Dr Niall Fitzgerald

I qualified from Queen’s in 2004 and spent eleven years doing what most dentists do: a bit of everything. Fillings in the morning, a root canal after lunch, an implant case if one came along. I was competent at all of it and exceptional at none of it, and the implant cases were the ones I thought about on the drive home.

In 2016 I stopped doing general dentistry entirely and opened Ardan to place implants and nothing else. Since then I have placed over 1,400 of them.

Why an implant surgeon narrows the work down

There is a fair argument that a dentist should be able to do everything. I do not agree with it for surgery.

An implant is a small operation in a jaw with a nerve running through it and a sinus sitting above it. Doing five a year and doing five a week are different jobs. The difference does not show up in the easy cases — it shows up in the case where the bone is thinner than expected, or where the sinus floor is where you would rather it were not, and the decision has to be made while the patient is sitting there. That judgement comes from volume, and volume is what a single-discipline clinic is for.

It also means I can say no. A general practice that places the occasional implant has an incentive to make yours work. When implants are all you do, turning down the ten per cent of cases that should not proceed costs you nothing, and it is the single most useful thing I can offer somebody.

How I plan a case

Every patient has a CBCT scan at the first appointment. Everything after that is planned on the scan rather than on the day: implant positions, angles, depths, where the bone is worth using and where it is not. The surgical guide is printed downstairs from that plan, so the position I decided on with time to think is the position the implant ends up in.

Dr Sinéad Mallon plans the teeth before I plan the implants, which is the correct order and the opposite of how it is often done. Where the tooth needs to sit determines where the implant goes. An implant placed where the bone happens to be convenient will hold, and it will hold a tooth in the wrong place.

What I will tell you

That most cases are straightforward. That some are not, and that I will say which is which before you have paid for anything. That smoking roughly doubles the failure rate and I would rather have that conversation than take your money quietly. And that an implant is a maintained thing, not a fitted thing — the appointments afterwards are not an upsell, they are the reason it lasts.

I see every implant patient personally from the consultation to the final review. If you come here, I am the person who does your surgery, and I am the person you ring if something is not right.

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