Dental Implant Solutions


Whether you have only one missing tooth or you have been wearing dentures for many years, the answers you receive from this questionaire will help you feel more informed and confident about taking up implant treatment.

On completition of the survey your personal report will be emailed to you. Please fill in your details below:

1. Do you have any teeth that are loose and failing?

2. Do you have teeth that are badly broken down?

3. Have you ever been told you have gum / periodontal disease?

4. Are you missing one or more teeth?

5. Have you had a facial trauma or surgery, either through an accident or illness that has caused you to have major tooth and bone loss?

6. Do you have a partial denture?

7. Do you wear a full removable denture?

8. Have you been told you are not a candidate for dental implants due to lack of bone?

9. Do you currently have dental implants or implant restorations that are failing?

10. Do you have concerns about how long implant treatment will take?

11. Do you feel that tooth loss has affected your: (tick all that apply)

Thank you for completing the survey