Missing teeth can be an embarrassing problem at best. At worst, they can make life very uncomfortable with issues that can affect your social life, speech, confidence and ability to chew.
In modern times, dental implants are the gold standard to replace missing teeth.
I have written this article to help anyone keen on getting their missing teeth replaced with dental implants. Many of my patients feel that the dental industry is not transparent enough. Thus, it is my wish to change that perception for the benefit of all.
In this article, I will address the important things about dental implants that you need to know. I hope that after reading it, you will be able to make the most informed decision possible.
Firstly, what are dental implants?
A dental implant is an artificial replacement for a missing natural tooth. 
To list, the implant components include:
- a connector as well as
- the implant tooth.
It is often known as a fixture, the ‘artificial tooth root’ that will be placed into the jawbone, beneath your gums. Made from medical-grade titanium, the screw-like design helps to strongly fixate the implant to the bone.
Often shaped like a hexagon or octagon, it helps to:
- support the implant crown
- secure the implant crown and
- retain its suprastructure .
The tooth-like part of the implant is widely known as the crown. Designed to look like a natural tooth, it is often made of ceramic or metal material.
The success of the implant treatment depends on how well these 3 components integrate with one another and how they integrate with your jaw bone and gums, resulting in improved function and aesthetics.
The location of the missing tooth will have the implant drilled into. Hence, providing it with a firm foundation to support the replacement implant crown.
Am I a good candidate for dental implants?
Generally speaking, most people are good candidates for dental implants.
You can enjoy success with dental implant surgery as long as you:
- are in good general health,
- have good oral hygiene,
- have healthy gums with sufficient bone to anchor the implant(s),
- not suffering from parafunctional habits like severe bruxism,
- have a good balanced and well-aligned bite.
Despite that, it also depends on the surgeon. He/she has to be competent, as well as skilled in:
- indications and contraindications,
- treatment planning,
- identifying risks,
- managing potential complications and
- executing proper surgery and treatment.
Here are examples of a few common risks that could significantly reduce the success rate of dental implant surgery:
- Chronic diseases that affect your ability to heal – diabetes, immune deficiencies, osteoporosis, etc. 
- People who have had chemotherapy/radiation to the head and neck .
- Smoking – in fact, the failure rate of implants is much higher in smokers as compared to non-smokers .
- History of moderate to severe gum disease such as periodontitis
- Significant bone loss and gum loss due to disease.
- Parafunction such as severe bruxism
- Severely imbalanced and mal-aligned occlusion (bite)
An experienced dental surgeon should examine carefully your medical and dental history and current condition. This is to ensure that you are indeed suitable for dental implant surgery before going for one.
How much does a dental implant procedure cost in Singapore?
In Singapore, the average dental implant fees per implant range from about S$3,500-6,000 in total (all 3 components) for a routine non-complex case. With that said, the range of fees is for conventional dental implants and not for mini-implants.
However, the range of fees typically does not include the fees for:
- the general consultation,
- treatment planning,
- reviews and even
The range of fees can also vary considerably due to:
- the complexity and difficulty of the case,
- additional procedures if any
- reputation, qualifications, skill and experience of the dental surgeon
- location of the clinic
The fees can well exceed S$10,000 in some cases!
So, what happens if I am told that I have a complex case?
To list, here are some examples of additional procedures required in complex cases:
- IV sedation or hospitalisation
- advanced 3D CT bone scans
- computer-guided surgical planning
- custom-made surgical guides or stents
- custom-made titanium meshes to hold bone grafts
- extensive bone grafts with membranes
- extensive gum grafts
- sinus lift surgery
Be sure to address any of your concerns with your dental surgeon as and when required!
Are dental implant procedures in Singapore Medisave-claimable or insurance-covered?
In fact, yes, the fees mentioned are Medisave-claimable! However, it is only claimable up to a limit of S$1,250 for one dental implant.
The Ministry of Health (MOH) website also provides a rough gauge of dental implant surgery costs in Singapore. The table shows the cost per surgical implant fixture that was found on the MOH website that was published in 2015 .
|Cost per surgical implant fixture:|
These above-mentioned fees are for the implant surgery alone and do not include:
- the abutment,
- the crown and
- any associated costs for complex additional procedures as mentioned above.
The final price for a dental implant
Here's an example of a typical bill breakdown at a reputable private dental clinic:
$40 - $80
Dental Panoramic X-ray
$80 - $120
3D CT bone scan (if any)
$350 - $500
Tooth study models (if any)
$100 - $250
Surgical guides (if any)
$250 - $800
Bone grafting (if any)
$800 - $3000
Sinus lifting (if any)
$1,000 - $3,500
Dental implant crown
$1,000 - $3,000
Dental implant surgery
$2,000 - $4,000
$35 - $80
Surgical guides – It’s a piece of guiding plastic placed in your mouth during surgery. This helps your dentist to place the dental implant in the correct angle and position.
Bone grafting – When there is not enough healthy bone to place the implant, bone grafting will be required. Depending on how much bone graft is needed, the cost will vary accordingly.
Sinus lifting – It’s a bone-grafting procedure that increases the amount of healthy bone to place dental implants in the upper posterior jaw area.
In some cases, dental implant procedures can be covered by personal accident insurance. However, do note that the loss of teeth resulting in the need for a dental implant replacement must be due to an accident. Only then the claim can be approved. Therefore, do check with your trusted insurance agent for further details.
Meanwhile, the price of an implant with a crown at a public hospital will cost between $3,200 to $5,700 .
What happens during dental implant surgery?
Examination and consultation
Firstly, the dental surgeon will:
- examine your medical and dental histories,
- take all the necessary dental X-rays and records,
- examine the current state and health of your teeth, gums and bone
At this stage, here are the things that will also be considered:
- the number of missing teeth,
- alignment of teeth and
- the balance of stability of your bite.
In addition, the dental surgeon will also consider how the proposed new teeth will fit in with the rest of your lips and face for a pleasing and natural result.
With all the information gathered, it will help the dental surgeon determine if your case is simple or complex. Hence, the dentist will let you know if any additional complex procedures are required. Most importantly, the dental surgeon will also identify potential risks and complications that may affect your success rates.
Apart from that, the dentist will finally formulate treatment plan options for you to consider. This will be before jumping into any kind of surgery or treatment. In addition, he/she will go through with you the estimated fees for the treatment.
Patients are required to sign a detailed consent form before any procedure. This is to ensure that patients are informed of the risks, side effects and benefits.
Surgical insertion of the implants
For the surgery, you will be put under either:
- local anaesthesia,
- IV sedation or
- in very complex cases, general anaesthesia in a hospital setting.
The surgical insertion of the implant can be done either free-hand or with a surgical guide fabricated computer-guided planning. Therefore, the method chosen depends on the merits and indications of the case. Your dental surgeon will explain to you in-depth if needed.
Depending on the treatment plan, advanced procedures can be done at the same time as the implant insertion. Examples of advanced procedures include:
- bone grafting
- sinus lifting
- gum grafting
Restoring the implants with crowns or bridges
After a typical healing period of 3-6 months, the implants would have fused together with the jaw bone. Therefore, it will be ready to be restored with a crown or bridge.
Subsequently, dental impressions are taken. The final restorations are fabricated in a dental lab. Then, the final restorations are screwed or cement-retained onto the dental implants.
In certain cases, dental implants can be immediately fixed with temporary restorations. But, this is strictly on a case by case basis.
Once the crowns or bridges are fitted, your bite will be checked. This is to ensure that there is a good balance in your bite as well as no discomfort. Finally, your dental surgeon will guide you on the best ways to care for as well as how to maintain your dental implants.
When is the best time to go for a dental implant after your tooth is removed?
Unfortunately, there is no consensus on when is the best time to place a dental implant for ALL patients.
A good dental surgeon will assess every patient on a case-by-case basis to determine the best timing for the implant placement. This has to be best suited according to the patient’s unique condition.
There will be indications and contraindications for immediate, early or late placement of dental implants. These depend on many unique patient factors.
Your dental surgeon will choose amongst these 3 options depending on your condition. 
- Immediate – at the time of extraction
- Early – 2 months after the extraction
- Late – more than 6 months
Is getting a dental implant painful?
There are a few factors that contribute to whether or not you will feel pain and discomfort during the procedure as well as after the procedure is over. To list, here are some examples:
- skill, care, qualifications and experience of the dental surgeon,
- type of anaesthesia used,
- any additional procedures,
- number of implants placed,
- pain threshold,
- type of medication prescribed,
- proximity to vital structures - such as major nerve branches
Thus, it is quite impossible to guarantee a completely painless surgery for ALL patients for ALL types of dental implant surgery without the use of sedation.
However, generally speaking, dental implant surgery is quick and painless for routine, non-complex cases done by an experienced and well qualified dental surgeon.
What is the success rate of a dental implant?
The success rate of dental implants is around 95-98% .
But the best dental implant procedures with the highest success rates really depend not only on careful treatment planning but also on identifying potential risks early. Case selection is critical, and planning for dental implants on patients who are not suitable is asking for trouble.
One crucial factor that contributes to successful dental implant surgery is the skill, qualifications and experience of your dental surgeon. Studies have shown that the survival of implants placed by inexperienced practitioners was 73% compared with 95.5% by experienced practitioners with advanced training in dental implants surgery .
Also read: 5 Reasons Why Dental Implants Fail
How long do dental implants last? Will I need to replace it over time?
With proper care and maintenance, dental implants can last for a long time. With that said, dental implant fixtures are designed to last a lifetime. On the other hand, dental implant crowns typically last 10 years or more. However, the longevity of implants is best in patients who:
- do not have parafunction such as nocturnal bruxism
- have a stable and balanced bite
- are able to always keep a high level of oral hygiene
- have regular dental checkups
- have good general health
- do not smoke
- have good gum health
In addition to the host factors, it is also important to note that the longevity of the implants can also be affected by:
- the correctness of the implant's 3-dimensional surgical placement,
- the design of the abutment, implant crown and material used.
Hence, the skill and experience of the dental surgeon can also significantly contribute to the longevity of the procedure.
How can I get the best results immediately after dental implant surgery?
For the best results immediately after dental implant surgery, my general advice would be as follows:
- Maintain meticulous oral hygiene and wound care.
- Follow post-op instructions carefully.
- Take all prescribed medications.
- Do not put any pressure on the wound.
- Do not subject the implant to excessive biting forces.
- Go for all scheduled post-op review appointments with your dental surgeon.
- Go back to your dental surgeon as soon as possible if you notice any unusual smell, discharge or symptoms.
What happens if my dental implant fails? Can I do it again?
It does not mean that you cannot have another implant placed if your previous implant fails and has to be removed.
Most importantly, your dental surgeon has to analyse why the dental implant failed so that these factors can be addressed at the second attempt.
It would be silly to do the implant surgery in exactly the same way without first figuring out what went wrong and the factors that have led to the failure.
Therefore, in my practice, if implants fail after 2 attempts, I do not proceed with a 3rd attempt.
How can you find the best dentist in Singapore for dental implants?
For starters, it’s important that you shortlist some dental surgeons with the relevant training and qualifications. You could also ask friends and family for word-of-mouth recommendations to a dental surgeon with experience in dental implant surgery.
Specialists for dental implants 
There is no such thing as a dental implant specialist. However, there are 3 specialists in Singapore that undergo structured training in dental implant surgery. It will be part of their specialist programme. To list, they are:
- Periodontist - also known as gum specialist
- Prosthodontist - also known as "missing teeth" specialist
- Oral & Maxillofacial surgeon
Also, read more: 8 Must-Know Insights About Dental Implants In Singapore
What should I also be doing?
Checking out their website, online presence and patient reviews can help narrow down the search. You could also ask your neighbourhood dentist for his or her recommendations too.
After comparing notes on the names you have gathered, you should then arrange for a consultation visit with the one you feel most comfortable with.
During the consultation, feel free to ask for before or after photos of successful dental implant cases, and the total number of dental implant procedures he/she has performed so far. This will give you a good idea about his or her experience.
Listen carefully to how the dentist formulates a treatment plan for your case and how he/she addresses potential risks and complications.
You should only continue with the surgery if you feel comfortable with his or her level of skill and experience, and that the dental surgeon has addressed all of your concerns and has communicated with you in a professional, respectful and caring way.
Lastly, the professional fees have to be within your budget! But often, it is best not to be penny-wise and pound-foolish when it comes to something as important as your health!
Dental implants can be a good option for you if your missing teeth negatively affect your social life, speech, confidence and ability to chew. This procedure can be really expensive, hence, you must do extensive research first. Everyone has a unique set of teeth and gums, thus, what works for others may not work for you.
The information here is accurate at the time of publishing, but dental implant technology is changing constantly. Hence, it is still best to consult with your trusted dental surgeon to get the most current information and to confirm if you are suitable for dental implant surgery.
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Dr Gerald Tan is a past president of the Aesthetic Dentistry Society of Singapore and Global Head, Novena Global LifeCare Dental Division and Founder of Elite Dental Group Singapore. Besides that, he has a special interest in bespoke cosmetic dentistry, dental implantology and digital smile design. In addition, he enjoys basketball, tennis and looking after his pet cockatoo in his free time.
Also, read more from Dr Gerald Tan in his Q&A here.
1. Shemtov-Yona K, Rittel D. An Overview of the Mechanical Integrity of Dental Implants. BioMed Research International. 2015;2015:1-11. doi:10.1155/2015/547384