Before you sign an implant plan

Implant treatment is a large, mostly irreversible spend, and some of it is sold under time pressure ("today only" discounts, same-day financing). The questions below come from what the ADA, the FDA and the Consumer Financial Protection Bureau have said patients should expect. They aren't a substitute for your dentist's judgment; they help you get the information to use it.

What the professional and federal bodies say

• ADA (November 2024): preserving healthy teeth is always a consideration; patients should expect a comprehensive exam and a discussion of the range of treatment options; financing for complex procedures such as full-arch implants should come only after that discussion; anyone uncomfortable with a recommendation should feel free to get a second opinion (ADA statement).
• FDA: before choosing implants, talk to your dental provider about the benefits and risks and whether you're a candidate. Listed risks include damage to nearby teeth, sinus perforation, numbness from nerve injury, and infection; smoking and uncontrolled diabetes raise the risk of failure (FDA, Dental Implants: What You Should Know).
• CFPB (May 2023): the typical medical credit card charged 26.99% APR, compared with about 16% for general-purpose cards; with deferred-interest offers, any balance left at the end of the promotion is charged interest back to the original purchase date; between 2015 and 2020, deferred interest was charged on 20% of healthcare purchases made with such cards (CFPB report).

At the first appointment

1. What did the exam and scan show, and can you show me on the images?
2. What are all my options, including a bridge, a partial or complete denture, or leaving the gap?
3. Which teeth could be kept, and what would a plan that keeps them cost?
4. Am I a good candidate? Do smoking, diabetes or any of my medicines change the risk?
5. Who will place the implant and who will make the crown or bridge?
6. How many visits, over how many months, and what will I wear in the meantime?

About the written plan

Ask for an itemized, written treatment plan with the procedure codes and a price for each line. Check it against the quote breakdown:

Then ask the practice to send a pre-treatment estimate to your dental plan, and wait for the reply before paying a deposit.

About money

• Does a quoted discount depend on signing today? Ask for the offer in writing with an expiry date so you have time to compare.
• If financing is offered, what is the rate after any promotional period, and is interest deferred (charged back to day one) or waived?
• Is a deposit refundable if I change my mind before treatment starts?
• Can the work be staged so it falls across two plan years? See the insurance planner.
• Can I pay from an HSA or FSA? See HSA, FSA and taxes.

Worked example: reading a financing offer

A full-arch quote of $24,000 with "0% for 18 months, deferred interest". If $2,000 is still owed when the 18 months end, interest at 26.99% can be charged on the purchase balance back to the start, not just on the $2,000. That could add several thousand dollars. A plain loan at a fixed rate, or saving and staging the work, can come out cheaper. Run the numbers before you sign, and read the card agreement for the exact method.

Second opinions

A second opinion means another exam, which may carry its own fee; on a $15,000-plus treatment that is a small share. Ask whether the second office can use your existing scans. If the two opinions differ, ask each dentist to explain the other's plan.

After treatment

Keep the itemized receipt, the implant details the practice gives you and your plan's explanation of benefits. You'll need them for HSA or FSA records, tax deductions and any future repair.