Are you missing something?

If you have lost all or some of your natural teeth, chances are you will be feeling that not just your teeth are missing.Despite medical advancements in tooth care, tooth loss remains a prevalent problem in the UK – mostly due to tooth decay, gum disease or injury.

dental-implant-process-in-MaryleboneTooth loss can cause a ‘sunken’ look to the face and can also cause problems with eating and drinking. Tooth loss also often affects speech.

Until recent years, the only treatment available was dentures or bridges, but technological advances now mean that you can now take advantage of the dentalimplant process in Marylebone.

The dental implant process in Marylebone

At David Madruga, Marylebone, the dental implant process always begins with a consultation with one of our dental professionals. At the initial consultation, we will assess the feasibility of providing implant treatment and discuss the treatment options available. Digital x-rays may be required and models of your teeth created. A written plan would then be produced, detailing the sequence of treatment and associated costs. We will then discuss the proposed plan with you before starting treatment.

The implant

A simple minor surgical procedure for placement of the dental implants is then carried out. This treatment can be carried out under sedation to make the process even more comfortable. If after the initial assessment, the underlying bone is judged to be deficient, several options are available for bone regeneration. This may be carried out prior to, or at the same time as,the dental implant process in Marylebone.


We suggest that a period of three to six months be allowed for the implant to fully integrate and fuse to the surrounding jawbone before completing the dental implant process in Marylebone. The patient’s own denture, or in some cases a simple adhesive bridge, can be worn during this healing phase, which is called osseointegration. This process is fundamental to the longevity of your dental implants.

After the osseointegration has occurred, you are then ready for an abutment to be placed. This holds your crown or bridge in place on your dental implant. When this is done, you will be ready to show off your dazzling new smile, created by David Madruga and enjoyed by you.

Offering new solutions for nervous patients

If you are one of the many nervous patients in Marylebone or around the country, it is good to know you have options when you come for dental treatment at David Madruga. The longer you put off any dental treatment generally the worse it gets and the more eventual work you will need. If you can visit a dentist that can give you options when it comes to your levels of awareness during treatment and shows genuine understanding of you concerns, then you are much more likely to see someone sooner.

nervous-patients-in-MaryleboneWhat is on offer for nervous patients in Marylebone?

Traditionally, dental treatments that involve discomfort are offered under local or general anaesthetic. These practices are designed to stop you feeling pain, but the former does not take the edge off of your experience, and the latter can mean a visit to hospital for treatment. This may seem like an extreme option if you do not need to have it.

At David Madruga, we offer conscious sedation. This is where you can have a local anaesthetic for the treatment site but we also offer you a level of sedation designed to decrease your general awareness of the sights, sounds and sensations of treatment alongside this. You will not be aware of what is going on and will likely remember nothing but you are actually awake during treatment.

Sedation is offered to nervous patients in Marylebone at our clinic though IV or orally. Your dentist will go through the whole process with you in detail and will also take a medical history from you to ensure you are a suitable candidate for conscious sedation.

At David Madruga, we have experience working with people from all over the country and we create a relaxed and professional atmosphere in which you can feel safe. We believe that, the more positive experiences you have at the dentist, the more overall relief you will get from any fear or phobia and so the more likely you are to visit for check-ups and to get the treatment you need. We look forward to working with you to give you the support you need at the dentist.

I am scared to go to a dentist!

Come and visit Dr David Madruga in Devonshire Place. We understand that the number of adults who hold a genuine fear of visiting the dentist is high. The statistics from the NHS, state that as much as one in four adults have such a fear of dentist, which consequently stops them visiting a dentist. Nervous patients in Marylebone can be assured that we are here to offer you a compassionate experience. Is it the pain that puts you off? Or perhaps the noise and smells of a dental practice? Well, we can inform you that with advances in dentistry, the tools used are quieter than they used to be. We also offer a range of pain relief including gum numbing gel and conscious sedation.

nervous-dental-patientsWhen did you last go to the dentist?

It is a good idea to have regular check-ups with a dentist to ensure you are caring for your teeth properly. Do you work or live near Marylebone? Nervous patients are relieved when they find our dental surgery, conveniently situated just a ten-minute stroll from Baker Street Tube Station. Did you know that it is recommended to visit the dentist once a year? This is, if you do not have any risk of gum disease or cavities. For some, it is essential for more frequent visits to occur. We understand, that due to the number of nervous patients in Marylebone, that there will be adults walking around with teeth that have not been seen by a dentist in many years. Is this you? Feel no shame if so, it is more common than you think and it could be that you have no oral problems. Wouldn’t it be good to put your mind at rest though? We can book you in for an appointment here at our practice. If it helps, why not come and visit us to get a feel for the place and see if you would feel safe having your first check-up here. Be assured, that a check-up will not involve any pain or tricky work being done. We will advise you if a follow-up appointment is needed.

Full Smile Makeover

Are you unhappy with or embarrassed about your smile, but uncertain what exactly you’d like to change, or unsure what cosmetic dental treatment would be the best option? Then you may benefit from a smile makeover with Dr Madruga and his team of experienced cosmetic dentist.

smile makeoverOur smile is the first thing many people notice about us. It’s not uncommon to be embarrassed about your smile, hiding it away in public. Cosmetic dental treatment can restore your confidence in the appearance of your smile, boosting your self-esteem and improving your personal and professional interactions.

When you come to see us for a smile makeover consultation, we will first assess your current smile, then recommend the best treatments to improve it. If there is a particular issue you are concerned about – a discoloured tooth, perhaps, or gaps between your teeth – please let us know. All of our treatment is tailored to suit your individual concerns, wants and needs.

We’ll undertake a full examination of your teeth, gums and surrounding structures, taking into account your whole face to ensure that any treatment we recommend looks totally natural.

After ascertaining what you would like to change, we will us photographs, wax models and mock-ups to show you what results you will get from a variety of treatment options. For some treatments, such as invisible orthodontics with Invisalign, we can also use computer animation. That way, you can be sure that you have all the information you need to make choices about treatment.

We offer a wide range of cosmetic dental treatments. Sometimes, you will need just one treatment; in other cases you will require a combination of two or more treatments.

Options include:

  • Teeth whitening
  • Veneers
  • Crowns
  • Gum reshaping
  • Invisible orthodontics

Whatever treatment you require, we will work with you to help you achieve the smile of your dreams.

Immediate Placement

If you lose a tooth or have to have one removed because of injury, accident or decay, the chances are you will want to replace it sooner rather than later. Particularly if the tooth concerned is near the front of your mouth, you may be left self-conscious about smiling if you have to live with a gap for any length of time.

immediate placementThere are also several health benefits for replacing a lost tooth with a dental implant as soon as possible. When teeth are lost, the bone beneath the gaps will resorb or shrink back over time, which can cause a sunken appearance to the face and can make the placement of implants more complicated – requiring a bone graft or sinus lift – in the long term.

Thanks to advances in dental implant techniques and technology, it is now often possible to place a dental implant at the same appointment as having a failing or broken tooth removed.

In some cases it is even possible to place both implants and restorations (new teeth) on the same day as having a tooth or teeth extracted. This is known as immediate loading, and systems such as Same Day Teeth are a popular choice for suitable patients, reducing both time spent in the surgery and overall expenses.

This can be particularly beneficial to patients who have lost a tooth though, for example, a sports injury sustained through not wearing a mouthguard, an accident or a failed root canal treatment. It will not be suitable for every patient, and some people will benefit from the healing time of conventional implants (between six and nine months) during which time the implant integrates fully with the bone to provide a strong base for your restorations.

If you opt for immediate placement, here’s how it will work:

  • Your dentist will remove your failing or broken tooth/teeth under local anaesthetic or sedation
  • Your dental implant(s) will then be placed, again under local anaesthetic or sedation
  • If you are suitable for immediate loading, your restorations will be placed immediately; alternatively, you may be given temporary restorations whilst healing takes place
  • You will be provided with full aftercare advice and any follow-up appointments to help ensure your implants’ success

Same Day Teeth

Just imagine walking into the dental practice in the morning with missing or failing teeth, and walking out the same day with a brand new set of teeth that look and act like their natural counterparts. Sounds too good to be true? Thanks to Same Day Teeth, this fantasy is becoming a reality for increasing numbers of dental implant patients.

same day teethStandard dental implants usually require a series of appointments spread out over a number of weeks or months while healing occurs. During this time the implants integrate with the jawbone to provide firm anchorage for your final replacement teeth – crowns, bridges or dentures.

With Same Day Teeth, the final restorations (replacement/false teeth) are placed on the same day as your dental implants, meaning you walk out of the practice the very same day with a brand new smile that you’ll want to show off. Same Day Teeth is not suitable for all cases, so we’ll discuss your suitability for this treatment at your initial implant consultation.

Same Day Teeth are non-removable, meaning they are fixed in place and provide the full functionality of natural teeth. The result is a beautiful, natural looking, natural-acting smile.

The good news is that you will not need an implant for every replacement tooth. In most cases we use four or six implants – depending on how much bone you have – and attach a fixed provisional bridge comprising several teeth.

Our expert team carefully position and angle the implants so that nerves and other important anatomic structures are avoided, while the forces created by biting and chewing food are evenly distributed across the implants, ensuring no one area comes under excessive strain.

Same Day Teeth have been proven to have a 98% success rate after five years in one arch of the mouth. With proper care, they are an excellent option for many patients with missing teeth.

Maintenance (Implants)

Dental implants have a very high success rate (up to 98%). The implants and their restorations look and act just like natural teeth – and just like natural teeth, they require good oral healthcare to increase the chances of success, and to keep them in good condition.

ImplantsIf you have lost one or more teeth once you won’t want it to happen again, which is why it is important to follow your dentist’s aftercare instructions carefully. Looking after your implants properly requires teamwork between your dentist, your hygienist and yourself with a strong home care routine.

Your implants will require regular maintenance appointments, just like your teeth require regular dental appointments to keep them healthy and to spot any potential problems as early as possible. You will be provided with full aftercare instructions once your implants have been fitted, and so long as you follow these carefully, your implants are unlikely to fail.

However, should this start to happen, spotting it early is the best way to avoid further complications. Early signs of failure will be identified with regular dental examinations and x-rays to monitor how well the implant is integrating with the bone. You may need to come for a check-up more frequently than the standard six months recommended for regular dental examinations, and you should always follow this advice to increase the chances of your implants succeeding. If anything unusual is spotted we are usually able to correct it with minor remedial treatment.

As well as attending regular follow-up appointments with your dentist, you should also make regular visits to the hygienist. The implant-restored teeth are no more difficult to clean than natural teeth, but there may still be areas that are difficult to reach. Your hygienist can help you clean these difficult areas, and will recommend the best products and techniques to use at home to maximise the chances of your implants’ success.

Sinus Lift

If you have been missing teeth in your upper jaw for some time, you may have been told you are not suitable for dental implants because you don’t have enough bone volume. The good news is that this may not be the full story. In many cases it is possible to have dental implants in your top jaw even if you have experienced bone loss – you will just need a procedure called a sinus lift first.

sinus liftBone loss is a common side effect of losing teeth, because over time the bone beneath any gaps starts to resorb. In the upper jaw, it is common for the maxillary sinus spaces – above the upper jaw – to increase in size, reducing the height and density of the bone and making it hard to place dental implants. A sinus lift helps to build this bone up again, increasing the chances of a successful dental implant procedure.

Dr Madruga is highly experienced in performing sinus lifts, helping patients to get their confidence back in their smile. He accepts referrals from other dentists whose patients would benefit from this procedure, so if your dentist has told you you are not suitable for dental implants in your top jaw because of lack of bone volume, please ask to be referred to Dr Madruga for a consultation.

What is a sinus lift?

A sinus lift is an oral surgical procedure that extends into the sinus cavity above the jaw. It involves repositioning the lining of the sinus, making it higher so that bone graft material can then be packed into the space.

The graft material may be made from organic or synthetic compounds, or in some cases will use bone from another part of your body (most commonly the chin or the posterior part of the lower jaw). This material bonds with the surrounding tissue, forming a solid structure very similar to bone. After a healing period, the bone density will be checked and when it has reached adequate levels, your dental implants can be placed.

Treatment with dental implants if you have low bone density

Dental implants are an excellent option for patients with missing teeth. At our Marylebone dental practice, implant dentist Dr David Madruga Gonzalez can replace one, some, or all of your missing teeth using implants – even if you have already experienced some bone loss.

dental implantsYour own dentist may have told you that they cannot place dental implants because you lack bone density. Bone loss is a very common side-effect of losing your teeth, which happens because without the tooth roots in place the jaw bone is likely to start to resorb (shrink back). Whilst this can make implant surgery more complex, by no means is it impossible.

Dr Madruga Gonzalez accepts referrals of complex implant cases at his Marylebone clinic. Using the latest technology, he will first assess the level of bone density in the relevant jaw, before drawing up a customised treatment plan.

Bone grafts and sinus lifts

Bone grafts and sinus lifts are two procedures that are used to rebuild the density of the bone in the lower or upper jaw prior to the placement of dental implants. Dr Madruga Gonzalez has carried out many such procedures successfully here at our Marylebone dental practice.

Bone graft material may be your own bone from another site in your mouth, or may be a bone substitute biomaterial – which may be of animal or synthetic origin. This procedure is usually used in the lower jaw, whilst a sinus lift involves lifting the sinus cavity and packing the space with bone graft material.

These procedures are carried out under sedation at our Marylebone clinic. In some cases, dental implants may be placed at the same time, whilst in other cases, a healing period is required, after which your implants will be placed in a standard, minor surgical procedure.

Nervous Patient Testimonials

Fear of the dentist is the main reason patients put off seeking treatment. It can be crippling, and can prevent you getting the help you need when a problem arises, as well as stopping you from preventing those problems arising in the first place.

nervous-patientsOur entire team is committed to treating nervous patients with care, respect and dignity. We will always listen to your concerns and take them seriously, and won’t be judgemental if your dental health is less than perfect because you’ve been afraid to seek treatment for many years.

We offer treatment under conscious sedation, which has helped many of our patients get the treatment they want or need. Don’t just take our word for it, though. Here is what some of our patients have to say. . .

“I am writing to highly recommend David. I first made contact in 2013 after not seeing a dentist for some years, due to being truly terrified. I remember standing in the reception area, sweating, shaking and trying not to cry but from that very first moment I was treated with kindness and reassurance.

“As I had a number of teeth missing, and quite a few loose I was put into the care of David Madruga Gonzalez, a truly magnificent implant surgeon. With ultimate patience, and a brilliant, easy to understand treatment plan (so I knew the exact procedures and cost), I now have brilliant strong teeth and a vastly improved quality of life.” – Sheila Webley.

“Just dropping a line to thank you for the sensitive help received during my last treatment.

“It is devastating to have problems with your front teeth and I appreciated the way you explained the options open to me. Having everything explained in detail helps to take away the anxiety and to decide on the appropriate way forward. It seemed to take forever waiting for the healing process between treatments but the end result is great!

“I can now smile again with confidence and it cannot be understated how this gives me back my ease of mind.” – Janis Pidgeon.