Denture Implants & Implant Retained Dentures: Procedure, Costs & FAQ

Few of us wish to lose a natural tooth, let alone all of them, but circumstances mean that many people each year, find themselves living with no natural teeth

In fact, 40 million people in the USA have none of their own teeth.

When you lose all the teeth in 1 or both jaws, you ideally need to do something about it, to be able to live a ‘normal’ life.

Modern dentistry has many solutions to prevent tooth loss in the first place, but there are a number of solutions too, when all teeth are lost.

Dentures are the go to option in most cases.  They provide an affordable and practical option for most.

The problem with dentures are that they rest on the gums and rely on suction to remain in the mouth.

Over time, the gum shape changes and fitting becomes worse, meaning loose and not always secure false teeth.  Wearers then become conscious of the fact and become less confident and concerned about living day to day life to the full.

Implants, specifically for dentures are a solution for many, doing away with some of the biggest inconveniences of traditional dentures.

In this article, we take a detailed look at implant supported and retained dentures, from what exactly they are, through to how much they can cost.

What are dentures/false teeth?

You may well know what a denture is, but to ensure the contents of this article is clear, let me take a moment to explain what exactly a denture is.

A denture is an artificial replacement for missing teeth and tissues in the mouth.

Most people know or refer to a denture simply as ‘false teeth’.

It is the equivalent of what a prosthetic leg is to someone who has lost a leg.

You get 2 main types of denture – full and partial.

Full dentures replace all the teeth in an arch, whilst a partial replaces just a few.

Depending on the individual, they may have just 1 denture for either the bottom or top row or teeth, or they may have a denture for both top and bottom.

You can learn a lot more about dentures and the various types available in our dentures guide.

What are denture implants?

Denture implants are man made screws, generally made of titanium, that are placed into the jaw bone of the mouth during a surgical procedure.

When placed into the bone, the screw acts a little like a natural tooth root would, giving a secure attachment to which a denture can be attached.

A jaw needs between 2 and 6 strategically placed implants to hold in place the false teeth (denture) that will be attached.

What’s the difference between regular dental implants and denture implants?

The word ‘implant’ is often incorrectly understood and used by people.

Many believe that an implant is the complete artificial replacement tooth, when the truth is that the implant is only the piece that is inserted into the jaw bone, essentially the root of the tooth.

A whole artificial tooth is made up of 3 main parts: the implant, an abutment and a dental crown.

Implants complete with crown are realistically, the closest you can get to replacing the sensation and strength of natural teeth.

However, replacing a full set of teeth with such, is expensive, time consuming and unnecessary, so most dentists would not advise such.

When you have no teeth of your own left, you ideally want something to replace them.  Dentures are the recommended option, but an increasingly popular option are dentures held in place using implants.

Compared to an implant and crown setup for each tooth, a denture held in place by an implant requires on average, only 2-6 strategically placed implants per jaw.

As such, the treatment and recovery are quicker and the costs lower too.

Implants are manufactured in a variety of sizes, depending on how thick the bone of the jaw is.  In most cases a standard sized implant is used when fitting a crown.

The larger the implant, the better the pressure and forces can be dealt with, as a general rule.

Some dentures will be secured with a standard sized implant, but very common is the use of the smaller mini or midi implants.

Mini and midi implants are better suited for those with lower bone density, which is quite common amongst the age group of individuals who usually seek a denture.

Less implants and the different spread of chewing forces means that more often than not, implants can be placed and dentures secured in a fraction of the time of regular dental implants.

Denture implants & dentures are 2 different things

A traditional denture is a piece that sucks/sticks to the gums in the mouth.  There is 1 piece per jaw that requires the false teeth, in most instances.

Where implants hold a denture in place there are technically 2 parts to the puzzle.

There are the surgically placed implants and then the denture itself, the latter you may already have.

The slight exception to the rule is the fixed dentures like ‘All-on-4’ which is essentially a kit which includes all the dentist needs.  With “All-on-4″the process of placing the implants is one stage, then fitting the dentures is another.

Who makes an ideal candidate for denture implants?

Denture implants are a great option for anyone who is missing many teeth, and who wants a more secure option than regular dentures. So long as you don’t have any medical conditions that mean you can’t have minor surgery, anyone could be an ideal candidate!

Dr Gemma Wheeler – In-house dentist – GDC Number: 259369

Benefits of denture implants

The benefits to denture implants are primarily the opposite to the negatives associated with traditional dentures.

We consider the main advantages of implants for dentures to be as follows.

Security and retention

Dentures held in place by implants cannot move, unless you actively take steps to move it.

Normally, when dentures are used without implants, the bone changes shape and the dentures become loose over about 5-10 years. When this happens the denture should be altered or replaced.  This can get expensive. It is simply not possible when implants hold the denture in place.

Preserve jaw bone and improve appearance

The body is extremely clever and when no teeth exist in the jaw, it essentially knows there is nothing left to hold onto.

As the body recognises this, the bone shrinks in a process dental professionals call ‘resorption’.

Unless something is done about it, the changing bone structure can mean that the smile, lips and face changes.

Ageing far beyond one’s actual years is common as are deep wrinkles forming around the mouth and even a downwards turn to what would otherwise be a smile.

This resorption is what causes dentures to loosen over time and require new dentures to be made or existing ones to be reshaped.  In fact, pressure on the gums actually speeds the whole cycle up.

However, dentistry has found that by placing implants, even though they may not be natural, the body considers them to be equivalent to teeth and thus the shrinking is stopped when implants are placed.

Actually placing metal screws into the jaw restores natural strength and promotes bone growth.

Smaller in the mouth and more natural looking

New materials, better technology and sculpting techniques means bulky dentures are not as common as they once were.

But, implants offer a different way to secure the denture, a way then needs far less material to grip to or around other parts of the mouth.  The result is that the denture can be even smaller and more comfortable when held in place by an implant.

When you smile you can be less concerned about the teeth looking fake, in fact few can really tell unless they observe very closely.

Comfort

The implants hold the denture in place rather than natural suction.

The physical presence of the implants help with stopping bone loss and therefore everything fits with more comfort in the mouth for longer.

Normal chewing and more taste

We explained how implants allow for a smaller profile and less need for structural material on a denture when held by implants.

This means that the large acrylic panels that would normally cover the roof of the mouth can be removed.

More of the taste buds and receptors in the mouth are revealed and allow for food and drink to be tasted with a lot less restriction.  You can enjoy flavours that you might have forgotten about, simply as a result of being able to reshape a denture.

The more secure fit and distribution of forces also helps with eating and chewing too, to give more balance and strength in the bite.

Confidence & quality of life

Dentures may cause you to fear that everytime you open your mouth your teeth will jump out, so that you look awkward, aged or generally unwell. This is going to have a significant knock on effect to you and the quality of life that you have.

When the implants hold a denture in place you can be assured that the bone is stronger for longer, that your smile will remain, and that the wrinkles will not appear so quickly, as well as eating being more enjoyable.

This peace of mind has a significant knock on effect to your confidence and approach to life.

With extra confidence comes the desire to live life and enjoy.

Implant retained dentures are very stable and have greatly reduced movement in the mouth. This can give a person extra confidence when eating and socialising that their denture wont have unwanted movements.

Dr Chhaya Chauhan – In-house dentist – GDC Number: 83940

Drawbacks of denture implants

There are some drawbacks to denture implants, but in most cases these are outweighed by the benefits.

Surgery

They say, no pain, no gain.

Although implants require surgery, there is no pain and there is much to gain.

Dentists use a anaesthetic so you cannot feel pain when the implants are placed, and with appropriate planning the surgery and the healing time can be relatively short.

Results can be achieved in as little as a day, with little in the way or real recovery time.

In some cases, for the procedure to be successful, bone grafts may be required meaning more invasive surgery and longer treatment times to achieve the desired results, but you will be told if this is necessary beforehand.

Cost

The surgery and dentures do not come for free and will incur a much higher cost compared to regular removable dentures held in place by nothing more than suction.

The following video highlights some of these but also shows how an implant based denture compares to that of a traditional one.

𝐒𝐧𝐚𝐩 𝐢𝐧 𝐃𝐞𝐧𝐭𝐮𝐫𝐞𝐬 𝐢𝐧 𝐌𝐞𝐱𝐢𝐜𝐨 with dental implants testimonial review | See how he got an amazing smile

Types of dentures for implants

When choosing the type of treatment suitable for you, you will need to consider:

• The type of implant
  • Implant supported dentures
  • Implant retained dentures
• Is the denture fixed?
  • Fixed denture.
  • Removable denture.
• The size of the denture
  • Full denture
  • Partial denture

In most circumstances, the implant is completely separate to the denture to which it is attached. This means there can be choice in materials look, quality and price of the denture itself.

When you have decided that dentures held in place by implants, is your preference over the traditional implant free option, you then have a choice as to which type of denture you opt for.

There a two main types of dentures that attach to the implants – there are those that are fixed, and those that are removable.

The types might well be self explanatory, but you should know that even the fixed dentures can technically be removed, this just has to be done by the dentist instead of you at home.

With both types of implant-retained denture you can have full or partial dentures that attach to the implant.  However, in most cases the implants are used to hold in place full row of teeth for the one or both jaws.

Implant supported dentures

Implant supported dentures are dentures that sit on implants in the jaws. The implants take the full force placed through the denture, and no pressure is placed on the gums.

Implant supported dentures are designed to take the full force of eating and chewing, and the the pressure is absorbed by the implant and the jaw bone rather than the gum.

The intended result is to give the most natural bite as is possible.

Due to the added pressure and the denture requires more implants compared to an implant retained denture, and all parts need to be made of more durable materials.

As a patient you need to have suitable bone and tissue for the implants to be successful.  It can sometimes incur additional surgery for bone grafting and tissue regeneration which can affect the cost too, but also make implant retained dentures more desirable.

Implant supported dentures rarely have a removable denture on top. The denture is normally fixed in place. Implant supported dentures can have a full denture, or a partial denture placed on top.

Implant retained dentures

Implant retained dentures use a small number of implants to hold the denture in place and spread any pressure placed on the denture between the implants and the gums.

Implant retained dentures are dentures that are held in place by the implants so most of the force that is applied when biting or chewing is transferred to your gums, more similar to the case with a regular denture.

With an implant retained denture, fewer implants are required and often mini implants can be used.

Because they are physically attached to the implant in the jaw the denture is less likely to pop out when eating or talking and give a bit more power and improvement in your bite.

Less bone density is required in most cases and is this is certainly a popular option for the older generation who want many of the benefits of implants, but perhaps are not as suitable for the implant supported option because of lack of bone.

This options tends to be the most cost effective of all the implant denture options.

Implant retained dentures normally have removable dentures on top. These may be called overdentures. Normally the removable denture on top is a full denture, and it is rarely a partial denture.

Removable dentures

You can have a removable denture whether you choose to have implants for an implant supported or an implant retained denture. The main point is that the denture can be removed by you at home, for example to be cleaned.

It is possible that an existing denture be adapted to fit to implants, should you decide you would prefer to make use of implants having tried regular dentures.

Such dentures tend to be more cost effective than fixed, but can require extra attention to care for the denture itself as it needs to be removed for cleaning.

These can too be called as overdentures, as they fit over the implants and rest on your gums.

Fixed dentures

Whilst nothing can replace the natural teeth, a fixed denture gives the most natural look and sensation of teeth.  The denture cannot be removed by you at home, and can only be removed by a dentist.

Fixed dentures can only be placed on implants that have been designed for an implant supported dentures.

In most cases you can essentially live life like you would have with a set of regular teeth.

The downside is the cost can be much higher, and you also need to meet certain criteria to get fixed dentures.

Implant supported fixed denture

Unlike the implant supported overdenture, with implant supported fixed dentures, you cannot remove the denture yourself at home.

Implant supported dentures require 4 or more implants are to be used to hold the denture in place with screws securing the denture to the implant.

An example of implant supported fixed dentures is the ‘All-on-4’ technique we discussed earlier. These have been made popular by dental firm Nobel Biocare, who own the trademark to ‘All-on-4’, which has become the most recognised name for this type of implant retained denture.

The advantage of this particular technique is the small size of the implants used, which rely less on lots of natural bone being present.

All-on-4® treatment concept | Nobel Biocare

Implant supported bridges

Where 1-3 teeth in a row are missing, it is quite common for a dental bridge to be used.

A bridge is a false tooth attached to teeth either side.  This relies on teeth either side of the gap supporting the false teeth.

However with an implant supported bridge rather than the natural teeth being used as support, implants are used.

It is a strong and reliable solution that can look really good too because more premium materials such as porcelain can be used for the teeth.  Sometimes this option may be called a implant supported fixed partial denture.

Denture implant procedure

The approach for actually placing an implant suitable for dentures or for a crown is very similar.

There are a few subtle differences.

Extensive information is provided in another article on our site, dedicated to dental implants.

However, all the key information you need to know, particularly in reference to implants and dentures is provided below.

The treatment journey is made up of 4 key phases.Within this time period you have 4 main phases.

1. Consultation and preparation
2. Placing the implants
3. Fitting the abutment
4. Fitting the denture

The amount of time required for treatment will depending on the type of implants and they type of denture being fitted.

It could be a few days or weeks to a few months, particularly if more complex surgery is required to help ensure a success is achieved.

Consultation and preparation

Everything begins with a consultation.

Depending on the dental office and their procedures this could be just 1 appointment, but more likely 2.

The first appointment may well be with the dentist, or it might be with a knowledgeable supporting member of the dental team.

This will be the initial, general discussion about what you want and your suitability.

If you dental office has the trained professionals in house then this whole process might be a bit quicker and more efficient than if you have to find a specialist.

During this consultation, your needs will be discussed, different types of implants and dentures may be explained and it will be an opportunity for you to ask any questions you have along with getting an idea of the cost.

If in principle you want to move forward, the next appointment will be about getting clear dental information on you and confirming and planning the exact treatment.

The dentist will usually make an assessment of your mouth, take x-rays and complete a CT scan to get as much information as possible.

Essentially it is like a blueprint to your mouth, so they know what they are working with.

From here the dentist can confirm what implants and dentures are most suitable, treatment time and costs.

It is at this stage where you will find out whether you have the bone structure etc to support implants correctly, without the need for additional surgery.

You are not normally committed at this stage, but may be expected to pay a small fee if you do not go ahead.  Some offices will offer this for free.

Placing the implant

Assuming you have agreed to the treatment, the costs and the next step has been booked in, that next phase is actually having the surgery to place the implants, however many that may be.

It is this piece that is so vital and the whole process is completed with real accuracy to ensure the surgery is a success and you can enjoy all the benefits listed earlier in this article.

in almost all cases this treatment is carried out in the dentist’s office and no hospital trip is required.

The dentist will use a local anaesthetic to numb the area where the implants will be placed.  You will not feel the treatment, but you will be conscious and aware that the dentist is working within your mouth.

In summary, the dentists cuts into the gum, reveals the bone below, drills a hole and screws in the implant.

Sometimes, the gum will be closed up and allowed to heal before the next step is completed.

More common today for dentures is the next phase to be completed at the same time as the implant is placed.  Particularly in the case of All-on-4 and implant retained dentures.

Although it can all be done in 1 day, long term healing does still take place and it can take up to 6 months for completely successful fusion of the bone and implant to happen, although this process begins almost immediately.

Installing the abutment

Some implants come fitted with the abutment, others will have special ones attached.

The abutments are different shapes to accommodate the different fittings of dentures. Those used for a removable denture will not be the same as those used for a fixed denture.

It is more common for mini implants to have the abutment formed as part of or attached to it.

The abutment is the link between the jaw and the denture, it holds the 2 pieces together.

This is also the piece that is visible when the denture is removed and it sits on and above the gumline, whereas the implant is actually below it.

Removable dentures, make use of a ball or rail/bar style abutment fitting.  This type of abutment allows for the denture to snap on or off of the implant and ultimately gives it the removable design.  You may hear people speaking about snap in or on dentures, this is what they mean.

Bar-retained dentures rely on a thin metal bar being attached to the implants. When placed over the bar, the denture is secured by the clips or fasteners.

Ball-retained dentures, also known as stud-attachment dentures, are held in place by ball-shaped metal parts. When the balls are aligned with corresponding sockets on the denture, they connect to keep it secure.  It is a little like a popper you may have on a piece of clothing.

Had healing time been needed between implant and abutment fitting, the dentist would need to be used local anaesthetic before cutting into the gum to reveal the previously placed implant.

Fitting the denture

If you wear a removable denture, prior to getting implants, your existing denture will likely be modified whilst you are in the chair, so you can go home that day with everything done.

The All-on-4 system is prefabricated and ready to go too.

In some instances, you may have to wait for a denture to be made, but a temporary one will likely be provided, so you can eat and live life semi-normally until such time as it is ready.

Fixed dentures will be securely fastened in place using specialist tools, whilst those removable ones will be snapped on.

The dentist will check the fit, make adjustments were necessary so it not only looks right in the mouth, but you feel comfortable with it.

Checks will be made, with removable dentures that you know how to pop it in and take it out as well as how to clean them.

The following video gives a summary of the majority of information already presented.

Dental Implants - Implant Overdenture in Denville, NJ

Choosing a dentist/implantologist

You may see your dentist every 6-12 months and think they are great.  However, not all dentists are trained to place implants.

Extra training is required, so you really need to see an implantologist or as they are otherwise known, prosthodontists.

A normal dentist they have just taken extra time and made extra investment in this area of dentistry.

Unless your dentist is trained, they should refer you to an implantologist.  This may be within the same dental office or at another location.

For your own peace of mind, it can be worth visiting and getting the opinion of a couple of different professionals before committing to any treatment, to make sure you are happy.

Getting implants is quite a serious consideration and it is vitally important that you are happy with who you chose.

You want to have a professional that not only knows their stuff, but makes you feel informed and comfortable about the whole process.

If you ask the dentist a question and they evade it or seem unsure or confuse you further, is this who you want drilling into your jaw?

What if they are pushy about getting you booked in and saying we have a special deal today only…?

Choosing a professional is not a decision you should take lightly.

A welcoming, confident, and helpful professional that clearly explains what is involved and answers your questions appropriately might be a better choice.

Do not be afraid to ask questions and ask about their experience.  You may prefer to have someone who has completed the procedure hundreds of times, rather than just a few times.

You need to have confidence in the dentist to do the job.

You can use the American Dental Associations ‘Find-a-Dentist‘ tool to find a professional near you who can offer denture implants.  Be sure to select ‘Prosthodontics’ from the list of specialities to get the best results.

To find one you trust, you may need to travel a little further and you really should seek the opinion of others.

Find reviews, asks the dentist for examples of their work and testimonials etc.

Do too be sure to ask any questions you have.

Only when you are confident you have selected a dentist you are happy with should you commit to any work.

Cost of denture implants

You probably already know that dental care is not cheap and you are right.

Getting implants is fairly expensive and might not be something you can afford to pay for out of your own pocket right now.

But, compared to regular dental implants that can cost from $40,000 right through to $90,0000 implant dentures are much more affordable.

Each implant will cost approximately $1,500-$3,000.

This price excludes the denture which can be as little at $500 per jaw, but usually are several thousand dollars.

So, let’s say you needed 4 implants in each jaw, and a denture, it is not unrealistic to hear prices of $20,000.

Cost can be saved if you have a denture already that can be adjusted.

The mentioned ‘All-on-4’ system will cost anything from $7,000-30,000 as a guide.

The price very much depends on your personal needs and what is involved or necessary to achieve those results.

As a general rule, the less implants you need, the cheaper it will be.  That does not mean you can ask the dentist to place 1 less implant in each jaw to save money, it doesn’t work like that.

Shopping around can help with ensuring the price you are being quoted is correct and fair, but it should not generally be a case of just going for the cheapest, although some sort-after dentists will charge a premium.

Treatment can be expensive, so be sure you can afford it and wait if you can do so, if it will be better for you financially.

If you have dental insurance, it is worth checking your policy to see if this is covered.  Many insurers see this as cosmetic and it is not considered ‘necessary’.

It is not covered in all cases, but some it will be.

Generally this cover is a fixed % or an amount, but either way it can be a welcome contribution.

Every policy is different and there is no flat rule on how much will, if any be covered.  It is likely to be nearer 50%, but can go as high as 80%.

If you need help paying, some dental offices will offer payment plans whilst others will require full payments.

Denture implants – before & after

Denture implants may all sound great, but what are the results really like to look at.

The following are a series of images of patients before and after having denture implants.

You can see how the transformations are really quite significant for some.

Please note: The results vary from patient to patient, so these images should be used as a guide only as to what is potentially possible.

What patients say

To understand the benefits of these implant based dentures there is nothing better than hearing first hand accounts of those that have been through it.

Below are a few videos from different people that have either removable or fixed dentures and each of them give their feedback on their experience and how they have found them.

All on 4 Dental Implants 1 year review.

Bar retained overdenture

Snap In Dentures 2 YEARS LATER.. IS IT WORTH IT?

Conclusion

Getting surgery just to keep your false teeth in the mouth may seem extreme, but for those that have done it, they cannot speak highly enough of it.

The cost and slight discomfort brings benefits that you cannot always put a price on.

Confidence tends to be the biggest factor.

No fear of slippage, a good looking smile that you can be proud of too.

Compared to traditional dental implants, dentures retained by implants are considerably more cost effective and require much less surgical treatment whilst being more suitable for a wider proportion of people.

For more information and to begin your journey to implant retained dentures, speak to your dentist.

FAQ

How much do denture implants cost?

As a guide, expect to pay $1,500 to $3,000 per implant.

The number of implants vary from 4-8 per jaw on average.

This cost excludes the cost of a denture, which can range from $500 to several thousand dollars per jaw.

Assuming just 4 implants are required per jaw, plus the cost of the denture $20,000 is a very realistic price you can be expected to pay.

In many cases it is possible to use mini implants which are just $500-1,500 per implant to help keep the total cost down.

How much for full denture implants?

If you do not already have a denture or are looking to upgrade, the ‘All-on-4’ system is particularly popular thanks to the speed at which it can be fitted and the lesser number of implants that are typically needed.

The cost for a full set of denture implants using such an options will be between $7,000 and $30,000.

However, advantages can be gained from implants and custom made dentures which might cost anywhere between $5,000 to $40,000 depending on the circumstances.

Cost of mini implants for dentures?

If you are a suitable candidate for mini or midi implants as opposed to traditional dental implants, the savings can be quite significant.

Price does depend on the number you require but there can be as much as 50-60% off the cost of a traditional implant.

This means a single implant will cost from $500-1,500.

Where conditions are right and you need only 4 mini implants, a fair estimation is $4000 ($1000 per implant) if you have an existing denture.

Implants in the upper jaw do tend to be a bit more expensive.

Denture implants near me?

To find an implantologist or prosthodontist near you, make use of the ‘Find-a-Dentist‘ tool created by the American Dental Association, to find a professional near you who can offer denture implants.

It can be useful to do a web search for ‘prosthodontist XXX (X= name of your location)’ to help find options too.

Denture implants in one day?

It is perfectly possible to get denture implants in just one day thanks to solutions such as ‘All-on-4’ from Nobel Biocare.  Not all are suitable for the same day solution that this offers and there are pros and cons, speak to your prosthodontist to find out if they are an option for yourself or what alternatives they can offer for fast denture implants.

Palateless denture without implants?

It is not really possible or practical to achieve this.

A traditional denture, fitted to the upper jaw has an expanse of material that covers the palate/roof of the mouth to help it stay in place.

Some people find that such dentures can make it hard to swallow or they can gag with an upper denture in place.  The palate surface of the denture can make it difficult to chew and even taste food.

The reality is that the palate part of the denture is present to give strength to the denture but to also offers the opportunity for a ‘vacuum’ to be created so that the denture sticks/suctions in place and does not fall out.

With a palateless denture, unless held in place by implants, it would feel like it was falling out all the time, because it has nothing to actually grip or hook onto.

So it is often not possible to have a palateless denture without implants. By getting implants the existing denture can be modified or a new one made that removes the need for this, giving back taste, improved ability to chew and comfort in everyday wear.

Pros and cons of denture implants?

For the positives associated with denture implants, click here to find out the benefits or here to find out the cons associated with such.

Denture implants insurance?

Some insurance policies will offer cover for denture implants, but this tends to only be a fixed % or $ towards the overall cost.

Each insurer and policy is different, but those that offer an allowance for such tend to be more expensive in the first place.

Insurance tends to favor essential and necessary treatments, which implants are not considered part of.  In most cases, implants are considered as cosmetic treatment.

It is best to speak to or check the terms of a policy you have or are looking to take out.

References

• Colgate
• Scott Arms
• Dental Care Plus
• Creekview Dental
• DDS Lab
• Rice Dentistry
• Macquarie Street Dental Clinic

Image Sources

• Burbank Dental Implants
• Chiswick Dental
• Facial Surgery UK
• Ellis Family Dental
• Complete Dental Care
• Dream Smile
• Anant Dental Clinic
• Elizabeth Bjornson
• Pimlico Dental