What is the cost of one dental implant in Singapore?

This is one of the most often asked questions about dental implants. Whenever, I hear this question in a social setting, or when a patient emails in an enquiry, I have to second-guess what the intention of the person asking the question is. Some want to compare the fees between one practice and another, just like comparing the price of a Big Mac between different cities. Others may just want to know so that they can decide if they are prepared to part with that amount of money. Where possible, I will answer the question with a question. For example, “which tooth is the implant replacing?”, “how did you lose the tooth?”, “how long have you lost the tooth?”, etc. The cost of one dental implant in Singapore can vary significantly depending on the circumstances of each case. I’ll illustrate with a few examples.

1. A straightforward case: A 30 year old man had a lower premolar extracted a year ago due to tooth decay and has not done any replacement for the tooth since. The wound had healed completely and the bone where the tooth once was had grown back fully. He wanted to have an implant-supported prosthesis to replace that missing tooth. He had no medical history and did not smoke. Treatment for this patient was straightforward. A local anesthetic injection to numb the area, a drill to prepare the bone and a single dental implant inserted. Six weeks later, treatment was completed with a crown placed onto the implant.

2. A trauma case with high aesthetic demand: A 20 year old girl slipped and fell and fractured her upper front tooth along with the bone holding it. The fracture of the tooth extended into the bone. She had a high smile line which showed her gums when she smiled. The tooth needed to be removed and be replaced with an implant supported prosthesis. She had a front line job and was unable to be without a front tooth for any length of time. Her treatment plan was as follow:
   1. Surgical removal of the fractured tooth bone grafting under intravenous sedation
   2. A temporary adhesive bridge was made as a provisional prosthesis
   3. Four months later, a gingival graft was done to thicken the gum around the future implant
   4. The implant was placed two months after the gingival graft
   5. Final crown on the dental implant was done two months later

3. A medically compromised elderly patient: An 80 year old patient who lived in a neighbouring country fractured a tooth while eating. He flew into Singapore to have the broken tooth removed and replaced with a dental implant. He had a history of heart valve replacement and was on anti-clotting drugs. Due to his medical history, he was referred back to his cardiologist for a preoperative assessment. His cardiologist recommended that the surgery be done in the hospital operating room with an anesthesiologist in attendance and that postoperative monitoring be done in the ward as an in-patient for 24 hours. Accordingly, he was admitted to the hospital whereby the cardiologist modified his anti-clotting medications pre and post operatively and instituted a course of intravenous antibiotics to prevent infection of the prosthetic heart valve. The broken tooth was extracted and an implant placed under light intravenous sedation. The implant was restored with a crown two months later in the clinic.

4. A bone grafting case: A 50 year old patient had a horizontal fracture of her upper molar. She had seen a root canal specialist who had diagnosed that the tooth was beyond salvage. She wanted to have the tooth removed and replaced with an implant-supported prosthesis. CT scan showed that the fracture was near the apex of the root and she had insufficient bone to support an implant. As such, she underwent the following
   1. Extraction of the tooth and surgical removal of the fractured root
   2. Sinus floor bone grafting under intravenous sedation
   3. Insertion of an implant a few months later
   4. Restoration of the implant with a crown a few months after implant insertion

The above are but a few examples of how different cases of single dental implants are and hence the difference in fees can be rather significant. Most of the time, a patient will not be able to tell whether he has a straightforward case or a complicated one. Even within each scenario, there is more than one possible plan and the cost can be very different. For example, for a patient requiring a bone graft, the bone can be harvested from the patient’s own jaw or from a commercially available source. Among the commercially available sources, there is also a great disparity in price. For example, a bone-inducing source such as bone morphogenetic protein is five to six times more expensive than the non-inducing type of commercially available bone grafts such as cow bone mineral.

A good implant dentist will be able to assess your situation and offer several options. There are pros and cons in each option and the final decision lies with the patient. The most expensive method and material are not always the best in every situation. When considering the options, start with the option that gives the best and most predictable results and work backwards from there. Sometimes, the best option is not adopted not because of high cost but because of the longer duration and frequency of treatment needed. By understanding the best option, you can appreciate what you are giving up when you opt for alternative plans. To some patients, aesthetics may not be that critical and they may not be willing to go through the extensive bone grafting and gingival grafting.

However, the major component of the fees is the skill and experience of the dentist. In some cases, one dentist carries out the entire treatment. In others, you have a team; an oral surgeon to do the bone and gingival grafting and implant insertion, and a prosthodontist to do the crown. While cost is understandably an important consideration, it is not wise to go only with the lowest cost option as that may result in more complications and higher costs subsequently.