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.

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.