Dental Implant Placement

A dental implant is a small titanium screw placed into the jawbone to act as an artificial tooth root, onto which a crown (the visible false tooth) or other restoration is later attached.

Once the implant is inserted, the surrounding bone gradually fuses to the titanium surface through a process called osseointegration (bone bonding). This anchors the implant firmly in place, much like a natural tooth root. The finished restoration looks, feels, and functions like a real tooth, allowing normal biting and chewing.

Dental implants are used whenever one or more teeth are missing and the patient wants a stable, long-lasting replacement that does not rely on neighbouring teeth for support.

• A single missing tooth — replacing one tooth without filing down the healthy teeth on either side.
• Multiple missing teeth — supporting a bridge (a row of false teeth) without removable dentures.
• All teeth missing in one or both jaws — anchoring a full set of fixed or removable teeth.
• Dentures that slip or cause discomfort — implants can be used to lock a denture firmly in place.
• Bone loss prevention — keeping the jawbone stimulated after tooth loss to prevent it from shrinking.

Implants are not suitable for everyone. The surgeon will carefully review each patient's situation before recommending the procedure.

• Insufficient jawbone volume or density — there may not be enough bone to hold the implant securely (though bone grafting may be considered first).
• Uncontrolled diabetes — poor blood sugar control slows healing and raises infection risk.
• Active gum disease (periodontitis) — infection in the gum tissue must be treated and cleared before any implant is placed.
• Heavy smoking — significantly reduces the chance of the implant bonding successfully to the bone.
• Certain medications — for example, drugs that affect bone metabolism, such as some osteoporosis treatments, may affect healing.
• Children and teenagers whose jaws are still growing — implants are usually deferred until jaw growth is complete.
• Recent radiotherapy (radiation treatment) to the head or jaw area — this can impair healing of the bone.

Dental implant surgery is generally well tolerated, but like any surgical procedure it carries recognised risks that patients should be aware of.

• Pain and swelling around the implant site — common in the first few days after surgery and usually manageable with pain relief.
• Bruising of the gum and surrounding skin — typically fades within one to two weeks.
• Infection at the implant site — may require antibiotics or, in rare cases, removal of the implant.
• Implant failure (failed osseointegration) — the bone does not bond to the implant; the implant may need to be removed and the procedure repeated after healing.
• Nerve or tissue damage — tingling, numbness, or altered sensation in the lip, chin, tongue, or nearby teeth, which is usually temporary but can occasionally persist.
• Sinus problems — if an upper jaw implant is placed too close to the sinus cavities (air spaces above the upper teeth), it may cause sinus discomfort or infection.
• Damage to neighbouring teeth or existing dental work — uncommon but possible during drilling.
• Bleeding — most settles quickly; heavy or prolonged bleeding is uncommon.
• Peri-implantitis (inflammation and bone loss around an established implant) — a longer-term complication if oral hygiene is poor.

Preparation for dental implant placement usually begins several weeks before the surgery date. Your dental team will give you specific instructions based on your health history and the complexity of your case.

Before the procedure, patients are typically asked to do the following. If local anaesthesia (numbing injection) alone is planned, fasting is usually not required. If sedation (a relaxing medication given through a drip) or general anaesthesia (being fully asleep) is planned, the team will give clear fasting instructions — commonly no food or drink for several hours beforehand. Blood thinners and certain other medications may need to be paused; the surgeon will advise which ones and for how long. Smoking should be avoided for as long as possible before and after surgery, as it slows bone healing. Alcohol should be avoided in the days leading up to surgery.

Before surgery is scheduled, the dentist or oral surgeon will usually arrange the following assessments.

• Dental X-rays or a cone beam CT scan (a 3-D X-ray of the jaw) — to measure the exact amount and shape of available bone.
• A full dental examination — to check gum health and treat any active infection or decay first.
• Blood tests — to screen for conditions such as uncontrolled diabetes or bleeding disorders that could affect healing.
• Medical history review — including all medications, supplements, and any previous reactions to anaesthetics or antibiotics.
• Impressions or digital scans of the teeth — to plan the size and position of the implant and design the final crown.

On the day of surgery, the procedure itself generally follows these steps, though the exact sequence and number of visits depends on whether any bone grafting is needed and which implant system is used.

• 1. Anaesthesia is given — local anaesthetic injections numb the area; sedation or general anaesthesia may be added if agreed in advance.
• 2. The gum is opened — the surgeon makes a small cut in the gum to expose the jawbone underneath.
• 3. The bone is prepared — a series of drills of increasing size create a precise channel in the bone.
• 4. The implant is placed — the titanium screw is carefully inserted into the channel and secured.
• 5. The site is closed — the gum is stitched closed over or around the implant. A healing cap (a small cover that keeps the site open) may be placed instead.
• 6. A temporary restoration may be fitted — in some cases a temporary tooth is attached the same day; in others the patient waits for osseointegration to complete before the final crown is made.
• 7. Post-procedure check — the team confirms the implant is correctly positioned, often with a final X-ray, before the patient is discharged.

After dental implant placement, most patients are able to go home the same day. The healing period has two phases: the short-term recovery from the surgery itself, and the longer osseointegration period during which the bone bonds to the implant. The total time before the final crown is fitted varies and is decided by the surgeon based on bone quality and the complexity of the case.

• Rest on the day of surgery — avoid strenuous activity for at least the first day or two; the surgeon will advise how long.
• Swelling and discomfort management — applying an ice pack to the outside of the cheek in short intervals during the first day can help reduce swelling; pain relief will be recommended by the dental team.
• Diet changes — soft foods and cool or lukewarm drinks are recommended for the first days to weeks; hard, crunchy, very hot, or spicy foods should be avoided around the implant site while healing.
• Oral hygiene — gentle rinsing with a saltwater solution or prescribed antiseptic mouthwash is usually advised from the day after surgery; careful brushing around the implant site as instructed.
• Smoking and alcohol — both should be avoided for as long as possible after surgery; smoking in particular significantly increases the risk of implant failure.
• Avoid touching or probing the implant site — with the tongue or fingers, as this can disturb healing.
• Stitches — dissolvable stitches absorb on their own; non-dissolvable stitches are usually removed by the dental team at a follow-up visit, typically within one to two weeks.
• Follow-up appointments — regular check-ups allow the surgeon to monitor osseointegration progress and the health of the surrounding gum and bone.
• Final crown placement — once the surgeon is satisfied that osseointegration is complete, impressions or scans are taken and the permanent crown or restoration is fitted.
• Long-term care — good daily brushing and flossing, along with regular professional dental cleanings, are essential to protect the implant from peri-implantitis (inflammation around the implant) and keep it functioning well for as long as possible.