Dental implants in Lisbon

Do you need an implant?

Losing teeth is common. The World Health Organization estimates that almost 7% of adults over 20 have lost all their teeth, and 23% of people aged 60 and over. In Portugal’s last national oral health study, from 2015, 14.4% of people aged 65 to 74 had no natural teeth, and 63.3% had fewer than 20.

The main options for a missing tooth are an implant, a bridge anchored on the neighbouring teeth and a removable denture. An implant replaces the root and does not need the neighbouring teeth to be filed down. For a jaw with no teeth, consensus statements recommend at least a two-implant overdenture as the minimum standard for the lower jaw, and a fixed bridge on implants is the option that feels closest to natural teeth. Your dentist should explain every option, including the ones that do not use implants.

How treatment works

• Assessment. An examination, X-rays and usually a 3D cone-beam scan to measure the bone and locate the nerves and the sinuses.
• Preparation. If a tooth needs extracting or the bone needs a graft, this comes first and adds healing time.
• Surgery. The implant is placed under local anaesthesia. For a single implant this typically takes around 90 minutes.
• Healing. The gum heals in one to two weeks, and the implant integrates with the bone over about two to six months.
• Crown or bridge. Once the implant is stable, the abutment and the final teeth are fitted over a few appointments.

With a bone graft, a sinus lift or several stages, the whole treatment usually takes at least a year. Sinus lifts are done awake under local anaesthesia in most cases, and the bone needs four to nine months to mature before the implants go in. Immediate loading, where teeth are fitted on the day of surgery, is possible only when the implants are very stable, and your dentist decides this during the operation.

Planning your trip

Most patients from abroad need two trips. The first lasts about four or five nights: the assessment, the scan and the surgery happen within a few days, and we book your return flight after the check-up. The second trip, about three or four days, takes place three to six months later to fit the final teeth. We prepare the plan and the budget remotely before you travel, so that you arrive knowing what will be done.

Timing your flights matters. A published review of the evidence suggests waiting about 72 hours before flying after uncomplicated implant placement and at least two weeks after a sinus lift, because pressure changes can affect the sinuses. Tell us when you need to be back and we schedule the treatment around it. Remember that the European Health Insurance Card does not cover private healthcare, so treatment is paid by you.

Costs and what they include

Our fixed prices start at €490 for a crown, €780 for an implant without a crown, €1,490 for an implant with an abutment and a ceramic crown, €250 for a bone graft and €450 for a sinus lift. A fixed full-arch bridge starts at €6,900 per jaw. The assessment and the 3D scan cost €90 and are credited against the treatment if you go ahead.

For comparison, Lisbon clinics publish prices of about €950 to €1,800 for a single implant with a crown, with premium clinics up to about €2,500, and some advertise an implant from as little as €350 that does not include the crown. In the United Kingdom, a major dental provider lists a single implant with an abutment and a crown from about £2,400, and the average price of one implant in the United States is about $2,100 without the crown. A low price is meaningful only if it includes the implant, the abutment, the crown, the 3D scan and the follow-up, so ask for every item in writing. Under the Portuguese dentists’ code, the dentist must justify the fees and give a fee estimate and the likely duration of treatment when you ask for it.

Success and risks

Systematic reviews report that about 94% to 96% of implants are still in function after ten years, and a review of full-arch treatments found survival of 94% to 98% over six to eleven years. Evidence beyond 15 to 20 years is of lower quality, and the figures are lower and less certain.

• Peri-implantitis: an infection of the gum and bone around an implant that affects roughly one in five patients in pooled studies. Good hygiene and regular check-ups lower the risk.
• Smoking: a major risk factor, and many hospitals ask patients to stop at least six months before starting.
• Gum disease, bruxism and poorly controlled diabetes can also increase the risk, so we treat them first.
• Aftercare: brush and floss every day, use the mouthwash your dentist recommends and see a dentist or hygienist every three to six months.

Safety and regulation

Dentistry in Portugal is practised by a médico dentista registered with the Ordem dos Médicos Dentistas, the OMD, and the Order publishes a public search to confirm it. Clinics must be registered and licensed with the Entidade Reguladora da Saúde, the ERS. A clinic must display its ERS registration certificate, its licence, the name of its clinical director, its opening hours and a price list, and the clinic and every dentist must hold professional civil liability insurance.

The Order recognises specialties such as oral surgery and prosthodontics, but implantology is not a recognised specialty, so a clinic that advertises an implantologist is using a title that does not exist in Portugal. Our surgeon is a specialist in oral surgery recognised by the OMD. Before treatment, the dentist must explain the diagnosis, the treatment plan, the alternatives and the foreseeable risks, and you have the right to receive this information in a way you can understand. We keep your consent, your plan and your implant details in your clinical record, and you receive a copy.

Questions to ask any clinic

• Which dentist will place my implants, and what is their OMD registration number?
• Is the clinic registered with the ERS, and can I see the certificate and the licence?
• Which implant brand will you use, and will I receive an implant passport?
• What does the price include: the 3D scan, the abutment, the crown and the follow-up?
• What happens if I need help after I return home?
• Is there an alternative that does not need an implant?

This guide is general information and is not medical advice. A clinical examination is needed to decide whether and how an implant can be placed.