Dental Implants: What to Expect, Complications, Procedure, and FAQs

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Hi, I’m Dr. B, practicing functional dentist for 35 years. I graduated from the Dugoni School of Dentistry in San Francisco, CA in 1987 and am a member of the American Academy of Dental Sleep Medicine (AADSM), Academy of General Dentistry (Chicago, IL), American Academy for Oral Systemic Health (AAOSH), and Dental Board of California. I'm on a mission to empower people everywhere with the same evidence-based, easy-to-understand dental health advice that my patients get. Learn more about Dr. B

Now that you’ve made the decision to get a dental implant after considering the costs, you may be experiencing a little apprehension wondering what comes next, if it will hurt, and how long it will take to recover. Relax. It’s easier than you think.

While a dental implant is by no means a simple procedure, just knowing what to expect will make all the difference.

The main steps of a dental implant:

1. X-rays

Your dentist needs x-rays for evaluative and prognostic purposes. X-rays, panoramic X-rays, or a 3D CT scan will be used to determine bone and gum condition and to identify anything warnings. Click here for an in-depth look at the different types of dental x-rays.

2. Impressions

Your dentist will need to take an impression of your mouth, which will provide a pretty good replica of your teeth, gums, and surrounding tissues from which to work with. He or she will determine the right size plastic or metal impression tray for your mouth and fill it with a soft liquid, such as alginate or polyvinyl siloxane. You will bite down on the U-shaped plastic or metal impression tray. The liquid will set after a minute or two and become a solid rubber mass. You will then open your mouth and the tray will be removed and sent to a lab for processing.

Keep in mind…

While most people have absolutely no problem, the impression process can be unpleasant for those who have an active gag reflex or experience panic over not being able to open their mouth or swallow properly.  Simple as it sounds, the best advice I can give is this: don’t think about it and don’t be afraid to share your concerns with your dentist.

There are techniques to keep you from gagging or panicking. Breathe deeply through your nose and try to distract yourself. If there’s a TV in the room, focus on that. If there’s music playing, listen to the beat. Count. Play a game of golf in your head. Dream of the beach. Your dentist should also try to keep you sidetracked by talking to you, asking you questions (that you can’t answer because your mouth is full of gunk!), and assuring you that it’s “almost over.”   

Because it is. An impression doesn’t take as long as you imagine and, like many other dental procedures, your mind is your own worst enemy.

Remember too, that your dentist is on your side. If you feel the need for nitrous oxide, just ask!

3. Tooth Extraction

If the tooth in question still exists, it will need to be extracted. This can be done at the same time as the implant insertion. Your dentist will explain what type of anesthesia he or she plans to use but, generally speaking, a local injection of lidocaine (what most patients still refer to as novocaine), will assure a pain-free procedure.  It doesn’t take long to pull a tooth, but if it is fractured, your dentist will be more cautious to avoid fragmentation. You will feel a little pressure and tugging as your dentist wiggles the tooth out.

For a minimum of 24 hours after the extraction, you will be asked not to smoke, drink through a straw, spit excessively, or blow your nose. Doing so can cause a dry socket and unnecessary pain.

4. Implant

After the tooth is extracted, your dentist will drill a hole in your jawbone. This will feel similar to having a cavity drilled. In some cases, your dentist may have to make an incision in your gum to expose the bone, in which case suturing (stitches) will be necessary.

The dentist will insert the implant deep into your jawbone. This serves as an artificial root for your new tooth.

Depending on the condition of your jawbone, a bone graft may be necessary. Usually this can be done with artificial bone materials and is such a minor part of the implant process that you won’t even know it’s happening.

Expect to be at this appointment for one to two hours. You’ll be fine to drive home and go about your daily routine following the procedure. However, you will most likely be restricted to a soft-food diet for up to a week.

5. Abutment Placement

As your jawbone heals, it will fuse with the dental implant. This process can take several weeks or even months. There is no way of knowing in advance how long it will take and differs in every patient. Once your dentist has determined your implant is stable enough, an abutment is placed on top of it to serve as a connector to the crown.

The abutment is tightened with a dental torque wrench so that it remains in place during chewing. Don’t worry – local anesthesia will keep you from feeling anything but a little bit of pressure!

In some instances, the abutment can be placed at the same time as the implant. However, because the abutment extends beyond the gum line, it will be visible, so make sure you discuss this option with your dentist beforehand! In other cases, a healing cap or healing abutment is used to keep tissue or bone from growing over the implant as osseointegration (the fusing of the bone and implant) takes place.

6. Permanent Crown

Your permanent crown is attached to the abutment and voila! You’re done!

Does a dental implant hurt?

During the procedure, you shouldn’t feel any pain at all.  However, you will feel vibration from the drill, maybe a little pressure, and lots of poking around.

After the anesthesia has worn off, you will definitely feel as though something has happened in your mouth. But, most people define it as discomfort rather than pain. You can expect to go about your daily routine after the procedure without a problem.

The truth of the matter is that most dental procedures are painless. It’s the anticipation and fear of the unknown that throw our minds into a spiral. When you are properly informed, have a dentist you trust, and know what to expect, dental work really can be a pleasant experience.

But my dentist didn’t tell me…!

Every healthcare practitioner is responsible for educating their patient on exactly what will be done before a procedure and what to expect afterwards. That being said, I can’t tell you how many times I’ve heard just the opposite! I encourage you to do your research beforehand so you can have an educated discussion with your dentist.

5 tips for avoiding surprises

  • Jot down notes in your phone or in a notebook at the initial consultation so you don’t forget anything.
  • Ask the office staff if there are any written materials on the implant procedure.
  • Do your research in advance.
  • Talk to someone who has had the procedure. Ask your dentist if there’s a patient who would be willing to share their experience with you.
  • Think of questions in advance and write them down.

6 things you need to know beforehand

  1. Your jawbone needs to heal.
    A dental implant is not a one-step process! There is a lot of waiting and watching to the procedure. It’s easy to get frustrated if you’re expecting this to be a one-and-done procedure.
  2. How much it costs.
    Just like any surgery, there are many factors that go into determining the 
    price of a dental implant. Make sure you have a discussion with your dentist about cost beforehand. Taking away any insurance differentials, I’d say you should expect the entire procedure, including the crown, to cost between $3,000 and $5,000 per tooth.
  3. You won’t leave the office with a tooth.
    Even though you won’t leave the office with a permanent crown, you don’t have to leave with a hole in your smile either. There are options for a temporary tooth including dental flippers, a retainer, or temporary crowns.
  4. Stock the fridge with soft foods.
    You may be restricted to a soft-food diet for a week or longer. It is extremely important to let the implant settle. Even if you 
    promise you’ll only chew on the other side, it is too easy to inadvertently forget and before you know it, you’ve crunched down on your implant. But, really, there are worse things than being told to eat ice cream! (Even though I wouldn’t recommend ice cream, since high sugar intake can actually slow your healing process. I’d recommend green smoothies and soups instead!)
  5. You’ll need to stop at the pharmacy.
    You will probably be prescribed a dose of antibiotics to prevent infection.
  6. Don’t book anything for the rest of the day.
    You won’t be given an exact time frame for how long the procedure, start-to-finish, will take. Everyone heals differently and there’s no way of predicting how fast that will happen for you.
  7. No two mouths (or surgeries) are the same.
    Just because your sister-in-law needed a bone graft doesn’t mean you will!

The great news about implants? They represent one of the biggest advances in dentistry and, according to the American Association of Oral and Maxillofacial Surgeons, have an overall success rate of about 95%. Though it’s not a one-day procedure and the length of the healing process can be frustrating, there should be no pain involved.

Assuming all goes well, as it usually does, a dental implant will leave you with a very real-looking and functional tooth.

Dr. Mark Burhenne

Got more questions about implants? Ask me a question!

Learn More: Dental Implants: How Much Do They Cost?