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Implant enquiry form

Step 1

Select your affected teeth

Please click on the teeth where you are considering dental implants, using the options below:

Click once for missing tooth

Click twice for loose or failing tooth

Click three times for a broken tooth

Key:

= Missing tooth

= Loose/failing tooth

= Broken tooth

Dental arch image All Top Teeth All Bottom Teeth Back Upper Left Third Molar/Wisdom Teeth Back Upper Left Second Molar Back Upper Left First Molar Back Upper Left Second PreMolar Back Upper Left First PreMolar Front Upper Left Cuspid Front Upper Left Lateral Incisor Front Upper Left Central Incisor Front Upper Right Central Incisor Front Upper Right Lateral Incisor Front Upper Right Cuspid Back Upper Right First PreMolar Back Upper Right Second PreMolar Back Upper Right First Molar Back Upper Right Second Molar Back Upper Right Third Molar/Wisdom Teeth Back Lower Left Third Molar/Wisdom Teeth Back Lower Left Second Molar Back Lower Left First Molar Back Lower Left Second PreMolar Back Lower Left First PreMolar Front Lower Left Cuspid Front Lower Left Lateral Incisor Front Lower Left Central Incisor Front Lower Right Central Incisor Front Lower Right Lateral Incisor Front Lower Right Cuspid Back Lower Right First PreMolar Back Lower Right Second PreMolar Back Lower Right First Molar Back Lower Right Second Molar Back Lower Right Third Molar/Wisdom Teeth implant teeth implant tooth tooth to click
You must not select more than 22 teeth. If you are missing more than 22 teeth please let us know in the Additional comments section.
Step 2

Implant enquiry form

A member of our friendly team will then be in touch to discuss your requirements

Please note you will receive an estimate of costs only. For a full and comprehensive quote you will need to attend an in-practice assessment.

We recognise that when you give us personal information (which includes health information) you're trusting us to take good care of it. Please see www.bupa.co.uk/privacy for more information about how we collect, use and protect your data.

If you don't want to receive marketing about Bupa products and services that we think are relevant to you, please contact us at [email protected].

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