All about dental implants: Procedure, benefits & risks

Modern dental implants were invented and first placed in humans in 1965.¹ In the 60 years since, they have become remarkably popular: approximately five million implants are placed each year in the U.S. alone.² Still, many people have questions about what implants are, what conditions they treat, and, most importantly, whether they’re a safe and appropriate choice for their dental needs.

Top line? Dental implants are often a safe dental solution. Reported success rates generally range between 90% and 95%, offering significant advantages over many other dental devices such as traditional bridges and removable dentures.^3,4 If you have missing or damaged teeth or are unhappy with your current dental device, this article will tell you about:

• What dental implants are

• Why people choose them

• What’s involved in the implant process

• The cost of dental implants, and insurance coverage

• Potential risks and considerations

What are dental implants?

Dental implants are simply artificial tooth roots that are surgically implanted into the jawbone. They serve as strong and stable foundations for attaching crowns, bridges, or dentures to replace missing teeth. The three components of a complete dental implant “system” are:

1. The implant post is a screw-shaped post, usually made of titanium or zirconia. It is surgically placed into the jawbone as a replacement for the natural tooth root.

2. The abutment is a small connector piece that attaches to the implant post, protrudes above the gum line, and serves as the anchor for the artificial tooth or teeth.

3. The implant crown or replacement tooth — made of porcelain, ceramic or metal — attaches to the abutment. It is designed to function like a natural tooth and is shaded to match your natural teeth. As mentioned above, implant posts can also support other dental devices, such as bridges and dentures, if needed to replace multiple missing teeth.

Together, these three components create a strong, functional, and natural-looking tooth replacement system.

The advantages of dental implants

Dental implants offer distinct advantages over traditional bridges and removable dentures, making them a preferred choice for many patients seeking tooth replacement.⁵ Potential advantages include:

• Increased comfort: Unlike removable dentures, the teeth anchored by dental implants don’t shift or cause discomfort during daily activities.

• Improved speech: While dentures can slip, causing you to mumble or slur your words, teeth secured by dental implants remain in place, helping you to speak more clearly and confidently.

• Improved chewing: Teeth secured by dental implants function more like your natural teeth, helping you to eat your favorite foods with confidence and without pain.

• Improved appearance: Dental implants provide a more natural appearance and help maintain facial structure, minimizing the risk of facial sagging associated with tooth and bone loss. The teeth attached to the implants are designed to look very natural and are custom shaded to match the rest of your teeth.

• Superior durability and longevity: Dental implants are designed to last significantly longer than bridges or dentures, often exceeding 15 to 20 years — or even lasting a lifetime with proper care.⁶

• Better oral hygiene and health: Dental implants make it easier to maintain oral hygiene compared to bridges and dentures. Implants can be cared for like your natural teeth —with routine brushing and flossing — while dentures need regular removal and cleaning, and bridges may allow bacteria to collect at their anchoring points.⁶

• Bone preservation: Implants stimulate the jawbone in a manner similar to natural tooth roots, helping to prevent the bone loss that typically follows tooth loss. Bridges and dentures do not act in the same way, and may contribute to bone deterioration over time, which can lead to facial sagging or jaw recession.⁷

• Less impact on your other teeth: A significant advantage of implants is that they don’t require support from neighboring teeth. Traditional bridges require adjacent teeth to be filed down for crowns, which can weaken healthy teeth over time. Partial dentures may also place pressure on remaining teeth, potentially causing damage.⁸

What you should know about the implant placement process

While dental implants may sound like a perfect solution, not every patient opts to move forward with them. Implant cost is a factor, but another is that the full dental implant process — from extraction of the failing tooth or teeth to placement of the final crown, bridge, or denture — takes an average of six to nine months. In some cases, it can even be longer, depending on the jawbone's health and the individual’s healing ability.⁹

That’s why it’s important to have a clear idea of what’s involved before making your implant decision. Here’s a step-by-step outline of the process:

1. Tooth extraction

Unless the tooth in question is already missing, your dentist or oral surgeon will have to extract the damaged or failing tooth. This process should take between 30 and 90 minutes and may involve some discomfort.

Healing time: The gums will require one or two weeks to heal after the extraction.

2. Bone graft

While some patients will be able to skip this step, approximately 50% to 60% of dental implant patients will require a bone graft in their jaw to increase bone density and ensure adequate jawbone support for implant placement.¹⁰

This procedure is safe and relatively painless, usually taking between 45 and 90 minutes. Your dentist may use natural bone from another location in your body or, more likely, a synthetic bone-substitute material.¹² It’s important to note that once the graft is placed, it will take a while until you grow enough new bone to support your implant.

Healing time: Most patients can expect a healing time of about 6 to 9 months before the jaw is ready for the implant surgery, though some cases might take longer.¹³

3. Preparation for implant surgery

Before the placement procedure, patients undergo diagnostic tests to help ensure proper placement of the implant post. These may include dental X-rays, CT or CBCT scans for 3D bone assessment, and a comprehensive oral examination.

4. Dental implant placement

The oral surgery to place a single dental implant post typically takes about 1 to 2 hours. During this time, the dentist cuts the gum to expose the jawbone, drills a hole, and places the implant deep into the bone where it will serve as a tooth root. The dentist uses either strong local anesthesia or light sedation, so that while the patient may feel pressure during the surgery, it should not be painful.

After surgery, patients may experience facial and oral bruising and swelling, some pain where the implant post was inserted, and minor bleeding. Most patients can get back to their normal activities within about 3 days.

Healing time: During this critical healing period — which typically lasts for 3-6 months — the implant post fuses with the jawbone to create a strong, stable foundation for the replacement tooth or teeth. Patients are asked to maintain proper oral hygiene and refrain from smoking or vaping to ensure proper healing.

5. Placement of the abutment

During this quick, painless procedure, the abutment — which connects the replacement tooth to the implant post — is installed.

Healing time: Approximately two weeks.

6. Installation of the replacement tooth or teeth

This is also a quick procedure — with little or no discomfort — as the replacement tooth, bridge or denture is secured to the abutment, completing the implant process.

Risks and side effects

If handled by a competent professional with experience in implant dentistry, dental implants and the procedures required to place them are considered very safe, and success rates are generally reported between 90% and 95%.³ That said, as with any surgical procedure or implant, there is always some risk of dental implant complications, including:

• Infection: Infection at the implant site, gum tissue, or bone can occur.

• Nerve damage: Improper implant placement may injure nerves, especially in the lower jaw, causing pain, numbness, or tingling in the lips, gums, chin, or face.

• Implant failure or rejection: The implant may fail to properly integrate with the jawbone or become loose due to peri-implantitis (gum infection), poor bone quality, or other factors.

• Sinus problems: Dental implants in the upper jaw may protrude into sinus cavities, potentially causing sinus infections or sinusitis.

• Allergic reactions: Rare allergic responses to implant materials, such as titanium, can occur, causing inflammation or rashes.

• Injury to surrounding structures: Surgery may injure blood vessels, gums, surrounding bone, or adjacent teeth if not properly performed.

The risk of any of these complications is very low for most patients. Risk factors that increase the chances include poor oral health, smoking, certain medical conditions (e.g., diabetes), medications, and age.¹⁴

Costs and coverage

As we’ve noted, one reason people pass on dental implants is the time and effort required to complete the full process. However, expense is also a factor.

In the U.S., dental implants for a single tooth generally cost between $3,000 and $7,500, with some regional variation. This price typically includes the implant post, abutment, and crown.¹⁵ Nationally, the average cost for just the post may be around $1,500 to $3,000, with crowns costing from $1,000 to $2,000 or more, depending on the material used.¹⁵

Full-mouth restorations can range from $15,000 to $60,000, depending on the number of implants and their complexity. The cost depends on factors such as location, the dentist's expertise, the materials used, and any additional procedures needed.¹⁵

Dental insurance can help

If you want to use dental insurance to help cover the cost of dental implants, there are a few things to consider.

• Type of plan: Lower-cost basic plans typically cover only routine treatment, such as exams, cleanings, and (potentially) basic fillings. However, more comprehensive full coverage dental insurance is available that may cover at least a portion of the cost for dental implants. Also, you'll likely have lower out-of-pocket costs with an HMO plan (which limits the number of dentists you can see) compared to a PPO plan, which lets you see virtually any dentist.

• Medical necessity: Dental insurance plans (and even medical insurance plans) are more likely to cover procedures deemed medically necessary, rather than just cosmetic. Dental implants are considered medically necessary in many situations, such as if the tooth was lost due to traumatic injury, treatment for other medical conditions (including chemotherapy), or if the patient is suffering from secondary health impacts like GERD or loss of function.

• Coverage levels: Many full-coverage dental plans may cover 40-50% of implant costs, after deductibles and up to the annual plan maximum. However, if you’re signing up for a plan and already have some symptoms, make sure the plan doesn’t limit coverage for a pre-existing condition.

• Waiting periods: All types of dental insurance plans typically include waiting periods to receive non-preventative treatment. For example, you can usually have an oral exam and cleaning as soon as coverage starts, but you may have to wait a few months until procedures like cavity fillings are covered. If covered, major dental work, including implants, may require longer waiting periods of up to 12 months. So it’s important to sign up for coverage before you actually need it.

• Your estimated expense: The actual out-of-pocket cost for implants can vary dramatically based on the extent of work needed, type of insurance, and even geographic factors, because treatment costs more in some parts of the country than others. Be sure to look at:

  • Estimated out-of-pocket costs for different procedures in your zip code.

  • Waiting periods for both minor and major restorative care.

  • The percentage of coverage for specific conditions, procedures, and treatments.

  • Policy factors like deductibles, co-pays, and annual maximums could impact how much you spend.

  • Whether pre-existing conditions would disqualify you from coverage for certain conditions.

Tips to help make dental implants more affordable

Try using these strategies to help make dental implants more affordable and get the most out of your coverage:

• Check your medical insurance coverage, as some health insurance plans may cover medically necessary implants needed due to certain causes of tooth loss.

• If you are eligible for at least some coverage through multiple dental and/or health insurance policies, look into coordinating benefits and increasing your potential coverage around lifetime maximum limits.

• If you are a member of a dental insurance plan, make sure that your dentist is in-network.

• Time procedures strategically around annual maximum limits or deductibles of your dental coverage.

• Work with your dentist to obtain a predetermination of benefits from your dental insurance plan. They should provide you with specific details and payment estimates for the proposed services.

• If a procedure is denied (or you can't get preapproval), talk to your dentist about how to appeal the denied claims.

• Work with providers to discuss discounts. And since providers have different rates, consider getting a second opinion and/or new quotes for at least some of the work needed.

• Leverage healthcare credit cards and savings accounts, including HSAs and FSAs, to make coverage more accessible.