Dental Implants

Where it may be suitable

• Adults missing one or a few teeth whose general health allows surgery and healing
• Enough bone height and width to hold the implant; where there is not, bone grafting or a sinus lift may be considered
• Healthy gums, or gum treatment already completed
• People who do not want their neighbouring teeth ground down
• People who cannot manage or do not want a removable partial denture

What is associated with higher risk

The figures below are pooled results of published observational studies, not our own records. They show association, not proven causation.

• Smoking. Compared with non-smokers, people who smoked more than 20 cigarettes a day had about 2.5 times the risk of implant loss per implant¹. Per patient, the risk was about 4 times higher¹. In that review the risk rose with the number of cigarettes, and no level of smoking was shown to be free of extra risk. For early implant loss, a review of 32 studies gave an odds ratio of 2.59 per implant², from the 21 cohorts analysed per implant. An odds ratio compares odds, not risks, so this does not mean that the absolute risk is 2.6 times higher.
• A history of periodontitis (gum disease that has damaged the bone around the teeth). Across 14 prospective studies, implants were lost at about 1.75 times the rate³ seen in people without that history. After fast-progressing disease the rate was about 6 times higher³. These are hazard ratios, which compare rates over time; they are not absolute risks. Peri-implantitis (inflammation around the implant with bone loss) was about 3 times more likely³. These were treated patients; implants are not placed while the disease is active.
• Clenching or grinding. Across 27 studies, people judged likely to clench or grind their teeth were compared with people who do not. The odds of implant loss were about 2.2 times higher⁴ in the first group (an odds ratio). These studies did not test whether a night guard prevents that.
• Diabetes. The findings are mixed. Two of three reviews found no significant difference in implant loss: a nine-study review of type 2 diabetes⁵ and an older review⁶. The third, covering 89 publications, reported a higher odds ratio⁷ for implant loss. All three found more bone loss around implants in people with diabetes. That is why blood-sugar control and regular reviews matter.
• Blood-thinning medicines. Scottish guidance for dentists counts surgery that raises a flap of gum as a higher bleeding risk⁸ than a simple extraction. Do not stop one without asking the doctor who prescribed it.
• Bone-strengthening medicines (bisphosphonates, denosumab). The risk depends on why the medicine is taken, and on its dose, route and duration. Whether it is given by drip, by injection or by mouth does not on its own decide it. In people on high-dose antiresorptive treatment for cancer, elective implant surgery is usually avoided. That group includes bisphosphonates given by drip and denosumab given by injection under the skin. The decision is made together with your oncology and oral surgery teams. Do not stop a medicine without asking the doctor who prescribed it. Doses used for osteoporosis, whether tablets, infusions or injections, are assessed separately. With these medicines the main concern is medication-related osteonecrosis of the jaw: an area of jawbone that dies and may not heal. Separately, a 21-study review looked at people taking bisphosphonates as one group, not by the reason they took them. In it, implant loss was about 1.7 times more likely per implant⁹. Jaw osteonecrosis was about 3.5 times more likely per patient⁹. The per-patient analysis of implant loss found no significant difference. These figures are for bisphosphonates and cannot be applied to denosumab; the certainty of the evidence is very low. Tell us about every medicine you take.
• Radiotherapy to the head and neck. Implants are lost more often in irradiated bone. After extractions and implant surgery there is a risk of wounds that do not heal and of bone death (osteoradionecrosis). We ask about the field and dose of your radiotherapy, and planning is done with your oncology team.

Where another step comes first

• A tooth that can be saved. Whether the tooth can be kept is assessed first. If root canal treatment, gum treatment or a crown could keep it, that comes first. Before you agree to an extraction, ask about the tooth's outlook and the ways of replacing it, an implant among them.
• Active infection, untreated gum disease, uncontrolled medical conditions. These are dealt with first.
• Not enough bone. For one or a few missing teeth, bone grafting or a sinus lift may be considered; both lengthen treatment and carry their own risks. Zygomatic implants are not the subject of this page. They are a separate method, considered for people with no teeth in an upper jaw whose bone has been severely lost.
• A jaw that is still growing. In young patients, implants wait until growth is complete.

Suitability is decided by an examination, a 3D scan and your medical history. A plan based on photographs or a panoramic X-ray is not final; it is a preliminary assessment.

There is more than one way to deal with a missing tooth, or one that cannot be saved. The list starts with the option that removes the least tissue.

• Doing nothing. For a single missing back tooth, this is a reasonable option for some people. The trade-off: over time the teeth either side of the gap can drift, and the opposing tooth can over-erupt. The bone in the gap also shrinks. Some of this loss is expected whichever option you choose, and we have found no good research showing that an implant prevents it. Discuss this option with your dentist too.
• Saving the tooth. If the tooth is still there, ask first whether root canal treatment, gum treatment, a repair or a crown could keep it. Keeping your own tooth usually preserves the most natural tissue.
• A removable partial denture. It is used for people who do not want surgery, or for whom surgery is not suitable. It is not a second-class solution; it is an option with its own indications. You take it out to clean it, and getting used to it takes time. As the gums and jawbone shrink or change over time, it may become loose¹⁰ and need adjusting.
• A resin-bonded (adhesive) bridge. For suitable single-tooth gaps, a bridge with a wing bonded to the back of the neighbouring tooth can be used. It needs very little or no grinding of that tooth, and no surgery. It does not suit every gap or every bite; it can come loose and may need re-bonding.
• A conventional tooth-supported bridge. The teeth either side of the gap are reduced and a bridge is made over them. If those teeth are healthy, the tissue removed does not grow back. On the other hand, no surgery is needed and the treatment is short.
• An implant crown or bridge. The neighbouring teeth are not ground down to support it. It needs surgery and a healing period. Where several teeth are missing, not every gap needs its own implant; a bridge can be made on a few implants.

Which option suits you depends on where the gap is, the state of the neighbouring teeth, the bone, your bite and your habits. If you have been offered only one option, ask why the others were ruled out. All of these options are also available from dentists in the UK, and a UK dentist can give you an independent opinion before you decide.

Implant treatment has two main stages, the surgery and the crown or bridge, with healing in between. The number of visits and the length of each depend on you and your plan; both are written in the plan. How the stages fit into visits to Antalya is explained under "Visits to Antalya, and the time between them" below. When the restoration is complete, probing measurements around the implant and an X-ray are taken as a baseline record¹¹, as the consensus report recommends.

This matters day to day, and the answer is not the same for everyone. One of these is chosen for the waiting period:

• The gap is left empty. Some people choose this for back teeth that do not show.
• A removable temporary denture. A small removable piece is made for one or a few teeth. You take it out, and it is adjusted so that it does not press on the healing area.
• A bonded temporary bridge. Where suitable, a thin temporary bridge attached to the neighbouring teeth can be used.
• A temporary tooth on the implant. This is done only in selected patients, if the implant holds firmly enough in the bone at placement (primary stability).

The last option is not for everyone; its risks, and whether it is in your plan, should be discussed separately. A Cochrane review of 26 randomised trials found no convincing difference¹² within one year between loading an implant immediately and waiting. Most of its trials were at high or unclear risk of bias. Another review of 39 randomised trials reported slightly lower implant survival¹³ with immediate loading. The decision depends on how firmly the implant holds during surgery, and on you.

Which of these you will have, and whether it is included in your plan, should be written in your treatment plan. If it is not, ask for it in writing. This is what you will live with at home in the UK between visits, so settle it before you book.

There are many different implant systems. Surface treatment, screw design, the range of parts and the availability of the parts that go on top differ from system to system. The 2017 international consensus report on diseases around implants set out how they are defined. In doing so, it noted that there is no generic implant¹¹: there are numerous implant designs, with different surfaces. As well as the brand name, ask whether the parts of that system can still be obtained years from now.

When you receive a quote, ask for these in writing:

• Which system is planned, and in which diameter and length?
• Is the part that goes on top (the abutment) from the same system?
• Will a dentist in the UK be able to obtain these parts years from now?
• Will I be given an implant card or a similar record?
• If the plan offers an 'upgraded' option, what changes, and why is it needed?

A brand name alone does not decide the result. Published survival rates are not the results of one brand, clinic or dentist either; they are averages pooled from different countries and different patient groups. We give you the systems we use, and the one planned for you, in writing in your treatment plan.

Risks

The figures below come from published studies, not from our own records.

• Implant loss. A review of 46 studies looked at implants carrying a single crown. Of every 100, about 97 were still in the mouth after five years and about 95 after ten¹⁴. The rest were lost. It is not always possible to place a new implant where one was lost; further surgery or a different restoration may be needed.
• Inflammation around the implant. Peri-implant mucositis is inflammation of the soft tissue around an implant. Peri-implantitis is that inflammation together with loss of the supporting bone. Its treatment may need surgery, and if it is not controlled, further bone loss can lead to losing the implant. A 57-study review reported peri-implantitis in about 20 in 100 patients and about 12 in 100 implants¹⁵. An older 11-study review found mucositis in about 43 in 100 patients¹⁶. The rates vary widely with the definition used.
• Technical and biological problems. The same 46-study review reported these cumulative five-year rates: screw loosening 8.8 per cent, soft-tissue problems 7.1 per cent and aesthetic complications 7.1 per cent¹⁴. Bone loss of more than 2 millimetres was 5.2 per cent and the crown coming loose (loss of retention) 4.1 per cent¹⁴. Chipped porcelain was 3.5 per cent¹⁴. A loose screw can be tightened and a damaged crown repaired or replaced; soft-tissue problems need assessment and treatment. Regular reviews are needed to find them.
• Surgical risks. Bleeding, swelling, bruising and infection can occur. In the lower jaw, nerves run close to where implants are placed, so the lip, chin or tongue can go numb. It is usually temporary; rarely, it does not go away. The root of a neighbouring tooth can be damaged while the implant site is prepared. In the back of the upper jaw the sinus is close. The sinus membrane can tear, sinusitis can develop, or an opening can form between the mouth and the sinus. A 3D scan and careful planning reduce these risks; they do not remove them.
• An implant placed at the same session as the extraction. A review pooling studies with different follow-up and patient selection found survival of 95.2 per cent¹⁷ for implants placed straight into the extraction socket. For implants placed in healed bone it was 98.4 per cent¹⁷ (per implant). This is a group average, not a personal probability for you. The review's authors ask for the method to be used with caution. The decision depends on the state of the tooth and the bone.
• Limits of appearance. At the front of the mouth, the shape of the gum, the lip line and the colour of the neighbouring teeth decide the result. The gum can recede over time, and the metal edge of the implant can then show. Your expectations are discussed before treatment.

Benefits

• The neighbouring teeth are not ground down; no healthy tooth is reduced for a bridge.
• It is fixed: you do not take it out, and there are no denture clasps. A screw can still loosen or the crown come loose, as the figures above show. It does not feel or work exactly like a natural tooth.
• Where several teeth are missing, a bridge on a few implants can do the job with fewer implants.

The first days

• Swelling and bruising usually increase over the first 48 to 72 hours, then settle. Use cold packs and the medicines prescribed.
• Choose soft, lukewarm food for the first days, and do not chew on the surgical site.
• Do not stop cleaning your mouth. Clean the surgical area the way your dentist shows you, and the rest as usual.
• If you had sedation, do not drive or operate machinery for as long as the sedation team tells you. Whether you need an escort depends on the method. For adults, every form of sedation other than inhalation sedation requires a responsible adult as an escort¹⁸. Without an escort, treatment under sedation is not given. If you are travelling alone, ask before you book how this works for you. Before you leave the clinic after surgery, you and your escort should have written aftercare instructions. You should also know how to reach the clinic, including out of hours.
• Smoking is linked with poorer healing. At the very least, do not smoke during the healing period.

Daily care

• Brush twice a day with a soft brush and fluoride toothpaste. Pay particular attention to the line where the implant meets the gum.
• Clean between the teeth every day with interdental brushes, floss or a water flosser. Your dentist shows you which works in your mouth.
• If you clench, a night guard may be advised to protect the crown or bridge. It has not been shown to prevent implant loss, and we hold no study showing how well it protects the restoration.
• Reviews. Follow-up for an implant is different from a general dental check-up. The consensus report recommends that an X-ray and probing measurements be taken as a baseline¹¹ when the restoration is complete. The European Federation of Periodontology guideline calls for a structured supportive care programme¹⁹ once implants are in use. The NICE guideline on dental recall covers check-ups in general, not implants. It recommends that the interval between reviews be set for each patient²⁰. It is based on a risk assessment and discussed with the patient. So there is no ready-made 'once a year' interval that suits everyone; yours may be shorter or different, depending on your risk. If your reviews will be with a dentist in the UK, give them your baseline record.

The rates below are not promises, and they come from published studies, not from our own records. They are pooled estimates, calculated with statistical models from studies with different lengths of follow-up. What happens in your case depends on your bone, your gum health, your habits and your care.

• The implant itself. In the 46-study review, of every 100 implants, about 97 were still in the mouth after five years and about 95 after ten¹⁴ (per implant).
• The crown on top. In the same review, of every 100 crowns, about 96 were in use after five years and about 89 after ten¹⁴ (per crown). In an older review the figures were about 95 at five years and about 89 at ten²¹. The rate for the implant is not the same as the rate for the tooth on top of it.
• No one can promise a lifetime result. The reviews we use give five- and ten-year estimates. The ten-year values are estimates from a statistical model, based on studies with a mean follow-up of at least five years. Longer-term reviews exist, but those we have checked cover different patient groups and restoration types, so their results are not carried over here. None of them promises a lifetime result.
• Being in place is not the same as being trouble-free. The rates above show only that the implant or the crown is still there. Regular cleaning and reviews are part of maintenance. A loose screw or chipped porcelain needs a repair, and replacing the whole crown counts as losing the restoration. Ask beforehand whether these are included in your plan, and who will do them once you are back in the UK.

We have found no good research comparing implant treatment squeezed into a few days with treatment spread over months; we say so plainly. The nearest evidence, the Cochrane review of loading times¹², followed patients for a year at most, so it cannot settle the question. The timing first has to meet clinical requirements: how firmly the implant holds and how you heal. Beyond that, judge it on practical grounds. How is healing checked? Who do you contact if something goes wrong? What aftercare does the plan include?

First visit: examination and surgery

On the first visit you have the examination and 3D scan, and usually the implant surgery, with any extraction that is needed. Some people need an extraction, gum treatment or a graft first, and must heal before the implant goes in; that can mean an extra visit. How many days each visit needs depends on your plan, and is stated in writing before you book travel. A 2023 narrative review suggests waiting at least 72 hours²² after implant placement before flying. After a sinus lift it suggests at least two, and ideally six, weeks. These intervals assume no pain, swelling or bleeding at the treated site²². If your plan includes a sinus lift, ask whether that means a longer stay or a separate visit. The authors say the research is limited and comes mostly from military aviation. Treat these intervals as a starting point for a conversation with the dentist who treated you, not as clearance. Your dates are planned around them.

You can say no, or ask to stop, at any stage, including after the examination. Ask before you travel what you would pay if the examination shows that an implant does not suit you.

At home: healing before the final crown

The implant needs time to fuse with the bone before the final crown or bridge is made. How long depends on the bone, the implant's position, any graft and how you heal; you are told your own period after the examination. For orientation, the Cochrane review calls a crown fitted more than two months after placement¹² conventional loading. Fitting it earlier is done only in selected cases. During this time you wear one of the temporary options described above. Do not shorten the healing period to fit travel plans. Ask how healing will be checked before you book the second visit, and what happens if it is not complete.

The NHS website for England advises you to discuss your plans with a GP²³ before making any final decisions about travel or medical arrangements. Tell your own dentist about the plan too, and ask now whether they will see you between the visits and afterwards. If you do not have a regular dentist, find one in the UK, NHS or private, who agrees to see you before you travel. A check with a dentist in the UK between the visits can be written into your plan. If so, ask for the records of the first visit before you fly home, so that dentist can see what was done.

Second visit: the crown or bridge

Once healing is confirmed, an impression or digital scan is taken and the crown or bridge is made and fitted. The bite is adjusted, and you are shown how to clean around the implant. Some plans need a further visit, for example when a try-in shows that a change is needed. You leave with your records and a written review interval.

Once you are back in the UK, the first person to see a problem may be a dentist near you rather than us. Plan for that before you travel. The British Dental Association advises patients to get advice on what to do if problems occur after they return²⁴.

• A loose screw, a crown that comes loose or chipped porcelain. These are the usual technical problems (see "Risks and benefits" above). Contact us through the route in your plan, and see a dentist near you with your records. Whether the repair is done in the UK or on another visit to Antalya depends on the problem.
• An implant that fails. It is not always possible to place a new implant in the same place. Further surgery, bone grafting or a different restoration may be needed, and that may mean another visit to Antalya.
• Who pays. Our written remake terms state who pays for further treatment and travel (see "Is the work guaranteed?" below).
• Reviews. Your review interval is set by your risk. Reviews can be done in Antalya or, where your plan says so, with a dentist in the UK. Ask who will do yours and who pays for them.

What the NHS does and does not do

NHS guidance for dentists in England and Wales says a patient treated abroad is dealt with like any patient previously treated by another provider. If you are accepted for NHS care, treatment that is clinically necessary within NHS services is provided, with your consent. But where another provider did the original work, further treatment within two months and free repair or replacement do not apply²⁵. That guidance does not say an implant or its crown will be repaired or replaced on the NHS. It covers England and Wales. Scotland and Northern Ireland have their own NHS rules, and we hold no record for them. The NHS also states that it is not liable for negligence or failure of treatment²³ you receive abroad.

Insurance

The NHS warns that most travel insurance policies will not cover you for planned treatment abroad²³, so you may need specialist cover. Ask your insurer, in writing, before you book.

The UK General Dental Council lists thirteen questions²⁶ to ask before dental treatment abroad, and the NHS has its own checklist. Below are the ones that matter most for implants, each with our answer. Where our answer is a commitment rather than something you can check today, it says so. Ask us the full list, and ask for the answers in writing.

Who will treat me, and how can I check their registration?

Before you commit, we name in writing the dentist who will place your implant. If someone else will fit the crown, we name them too. In Turkey a dentist in private practice must register with the local dental chamber²⁷ within a month of starting, and cannot practise privately without it. The Turkish Dental Association's website offers a search of registered dentists by name and province²⁸. Ask us for the treating dentist's registration details.

How often do you do this, and what are your complication rates?

The GDC suggests asking how many times the procedure has been carried out, and the success, complication and infection rates²⁶. The figures on this page come from published reviews, not from our own patient records. We publish no implant figures of our own yet, so ask us for them, how complications were defined and over what period.

Is the clinic licensed and regulated?

In Turkey a dental clinic cannot open without a licence or treat patients without an operating permit. It is inspected at least once a year²⁹. To treat international patients, a facility also needs an authorisation certificate from the Ministry of Health³⁰. The Ministry publishes a register of authorised facilities³¹ that you can check yourself. We give you our authorisation details before you commit. A licence or authorisation is a legal minimum, not a statement about the result of your treatment. The GDC itself cannot guarantee that a regulator like it exists in another country²⁶.

Will I get the plan in writing?

Yes. The GDC says you should be assessed by a qualified dentist before being given a treatment plan and cost estimate²⁶. Your written plan states the number of implants and why, the implant system, the temporary solution, the alternatives and how many visits are needed. It also states what the plan covers and does not cover. A plan made from photographs or X-rays you send is preliminary. It is confirmed after the examination and 3D scan, and we tell you before anything in it changes. You can take the written plan to a dentist in the UK for an independent opinion before you commit.

Is the work guaranteed?

The GDC suggests asking whether the work is guaranteed and for how long²⁶. It also suggests asking whether further treatment is included if there are complications, and who pays for extra flights, hotel and remedial work²⁶. The GDC sets no minimum period itself. Before you commit, we give you our complication route and remake terms in writing. They state what is covered, for how long and what is excluded. They also state what you must do to keep the cover, such as attending reviews, and who pays for further treatment and travel. Read that document before you decide, rather than relying on the word "guarantee" on any web page.

Am I insured if something goes wrong?

The GDC lists insurance among its questions. In Turkey a facility treating international patients must take out complication insurance for surgical and interventional procedures carried out in an operating theatre³⁰. That does not by itself tell you whether your implant surgery is covered, so ask which procedures in your plan fall under it. Ask us in writing whether the clinic or the treating dentist holds insurance for complications or errors. Travel insurance is covered in the section on problems after you are home, above.

Who do I contact after treatment?

Your written plan names the contact route for questions and problems once you are home, and your review interval. For urgent symptoms, get emergency care where you are first (see "When to contact a dentist" below).

What records will I take home?

The NHS lists exchanging medical records and arranging aftercare back home²³ among the things to consider. In Turkey you are entitled to an itemised bill, and on request to free copies of the records of materials, tests and imaging³⁰. You may also examine your file and take a copy³². At the end of treatment we give you your records in a form a UK dentist can use. They include the plan, X-rays and scan, the implant system with its diameter and length, the parts used, and the baseline measurements.

What if I am unhappy, and where can I complain?

We give you our written complaints procedure before treatment. A complaint goes to the clinic first; private dental polyclinics, centres and hospitals in Turkey must have a patient rights unit²⁹. If the clinic does not resolve it, you can apply to the provincial health directorate's Patient Rights Board³². The Board decides within thirty days, but it does not assess allegations of medical error. The dental chamber can also open disciplinary proceedings²⁷ against a dentist. Do not expect the UK regulator to settle it. The GDC states that it cannot resolve complaints or help with refunds³³; its investigations are about whether dental professionals are fit to practise.

Will the team speak English?

The GDC suggests asking whether the team speaks your language and, if not, whether a translator is provided²⁶. We confirm in writing, before you commit, who will explain the plan, the consent form and the aftercare instructions to you in English.

Warning signs, including for us

The NHS checklist names five signs to think twice about before booking. They are a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, and no mention of aftercare³⁴. Apply them to us too. If you feel pushed to decide quickly, wait.

After surgery, or at any time later, contact us and see a dentist near you in these cases.

• Pain or swelling increases after the third day, or bleeding does not stop
• A high temperature, or swelling of the face that keeps growing
• Numbness of the lip, tongue or chin lasts beyond the expected duration of the anaesthetic
• The implant or crown moves, a screw feels loose, or a piece cracks or breaks
• Bleeding, a bad smell, pus or receding gum around the implant
• Pain on biting, or the bite feels high
• Nasal discharge, a blocked nose or sinus pain on the side of an implant in the back of the upper jaw

Before you fly home. If any of these starts while you are still in Turkey, tell us before you travel.

Once you are home. Contact us through the route written in your plan. If numbness persists, pain or swelling keeps increasing, or the implant moves, also see a dentist near you without waiting for our reply. In England, if you do not have a dentist or cannot get an emergency appointment, the NHS says to call 111 or use 111 online³⁵. Elsewhere in the UK, check the local arrangements.

Emergencies. In the UK, call 999 or go to A&E³⁵ if you have any of the signs below. Do not wait for our reply. In Turkey, call 112.

• It is hard to breathe, speak or swallow
• There is a lot of swelling in your mouth, or it is hard to open your mouth
• Your eye is swollen or painful, or your eyesight changes suddenly
• Your neck is swollen³⁶

This page carries no prices. The main things that shape a plan are:

• How many teeth are missing and where; whether extractions are needed
• Whether bone grafting or a sinus lift is needed
• The number of implants, the system chosen and the abutment that goes on it
• The material of the crown or bridge
• The temporary solution used during the waiting period
• Sedation; the number of visits and the review programme
• The remake terms if there is a complication

Ask for three things in writing. What does your plan include? Which items are left 'to be decided later'? Who pays for further treatment and extra travel if there is a complication? Add your own travel for every visit, and reviews with a dentist in the UK, to see the whole cost. If you are comparing with a quote from a UK practice, compare what each one includes, item by item.