Often people ask me, why are dental implants so expensive? The question itself is flawed, how expensive is relative to each individual person and their individual values. For instance, a 70 foot Sunseeker motor yacht is an enormously expensive item to the normal man on the street, but merely pocket money to a Russian oligarch. However, I have long ago stopped trying to guess whether my patients are wealthy. Some wealthy people have appalling teeth and other people with quite modest incomes have an amazing amount of work done on the teeth, and this course is down to whether that individual values dental health or not.
I used to know a dentist many years ago, who would set his fees by trying to guess how much income the particular person in front of him might have. I was taught a salutary lesson some years ago when an old man, probably in his mid-70s came to my surgery wanting a new set of dentures. He really looked a state his trousers were held up with baler twine and his jacket was literally falling off his body. I took pity on him and constructed a new set of dentures, free of charge, which made me feel good inside for precisely two weeks, when walking up the High Street with a friend. We saw this gentleman on the other side of the road. My friend then informed me this particular gentleman owned a £10 million house in the foothills of Buckinghamshire, and was undoubtedly one of the richest people in the area! I gave up trying to judge people at that point, and went over to a fixed price list based on how much time a procedure would take, and how many bits I may have to buy in order to complete the work. I use this formula to this day.
Dental implants are undoubtedly difficult to do well, and I have spent the last 28 years of my professional career trying to hone my skills to perfection, I would add, I still have things to learn, but don’t we all. The first thing that we have to do when planning an implant, is to look carefully at the whole mouth, not just the missing tooth, a holistic approach (although I hate the word) is necessary as there may be other things more important that require attention before replacing the missing tooth. We also gather information from the patient in order to make our decisions such as photographs, models and mouth, thorough examination and x-rays; further, our technicians become involved by making us models, perhaps producing a mock-up of the potential restoration and of course we may require more detailed knowledge of the bone volume with a CBCT scan, all of these items costs considerable amounts of money, and that is before we even start work on a patient. Having planned the implant restoration, it is necessary to write a written treatment plan and discuss this with the patient. This again takes a lot of time and effort, on average, for me, a simple case takes approximately an hour to plan, and a difficult case may take up to 20 hours of my time just to plan. These days it is sometimes easier (or maybe more difficult!) to plan this virtually in a computer.
Having gained the patient’s consent, we may then go to surgery to place the implant, here we require multiple sterile goods, and a dedicated specialist team of implant nurses and support staff to bring the whole operation together. We also use premium implants, as opposed to some of the cheaper items that are available on the market, which again increases the overall cost. We provide the patient with everything they may require in terms of painkillers, mouthrinses, hotpacks and most importantly, out of hours contact details, so they may feel reassured they are being looked after properly.
Having allowed the implant to heal for sufficient time, we then require more time with the patient to take impressions and then transfer the impressions either physically or electronically to the laboratory, where a whole new team of highly qualified professionals take over for the next stage, clearly, this operation in itself absorbs a great deal of expenditure to produce a beautiful real looking handmade tooth.
The restoration is then returned to the surgery, where I would spend further time trying restoration in ensuring that its fit, bite, colour is perfect, before closing and finalising case. We would then do follow-up appointment, to ensure that the function of the new tooth is perfect, and the patient is happy in every way with the result.
I think you can appreciate from the description that I have given, that dental implants are challenging and that to obtain a great result requires a lot of people, doing a lot of work, all together as a team. Personally, I think dental implants are extremely good value for money as the amount of work and effort skill and art that goes into the restoration, is far less then goes into good jewellery, and that is expensive!