Why make it any harder?

We all need to eat. We all need to smile, to talk, laugh and yawn. When you have all your teeth in place and in good working order, you probably never even consider how hard life might be if being able to do any or all of these things became hard, or even impossible.

Full Mouth Rehabilitation in MaryleboneBut start to lose your teeth and you soon find out. Lose most or all of them and, even if you have dentures, these simple and important tasks can become unbearable. You may find yourself turning down dinner invitations because you don’t want to try crunchy or chewy foods. You may find yourself smiling with lips tightly shut, if at all, and as for bursting out laughing, forget it. There is so much fundamental pleasure tied up with eating and yawning, laughing and chatting, that when you’re more worried about making a twit of yourself because of your teeth, pleasure and confidence drain away.

If this is how your life has been for a while, maybe now is the time to invest in improving your quality of life with a full mouth rehabilitation here with David Madruga in Marylebone.

With a full mouth rehabilitation, we replace all of your teeth with dental implants. This may mean having to remove your remaining teeth, which are already on the way out.

This gives us a blank canvas on which to rebuild your smile so that it looks great and works well too.

The great thing about dental implants is that one implant can support several teeth on a bridge, so you won’t need to have 32 of them. We do a great treatment called All-on-4 that allows us to replace an entire arch of teeth on just 4-6 dental implants.

We will fit you with temporary dentures while your implants are given time (somewhere from 2-6 months, depending on your individual rate of healing) to fuse with your jawbone. Then we fit you with custom-made crowns that are designed to look like your own teeth. These are permanently fixed in place, so there’s no need to worry about wobbling. You just treat them as carefully as your own natural teeth and they can last for decades.

The skinny on replacing missing teeth

If you are about to lose some teeth, or if you have already lost some, you need to start thinking about how you are going to replace them. It’s important not to leave yourself with gaps in your teeth for any length of time, for 2 reasons:

Replace Missing Teeth in MaryleboneLoss of jawbone

When you lose a tooth the jawbone in the area where it used to be is no longer stimulated by the vibrations that used to come down through the tooth into the root every time it met with the tooth on the opposite jaw. The lack of vibration is interpreted as the bone no longer being in use and the bone cells start to dissolve themselves, making the jawbone smaller and less dense in that area. When you have lost all your teeth, the whole jawbone shrinks away, leaving you looking very pointy-chinned and your face collapsing inwards.

Destabilisation of remaining teeth

When you have a gap in your teeth, the neighbouring teeth are no longer securely held in place and can start to drift around and even topple into the gap.

Dental implants for replacing missing teeth

The most effective way to replace missing teeth is with dental implants. This is because they replace the tooth roots. Having replacement tooth roots means the jaw stays strong and healthy because it is receiving the stimulation it needs to keep renewing itself.

Tooth roots also provide stability when you eat, so replacement roots give you the freedom to eat whatever you like. Dentures only provide about 25% of the chewing power of natural teeth. Fixed bridgework is more stable, but it means sacrificing 2 perfectly healthy teeth, which need to be ground down to act as buttress crowns for the bridge.

Here at David Madruga in Marylebone, we can replace a single tooth, a few teeth or even all your teeth with dental implants. You don’t have to have an implant for every lost tooth. One implant can support up to 3 crowns on a bridge. And we can replace an entire arch on just 4-6 implants.

Why not make an appointment for a consultation to find out how we can help you?

The dental implant process

Getting dental implants is not just a quick in and out and Bob’s your uncle. If you decide to go for this method of tooth replacement, you are looking at a series of appointments stretching out over a matter of months rather than one simple appointment.

Dental Implants in MaryleboneThe consultation

The first stage when you decide to get dental implants in Marylebone with David Madruga is to come in for a consultation. David will make a thorough examination of your teeth and jaw, including beneath the gums to find out what condition your jawbone is in. This means x-rays and scans. If your jawbone is strong and healthy, David will go ahead and put together a careful plan to site the implants, avoiding any nerves or blood vessels.

Preparatory treatments

If your jawbone needs help before you can have implants, David can carry out a bone graft or a sinus lift. Both treatments add extra bone material into the jawbone to strengthen it and get it back to renewing itself rather than being in a process of resorption. This can add several weeks to your treatment time.

Implant surgery

This is carried out under local anaesthetic, and if you are nervous, you can also have either oral or intravenous sedation to help you deeply relax throughout the surgery. Placing the implants involves opening up the gum and creating new implant channels in the jawbone. This has to be done carefully.


This is a crucial part of the dental implant process. It takes 2-6 months, depending on your body’s healing speed, for your jawbone to bond with the implants by growing new tissue all over them. By the end of the process, the 2 will be fused together. During this time, you will gradually move from a liquid diet to a soft food diet.

New crowns

When osseointegration is complete, you can have new handmade porcelain crowns fitted. These will match your other teeth in size, shape and colour.


Twice daily brushing, daily flossing, regular hygienist cleanings. This is all you need to do to maintain your dental implants. Do this diligently and they could last for decades.

Forget your nerves and get your life back

It’s only when you start to lose your teeth that you realise how vital they are, not just for eating but for talking, smiling, laughing and holding your face in place. Now that yours are on the way out, how will you replace them, bearing in mind that you aren’t the world’s most fearless dental patient?

Nervous Dental Implant Patients in MaryleboneWell, it would be easy to go for the least invasive option and get dentures made. But dentures only give you about 25% of the chewing power of real teeth, and after a while they lose their grip and can give you all sorts of embarrassing moments. How about, if you’re only losing a few teeth in a row, fixed bridgework? It’s more stable, for sure, but having a bridge means compromising 2 neighbouring teeth, which have to be ground down and fitted with crowns to become buttresses. Seems a bit extreme.

So what about dental implants then? Or does your fear outweigh the opportunity to have replacement teeth that give you back full functionality? Please don’t let it. Instead, come to David Madruga in Marylebone and receive treatment from a dentist well used to nervous dental implant patients. In truth, with dental implants, you have nothing to fear but fear itself, but that’s not very helpful when you are up against anxiety.

David Madruga and his highly experienced team have treated many nervous dental implant patients using conscious sedation.

What is conscious sedation?

Conscious sedation means that you are awake and can respond to questions should you need to be, but you are so deeply relaxed that most of the time, you are not really even concentrating on what is going on with the implant surgery, let alone able to get worried about it.

You can have oral sedation, which means taking a tablet about an hour before surgery. Or you can have intravenous sedation, which is administered straight into the bloodstream through the back of your hand. The latter can be controlled as we go through surgery.

Afterwards the sedation wears off quickly, but you will need someone to make sure you get home safely.

Look what we can do with dental implants these days

Although dental implants have now been around for more than 30 years, they are still the latest generation of tooth replacements available and dental researchers continue to experiment with them and find ways to make them do more and be available to more people. At David Madruga, we use advanced dental implant technology in Marylebone to make dental implants work for people who have been told by other dentists that they can’t have dental implants.

Advanced Dental Implant Technology in MaryleboneHow is your jawbone?

The success of dental implants depends very much on the state of your jawbone. Dental implants are a bit like rawl plugs in walls. They need something dense and solid to grip onto if they are going to give you the stability you need to chew with. Stick a rawl plug in a plasterboard wall and you won’t be able to hang a heavy mirror on it. Put it into a brick wall and you will. The same goes for jawbones, which can become thin and spongey and no good at all for supporting dental implants. But we have ways round that.

Guided bone regeneration and bone grafting

These are ways to rebuild lost bone tissue. We can insert new bone tissue, either from somewhere else in your body or another source, into the jawbone. It needs some time to integrate with your existing bone tissue. This gives you back the shape of your jaw as well as something to anchor dental implants into.

Plasma rich in growth factors (PRGF)

This is when we use some of your blood to create a liquid that will help you heal more quickly. We take some of your blood, spin it in a centrifuge and fractioning process to create PRGF. We will use the PRGF either as a liquid, or as a gel or a membrane around your implant so that the integration process can happen more quickly and effectively. This is a great treatment if healing might be a problem for you, such as if you have diabetes or bone loss. It is also a natural antibiotic and a painkiller, so the post-operative period is easier to go through.

We can make it easier for nervous patients in Marylebone

It’s no fun being scared of things that other people have no problem with at all. Thunderstorms, for example. Some people find them exhilarating, others are hiding behind the sofa with the dog. Spiders, too. One person can pick them up and put them outside while their friend is whimpering with terror of this thing with 8 hairy legs and a desire to terrify. Dentists too. Your friend sails in to get their check-ups, doesn’t think twice about local anaesthetics and fillings. You though. Well, you’ve lost count of the number of appointments you’ve missed because when it came down to it, you were just too scared to go.

Nervous Patients in MaryleboneWas it because your mum was scared of the dentist too? Was it because she never took you when you were young so the first time you went you had to have loads of fillings and they didn’t even offer you a local anaesthetic? Was it the noise of the drill? You can’t quite remember. You just know that all your life, you’ve been lucky to make it to one check-up every 5 years, let alone twice a year. And every time you go, there’s always a long list of work that needs to be done. In fact, it gets longer every time and last time, they were talking about root canals and extractions, maybe even dental implants, if you wanted to get out of the vicious cycle you are in with your teeth.

Because that’s the thing with being scared of the dentist. You don’t go, and you don’t go and you don’t go, and when you do, decay and gum disease have made things so much worse than if you’d gone for regular check-ups in the first place. It’s such a horrible situation to be in.

But here at David Madruga, we know all about dental phobia. It is real. It affects about 13% of the population and you are not alone. When you come to us for help, we will be able to take you through the whole treatment process with a great deal of compassion, zero judgment on the state of your teeth and sedation so that you can finally relax.

What makes a great smile?

Do you know what you would like to have done to give yourself that great smile you have wanted for such a long time? Or do you look in the mirror, smile at yourself, see that there are ways it could look better but not know exactly? If you are unsure as to how you should go about getting a smile that works for you, then you probably need to have a full smile makeover.

There are 2 ways to go about cosmetic dentistry. One is to have bits done piecemeal as and when the need arises. The other is to have a full smile makeover in Marylebone and make a project out of getting that great smile.

Full Smile Makeover in MaryleboneIt starts with a consultation

When you come to David Madruga in Marylebone for a full smile makeover, we start off with an in-depth consultation. David will want to find out all about your dental aspirations and your history, if you are not already a patient with us. Then David will carry out an thorough examination, taking into account your teeth, gums, lips and face, all of which have to be in balance for a really great smile to come through. We can even make mock ups so that you can see how your smile is going to look after treatment.

He will then discuss treatment options with you and agree on a schedule, which will be submitted to you in writing, along with costs, for your approval.

The treatments

Typical treatments include whitening, realignment, gum sculpting, cosmetic bonding and veneers, dental implants and facial aesthetics.

It is not possible to say here how long it takes to have a full smile makeover as some treatments can take a long time to complete. For example, getting your teeth realigned can take a year or so (sometimes a lot less), and dental implants can take several months. Some treatments, such as teeth whitening, can be carried out in little more than an hour.

What you need and in what order can only be ascertained with a consultation, so why not book one now and find out how David can take you on a journey you will always be grateful you embarked on.

So fast these days

Dental implants may have been around for more than 30 years but the innovations keep on coming, and we love sharing them with you at David Madruga in Marylebone.

Immediate Placement for Dental ImplantsOne of the biggest frustrations with having dental implants fitted has always been having to wait so long between appointments for healing to happen. In the past, it took about six months between having your dental implants fitted and getting the porcelain crowns put on. This was so that the implants could have plenty of time to integrate with the jawbone, and the time it takes for the two to integrate is still vital to the success of dental implants. Things could take even longer if teeth had to be removed first, which meant more healing time.

However, for many people, especially super-busy Londoners and people who work abroad a lot, having to have several appointments before the process was finished could make life very complicated.

Now it is possible to have immediate placement for dental implants. This means that if you do need have to failing teeth extracted before replacing them with dental implants, we can do that first and then follow up immediately with inserting your dental implants. We can even put on your crown straightaway, so that you walk out with your new tooth already in place. That can save you 6–9 months of healing time.

You still have to heal

Don’t be fooled though. You still need to allow your implants to heal into your jawbone. This means being very careful and starting off on liquid foods for a good week before progressing to soft foods and then slowly, over time, introducing more challenging foods.

You may perhaps also be able to take advantage of our technique that uses protein rich in growth factors (PRGF) spun out from your blood to speed up the healing time. Ask us if this is possible.

So many ways to use dental implants

Dental implants can be used to replace any number of teeth from a single knocked-out tooth to a whole arch. One implant can support up to three teeth, and we have great techniques for whole arch replacement that reduce the number of implants required.

Why wait? Same day teeth in Marylebone

Life moves at quite a pace these days. Once you make the decision to do something, it’s possible to follow it up and achieve it quickly with the abundant resources in the world. Why should tooth replacement be any different? Under the right circumstances, it doesn’t need to be. At David Madruga, we can offer a same-day teeth service to many of our patients.

Same Day Teeth MaryleboneThe process of getting dental implants usually involves a consultation followed by any preparatory work. Next comes the fitting of the implants and teeth are added later. In the meantime, someone often has to do without teeth or they have cosmetic stand-ins only. With same-day teeth, prosthetics can be added straight away, which eliminates the need for a second appointment to fit them. This creates a very satisfying, immediately beneficial dental treatment.

How are teeth added to dental implants?

There are three forms that prosthetic teeth come in when they are added to dental implants:

  • Crown – this is for single tooth replacement. It may be that you only need one tooth replaced or you may have one tooth that is not adjacent to any others. A crown can be used in either of these cases;
  • Bridge – where two or more teeth that are next to each other are missing, a bridge can be used to replace them without the need for a dental implant per tooth. A single dental implant, with the right anchorage, can support multiple teeth;
  • Denture – a denture is usually used to replace an entire arch. It can be supported on about four implants, but the exact number depends on the circumstances and environment.

When you have dental implants with David Madruga, we discuss all of these options with you and talk to you about eligibility for same-day teeth. We adapt standard treatment procedures to suit your circumstances so that you end up with a uniquely tailored treatment plan that takes advantage of as many modern and efficient techniques as possible. We know that the easier and quicker your dental treatment is, the more likely you are to go ahead with it. Quicker treatment also means less disruption to your life so that you can enjoy only the positive benefits of your treatment.

Dental implants maintenance in Marylebone

If you have had your teeth replaced with dental implants from David Madruga – congratulations! You now have new teeth to enjoy. Once the healing phase is complete, you should experience all the functionality and aesthetics of a natural smile. All you need to do now is make sure that you take steps to maintain your dental implants according to instructions from a member of our team.

Dental Implants Maintenance in MaryleboneCheck-ups

Directly after treatment, you will have frequent check-ups to ensure that healing is taking place as planned. Once this period is over, you simply need to visit the dentist for your regular check-ups and if you ever have any issues. We keep a close eye on your dental implants, as well as any remaining teeth, to ensure a continued state of health.


When you visit David Madruga for your dental implant maintenance, we may also offer you a clean and polish. This is to remove any plaque or tartar which has built up on your teeth. Even though your prosthetic teeth will not decay like natural teeth, debris can still accumulate and this puts your gums at risk.


As long as your mouth is healthy and there are no other unexpected issues, your dental implants should last a long time. This means a lifetime in some cases. However, the attached teeth may need replacing from time to time. How often depends on where they are in your mouth as different areas experience varied forces during chewing. There is also some variation in longevity depending on the type of material your replacement teeth are made from.

Dental implant maintenance is simple and non-invasive. Your dentist can give you more details on repairs and restorations as they become necessary.

At home

All that being said, the most important care for your dental implants takes place at home. Your dentist at David Madruga is there to support your efforts. We can give you advice about the best techniques to use, how to adapt your normal dental hygiene routine and what you should expect to see and feel as you get used to your dental implants. You need to take note of all this information and follow it to the letter for best results.