Dental Implant Stages: What to Expect When Getting Implant Surgery

Do you have a tooth (or teeth) that is missing or needs to be removed? A dental implant can restore your smile permanently.

Dental implants replace broken, rotten, and missing teeth and allow you to skip the bridgework and dentures. However, the process doesn’t happen overnight. There are three major dental implant stages that every patient goes through. And you could spend up to a year completing them. They include:

• Pre-surgical appointments
• The surgery itself (three individual stages)
• Recovery and follow-up appointments 

Have you thought about implants but aren’t sure what to expect? Keep reading, and we’ll show you what happens at every stage of the dental implant procedure.

What is a Dental Implant?

Before diving into the dental implant surgery, it’s worth reiterating what a dental implant is – and isn’t.

Dental implants aren’t teeth.

Instead, the implant is a prosthesis. When we talk about implants, we refer to the small post that goes into your jaw bone and forms the foundation for your crown (or bridge). The crown is the tooth, i.e., the part you see.

The implant is the most complex part of the procedure because it requires interaction with your jawbone and gums. If it doesn’t set correctly, it not only means your tooth won’t stay in place, but it can also result in problems for the rest of your mouth.

How Much Do Implants Cost in Ontario?

The cost of dental implants in Ontario varies wildly. The two biggest factors impacting price include the type of implant you choose and the state of your oral health (i.e., the difficulty of placing the implant).

It’s estimated that you will spend $1,000 to $6,000 per tooth. A full mouth can cost significantly more. Unfortunately, it is very unlikely that your insurance plan will fully cover implants.

Please also take a look at the Canada Dental Benefit Plan 2022

What to Expect Pre-Surgery

You can’t waltz into a dental office and get implants. The planning process is one of the longest implant stages because it requires you to see multiple professionals, each of whom has different specialties.

For example, you need to see an oral and maxillofacial surgeon for a full exam of your mouth and jaw to see if you are a good candidate for the surgery.

You will also visit a periodontist, who examines your gums, jawbone, and the other structural support around your teeth. They also consider your candidacy for dental implants.

Then, you need to see a prosthodontist who specializes in both dentures and implants.

And in some cases, you make an appointment with an ear, nose, and throat specialist.

Why does all this need to happen? Dental implants always require one surgical procedure, but many people need more help along the way to make sure the implant is a good fit for your mouth.

The whole process can take between six to nine months in total.

Will I Be a Candidate for Dental Implants?

A significant part of the pre-surgery assessments with the various specialists revolves around assessing your candidacy for dental implants.

The ideal candidate is someone who has good general health as well as adequate oral health. Ideally, you have healthy gums (no periodontal disease) and a strong jaw bone (more on that later). Both are important for supporting the implant (the prosthesis).

You typically qualify for dental implants whether you are missing one or all of your teeth. The price per tooth tends to go down when you need more teeth.

However, there are specific groups of people who need further consideration.

If you have diabetes (either type 1 or 2), you may need further exams. You need careful control of your blood sugar to ensure the healing process goes as planned. Immune deficiencies may also disqualify you because they compromise your ability to heal.

If you are pregnant, you may be told to wait until after you give birth before the surgery itself.

Do You Need Bone Grafting? It Could Add Days or Months

Dental implants are built into your jaw – just like real teeth. Your jawbone needs to support them for the implants to function correctly.

You already read that you will visit a periodontist who will examine your jaw. They do this to make sure the bone is thick enough to hold the implant over a long period fo time. If they determine you cannot, they then decide whether you need a bone graft.

A bone graft is a surgery that involves transplanting bone tissue. In this case, you will transplant the tissue to your jaw bone to strengthen or thicken it. The bone used may be from elsewhere in your body or synthetic.

What happens next depends on the extent of the graft needed. Significant grafts can take days or months to complete. Using artificial material works faster because you don’t need to regrow the bone.

In cases where the graft is artificial and straightforward, you may have the graft on the day of your implant surgery. However, you may also need one or more appointments well in advance. Your care team will be able to explain the plan that works best for you.

What to Expect During Your Dental Implant Surgery

As you draw nearer to your surgery, you will need to follow some pre-operative procedures. Most of these are designed to keep you healthy in the days and weeks after the surgery.

You may receive an anti-bacterial mouth wash or some prescription antibiotics. These are preventative measures that lower your risk of infection after the procedure.

Finally, you need someone to drop you off and take you home. While this isn’t essential for localized anesthetics, it is imperative if you use an IV or oral sedation.

Do You Need Sedation?

The type of sedation you need is mostly up to you.

The procedure always involves a local anesthetic at a minimum. However, due to the nature of your surgery, it is in your interest not to feel every second of it, particularly if you need multiple dental implants.

Both oral and IV sedation are available to dental implant patients.

Oral and IV sedation range from minimal to moderate to deep sedation. What you choose should depend on issues like:

• Your pain threshold
• Your teeth sensitivity
• Your gag reflex
• The work needed

If you have a low pain threshold and require a significant amount of work, then you may benefit from a higher level of sedation.

Your dentist can tell you more about the sedation offered and what type makes the most sense for your procedure.

You may be under instructions to avoid food after midnight before the surgery if you are using IV sedation. If you stick to localized anesthetics, then you need to eat a big breakfast because you won’t eat again for several hours. Additionally, eating will be painful for a few days post-op.

With these notes in mind, you’re ready for your procedure. Here’s what a typical implant surgery looks like.

The Three Dental Implant Surgery Phases

The surgery takes places in three stages:

• Placement of the implant
• Attaching the abutment
• Fitting the crown

The first phase would take place in your dental office unless your care team determined that you need an oral surgeon. You may also see an oral surgeon if you need IV sedation.

During the first phase, your provider will numb your mouth with local anesthesia. Once the drug works, they will make an incision in your gum and expose the bone.

With the incision in place, they use a drill, which creates space in the bone for the implant screw. Don’t worry, the drill is very quiet, so it shouldn’t startle or scare you if you remain awake for the procedure.

From here, the implant goes into place, and your incision may receive a stitch or two depending on the size.

Then, you wait a few months so that the implant and the bone become one piece (through osseointegration) to ensure there’s a secure attachment.

When it heals, you undergo the second phase of the procedure. During this appointment, your provider re-exposes the implant through another incision. Your dentist will then place the abutment on the implant and take the impression needed to fit the crown.

Creating the crowns takes several appointments, and they differ by the dentist’s preferences and by case.

During the final step, you receive your new crown(s). You may receive a trial procedure before the final fit that allows the dentist to ensure that everything fits perfectly.

What to Expect During Dental Implant Recovery

Recovery time varies patient by patient. If you needed one tooth removed and replaced, then your recovery time will be much faster than someone who needed several implants and a bone graft.

For most people, there is bruising, swelling, and some localized pain after the surgery. The worst day is typically the second, and it declines across the third. However, it doesn’t require more than an over-the-counter NSAID (ibuprofen or Tylenol) or at the most codeine or hydrocodone. You may not be comfortable, but you can go back to work the day after surgery.

How to Protect Your Dental Implants After Surgery

You will receive a full list of post-operative instructions from your care provider. These may differ depending on the kinds of procedures you had.

In general, you can expect to stick to soft foods for several days after the procedure. You also need to brush your teeth carefully to compensate for any bruising and swelling in your gums and mouth.

You can also manage the swelling and discomfort simply through using ice packs and warm, wet washcloths at different intervals throughout the day. You may find the swelling continues up until 40 hours post-op, and then it begins to decline.

Your incision wounds should heal quickly, but you do need to use a warm saltwater solution to keep it clean. You should also limit beverages that aren’t water.

Finally, although you will be undoubtedly excited that you have the smile you always wanted, you need to be careful when examining your mouth. Avoid pulling on your lips or cheeks to see your teeth because you might inadvertently re-open some sutures.

What Foods Should You Eat After Surgery?

Soft foods are the best choices after surgery. A list of good food choices includes:

• Oatmeal
• Scrambled eggs
• Broiled fish
• Mashed potatoes
• Soft-cooked vegetables
• Soups
• Jello
• Cottage cheese
• Ice cream

You don’t need to eat foods that require a straw, nor should you stick to ice cream or pudding for the duration of your healing process. Maintaining a healthy (but soft) diet during the weeks after your procedure will ensure you heal quickly.

Additionally, you need to eat enough to prevent nausea, that may come with prescription medications.

How Many Checkups Do I Need After Surgery?

Once you have your final appointment to place the crown, you will need several checkup procedures.

The first appointment is usually one or two weeks after the placement. During the appointment, the dentist removes any sutures and ensures everything is healing. They also check for any signs of infection.

After six weeks, you return to the dentist again. They will examine your oral hygiene and ensure that your gums (soft tissue) are healing well.

Next, you have a three-month maintenance appointment. At the appointment, your dentist will use radiography to examine your jawbone and ensure that the implant is in place and there is no sign of bone loss around the implant. They also look for signs of apical periodontitis and inflammatory bone lesions around the implant.

You then have a new appointment at six months and then annually for three years. These are in addition to your typical annual or biannual cleanings, which you need for general oral health.

These checkups are essential. Most implant complications begin as minor issues. However, leaving them unchecked can transform them into severe and irreversible problems that could lead to the loss of your implants or even other teeth.

Are You Ready for Dental Implant Surgery?

Dental implants can restore and transform your smile. However, they are a significant undertaking. Because the implant goes directly into your jawbone, you need your whole mouth assessed to ensure that the implant won’t fail.

The dental implant stages can take up to nine months, depending on the kind of care you need. At the same time, they offer a permanent fix to your smile that comes without the disadvantages of bridges or dentures.

Read our blog for more information on dental implants and get in touch to learn whether you’re a candidate for this transformative procedure.