Am I too old for implants?

There is no defined upper age limit for implant treatment. The jaw of a patient aged seventy-five can be better suited to it than that of a patient aged sixty. Age on its own tells us nothing; three things do tell us something: the condition of the hard outer layer of the jawbone, your general health and the medicines you take regularly. These are exactly what we look at during the examination.

The jawbone is not one solid block. On the outside, a hard, dense layer wraps around the whole jaw; this is called cortical bone. Inside is a porous, softer tissue. When a tooth is extracted, it is mainly this soft inner tissue that shrinks, because it no longer takes any chewing load. Thanks to its dense structure, the hard outer layer is far more resistant to shrinking; even if the teeth were lost years ago, it largely stays in place. This distinction usually lies behind what older patients mean when they say 'my bone has shrunk'.

A conventional implant sits in the part that shrinks, and it has to wait months for osseointegration with the soft bone around it. If there is not enough bone volume, volume is first added with a graft, then there is a wait for healing, and only then is the implant placed. The whole timeline comes to about a year. When this timeline is explained to a seventy-year-old patient, it often ends with them giving up on treatment, and that decision comes not from their age but from the length of time itself.

A strategic implant does not look for volume in spongy bone. The implant is placed so that it reaches the hard outer layer, at an angle that locks it mechanically into that layer. What provides the anchorage is not months of waiting for osseointegration but this mechanical locking, which is there from the first day. We work without bone graft material, and the final fixed teeth are fitted within three clinical days. For an older patient, what makes this difference important goes beyond comfort: the months that would otherwise be spent without teeth, or with a removable denture, during the waiting period disappear.

The surgery is completed in a single session under local anaesthetic. There is no need for a general anaesthetic or a hospital stay. For patients whose heart, blood pressure or breathing is being monitored, this has a direct meaning: the strain that comes with a general anaesthetic stays out of the plan. You will not feel pain. After the procedure you are up on your feet the same day and go back to your hotel or your home.

This page is about full-mouth treatment and cases with many missing teeth. Most older patients who come to us are already in this situation: either they wear a full denture or only a few teeth are left to hold anything in place. Restoring the whole jaw with a single plan is the most efficient way to use the bone that remains, and it takes the patient through just one surgical process. A piecemeal plan that stretches over months weighs more heavily at this age, both physically and emotionally.

The two lists below become clear after the examination and the CBCT scan. Seeing yourself in the list on the right does not mean the door has closed; some items do not mean 'no' but 'let us sort this out first'.

This sequence is for the decision, not for the treatment. At the end of it, you know what is possible in your jaw and what that is based on.

1. 1

   Send us your X-ray or scan

   If you have a panoramic X-ray or CBCT scan, send it through the form. The images are read by the dentist who will carry out the treatment; the first reply is written by the dentist, not an assistant. There is no need to travel; we get back to you within one working day.

2. 2

   Medication list and test results

   We ask for every medicine you take regularly, with its name and dose. Bone medication, blood thinners (anticoagulants) and steroids directly affect the plan. If you have blood test results from the last three months, we would like to see those too.

3. 3

   3D CBCT scan

   A panoramic X-ray is two-dimensional; it gives an idea of the height of the bone, but not of its thickness or the condition of the hard outer layer. With this method, the decision rests directly on where the cortical layer is, how thick it is and how sound it is. We make no promises without seeing a CBCT scan.

4. 4

   The rest of your mouth

   The health of your gums, the condition of your remaining teeth, any roots that need removing and the bite with the opposing jaw are all part of the plan. A plan built only on bone measurements is an incomplete plan.

5. 5

   What needs to be discussed with your doctor

   If you take a blood thinner, do not stop it on your own. We plan any adjustment before surgery together with the doctor who prescribed it. The same applies to bone medication and steroids.

6. 6

   You receive the plan in writing

   How many implants, in which jaw, with what bridgework and what will be done on which day are all set out in writing. If it is not suitable for you, we put that in writing just as clearly.

There is more than one route, and the condition of your own jaw determines which one is right for you.

We are not writing this to frighten you, but so that you can ask the right questions, whichever clinic you go to.

The sequence below applies to patients treated with strategic implants. Later in life, healing can be somewhat slower; we set up the check-up schedule with that in mind.

1. Three clinical days

   Once the examination and planning are complete, the surgery and the fitting of the final fixed teeth are spread across these days. The surgery is finished in a single session under local anaesthetic. You leave the clinic with your fixed teeth. Some swelling and tenderness during these days is normal.

2. The first week

   The swelling goes down. We ask you to stick to soft foods, avoid hard and hot foods, and brush the area gently. If you have stitches, they are removed during this period. You carry on with your regular medicines from where you left off.

3. The first few weeks

   We increase the chewing load gradually. If you have worn a denture for years, your chewing habits are being rebuilt too; do not go straight back to meat and hard nuts. During these weeks your gums settle into their new shape.

4. Check-ups and the long term

   We give you the check-up schedule and the care instructions for the bridgework in writing. Cleaning between the teeth, regular professional cleaning and a yearly scan are what make this treatment last.

We do not give figures on this page, because an accurate figure can only be given once the CBCT scan has been seen. Send us your X-ray or scan, and we will set out the scope item by item in writing. These are the items that determine the total:

Number of implants and which jaw

Whether it is one jaw or both, how many implants are planned and which areas they will be placed in directly determine the total.

Preparing the mouth

If teeth need extracting, gum inflammation needs treating or roots need removing, these are added to the plan and affect the timeline too. In people who have worn a denture for a long time, this item is often small.

Bridgework

The material of the fixed teeth and the laboratory work directly affect the total. We tell you the brand of the material we use in writing from the start.

Additional medical assessment

If you have a systemic condition, additional tests or an exchange of views with the relevant doctor may be needed before surgery. We include this in the plan in writing.