Are dental implants right for me ?

Send your details for a preliminary consultation with an implant dentist


* Mandatory field


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)

UPPER JAW



Complete
upper JAW

LOWER JAW



Complete
lower JAW

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?

  • Yes
  • No

Any other requirements?

Do you have any other questions about dental implant treatment?

Your details




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