What a dental implant is, and what it is not
A dental implant is a titanium screw placed inside the jawbone, occupying the space left by the root of the lost tooth. An abutment sits on top of it, and a crown on top of that. They are three separate pieces, made and fitted at different moments: when someone says "they put my implant in within the hour", they almost always mean only the first.
What an implant is not: it is not a tooth. It has no periodontal ligament — the thin membrane that cushions a natural tooth and tells the brain how much force is being applied. An implant is anchored directly in bone, it is rigid, and it does not complain when it is overloaded. That difference explains most of the precautions further down this page.
Nor is it permanent by default. A well-placed, well-maintained implant can be with you for decades; one placed on inflamed gums, in an active smoker, or never followed up, can be lost within a few years. The difference is not the brand of the screw.
- The implant
- The titanium body that sits inside the bone. It is the only part that actually integrates with it.
- The abutment
- The intermediate piece, joined to the implant, that passes through the gum and carries the crown.
- The crown
- The visible part, in ceramic, made to measure from an impression or a scan of your mouth.
Are you a candidate for an implant?
The honest answer is that nobody knows until they look. Candidacy is decided with a clinical examination and an x-ray — a panoramic film, or where the case calls for it a cone-beam CT scan, which measures bone in three dimensions. Without that image nobody can tell you whether there is enough bone, or where the inferior alveolar nerve runs.
That said, some factors are known in advance and are worth putting on the table at the first visit, because they change either the plan or the prognosis:
- Healthy gums
- Active periodontal disease is the most common avoidable cause of failure. It is treated before anything is placed, not afterwards.
- Bone volume and density
- If height or width falls short, there are regenerative techniques: bone grafting, sinus lift. They lengthen the schedule; they rarely close the door.
- Smoking
- Smoking reduces blood supply to the gum and is associated with more failures and more peri-implantitis. It is not an absolute contraindication, but it changes the prognosis and you deserve to know that before deciding.
- Systemic conditions
- Well-controlled diabetes does not rule out an implant; uncontrolled diabetes slows healing. The same applies to bisphosphonates and other antiresorptive drugs, head and neck radiotherapy, and immunosuppression: these need discussing in detail, and sometimes coordinating with your physician.
- Bruxism
- Clenching or grinding loads the implant with forces it has no cushioning against. It does not rule you out, but it usually means a night guard and a careful look at the bite.
- Unfinished growth
- In adolescents we wait until facial growth has finished. An implant stays fixed while the neighbouring teeth keep moving, and the step between them becomes visible over the years.
The treatment sequence, step by step
A single uncomplicated implant is usually spread over five or six visits across several months. Most of that time is not treatment: it is biological waiting, and it cannot be compressed for convenience.
Assessment and planning
Examination, x-ray and, where the case requires it, a CT scan. The position, diameter and length of the implant are decided, and you are given a written quote before anything starts.
Preparation
Decay, infection or gum disease are resolved first. If bone is missing, this is where the graft happens, and the schedule lengthens accordingly.
Placement surgery
Under local anaesthetic. The bone is accessed, the site prepared with slow-speed drills and copious irrigation so it is never overheated, and the implant is placed. A single tooth usually takes thirty to sixty minutes, and you go home the same day.
Osseointegration
The period in which bone bonds to the implant surface. Nothing is done here: we wait, and we check.
Second stage and impressions
The implant is uncovered if it was submerged and a healing abutment shapes the gum. A few weeks later the impression or scan is taken and sent to the laboratory.
Fitting the crown
It is tried in, the bite is adjusted a fraction at a time, and the definitive crown is fixed. From there the treatment becomes maintenance.
Osseointegration and the real timelines
Osseointegration is the process by which bone grows into direct contact with the titanium surface, with no fibrous tissue in between. It is what turns a screw into an anchor. It is not glue and it is not setting: it is living bone remodelling against metal.
That process runs at its own biological pace. The figures ordinarily used are around three months in the lower jaw, where the bone is denser, and four to six months in the upper jaw, which is more porous. If there was a graft, add the graft consolidation time before the implant is even placed.
Your case may fall inside or outside those ranges. The density of your bone, the stability achieved at the moment of surgery, and your own healing outrank any printed calendar. That is why the final timeline is confirmed after the surgery, not before it.
Immediate loading, in which a temporary prosthesis goes on the same day, does exist. It does not shorten osseointegration: it lets it happen underneath a prosthesis designed not to take chewing force. It has its own requirements and its own page.
Materials: titanium, ceramic and the crown
The implant body is medical-grade titanium, or a titanium-zirconium alloy. Titanium has been used in orthopaedic and dental surgery for over half a century because the body tolerates it well and bone adheres to its surface. Metal-free zirconia ceramic implants also exist, used mainly for aesthetic reasons in thin gum tissue or in people with documented metal sensitivity.
The crown is a separate piece, and there is more than one reasonable option. Monolithic zirconia is very strong and suits the back of the mouth, where chewing forces are highest. Lithium disilicate is more translucent and is usually preferred at the front, where appearance is what is being judged. Porcelain-fused-to-metal remains a valid and thoroughly proven solution.
No material performs well outside its indication. A highly aesthetic ceramic in a high-load area fractures; an opaque one on a visible incisor shows. That decision is made tooth by tooth, looking at where it goes, how much force it takes and what colour the neighbouring teeth are.
What determines the price of an implant
You will not find a figure on this page, and there is a reason. An implant quote is not a catalogue price: two people who both say "I need an implant" can receive quotes that differ by a factor of three, because what is billed is not the screw.
- How many teeth, and of what kind
- A single implant, three separate implants and a full arch on four or six implants are different treatments, not multiples of the same one.
- Whether the ground needs preparing
- Extractions, periodontal treatment, bone grafting or a sinus lift are procedures with their own cost and their own calendar.
- The type of prosthesis
- Crown material, screw-retained or cemented, whether a temporary is needed and for how long.
- Imaging
- A three-dimensional scan is not needed in every case. Where it is, it belongs in the quote and should appear as its own line.
- The number of visits
- Every check, adjustment and review takes chair time. Sometimes it is included and sometimes it is not; asking is entirely reasonable.
Recovery, day by day
Single-implant surgery is less unpleasant than most people expect; it usually compares favourably with a difficult extraction. That said, there is a real recovery and it is worth planning for, particularly if you have commitments in the days that follow.
The first twenty-four hours
Swelling and slight bleeding are expected. Intermittent cold on the cheek, the medication as prescribed, no vigorous rinsing and no spitting. Soft food, cold or lukewarm.
Day two to day five
Swelling peaks between forty-eight and seventy-two hours and then subsides. A bruise may appear on the skin. Gentle hygiene around the wound, with no brushing over the suture.
Week one and week two
Sutures out, where there are any, between seven and fourteen days. Most people are back to normal activity in two or three days, and to strenuous exercise at around a week.
Until the definitive crown
While the implant integrates you chew on the other side and attend the checks. If you are wearing a temporary, do not use it to bite anything hard.
Risks and complications
Dental implants are a predictable and thoroughly documented treatment, but they are not a treatment without risk. Any practice that presents a surgical procedure with no list of complications is withholding information you need in order to decide.
- Failure to integrate
- The implant does not bond to the bone and stays mobile. It usually shows in the first few months. It is removed, the site is allowed to heal, and in many cases it can be attempted again later.
- Peri-implantitis
- Chronic inflammation of the tissue around an integrated implant, with progressive loss of the bone holding it. It is the most common late complication and the one most tied to hygiene, smoking and skipped check-ups.
- Nerve injury
- In the lower jaw the inferior alveolar nerve runs close by. Injury can cause numbness of the lip or chin, usually temporary and rarely permanent. It is why the case is planned on imaging and safety margins are respected.
- Communication with the maxillary sinus
- In the upper back jaw the sinus sits directly above. Where bone is scarce the membrane is lifted in a controlled way; an unnoticed perforation can lead to sinusitis.
- Mechanical complications
- A loosened or fractured screw, a decemented crown, a fractured ceramic. These are usually repairable, and they are more frequent in people who clench.
- An aesthetic result that falls short
- Gum recession, a visible grey margin, or a papilla that does not fill the space between teeth. More likely at the front and in thin gum tissue, which is why those cases are planned more cautiously.
Looking after an implant long term
An implant cannot decay. The bone holding it can be lost, and that is what the whole of maintenance is about. Three things, none of them optional.
- Specific daily hygiene
- Brushing twice a day, plus cleaning between the teeth with a correctly sized interdental brush or a water flosser. Conventional floss is not always the right tool around an implant.
- Regular reviews
- Clinical and radiographic checks. Early bone loss does not hurt and cannot be seen: it can only be measured, and it is far easier to correct at the start.
- Controlling what loads it
- A night guard if you clench, a bite adjustment where one is needed, and stopping smoking if that is within your reach.
When an implant is not the best option
Recommending an implant to everybody would be convenient and would be dishonest. There are situations where something else serves better: a fixed bridge when the neighbouring teeth are already crowned or will need crowns anyway; a well-made removable prosthesis when the state of the bone, general health or budget does not allow otherwise; or simply monitoring, when the missing tooth is a wisdom tooth and compromises neither function nor appearance.
And there are cases where an implant is clearly the better choice, which deserves saying just as plainly: when the neighbouring teeth are healthy and cutting them down for a bridge would mean destroying sound tissue, or when a lower full denture will not stay put and two implants stabilise it completely.
What should come out of the first visit is not a "yes" to a treatment, but a comparison of the options that genuinely exist in your case — what each one costs, how long each lasts, and what each will ask of you.
This page is general patient information, written so that you arrive at the practice knowing what to ask. It is not a diagnosis or a treatment recommendation: those can only follow a clinical examination and the appropriate imaging.
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