This is a loaded question as it can be answered in a variety of different ways. The tendency in marketing these treatments today is to provide the consumer with a “teaser” price to get them to come in for a consultation. We will try to break this down so that after reading this section, you will have a pretty decent understanding of the actual cost of dental implants.
First, we need to define the terminology:
The easiest way to think of an implant is a titanium screw that is embedded in the jaw bone. Many patients believe that dental implants involve a single process which restores a missing tooth. This is a common misunderstanding and can lead to confusion about the cost. Some offices only perform surgical placement of implants in bone (e.g. periodontists and oral surgeons). As such, they are only able to provide patients with the surgical cost, not the total treatment fee all the way to the final restoration.
Typically, the implant crown is the part patients think of when they hear the phrase “dental implant”. This is the final piece of the restoration that looks, feels and functions like the missing tooth. Like regular crowns, they can be made of porcelain, metal or some fusion of the two. The main difference is that, instead of resting on a natural tooth, implant crowns are supported by the titanium implant below.
The component patients are least familiar with is the abutment. This is the intermediate piece that holds everything together. Abutments are almost always necessary when restoring implants, whether they are held in by cement or screws. The only exception is when a one-piece implant is used. This technique is ill-advised because it dramatically limits the restorability of the implant, particularly if the patient loses additional teeth in the future.
Now that we have a general understanding of the terminology, we can begin looking at the factors that influence the cost of the process:
Education and Training
In the dental industry, it is very easy to believe you are purchasing a product instead of a service. Many patients believe they are purchasing a dental implant when they are actually paying for the surgical placement of the dental implant. This is a technically challenging procedure. There is often less than 7 millimeters (9/32nds of an inch) of bone into which the implant can go. Within this small area, there is an even smaller space for the implant to go if we want the final restoration to look like the original structures it is replacing. An implant placed too far to the front, back, left, right, too shallow or too deep may result in a crown that looks nothing like the original tooth. Even worse, the implant may not be restorable or it may be placed in a position that injures the surrounding anatomical structures. To make this endeavor even more challenging, the oral cavity is a difficult place to work due to its small size. Obstacles like the tongue, cheeks, lips or even other teeth often get in the way.
Placing an implant well takes preparation and practice. This is the very reason dental specialists go back to school for an additional three to six years after graduating from dental school. Specialist training programs involve many hours of education and practice where residents can learn from senior instructors and experts in the field. To find out more about what it takes to become a specialist, please visit our page on why you should see a prosthodontist. Education and training are the main reasons that specialist fees are generally higher than those for a general dentist. When you see a specialist, you are paying for the extra time and effort that has been invested into ensuring you get the best possible outcome.
The cost of doing business varies by region. Dental implants are no exception; there are some differences in fees, depending on where you have your implants placed and restored.
Type of Dental Implant
Manufacturers’ prices vary depending on the brand of implant. However, this difference is rarely passed on to consumers. A more important consideration is whether regular-sized implants (2.8-6.0 mm in diameter) or mini implants (1.8-2.8 mm in diameter) are placed. There are many practices that only place mini implants. These have a very limited scope in implant dentistry but tend to be overused as they are much cheaper and easier to place. Be wary of practices that quote prices that seem too good to be true as they probably are.
Implant Restoration Quality
Dental laboratories that fabricate implant restorations are manned by technicians with extremely wide variability in skill level and experience. This is often reflected in the fees they charge. Poor labs may charge as little as $85 per crown while excellent ones go as high as $850. This is a difference of 1000%! This quality is reflected most clearly in the overall esthetics of the crown. Beyond making beautiful restorations, a skilled technician knows the mechanical properties of the latest dental materials and how to manipulate them in order to ensure that they last a long time. A respectable laboratory and, in turn, a respectable office should provide a guarantee with all treatment. This is a sign they stand by the quality of their work.
Dental Implant: $999 to $7500. This seems like a huge range and the reasons are explained above. In Dallas, you will typically see a range from $1500 to $2500. This includes only regular diameter implants (2.8 mm to 6.0 mm). Mini implants are less expensive but are rarely the best choice for crowns or bridges.
Abutments: $250 to $2000. The range here depends on the type of abutment used. A standard abutment is cheaper and is mass-produced by an implant company. In contrast, a custom abutment must be made custom-made for a single patient and a single tooth.
Implant Crown: $1000 to $3000. This reflects the difference in quality of laboratory work (described above). Poorer quality labs charge less for their crowns while those made with more skill and care are usually more expensive.
These are general costs for treatment in Dallas, Texas. If your quote is very different, you should ask why or seek a second/third opinion. The average costs incurred by offices is usually quite similar so it is quite difficult to justify fees outside these ranges.
Once a tooth is extracted, the surrounding bone loses stimulation and begins to remodel. The amount of bone loss and remodeling that occurs is closely related to how long the tooth has been missing and the space left empty.
Because most people lose bone after a tooth is removed, bone grafting is often necessary. In most cases dental implants need at least 6 millimeters (1/4 inch) of bone. The average dental implant is 4.0 mm (3/16 inch). When you start with 6 mm of bone, after site preparation it leaves only one millimeter of bone on the front and the back sides of the implant. One millimeter (1/32 inch) is very little bone remaining around the implant. Ideally, 8 mm (5/16 inch) is much better. One of the most common mistakes in implant dentistry is when the dentist attempts to put the implant into inadequate bone.
Many dentists who perform dental implant treatment do not perform bone grafting. Frequently, they do not recognize those sites that require bone grafting. When an implant is placed in a site with inadequate bone the outcome is almost always compromised. An implant in the back of the mouth with compromised bone may be considered a success while an implant in the front of the mouth that has compromised bone is almost always a train wreck. Rarely can these situations be rectified without implant removal. When an implant is removed it is a very traumatic procedure for the bone, further compromising the site.
Sadly, these situations can usually be avoided with proper planning and execution. The key to success is to find an implant dentist with the best credentials and the most experience. While at a dental implant consultation, ask to see as many outcomes as you time will allow. If a dentist cannot show you a dozen of his or her cases as an example of what you can expect you should seek additional consultation(s). Ask to speak to former patients. Search the internet for complaints against the dentist.
Once a dental implant is improperly placed in the bone it is very difficult to fix. Dentists work in a very small space and good outcomes have a very small tolerance for error. It really needs to be done properly the first time.
Bone grafting can be done in a variety of different ways with a variety of different materials. A bone graft can be completed at the time of the tooth extraction. This is called a “socket preservation bone graft”. The intent is to increase bone volume as the bone remodels after the extraction. Human bank bone or demineralized cow bone is placed in the bony socket after the tooth/root is removed. A small white membrane is then sutured over the bone graft material. This membrane is non-resorbable which means it must be removed in 21-28 days. It then takes between 4 and 6 months for the body to convert the bone graft material into mature bone ready for an implant.
An “onlay bone graft” is done when an existing site, without a tooth, has inadequate bone for a dental implant. Again, human bone or cow bone can be used. Cow bone typically converts much more slowly than human bone. This is a much more invasive procedure. The tissue around the site must be raised away from the bone to be able to add bone to the deficient site. Because some of the bone graft volume is lost during healing, a strong attempt to over build the site is made. Meaning we try to add 30% more bone than will be needed after healing. Some tissue will not accommodate this volume. The usual healing time after an onlay bone graft is 6 months.
Growth factors such as PRP (platelet rich plasma) and BMP (bone morphogenic protein) are two examples of materials commonly used to enhance or promote better and faster bone healing. There is some debate as to whether the net increase in bone volume can justify the significant increase in the cost of the procedure.
There are techniques that implant dentists can use to avoid bone grafts. See our Alternatives to Bone Grafts Section in the FAQs.
Yes, dental implants are made of titanium. Titanium is a “non-ferromagnetic” metal, meaning patients can safely receive MRIs (magnetic resonance imaging).
The American Dental Association does not recognize any specialty field specifically for dental implant treatment. Therefore, it is against our bylaws for anyone to call themselves a “Dental Implant Specialist”. However, there are three dental specialties that have specific training for dental implants: Prosthodontics, Oral and Maxillofacial Surgery and Periodontics.
Prosthodontics is the specialty and a “Prosthodontist” is the reconstructive specialist. The “prostho” means prosthetic, or any dental device that is made as a tooth replacement. A prosthodontist attends a 3-year residency program focused on the restoration of adult teeth. It is the only dental specialty specifically oriented to the restoration of adult teeth. A surgical prosthodontist is a dental specialist that also does dental implant surgery and the subsequent tooth replacement. People seek out these specialists because all work can be completed in one office.
Oral and Maxillofacial Surgery is the specialty and an “Oral and Maxillofacial Surgeon” is the specialist. An oral and maxillofacial surgeon goes an additional 4 or 6 years to learn jaw surgery, wisdom tooth extractions, dental implants and oral pathology. An oral surgeon can place the dental implant in the jaw bone but does not make the teeth, after healing.
Periodontics is the specialty and a “Periodontist” is the specialist. A periodontist attends a residency program for three years after dental school. This specialty tends to the bone and gums around teeth. They are responsible for diagnosing and treating “gum disease”. They can also do gum grafts and the surgical phase of dental implant treatment.
A patient should educate themselves about the various levels of training and education that their dental care providers have achieved. Many dental offices advertise to be “specialists” in dental implants but the reality is that these practices have much less training and education compared to a specialty practice.
Board certification by one of the specialty groups discussed above should also give the consumer some clue as to how far the dentist has taken his or her career. Board certification in other areas of dentistry are also very favorable for patient outcomes. Even though an area of interest does not qualify as a “specialty” designation they speak volumes to the level of commitment of a professional to better themselves. For example, the American Academy of Implant Dentistry, the American Academy of Cosmetic Dentistry and the American Board of Oral Implantology all offer board certification examinations. They are very difficult and time consuming tests. Very, very few dentists have completed these rigorous examinations. So, it is possible for dentists and dental specialists to have more than one board certification. In medicine, it is a common phrase to hear that someone is a “dual board certified” specialist. In dentistry it is practically unheard of to have dual board certifications. So, the responsibility is on the consumer to verify the credentials of the dental care provider they choose.
At the Dallas Dental Implant Center all dentists are board certified specialists in tooth replacement. Additionally, the senior partners are dual board certified in tooth replacement.
A simple dental implant or two has become so routine that many of our patients go back to work the same day. We encourage people to take the rest of the day off but oftentimes their schedules do not allow this post-operative course.
For other patients needing more complex procedures like extractions and bone grafts the post-operative discomfort can be more severe. However, more often than not, patients report much less pain than they anticipated. Even with the more complex procedures, when patients follow the post-operative instructions and take the first dose or two of pain medication it is normal for them to feel good by the next day, or two.
We offer IV Sedation for patients that have anxiety. When a patient has IV Sedation we can give them a steroid as part of the IV fluid. This really helps with post-operative discomfort and swelling. For any procedure that has a high likelihood of swelling and discomfort we encourage our patients to allow us to perform IV Sedation.
The fear of pain should not prevent a patient from receiving dental implant treatment. Ask us during your consultation which approach is best suited for you.
Dental implants have been used for tooth replacement in humans for more than 55 years. Because of i’s high strength to weight ratio and a modulus of elasticity similar to human bone it is an “ideal” metal for use in humans. For tooth replacement it is stronger than the natural root that it replaces and it cannot decay or corrode in the mouth.
After the titanium implant is surgically placed in the jaw bone it begins a process called, “osseointegration”. The surgical placement of the implant in direct contact with the jaw bone starts a healing process by which the bone cells attach directly to the titanium without any soft tissue at the interface. This fact is why a dental implant is more solid than a tooth. The tooth has a ligament attachment to the bone (periodontal ligament) which allows the tooth to move ever so slightly when compared to the implant.
Once a dental implant becomes osseointegrated it is ready for a tooth or teeth to be placed on it. Since about 2005 we can often place teeth on the implants immediately after the implant is placed in the bone. The implant surface treatment has become so good that the bone grows around the implant very quickly. This has opened up faster and more patient friendly uses for dental implants. Many times, patients no longer need to wear a denture or a flipper after treatment. When immediate teeth are not indicated the healing time of a dental implant is rarely longer than 8 weeks. During the healing period patients wear a removable temporary prosthesis. No one ever leaves the office without teeth! Below are the Wikipedia definitions of Titanium and Osseointegration:
Titanium Medical Use:
Because it is biocompatible (it is non-toxic and is not rejected by the body), titanium is used in a gamut of medical applications including surgical implements and implants, such as hip balls and sockets (joint replacement) that can stay in place for up to 20 years. The titanium is often alloyed with about 4% aluminium or 6% Al and 4% vanadium.
Titanium has the inherent ability to osseointegrate, enabling use in dental implants that can remain in place for over 30 years. This property is also useful for orthopedic implant applications. These benefit from titanium’s lower modulus of elasticity (Young’s modulus) to more closely match that of the bone that such devices are intended to repair. As a result, skeletal loads are more evenly shared between bone and implant, leading to a lower incidence of bone degradation due to stress shielding and periprosthetic bone fractures, which occur at the boundaries of orthopedic implants. However, titanium alloys’ stiffness is still more than twice that of bone, so adjacent bone bears a greatly reduced load and may deteriorate.
Osseointegration is also defined as: “the formation of a direct interface between an implant and bone, without intervening soft tissue”. Osseointegrated implant is a type of implant defined as “an endosteal implant containing pores into which osteoblasts and supporting connective tissue can migrate”. Applied to oral implantology, this thus refers to bone grown right up to the implant surface without interposed soft tissue layer. No scar tissue, cartilage or ligament fibers are present between the bone and implant surface. The direct contact of bone and implant surface can be verified microscopically.