It's been a while since our last Case of the Month! Something called Corona Virus stopped us from working for a couple of months and we have been working extremely hard since then catching up and sorting out the dental health of Fulham residents and Londoners in general. In fact we have had clients from Yorkshire, Lincolnshire, Dorset and even the USA coming to see us post lockdown.
The case we would like to post to cover the last 5 months since our last one is one that really personifies what we do here at Progressive Dentistry. The treatment involved lingual braces, teeth whitening and teeth bonding. There was no drilling of the teeth, no needles, no pain and all at an affordable price scale.
The initial problems we were faced with included some crowding of both the upper and lower front teeth, quite severe wear and tear and discolouration:
The course of lingual braces lasted just a few months. Being placed on the inside of the teeth, this type of orthodontic appliance is invisible making it unique compared to other teeth straightening systems such as Invisalign, 'train track' braces for example. Teeth whitening with Philips ZOOM LED in chair whitening provided an instantly whiter smile which was followed by a take home kit to really hit the optimum level of brightness.
Teeth bonding completed the treatment which is where the worn areas are re layered and built back up using composite resin such as Empress Direct The change is dramatic as can be seen below:
Wow! A great new smile within just a few months using minimally invasive dentistry.
If you would like to transform your smile post lockdown, there is no better time. We have improved our practice to offer a safe environment for treatment and measures have been implemented that reduce risks for staff and patients alike.
Why not arrange your free video consultation from the comfort of your own home. Appointments are available 7 days a week with Dr Nissit Patel, our Clinical Director. Welcome to the new norm!
Dental implants can be a costly procedure. During this article I will explain why dental implants cost what they do and how the prices vary so much. I will not dwell on the technical aspects of dental implant treatment but simply concentrate on costs with an emphasis on a single dental implant treatment.
Firstly, it is important to recognise that dental implant treatment cannot be offered by any dentist on the high street. It takes a great deal of time to train in the implant field. Although there is no recognised speciality of dental implants, it is nonetheless a highly technical aspect of dentistry and one that must be respected. In the past, one could take a weekend course and start placing implants the following Monday. This is no longer the case.
Typically, at least a one-year course is required for training which will involve taking time away from the practice and hence add a greater cost with the subsequent loss of earnings. Most dentists are self-employed and must fund training themselves. A well-known Implant Diploma course run by the Faculty of General Dental Practitioners FGDP costs in excess of £23000. https://www.fgdp.org.uk/courses-implant-dentistry
Apart from training, the other essential requirement is the equipment. Implant dentistry requires a vast array of surgical equipment, specialised motors, handpieces, sterile covers, dedicated drill sets and insertion tools. Every implant company will have their own surgical drill set and restorative components. A typical set up cost for all the above will be in the region of £10,000 to £15,000.
Let us not forget the cost of the dental implant. There are literally hundreds of dental implant systems now available and the costs do vary per company. For the case of simplicity, the main implant companies tend to have similar pricing for their implants. Typically, the cost of one implant will be £250-300 which includes a cover screw. In most cases, healing abutments are not provided with the implant. Healing abutments will generally be used with most simple implant cases. The cost of a typical healing abutment is between £60-80.
PLANNING AND TIME COSTS
I would say a typical case would take 1 hour of planning, but this could be more for a more complex case. Most cases are planned digitally these days using cone beam CT scans or CBCT. We have invested in our own CBCT machine so that scans can be taken immediately. These machines are not cheap and cost the same as a new BMW M3 or M5 depending on the specification. Now there is also the cost of set up, CEAT certification, RPA fees and costs of training to be able to take the scans themselves and report on them. The set-up fees for us were approximately £1800 and the annual maintenance fees will be around £1000. I myself went on a dedicated training course which cost £1000 and 2 days away from clinical practice.
Previously we would refer our scans to Cavendish Imaging in Harley Street,https://www.cavendishimaging.com/ . The scan fees are be between £100-150 and if a specialist report is needed, there is a fee of between £85-105. However, the cost is worth it in our opinion. The amount of information with a 3-D CBCT scan is invaluable and we now cannot work without such knowledge prior to implant treatment.
Although most simple cases can be planned on free software such as I CAT vision, Blue Sky Plan or Morita One Volume viewer, it is becoming more common place for dedicated planning software to be used. Implant Studio by 3 Shape and Nobel Clinician by Noble Biocare are examples. This software is not free and there are yearly licence fees. Implant Studio costs between £2800-3500.
The use of surgical stents in the field of implant dentistry is now becoming common place. Once a case has been planned digitally, we can print surgical guides to accurately relay that information in the mouth to ensure the correct position and angulation. Digital prints will be between £200-300 with traditional analogue models and guides only a little less.
Just remember, a dental practice is like any other business. There are running costs every hour of day regardless of whether the practice is open or closed. This will involve the usual costs of rent, rates, staff, utilities, insurance, indemnity fees and materials for example. Every business will have their own running costs and hourly rates which will equate to how much time is allocated to each treatment.
We will generally block a two- or three-hour window for an implant case. We need at least 30 minutes setting the surgery ready, 1-2 hours for the surgery and another 30-45 minutes cleaning up and sterilising all the equipment. This is a long time and essentially will take up most of a morning or afternoon session. For one single implant this is not cost effective, but we take the same measures for one or several dental implants.
To restore a dental implant, we need to replicate the position of the implant. For this we take either a digital impression or a conventional impression. A special impression coping or digital scan body is required for this with the typical cost of these between £70-90.
The other required components and costs are:
Implant replica £30-50
Custom made abutment £180-250 OR
Stock abutment £60-100
Of course, the whole point of undergoing an implant treatment is to replace the tooth. So the final cost will be the laboratory fee to make the dental implant crown. This will either be cement retained on an abutment (stock or custom made) or screw retained where the crown seats directly into the implant, again with the lab using a custom abutment or stock abutment. The typical laboratory fee for the crown is in the region of £250-350.
Let us do a little round up purely of costs to us the dentist, forgetting all of the training, set up, sundries and maintenance costs involved in providing dental implant treatment for a single tooth replacement.
Surgical planning and guide £300
Dental Implant £250
Healing abutment £60
Custom abutment £250
Screw retained implant crown laboratory fee £300
The time frames involved are:
Planning 1 hour
Surgery 2 hours
Review appointment 15 minutes
First stage uncovering if required 30 mins
Impression/ scan stage 1 hour
Fitting of final crown 45 mins
Total time 5 hours 30 minutes
Our Fee to you
As a member, our fee for a simple dental implant without bone grafting is £2040. Does this now seem quite reasonable?
Would you now think again when seeing an advert on Google for an implant all-inclusive at £999? Certainly food for thought. Visit our dental implants page for further information.
We are delighted to say that from the 8th June we have opened our dental practice after a huge amount of work behind the scenes to keep our staff and patients safe. We have made a major investment in our business including:
Newly painted exterior and signage. No more black!
New flooring internally with a lovely white oak effect vinyl which can be steam cleaned
PPE for all staff including custom made washable gowns, masks, caps, half face respirator masks by 3M and full face visors
Virus Killer air filtration units (due to 2 weeks) using 5 types of filter and UVC lamps to destroy bacteria and viruses. www.radic8.com
Infra red hand sanitizer station on our bar in reception
Reception screening with custom made perspex barriers
What to expect at your next visit
Covid 19 has changed everyday life as we know it. We have had to follow various regulations, operating procedures and risk assessments. These include:
A text message will be sent to you for pre screening. Please click the link and in fill in the questionnaire. Your answers will be remotely sent back to us. There is no need to sign anything.
Temperature check on arrival using a contact free thermometer
You will be asked to use a pre treatment hand sanitizer
You will be asked to wear gloves, shoe covers, a mask and gloves
Please refrain from touching anything
Toilet area will be out of bounds. Please go before you see us!
Pre treatment mouth rinse Post treatment mouth rinse
Post treatment hand sanitizer
Contact free payments are preferred or remote payment by BACS or over the telephone.
Please report any signs of Covid 19 up to 14 days after your visit to us
Behind the scenes
Before and after your appointment, we will be working hard cleaning and disinfecting the surgeries. We have adopted a longer time frame for cleaning including spraying and cleaning the usual surfaces and extra areas such as desks, chairs, surfaces, door handles, keyboards and floor. Therefore it is even more important to be on time for your appointment. Please do not be early as we would like to keep the waiting area as free as possible but on the flip side, do not be late! This is even worse and will have a knock on effect for the rest of the day.
We appreciate your patience at this time
These measures mean it is impossible to see as many patients in a day as before. We will usually only have one clinician working per day to minimise staff and patient numbers at any one time. We know this is not ideal and hope that the measures will relax in the next few weeks. Please be patient with us, however, if you do have an emergency we will do everything we can to see you on the same day.
New opening times
Our new opening times are:
Monday to Friday 0900-1700
Video consultations are still available 7 days a week with Dr Nissit Patel.
We will extend our opening times as soon as it is safe to do so and when we have a full complement of staff.
New patient examination £95
Emergency visit £95
Routine examination £60
Routine hygiene maintenance 45 mins £120
Routine hygiene maintenance 30 mins £80
We look forward to seeing you at Progressive Dentistry
t 0207 7311162
WhatsApp +44 7508 663942