Replacing missing teeth
What is a dental implant, and how long does it take?
An implant is a titanium post placed in the jawbone as an artificial tooth root. Bone fuses to it over several months, after which a crown, bridge or denture is attached to complete the tooth.
How does an implant stay in the jaw?
Through a biological process called osseointegration. The implant is a small titanium post placed into the jawbone, and over the following months bone cells grow directly onto its surface, locking it in place. It is not screwed in and tightened like a wall fixing — the bone does the holding, and that takes time.
This is why the waiting period is not optional and cannot be shortened by preference. Loading an implant before integration is complete is how implants are lost.
Once integrated, the post functions as an artificial tooth root. What sits on top depends on what is missing: a single implant carries one crown, several implants can carry a bridge across a longer span, and implants can also be used to retain a denture that would otherwise rest on the gum.
Osseointegration is bone growing onto a titanium surface. It is a real and well-documented biological process, but it is not tooth regeneration — an implant replaces a tooth, it does not regrow one.
What happens at each stage?
Implant treatment runs over months rather than weeks, and the stages are sequential.
- Consultation and assessment. The mouth is examined, radiographs are taken, and the volume and quality of bone at the site are assessed along with gum health and your medical history. This stage determines whether the site can take an implant at all, and whether grafting is needed first.
- Placement. The implant is positioned in the jawbone under local anaesthetic. This is minor surgery, not a general anaesthetic procedure for most patients.
- Healing and integration. Over several months the bone fuses to the implant. During this period the site is left to heal, and where the gap is visible a temporary replacement can usually be worn.
- Restoration. Once integration is confirmed, an abutment is attached to the implant and the crown, bridge or denture is fitted onto it. This is the point at which the tooth is finished and functional.
Who is suitable for an implant?
Many people who are not immediately ready can become suitable with preparation, so being told 'not yet' is different from being told 'no'.
The requirements are reasonably consistent.
- Healthy gums. Active gum disease must be treated and controlled first — the same bacterial process that destroys bone around teeth will do so around an implant.
- Enough bone to hold the implant, or a willingness to have bone grafting to build up the site. Bone volume is assessed radiographically, not by appearance.
- Not smoking, or stopping for the healing period. Smoking measurably impairs integration and raises the failure rate.
- General health sufficient for minor surgery. Uncontrolled diabetes, certain medications — bisphosphonates in particular — and some medical conditions affect healing and must be discussed beforehand.
How do implants compare with a bridge or a denture?
The distinguishing feature of an implant is that it stands alone. A traditional bridge requires the two teeth either side of the gap to be reduced and crowned — healthy teeth permanently altered to replace a third. An implant involves neither of them.
The second real difference is bone. When a tooth is lost, the bone that held it is no longer being loaded and gradually resorbs, which is why long-standing gaps develop a visible dip and why a denture that fitted well loosens over the years. An implant transmits chewing force into the bone, which helps maintain it. A bridge or denture does not.
Against that: implants take months, involve surgery, and are the most involved of the options. A fibre-reinforced bridge closes the gap in a single appointment with minimal preparation. A denture requires no surgery and can replace many teeth at once. A traditional bridge is finished in weeks.
There is no universally correct answer. The decision turns on the condition of the neighbouring teeth, how much bone is present, how many teeth are missing, and how much time and surgery you are prepared to undergo.
What is recovery after implant surgery like?
Most people report mild swelling and tenderness at the site for a short period, manageable with simple pain relief and cold compresses. It is generally described as less uncomfortable than an extraction.
In the first days: eat soft food, chew away from the site, avoid rinsing vigorously, and keep to any instructions given about cleaning the area. Smoking during this period is the single behaviour most strongly associated with early implant failure.
Contact the practice rather than waiting if pain increases after the first few days instead of subsiding, if swelling worsens after day three, if bleeding does not settle, or if the site develops a bad taste or discharge. These are not expected and they are treatable early.
How do you look after an implant long-term?
An implant crown cannot decay. The tissue around it can still become diseased, and that is what causes implants to be lost years after they were placed.
Peri-implantitis is inflammation and progressive bone loss around an implant, driven by plaque at the gum margin in the same way gum disease is around a natural tooth. It is often painless in its early stages, which is precisely why routine check-ups matter — bone loss around an implant is detected radiographically long before it is felt.
Day to day the requirement is unremarkable: brush twice daily, clean between the implant and the adjacent teeth with floss or an interdental brush, and keep to your recall interval. Grinding places heavy load on implants and should be mentioned, since a nightguard may be advisable.
What drives the cost of an implant?
An implant is generally the most expensive way to replace a single tooth, and the reason is that it is several procedures rather than one.
The main variables are whether bone grafting or a sinus lift is needed before placement, the number of implants required, what they will carry — a single crown, a bridge across several units, or a denture attachment — and the imaging and planning involved.
Medical aid cover for implants varies considerably between schemes and many exclude them or classify them as a non-essential benefit. Confirm this with your scheme before treatment rather than after, and ask for treatment codes so you can check.
An accurate quote requires an examination and radiographs, because the largest single cost variable — whether grafting is needed — cannot be assessed any other way.
Common questions
Does implant surgery hurt?
The placement is done under local anaesthetic, so you should not feel pain during it. Afterwards, mild swelling and tenderness for a few days is usual and manageable with simple pain relief. Most patients describe it as less uncomfortable than having a tooth out.
How long do dental implants last?
Implants are a long-term restoration and many function for decades, but longevity depends on gum health, bone maintenance, smoking, grinding and regular monitoring. The crown on top typically has a shorter service life than the implant itself and may be replaced without disturbing the post.
What if there is not enough bone?
Bone grafting can build up the site, adding time and cost but making implants possible in many cases that would otherwise be unsuitable. Bone loss increases the longer a gap is left, which is one argument for assessing the site sooner rather than later.
Can I get an implant if I smoke?
It is possible but the failure rate is measurably higher, because smoking impairs the blood supply the healing bone depends on. Stopping before placement and through the healing period substantially improves the odds, and you should expect this to be discussed frankly.
Will I be without a tooth while it heals?
Usually not in a visible area. A temporary replacement — commonly a small denture or a bonded provisional — can be worn during integration. Discuss this at the consultation, particularly if the gap is at the front.
Can implants hold a loose lower denture in place?
Yes. An implant-retained overdenture clips onto implants instead of resting on the gum, which addresses the instability most lower full denture wearers experience. It uses fewer implants than replacing every tooth individually.