Dental implants

What an implant is

A dental implant is an artificial tooth root, typically made of titanium. It's placed in the jawbone where the natural root used to be.¹ A small post called an abutment connects the implant to the replacement tooth, which is called a crown.^1,2 Implants can replace a single tooth or several teeth, or help hold a denture in place.³

The steps

1. Assessment. The dentist examines your mouth and takes X-rays to see whether implants are right for you.¹
2. Placing the implant. In a surgical procedure, the implant is placed in the jawbone, beneath the gum.^1,9
3. Healing. As the area heals, the implant bonds with the bone. This can take several months.¹ You may be able to wear a temporary tooth over the area in the meantime.²
4. Uncovering. Often a second procedure uncovers the implant and attaches an extension, and the gums heal for a couple of weeks.² In some cases the first and second stages are done together.¹
5. The new tooth. The crown is made and attached to the abutment. Getting the fit right can take several appointments.¹
6. Follow-up. Check-ups during the following year make sure the implant is working properly.¹

We place implants at our clinic, depending on the case. Some cases, such as those that need a direct sinus graft (one of two approaches to a sinus lift), are referred to a periodontist, a dentist who specializes in gum disease.^14,16 A sinus lift adds bone under the sinus in the upper back jaw, so there's enough bone to place and support an implant.^14,15

Who is a good candidate

Implants may be right for you if you're in good general health, have healthy gums, and have enough bone in your jaw to hold an implant.^1,3 Some things make implants less likely to succeed:

• Smoking. Smokers can be poor candidates for implants.⁴ A review of the research found higher implant failure rates, more infections and more bone loss in smokers, though the authors noted other factors may also have played a part.⁵
• Poorly controlled diabetes. People whose diabetes is poorly controlled have more problems around implants and lose more of them over the long term. When diabetes is well controlled, success rates are similar to people without diabetes.⁶
• Past gum disease. A history of periodontitis (advanced gum disease) raises the risk of losing an implant, especially over long periods (ten years or more) and after fast-progressing gum disease.⁷

If your jawbone has shrunk, or didn't develop normally, a bone graft may be able to build it up.¹ The bone starts to shrink in height and width after a tooth is removed.³

Tell your dentist about all your health conditions and every medicine you take.¹³ Serious complications from the surgery are rare, but they can include bleeding, infection, numbness, or injury to nearby muscles or the sinus. Sometimes an implant doesn't bond to the bone.¹

Other ways to replace a missing tooth

An implant isn't the only option, and your dentist can talk through each one with you.

• A bridge is a fixed replacement that can't be taken out. To prepare for a traditional bridge, the dentist files down the healthy teeth on each side of the gap.⁸ It doesn't involve surgery.⁹ As an alternative to a bridge, a single implant can replace a missing tooth between two healthy teeth.⁸
• A partial denture is one or more artificial teeth held in place by clasps on nearby teeth. You can take it out yourself for cleaning and at night.¹⁰
• A complete denture is removable and held in place by suction.¹⁰

Replacing a missing tooth helps you chew properly and keeps the other teeth from shifting.⁹ Implants can cost more than other kinds of replacement teeth and might not be covered by your dental plan.¹

Caring for an implant

Like natural teeth, implants need to be kept clean with a toothbrush and floss, and the dentist will show you how. Regular check-ups let the dentist make sure your bite is right and your implants aren't loose.¹

The gum and bone around an implant can become inflamed, much like gum disease around a natural tooth. Signs include red or tender gums around the implant, or bleeding when you brush. Past gum disease, poor plaque control, smoking and diabetes all raise the risk. Caught early, the milder form can be reversed; the advanced form (peri-implantitis), which also affects the bone, usually needs surgical treatment.¹¹ This is fairly common: a 2025 review of the research estimated that the milder form affects about 46% of people with implants, and peri-implantitis about 21%.¹² Home care and regular check-ups help prevent it.¹¹