Diagnostics before any irreversible work
- CBCT (3D) scan obtained and reviewed with you, not just stored.
- Periodontal evaluation (probing depths, bleeding, bone level) documented.
- Occlusal analysis: how your teeth meet, parafunction (clenching/grinding) noted.
- Photographs and digital scan or impressions for treatment planning.
- Medical history reviewed: medications, anticoagulants, bisphosphonates, diabetes control, smoking, history of head/neck radiation.
Treatment plan & informed consent
- Written treatment plan listing every procedure, material, and fee.
- Implant brand, model, abutment, and crown material specified by name.
- Alternatives discussed in writing, including doing nothing.
- Realistic outcomes, longevity ranges, and revision possibilities discussed.
- Risks specific to your case (sinus, nerve, esthetic, biomechanical) reviewed.
- Sedation plan and provider qualifications confirmed.
- Written warranty terms reviewed: what is covered, for how long, what voids it.
Day of surgery / treatment
- Time-out: confirm patient, site, procedure, implant brand and size before starting.
- Sterile technique observed: gowned and gloved appropriately, instruments unwrapped in front of you when possible.
- Vital signs monitored if sedation is used; appropriate monitoring equipment present.
- Implant placement torque values recorded.
- Post-op instructions provided in writing, including medication doses and warning signs.
First 72 hours
- Pain controlled with a clear medication schedule.
- Bleeding controlled within hours, not days.
- No fever above 38.5°C / 101.3°F.
- No spreading swelling, no difficulty swallowing or breathing.
- Soft diet, no straws, no smoking, no vigorous rinsing as instructed.
- Emergency contact number for the surgeon or on-call coverage.
Follow-up & long-term
- Post-op visit at 1 – 2 weeks for suture check and healing assessment.
- Osseointegration check before final restoration (typically 8 – 16 weeks).
- Hygiene protocol for implants and veneers reviewed.
- Annual peri-implant evaluation: probing, radiographs as indicated, occlusal check.
- Nightguard if any history of clenching or grinding.
- Long-term records (implant brand, lot, torque, prosthesis materials) kept with you, not only the dentist.
Red flags that warrant a second opinion before proceeding
- Pressure to sign or pay the same day.
- No CBCT, no written plan, no itemized fees.
- Refusal to name the implant brand or crown material.
- Unwillingness to discuss alternatives or risks.
- Promised timelines that contradict normal healing biology (e.g., final teeth in 5 days for a complex case).
- Quotes substantially lower than every other quote you receive, with no clear reason why.