CASE STUDY
- Patient: Claire
- Age at Treatment: 75
- Treatment: Upper arch fixed implant bridge. Smile-in-a-Day protocol. Lower teeth retained.
- Treating Clinician: Dr Nikhil Oberai MSc · GDC No. 150126
- Presenting Situation: Multiple missing teeth, gum disease, fractured teeth with retained roots, difficulty eating and speaking
- Outcome: Complete fixed upper arch. Permanent bridge fitted after 12-week healing. Life significantly improved. Eating with family and friends again. Delighted with the result.
- Treatment Duration: Five months start to finish.
She was 75 and she wanted fixed teeth. That seemed entirely reasonable to me.
Claire came in for a free consultation wanting to know her options. Her upper teeth were severely loose and mobile, well beyond saving. Her lower teeth were also compromised. She was very conscious of her situation and deeply worried about what treatment would mean for her day-to-day life.
What she told me at that first appointment was straightforward and completely clear. She did not want to be toothless. She did not want a denture, something she could take in and out. She wanted fixed teeth. She was sociable. She liked going out for meals with friends and seeing her family. She felt her teeth were already knocking her confidence in ways that were beginning to affect her life. She wanted that addressed properly.
She was 75 years old when she said all of this to me. And I want to be direct about my response: age was not a factor in my assessment and it did not change a single thing about the treatment plan.
Loose teeth that were affecting everything. And the worry about what came next.
The anxiety that comes with failing teeth is particular. It is not just the discomfort or the difficulty eating. It is the uncertainty. Claire knew her upper teeth were not going to hold on much longer. She could feel it. And the prospect of being without them, of having to wear a traditional denture, of losing the freedom and confidence she valued so highly, was weighing on her heavily.
She was a sociable person. She liked meals out. She liked being with her family. These are exactly the situations where teeth matter most, where how you feel about your smile directly affects how present and confident you can be. And her teeth were making her feel the opposite of confident.
She had reached a point where the question was no longer whether to do something. It was whether something was actually possible. She came to see me to find out the answer.
After a thorough examination we went through her options together. We analysed her bone levels and assessed her gum condition in detail before committing to any treatment path. The plan we agreed on was to fix the upper arch with implants and save the lower teeth where possible, preserving as much as we could while giving her the fixed upper smile she wanted.
- Planning the treatment
A thorough assessment, an honest plan, and a decision made with full information.
Before any treatment began, we went through a staged assessment process. Bone levels were measured from the CT scan to confirm that implant placement was viable on the upper arch. Gum health was reviewed on both arches. The lower teeth were assessed for their long-term viability and a decision made about which could be retained.
The treatment plan that came out of this assessment was clear. Upper arch: extract all remaining teeth, place implants, fit a temporary fixed bridge on the same day. Lower arch: treat and retain the remaining teeth. No denture at any point during the treatment period. No gap. No interim period of being without teeth.
Claire was part of every decision. She understood each stage before it happened. She knew what the day of surgery would involve, what the healing period would look like, and what the timeline to her permanent bridge was. There were no surprises, which I think mattered enormously to someone who had been anxious about the outcome for a long time.
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Extractions, implants, and a fixed smile. All on the same day.
The treatment took five months from start to finish. On the day of surgery, Claire’s remaining upper teeth were carefully extracted and the implants were placed in the same appointment. A temporary fixed bridge was attached on the same day.
She left the clinic that day with fixed teeth in place. Not a denture. Not a gap. A fixed, functional upper smile on the same day as the extractions and the implant placement. She did not wear a denture at any point across the entire five months of treatment. That was important to her and it was something I was able to deliver.
The temporary fixed bridge remained in place for 12 weeks while the gums healed and the implants integrated fully with the bone. During this period Claire carried on with her normal life. She ate, socialised, and went about her days with no outward sign that she was mid-treatment.
After the 12-week healing period, we began the construction of the permanent bridge. This stage involved the careful design of the smile to suit Claire’s face, the right shade, shape, and proportion for someone of her features and colouring. Claire was involved in reviewing and approving the appearance before the permanent bridge was finally fitted. She confirmed she was happy with what she saw before we proceeded.
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- The outcome
Life significantly improved. Confident her smile will not let her down.
The results, as Claire’s photographs show, are exactly what we set out to achieve. A completely natural-looking, aesthetically pleasing upper smile that no one would identify as implant-supported unless they already knew.
Three months after the surgery, Claire told us that her life had significantly improved. She was going out for meals with family and friends again, confident that her smile was not going to let her down. The worry that had been growing for years, the anxiety about loose teeth, about being toothless, about what people could see, was simply gone.
She was delighted. That is her word and it is the right one.
What I find most meaningful about Claire’s story is not the clinical complexity or the technical outcome, both of which I am proud of. It is the fact that she came in at 75, having been told implicitly or explicitly that perhaps her situation was what it was, and she left five months later with a fixed, permanent smile and a significantly better quality of life. That should be available to everyone who wants it, regardless of age.
- A note from Dr Nikhil
Age is not a barrier. It has never been.
I want every patient who is reading this and wondering whether they are too old to have this conversation to hear this clearly: there is no upper age limit for dental implant treatment. I have treated patients in their eighties and nineties. What I assess is the clinical picture, the bone, the gum health, the general health. Not the year on the birth certificate.
Claire’s case is one I share when patients raise age as an objection, because it illustrates something important. The desire to live well, to eat with friends, to feel confident in your smile, does not have an expiry date. And in most cases, the clinical conditions for successful treatment are present regardless of how old the patient is.
If you are in your sixties, seventies, or eighties and you are reading this with a situation that sounds like Claire’s, please come and see me. The free 3D Smile Assessment will tell us both what is possible for your case. The answer may well be more encouraging than you expect.
“For every problem, there is a solution. It might be challenging, but it is almost always possible.”
“She now feels that her life has significantly improved. She can enjoy going out with family and friends again, confident her smile will not let her down.” — Dr Nikhil Oberai, on Claire’s outcome
- Treatment involved
Smile-in-a-Day Fixed Upper Arch Implant Bridge
Claire had her upper arch restored using the Smile-in-a-Day protocol. All remaining upper teeth were extracted and implants placed in a single appointment, with a temporary fixed bridge fitted on the same day. After a 12-week healing period, a permanent fixed bridge was designed and fitted to complete the upper arch. Her lower teeth were retained and treated alongside.
This treatment falls within the Gold Package at my Cheshire practices. Full arch treatment starts from £15,500. 0% finance is available through Tabeo over 12 months.