Are dental implants safe? Myths, facts and risks

Many people who are considering dental implants have one main worry: are dental implants safe? For many healthy adults, implant treatment is a well-established, well-researched way to replace missing teeth. It is still surgery, though, and it carries some risks. This guide separates common myths from the facts, explains the real risks and who needs extra care, and describes how careful planning helps to keep treatment safe.

Are dental implants safe? The short answer

Dental implants have been used for decades. A review of studies that followed implants for ten years or more concluded that implant treatment is a safe option with high long-term survival (Moraschini and colleagues, 2015). An implant can stay in place and still have complications, so regular check-ups matter. Safety, however, depends on the individual: your general health, your gums and bone, habits such as smoking, the planning of the treatment and how well the implant is cleaned and checked afterwards.

Dental implant myths and facts

Myth 1: "Implants are risky and often fail"

Fact: Most implants heal into the bone and function for many years. Failures do happen, and they are more likely in people who smoke, have uncontrolled diabetes or untreated gum disease, or do not keep up maintenance. A careful assessment before treatment helps to identify and reduce these risks. Read more about common implant complications and how to avoid them.

Myth 2: "Implant surgery is very painful"

Fact: Implant surgery is usually done under local anaesthetic, so the area is numb during the procedure; you may still feel pressure. Afterwards, some soreness and swelling for a few days are common and are usually managed with simple pain relief and cold packs. For anxious patients, sedation may be discussed; see IV sedation and tips to overcome fear of the dentist.

Myth 3: "I am too old for implants"

Fact: Age alone is not usually a barrier. A systematic review concluded that advanced age by itself is not a reason to avoid implants, although some medical conditions and treatments need extra care (Schimmel and colleagues, 2018); these are listed below. What matters more is general health and the ability to clean the implant.

Myth 4: "Implants cannot get gum disease, so they need no care"

Fact: An implant cannot decay, but the gum and bone around it can become inflamed. Peri-implant mucositis is inflammation of the gum around an implant; peri-implantitis also involves loss of the supporting bone (Berglundh and colleagues, 2018). Daily cleaning and regular check-ups are essential. Read our home-care tips for healthy dental implants.

What are the real dental implant risks?

Possible problems include (Cleveland Clinic; American Academy of Periodontology):

• swelling, bruising or minor bleeding for a few days, which are common; infection, which is less common
• injury to a nerve in the lower jaw, which can cause numbness or tingling of the lip, chin or tongue that may settle or may last
• the drill or implant entering the sinus in the upper back jaw (a sinus lift is a separate, planned procedure used when bone height there is low)
• damage to neighbouring teeth or roots
• an implant that does not heal into the bone and may need to be removed
• inflammation and bone loss around the implant later on (peri-implantitis)
• mechanical problems such as a loose screw or a chipped crown (see loose implant treatment)

If an implant fails, replacement is sometimes possible after the site has healed and been assessed again. Read about failed dental implants: care, replacement and prevention.

Who needs extra care before implants?

Implants are possible for many people in these groups, but not for everyone; planning, timing or aftercare may need to change:

• People who smoke. Smoking is linked with higher implant failure and more complications (Chrcanovic and colleagues, 2015). Read about smoking and dental implants.
• People with diabetes, especially when it is poorly controlled.
• People with a history of gum disease, which should be treated and stable first (see gum disease treatment).
• People who have had radiotherapy to the head and neck or who take high-dose antiresorptive medicines (for example certain bisphosphonates or denosumab, often used in cancer care), which can affect healing of the jawbone.
• People who grind or clench their teeth, who may be advised to wear a night guard to reduce the load on the implant crown.
• People with limited bone, who may need bone grafting or a sinus lift before, or at the same time as, implant placement (see dental implants with bone loss).

There is no single list of people who must never have implants, but these factors are reasons to pause until your dentist has reviewed them. Always tell your dentist about your medical conditions and every medicine you take.

How careful planning lowers the risk