneDr David Madruga is specially trained in treating nervous patients in Marylebone. He is caring and sympathetic and ready to listen to your needs, concerns and answer all your questions. He will take the time to explain every step of your treatment in understandable terms and will help you cope with your dental anxiety. More importantly, nervous patients can take advantage of our conscious sedation options.

Feel relaxed and comfortable

At your first appointment with Dr Madruga, you will be met and treated in a friendly and reassuring manner. You will never be judged for the state of your teeth or any phobias you may have. Dr Madruga is specially trained in the most advanced techniques available and has invested in specialist equipment designed to eliminate any pain during treatment.

Conscious sedation is not like general anaesthesia. Dr Madruga will use either oral or IV (intravenous) sedation, to help you relax during your dental treatment. IV sedation is more substantial compared to oral sedation, because it involves administering the sedative directly into the bloodstream. In both cases, you will be awake but unaware of what’s happening, feeling very relaxed and not experiencing any pain or discomfort.

When you are under oral or IV sedation, you can still communicate with the dentist. Conscious sedation is extremely safe and well-tested and has proven to be effective with nervous patients. If you opt for conscious sedation, you will need to bring a friend or family member with you to your appointment to make sure you return home safely.

Our commitment

For nervous patients who avoid the dentist because of their phobia, why not let us help? Dr Madruga will help you overcome your fears and worries and allow you to have any necessary dental care in a calm and relaxed environment.

We can help you get your mouth back

It can be so very disheartening to watch your teeth fail one by one over the years. It does seem that if one goes, the others soon follow. They need each other to remain in place in the jawbone and when there is a gap left by a missing tooth, the other teeth can start to wander, tip into the gap and even fall out. Or maybe, you were not born with healthy teeth and it has always been a big struggle to keep them in good condition.

Full Mouth Rehabilitation in MaryleboneWhatever the reason, if you have lost or are about to lose all your teeth, do not sink into despair. At David Madruga in Marylebone, full mouth rehabilitation can give you back your smile and your ability to chew, laugh and speak with complete freedom, by using dental implant restorations.

How it works

As the name implies, full mouth rehabilitation is a big job. We need to plan it carefully, and to do so we will need to do CT scans, and take x-rays. This is so that we know exactly where to place the dental implants without damaging nerves or blood vessels.

If you have been without teeth for a while, you may need to have extra procedures, such as bone grafts or sinus lifts, so that your jawbone will be strong enough to take the implants, integrate with them and withstand the incredible forces created by chewing.

We will extract any remaining, failing teeth and fit between four and six dental implants per arch. You will then wait a few weeks while the dental implants integrate with your jawbone, and during this time you will wear temporary restorations.

Then we will fit you with handmade porcelain crowns that will have been created to suit your mouth perfectly. All you need to do to look after your implants is to brush them carefully twice a day, floss your teeth and then come in for a check-up and to see the hygienist twice a year.

Why not come in for a consultation to find out how David Madruga can help you get your smile back.

Repair and improve your smile with dental implants in Marylebone

If you are missing one or several teeth, you may feel embarrassed by the gaps in your smile and even find it difficult to enjoy your favourite foods. Luckily, modern dentistry has come a long way and nowadays dentists offer patients the option of dental implants. Unlike dentures and bridges, dental implants are long-lasting and look and feel like your natural teeth.

If you are concerned about missing teeth and you have you been neglecting them for a while, you should visit Dr David Madruga as soon as possible to repair your smile. Missing teeth are not only an aesthetical problem – they can also cause bone deterioration and hinder the function of your bite. Dr Madruga will examine your teeth thoroughly and help you determine whether dental implants are the right treatment for you. Replacing missing teeth in Marylebone has never been easier.

Replacing Missing Teeth in MaryleboneHow dental implants work

Dental implants are artificial, titanium tooth roots that are surgically inserted into your jawbone. Implants replace any natural tooth roots that you may have lost to decay, injury or other causes.

After the artificial root fuses with your jawbone over a period of time (which can last from a few to several months), it can then hold a replacement tooth such as a dental crown.

Your replacement tooth is customised to match your natural teeth. Patients with several missing teeth can also have implant-supported dentures or bridges.

Dental implants feel, look and function just like your natural teeth. They can be placed in the upper or lower jaw bone and x-rays are taken to determine the best locations in your jawbone for the implants to be fixed.

How can you benefit from dental implants?

Dental implants offer many benefits as they can restore your ability to speak and chew food properly. Moreover, they are very durable and can last for many years. More importantly, dental implants protect your jawbone from deterioration and encourage the growth of bone tissue.

Contact us

Considering replacing your missing teeth in Marylebone? Our dental team strives to provide the best dental care for our patients, so give us a call today and we will book a consultation appointment for you.

It’s all part of the process

People often wonder just what goes on during the dental implant process. In Marylebone, at David Madruga, we make sure our patients fully understand what the dental implants process involves because it requires a certain amount of commitment.

Let’s take a look at what goes on with a very simple single dental implant insertion.

Dental Implants in MaryleboneThe consultation

During your consultation, Dr David Madruga Gonzalez will thoroughly examine your teeth to make sure that you are able to receive dental implants. The main thing he will be looking at is your jawbone in the area where you lost a tooth. It needs to be strong and dense in order to be able to withstand the strong forces created by biting and chewing without the implant coming loose. If you have been missing a tooth for quite a while, chances are that there will be some deterioration in the bone in that area. If so, you may need to have a bone graft, a sinus lift, or cheek implants to fix this.

If you are a smoker or have uncontrolled type 2 diabetes, it is going to interfere with your healing, so you will have to give up smoking and get the diabetes under control before you can have dental implants.

The surgery

This is performed under local anaesthetic, with either oral or intravenous sedation if you are anxious. There is not much pain because there are fewer nerves in the jawbone. Once the dental implant is in place, it takes about two months for the titanium post to integrate with the jawbone in a process called osseointegration. The implant stimulates the jawbone to grow new tissue all over it, to holding it in place like a natural tooth root.

Your new teeth

After osseointegration, you come back and Dr Madruga Gonzalez fits your new custom-made porcelain crown. And after that, you are good to go.


You need to take good care of your implants with regular diligent cleaning to remove plaque. If it builds up enough to cause gum disease, this can lead to your implant becoming loose. If you take good care, however, your implant can last you for the rest of your life.

Solutions for missing teeth

If you have missing teeth, then you know that you can feel insecure about your appearance or experience difficulties with everyday activities such as eating and speaking. You may have considered removeable appliances, but worried that they would be loose, inconvenient to clean or uncomfortable. If you have resigned yourself to the difficulties of living with gaps, you might like to hear about dental implants.

Many people have restored their quality of life using this established procedure for replacing teeth. In Marylebone, nervous dental implant patients can benefit too. At David Madruga, we pride ourselves on a relaxed, reassuring approach, combined with techniques such as conscious sedation to make sure that you get treatment you need.

Nervous Dental Implant Patients in MaryleboneCare for anxious patients

For up to 13% of people in western countries, severe fear of dentists or dentophobia is a very real problem. This can prevent some people from ever visiting their dentist, and make it a very unpleasant experience for others. In fact, this is the main reason that people avoid having the treatment they need. Some people feel out of control, while others have had a bad experience or simply get nervous at the thought of attending an appointment or having work carried out.

Sadly, many people would rather endure the discomfort and inconvenience of missing teeth rather than seek help. If this sounds like you, we can help. We want to make treatment accessible so we ensure that you feel as comfortable as possible.

What happens if I choose dental implants?

The first stage is a consultation in which we assess the condition of your jaw and mouth, plan a treatment programme, including sedation options if necessary, and answer any questions that you might have. The implants are metal screws that are placed into the jaw under a local anaesthetic. During healing, the bones and tiny blood vessels of the jaw mesh around the implants, holding them securely in place. When they have settled, they are used as a secure base to support a replacement tooth, a whole set of dentures, crowns or bridges. The implants function just like the roots of natural teeth, so you will be able to enjoy your favourite foods and an improved appearance.

A new future for your teeth

Our natural teeth tend to do their jobs with minimal fuss. They enable us to bite into food, chew it, and display a nice smile afterwards. When we lose them, we realise how much we relied on them. Temporary replacements can mimic the appearance of lost teeth, but they often don’t perform as we’d like them to, and they can be awkward to maintain.

Dr David Madruga Gonzalez has been solving the problems caused by missing teeth for many years. At his practice in Marylebone, advanced dental implant technology allows him to replace lost teeth with fully-functioning substitutes. These contemporary teeth fully integrate with your jawbone in a process called osseointegration. This means your replacement teeth have a long-lasting stability that temporary replacements can’t provide.

Dental Implants in MaryleboneLasting changes to your dental experience

Having dental implants can transform your quality of life. If you’re used to wearing dentures, you can wave goodbye to the messy adhesives that keep them in place. Once your implants are installed in your mouth, that’s where they’ll stay. You can relax and enjoy yourself at the dinner table, focussing on the deliciousness of the food without the nagging worry that your teeth might come unstuck and cause embarrassment.

Another advantage of this procedure is that it will help to keep the underlying firmness of your facial appearance. One of the effects of long-term temporary denture usage can be a deterioration in the face’s bone structure. After many years of this, you might develop a sunken, unhealthy appearance. Dental implants engage with the bone structure, ensuring it maintains its natural density.

A range of applications

It’s not just decay that leads to the need for new teeth. You can lose one suddenly, for example while playing sports. Implant dentistry will replace this lost tooth with one that looks and feels natural.

Dr David Madruga Gonzalez will talk you through the details of this life-changing procedure in a relaxing consultation. Careful dental measurements are taken to maximise the effectiveness of your treatment. After the work is done, you’ll be able to enjoy the oral health benefits for decades to come.


People in personal growth circles love to turn words into acronyms. With F.E.A.R., you get to choose between False Evidence Appearing Real and Face Everything And Recover. In other words, fear is a feeling. It’s a negative feeling about the future.

The thing is with fear, it’s a very powerful feeling that can stop people doing things they know would be great for them. One thing it stops people doing is getting dental implants. This is such as shame as, in fact, having surgery on the jawbone is a lot less painful than work on the teeth as there are far fewer nerve endings.

Nervous Patients and Dental ImplantsFor some reason, nervous patients and dental implants combined can create fear. But feeling scared, even more than scared, is no reason not to go through with a dental procedure that can be completely life changing.

At David Madruga in Marylebone, we’d hate for anyone who comes to us for dental implants to decide that the procedure is just too nerve-wracking to go through with.

Conscious sedation

We are big fans of conscious sedation here at David Madruga. This is a way for our patients to go through dental implant surgery in a completely relaxed way, not feeling any pain, not really aware of what’s going on, but able to respond should we need to talk to you; not knocked out cold with a general anaesthetic.

Oral sedation

This is the lighter of the two sedation techniques we offer. You take a pill an hour or so before your appointment, so that by the time you lie back in the chair, the sedation is beginning to take effect.

Intravenous sedation

Much faster-acting because we administer the sedative directly into your bloodstream, and will monitor you throughout treatment. It is a deeper sedation that might send you to sleep, but you can be woken up if necessary.

Whichever type of sedation you choose, you will need to bring someone with you to make sure you get home safely, which is what we always recommend for patients having implant surgery.

Do call us to find out more about sedation and how it can help you through implant surgery.

Ask the experts

When you know something is wrong with your car, but you don’t know what you need to do to make it a thing of beauty and a joy to drive again, you ask a car expert. The same is true with teeth and mouths. It’s very easy to carry on for years with teeth that don’t look great and maybe even have a few issues, other than decay or gum disease, that cause discomfort. You might know how this feels. You don’t smile as much as you might. You certainly don’t tend to roar with laughter. If you have removable false teeth or a fixed bridge, you no longer eat your favourite foods.

Full Smile Makeover in MaryleboneAll in all, not having a great smile, for whatever reason, can be an experience that each day, in subtle but undeniable ways, chips away at your self-esteem.

So, treat your teeth like your beautiful but battered old car and take it to an expert to find out how they can restore it to its full gleaming former glory. Or, if your smile was never an Audi, find out how it can be turned into one.

What’s on offer?

An expert, like David Madruga can give you what is known as a full smile makeover in Marylebone. This is a cover all term for a combination of cosmetic dentistry treatments to bring your smile to peak condition.

You may need to have some teeth straightened. Doing so not only makes them look better, they will last longer and all your teeth will wear better when the pressure of chewing is evenly distributed.

Perhaps your teeth are also chipped and worn. They can be repaired by covering them with veneers or composite bonding. Back teeth may need something stronger like crowns.

Discoloured teeth, as long as there are no prosthetics such as veneers, can often be whitened.

If you have a gummy smile, you might need to have gum contouring to bring it into ratio with your teeth.

How these treatments are combined and in what order they are performed is vital to the success of your treatment, and you will receive a treatment plan with the order and cost of treatments needed to make over your smile.

Immediate placement dental implants in Marylebone

Following years of development and dental practice, dental implants are now part of routine dental therapy and should be considered as an option in every treatment that requires tooth replacement. Unlike other tooth replacement options, dental implants replace missing teeth permanently and restore your oral function.

At David Madruga, we are pleased to offer immediate placement dental implants in Marylebone. Tooth extraction followed by immediate implant placement is now a viable option. This treatment is ideal for patients who want to avoid further bone loss and reduce surgery time and expenses.

Immediate Placement Dental ImplantsWhy choose dental implants?

Dental implants are small titanium posts that are surgically inserted into the jawbone to replace missing tooth roots. Once in place, they tend to fuse with the jawbone and encourage the growth of new bone tissue. Unlike conventional dentures and bridges, dental implants restore your biting and chewing power to its full potential and look and feel just like your natural teeth.

Implants are a safe and effective treatment for patients who wish to replace their missing teeth permanently. Much like natural teeth, dental implants will last for as long as take good care of them.

Immediate placement of dental implants

In some cases, dentists are able to remove a failing tooth, fix a dental implant into place on the same day and restore the dental implant with crown or other restoration in the same day. This way, patients don’t have to wait for long periods of time for the bone to heal, before they have their restorations placed on top of their dental implants.

Immediate placement and loading of dental implants is a fairly new procedure in implant dentistry and does not apply to all patients. In order to be eligible you need to have sufficient bone to ensure implant stability, good health and a lack of habits such as smoking.

Immediate implants are ideal for single tooth replacements, especially for patients who have lost or broken a tooth due to an accident or trauma. The procedure is quite simple and our dental team will give you instructions on how to look after your implant.