Dental Blog David Madruga Gonzalez -

A second opinion on dental implants

When people lose their teeth, they can replace them with fixed bridgework, full or partial dentures and dental implants. Dental implants have become the option that most people choose first.

Dental Implants in Marylebone This is because they give better chewing power without compromising any other remaining teeth. They will never slip or slide in the mouth and people can relax, knowing that their replacement teeth will look and behave exactly as their natural teeth did.

However, sometimes patients are told that they cannot have dental implants because their jawbone has deteriorated and will not be able to grip onto the implants firmly enough. Jawbones deteriorate after tooth loss because they no longer receive impact signals when the teeth from upper and lower jaws meet together. These impact signals indicate that they are still in use and without them, the bone starts to resorb, quickly becoming smaller and less dense.

If you have been told you cannot have dental implants, it is worth coming to David Madruga in Marylebone for a second opinion. David has been fitting people with dental implants for many years and is skilled in using the various techniques that enhance jawbones to accept dental implants.

One of these is sinus lifts. Let’s take a look at it in more detail.

Sinus lifts

When the teeth have been missing from your upper back jaw for some length of time, the sinus cavity in the bone gets bigger and there is less bone below it to make a channel to hold a dental implant. If the dentist put one in, the end of it would be wiggling around in thin air. It would not be able to withstand the forces created by chewing, which, on the average male can be as much as 220lbs or 97kg.

At David Madruga, we can solve this by gently pushing up sinus cavity lining and then putting bone graft material into the space created between the bone and the sinus cavity lining. The bone graft can be taken from elsewhere in your body, or from an animal source.

After several weeks of integration, you can then get your implants put in.

Why not give us a call to find out more?

Relax, you’re at the dentist

Being scared of going to the dentist can have consequences for your oral health. If you put off going to the dentist because you are scared of the pain, the noise, the needles, then you could be going about not having to experience these things the wrong way.

Nervous Patients in Marylebone The best way to avoid having to have any dental treatment is to turn up to twice-yearly check-ups and make sure you also get your twice-yearly deep cleans with the hygienist.

That’s great advice if you have not already been putting off going for a check-up for some time, in which case it’s not much help at all.

What might help however, is to know that at David Madruga in Marylebone, we are very experienced in dealing with nervous patients and do all in our power to make your experience with us as relaxing as possible.

When you come to see us, you will find yourself in a friendly, calm environment where the staff will take care of you.

If you have never been to us before, it can help to pop in and meet us for a chat before having any treatment so that you can get used to being here. Next time you come, it won’t seem so daunting.

We will always take the time to discuss your treatment with you so that you understand what is going to happen and are satisfied that all your questions have been answered.

If, at any time, you need to stop your treatment to take a break, that is fine. You just need to let us know that you need a breather.

If you want, you can also have conscious sedation, which is a way to deeply relax you without giving you a general anaesthetic. You can have either oral or intravenous sedation.

Oral sedation is a tablet that you take about an hour before your appointment. It will wear off pretty quickly after your treatment is over.

Intravenous sedation goes straight into your bloodstream and is more immediate. You might be groggy for a while after treatment.

Both forms will relax you really deeply, but you will still be able to answer questions if we need to talk to you.

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 Marylebone But 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:

Loss 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.

The 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.

Osseointegration

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.

Maintenance

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 Marylebone Well, 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.

How 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 Marylebone Was 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.

It 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 Implants One 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.