Dental Implants on the Upper West Side

What a dental implant actually is

A dental implant is a small titanium post that takes the place of a missing tooth root. It is set into the jawbone, where over the following weeks the bone grows tightly around it — a biological process called osseointegration. Once that has happened, the post is stable enough to support a crown, a bridge, or a full set of teeth.

It helps to think of an implant as three separate parts. The implant itself lives in the bone and is never seen. A small connector called an abutment sits at the gumline. On top of that goes the crown — the part that looks like a tooth and does the chewing. Each part is chosen and fitted individually, which is why the quality of the planning matters as much as the quality of the surgery.

What makes implants different from a bridge or a denture is that they replace the root, not just the visible tooth. That matters more than most people realize. When a tooth is lost, the bone that used to hold it begins to shrink away, and over the years that changes the shape of the face around the mouth. An implant keeps that bone working, and the shrinkage largely stops.

Why it matters that a prosthodontist does the work

Any licensed dentist in New York is permitted to place implants. There is no law requiring specialty training, and weekend courses on implant placement are widely available. That is worth knowing when you are choosing where to have this done.

A prosthodontist completes three additional years of full-time hospital residency devoted specifically to replacing and restoring teeth. Dr. Berkowitz trained at the University of Michigan, one of the strongest programs in the country, where the training was surgical as well as restorative — he placed hundreds of implants over the course of the residency. He served as Chief Resident in his final year, and went on to spend ten years as the attending prosthodontist at the Northport Veterans Administration Medical Center. Prosthodontics is one of only twelve dental specialties formally recognized in the United States.

There is a second, more practical advantage. In many practices, one office places the implant surgically and a different office makes the tooth that goes on top. When the result is not right, the patient ends up in the middle of a disagreement between two dentists. Dr. Berkowitz is surgically trained and does both parts himself. One person plans the case, one person executes it, and one person is accountable for how it turns out.

Are you a candidate?

Most adults are, including many who have been told elsewhere that they are not. The main requirements are enough healthy bone to hold the implant, healthy gums, and reasonable general health.

Age is almost never a barrier on its own. We routinely place implants for patients in their seventies and eighties, and for someone who is otherwise healthy the healing is usually uneventful. What matters far more than your age is the condition of your gums and whether any medical conditions affect healing.

Some situations need more planning. If a tooth has been missing for many years the bone may have thinned, and a bone graft may be needed first — a common and predictable procedure. Uncontrolled diabetes, active gum disease, heavy smoking, and certain bone medications all affect how implants heal, and each needs to be discussed honestly before treatment rather than discovered afterward.

If you have been told you do not have enough bone for implants, it is worth getting a second opinion from a specialist. Techniques that were unavailable ten years ago now make many of those cases treatable.

What it costs, and why the range is so wide

Most patients want a number before they are willing to schedule a consultation, and it is unhelpful to pretend the question cannot be answered.

In Manhattan, a single implant with its abutment and crown generally falls somewhere between $4,500 and $7,000 in total. Where a given case sits in that range depends on whether a tooth needs to be extracted first, whether bone or gum grafting is required, which implant system is used, and what the crown is made of.

Be careful with advertised prices well below that range. They frequently quote the implant post alone and exclude the abutment and crown, which together are usually more than half the real cost. A price that seems remarkably low is almost always a partial price.

Dental insurance sometimes contributes toward implants, though rarely the full amount, and annual maximums on most plans are low relative to the cost of treatment. We will check your specific benefits before you commit to anything, and we will give you a written estimate with the full cost laid out. Where a case is large, we can phase the treatment across time so that it is easier to manage.

One implant, several implants, or a whole arch

A single missing tooth is the simplest case: one implant, one crown, and the teeth on either side are left alone. Several missing teeth in a row can often be replaced with two implants supporting a small bridge, rather than one implant per tooth. And when an entire upper or lower set of teeth is failing, four to six implants can carry a complete fixed arch — the treatment usually called All-on-4.

For someone who already wears a denture, two implants under the lower denture are often the single most effective change available. The denture snaps onto them and stops moving. That option is described on our dentures and implant overdentures page, and compared with fixed teeth in our guide to All-on-4 versus dentures.

Which of these fits you is decided at the consultation, from the 3D scan and a frank conversation about what you want the result to do. We will tell you if a simpler, less expensive option would serve you just as well.

Implants done elsewhere that have not worked out

A meaningful share of the implant work in this office is correcting or completing work that was started somewhere else: an implant that has become loose or sore, a crown that never looked right, an implant placed at an angle that makes a good tooth impossible, or a case that stalled between a surgeon's office and a restoring dentist.

If that is your situation, you are not alone and it is usually fixable. Start with our implant second opinion page, which explains what we look for and what the consultation involves. If an implant is loose, painful, or the gum around it is swollen, call the office rather than waiting — early treatment is what saves the implant.

Finding us from the Upper West Side and beyond

The office is at 40 West 86th Street, Suite 1C, between Central Park West and Columbus Avenue, half a block from the park. The 1 train at 86th Street and the B and C at 86th Street are both a short walk, and the M86 crosstown stops on the corner. Most of our implant patients live on the Upper West Side, but a good number come from across Manhattan and from Westchester and New Jersey for a specialist who places and restores in one office. Implant treatment involves only a handful of visits spread over several months, so the trip is manageable even from a distance.