What diagnostic tests will I need before dental implant treatment?

Successful dental implant treatment depends on detailed planning and preparation.  If you are considering dental implants, you may find it helpful to first attend an exploratory consultation.  Many implant dentists will offer a free, 15 minute, initial consultation for prospective patients.  The discussion may be held with the implant treatment coordinator at the practice, or the dentist.  It can help you consider all the options available to treat your dental problems, so that you can make an informed decision.  In order to give you the best advice, you will be asked for details about your medical history and lifestyle, and anything else that may affect the treatment.

If you decide that you would like to progress to the next stage and if your dentist thinks that you are a possible candidate for dental implants, the next step is a full clinical consultation. 


What happens in a clinical consultation for dental implant treatment?

This is a more detailed examination, for which most dentists will charge a fee.  However, some clinics refund this cost when you proceed with dental implant treatment.  A full clinical evaluation usually includes the following:

An examination of your mouth - the dentist will make a full assessment of your mouth.  He or she will check the health of your remaining teeth and ensure that surrounding dentition will not interfere with the placement of your new implant.  To ensure the best possible outcome, it is vital that your oral hygiene is good and your gums are healthy.  Any pre-existing oral health issues, such as periodontal (gum) disease, must be dealt with before having dental implants placed.  Plaque must be treated and under control.  You will also be examined for any jaw joint problems (temporomandibular joint disorder).

Health check - a thorough review of your dental problems, social habits and medical history will be taken by your implant dentist.  If you smoke, you will be strongly advised to give up before starting implant treatment.  Many dentists will not carry out implant treatment unless smoking has ceased or significantly reduced.  Amongst other things, smoking can cause damage to the salivary glands, resulting in a drier mouth.  This can promote bacteria which can worsen periodontitis (gum disease).  Nicotine can also reduce blood flow, which can affect healing and immune response.  Any of these factors could cause your implants to fail.

Medical conditions such as cancer, radiation to the jaws, alcoholism or diabetes can also affect your body’s ability to heal.  If you are undergoing chemotherapy, your dentist will want to wait for your treatment to be completed, before proceeding with implants.  In addition to your medical history, it is important that your implant dentist is aware of any ailments you have and medication you are currently using, to avoid any unnecessary complications.

Checks on bone structure - one of the key requirements for dental implant treatment is having enough bone in your jaw.  Your dentist will check that your bone is of sufficient height and density.  A solid, reliable base is needed to anchor the implant.  If your bone volume needs to be increased, you may be able to have it built up.  Grafting techniques involve adding bone to the jaw.  A successful bone graft allows your jaw to be strong enough to support your dental implants.  Your bone structure can be checked using X-rays and CT scans.

Impressions and plaster models - your dentist will take X-rays and impressions of your mouth, in order to produce plaster study models to help establish the length, diameter and position of the implant(s).  Sometimes a dummy wax model, or wax-up, of the proposed final result will be created.  Impressions are also taken to ensure that a new dental restoration, such as a crown, bridge or implant will align with your current bite.  If necessary a set of photographs will be taken.

What scans can I expect?

When planning for dental implants, imaging technology such as, dental X-rays, computed tomography (CT) or cone beam computed tomography (CBCT) scans, may be used to provide precise information, so that your implant dentist can develop an accurate diagnosis and treatment plan.  Many dentists have X-ray machines and some have invested in their own CBCT scanners.  Sometimes, if the practice doesn’t have the equipment in-house, you may be referred to another local dentist or imaging centre for your scans.

Dental X-ray  dental X-rays are the standard way to obtain an initial image of the mouth.  They show large amounts of detail, but only in two dimensions.  From an X-ray it is possible to judge the height of bone available for implant placement, and the location and size of anatomical structures, such as the maxillary sinus and alveolar nerve.  They provide the dentist with the exact position of remaining teeth.

X-rays can reveal decay that may not be visible in the mouth, for example, under a filling.  They can also show whether you have an infection in the root of your tooth and its severity.  There are various types of X-ray, including periapical, panoramic and sinus radiography.  

X-rays can help to show whether additional procedures are required, such as bone grafting, and help determine the size of the implants and where they should be placed.  More advanced imaging techniques are sometimes needed to determine bone width.

Computed tomography (CT) scan – a CT scan provides a three-dimensional image.  It uses X-rays to create pictures of cross-sections of the body.  The CT scan records data with a fan-shaped X-ray beam onto image detectors, producing a single slice per scan.  Each slice overlaps slightly in order to correctly reconstruct the images.

A CT scan for dental implant treatment creates three-dimensional, complex images of the teeth, mouth, jaw and neck.  The scans will allow the dentist to determine bone quantity and quality.  The technology can be used to plot virtually the ideal location of dental implants, prior to any surgical intervention, to aid treatment planning.  The use of CT scanning in complex cases helps the implant dentist identify and avoid vital structures.

Cone beam computed tomography (CBCT) – if you are a suitable candidate for implants, a dental CBCT scan may be taken. CBCT is a variation on traditional computed tomography and provides the greatest detail.  It uses advanced X-ray techniques and generates a three-dimensional image of the jawbone, providing information such as bone height, width, density and shape.  It also reveals the proximity of vital structures like nerves and blood vessels.

Unlike traditional CT scanners, CBCT uses an X-ray tube and detector panel, which rotates around the patient.  It captures data with a cone-shaped X-ray beam, instead of the ‘slices’ provided by the CT scan.  The cone-shaped X-ray beam reduces the size of the scanner, radiation and time needed for scanning.  The CBCT scan data is converted into a three-dimensional, virtual model and, with CAD/CAM planning software, it ensures optimal, precise placement of the implants. Many dentists use a CBCT scan and specialised software, to prepare a digital, three-dimensional, treatment plan.

Treatment plan and cost estimate

When all the examinations and scans are complete, your dentist produces a treatment plan, which is discussed with you.  The plan usually includes time frames, cost and the consent forms.  At this stage, take time to ask any questions you may have about having dental implants.  Afterwards, you may meet an implant treatment coordinator, or other member of the implant team, to discuss price plans and payment options, before booking further appointments to begin your treatment. 

Most of the featured dentists on click4teeth.com offer a FREE exploratory consultation for prospective implant patients.  Book a FREE initial consultation appointment.

This article was written with advice from:

Dr Mitesh Badiani

Dr Alan Carter

Dr Hiten Pabari