Are dental implants right for me - ask a local dentist

Describe your dental problem and/or the treatment you want. However, you may wish to save discussion of any sensitive medical information until your face-to-face consultation with the implant dentist of your choice.

Your current oral health

Missing or failing teeth:

Please indicate below by checking the relevant box(es)

How long have the teeth been missing?

Has the underlying bone shrunk?

Relevant background information or medical conditions:

What do you have at the moment?: eg. gap, denture, bridge, crown

Are you a smoker?

Any other requirements?

Do you have any other questions about dental implant treatment?

Your details

Title: *

First Name: *

Surname: *

Address:

Town:

Postcode: *

Best contact telephone number:

Best time of day to call:

Alternative number:

Email address: *

How did you hear about click4teeth.com?

Choose a dentist for your enquiry *

Closest to your postcode :

Select the dentist above OR one of the list below

Unsure which dentist to choose? Find an implant clinic near you, using the map or the clinic finder in the right hand column.

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Submit this form for a FREE preliminary consultation about dental implant treatment

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Are dental implants right for me ?

Your current oral health

Your details

Choose a dentist for your enquiry *

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