What to expect at your first dental implant consultation

The most common thing patients say at the start of an implant consultation is some version of: "I almost didn't book this." They've been researching online, reading forum posts, watching videos, and the information ranges from useful to alarming. I've been placing implants for over fifteen years, in Johannesburg and now in Stevenage, and I want to tell you exactly what happens when you sit in my chair for the first time. The more you know beforehand, the easier it is to walk through the door.

Before you arrive

If you've had recent dental X-rays taken elsewhere, it's worth bringing them along. Not essential, as we'll take our own, but they can give me useful context: how long the tooth has been missing, what the surrounding bone looked like previously, whether there's any ongoing infection I should know about. If you're on any regular medications, make a note of them. Certain blood thinners and bisphosphonates (used for osteoporosis) are particularly relevant to implant treatment.

Beyond that, you don't need to prepare anything specific. Come as you are.

The first ten minutes: a conversation, not a procedure

Nothing happens to your teeth at the consultation. I'll start by sitting down with you and asking what's brought you in. Which tooth are we talking about? How long has it been missing? Have you had any implant treatment before? Do you have dentures or a bridge in the meantime?

I also ask about your general health. Implants involve a minor surgical procedure and overall health matters. Diabetes that isn't well controlled, heavy smoking, a history of radiotherapy to the jaw, certain autoimmune conditions: these are all things I need to know upfront, because they can affect healing and long-term success. They don't automatically rule out treatment, but they change how I plan it.

I won't rush this part. Patients who feel properly listened to from the start have a better experience all round.

The clinical examination

Once we've talked, I'll examine the gap and the surrounding area. I'm looking at the condition of the adjacent teeth, the health of your gums, your bite, and whether there's any sign of existing gum disease. Healthy gums are a prerequisite for successful implant treatment. An implant placed into a mouth with active, untreated gum disease is an implant at risk. If I find anything that needs addressing first, I'll tell you clearly and explain why.

The CBCT scan

This is where the consultation becomes most useful. We use an Orthophos 3D CBCT scanner, which produces a three-dimensional image of your jaw. A conventional flat X-ray tells me quite a lot, but it can't show me depth. The CBCT shows me the precise height and width of bone available, the exact location of your inferior alveolar nerve (which runs through the lower jaw), sinus proximity in the upper jaw, and whether bone grafting will be needed.

When I was placing implants in South Africa in the early 2000s, we planned cases using two-dimensional X-rays and clinical judgement. CBCT technology has transformed what's possible. I can plan the entire case on-screen: the angle, depth and diameter of the implant, before placing anything. That's better for the patient and it's better dentistry.

The scan takes about thirty seconds. You sit still in front of the machine and the radiation dose is very low. The CBCT is taken once you decide to proceed with treatment, either at the consultation appointment itself or at the next visit, when we also use it to plan the exact position and angle of the implant.

Bone grafting: the honest version

Some patients come hoping to hear that they can have an implant placed immediately, and I have to tell them a bone graft is needed first. This happens, and it's nothing to worry about.

When a tooth is lost, the bone underneath begins to resorb within weeks. After a year or more without a root in that socket, the volume of bone available can be insufficient to hold an implant securely. Whether a graft is needed is determined by the clinical examination and the CBCT scan together. A bone graft rebuilds that volume. At Bowling Green, grafts start from £450. Where the anatomy allows, I carry out the graft and implant placement in the same appointment, which keeps the total treatment time down.

A bone graft does extend the timeline and may add some post-operative discomfort, depending on the site. But the long-term outcome of a well-grafted case is no different from a straightforward one. If a graft is needed, it's needed. There's no shortcut worth taking.

The treatment plan and what happens next

At the end of the consultation, I give you a written treatment plan with itemised costs. A single tooth implant at Bowling Green is £2,300, including the Astra Tech implant, abutment and crown. If bone grafting is indicated, that's listed separately. Nothing should come as a surprise on treatment day.

I use Astra Tech implants, which have one of the most extensive long-term clinical track records in the industry. It's the system I trained on and have used for over fifteen years. I don't use different implant brands to hit a price point.

I don't expect anyone to make a decision at the consultation. Take the plan home. Think about it. Talk it over with your family. If you have follow-up questions, call us or send an email.

Questions worth asking at your consultation

• What implant brand do you use, and why? (My answer: Astra Tech, because of its clinical longevity data and osseointegration surface design.)
• Will I need a bone graft? If so, can it be done at the same appointment as the implant?
• What are the alternatives? A bridge and a partial denture are both valid options and I'll give you the honest pros and cons of each.
• What is the realistic total timeline from today to final crown?
• What happens if the implant fails? Long-term survival rates for Astra Tech implants placed by experienced clinicians are in the 95 to 98% range in the literature, but it's worth understanding the protocol.