An implant can go in on the same day a tooth comes out, or it can wait anywhere from a few weeks to several months. The right gap depends mostly on two things: how much bone is left around the socket, and whether the area was infected. A front tooth with thick bone and no infection is a very different case from a lower molar that has had an abscess for a year.
Dentists usually describe the timing in four stages. They are defined by what has healed in the socket, not by a set number of days, so the week counts below are a guide.
Same day as the extraction
This is called immediate placement. The tooth is removed carefully to keep the thin outer wall of bone intact, and the implant is placed into the fresh socket in the same visit. A temporary tooth can sometimes be fitted on the day as well, although it is shaped so that you do not bite on it while the implant heals.
It only works when there is enough solid bone beyond the tip of the root to hold the implant firmly from the start. An implant that moves under light pressure in the first weeks is unlikely to fuse with the bone. There also needs to be no active infection draining from the socket.
The main reason to do it is the gum line at the front of the mouth. When a front tooth is lost, the gum and the bone under it tend to shrink back, and that can leave an implant crown looking longer than its neighbours. Placing the implant and a temporary tooth straight away can help support the gum shape. It does not stop the bone from remodelling on its own, which is why a graft is often packed around the implant at the same time.
Four to eight weeks later
By this point the gum has closed over the socket, but the bone inside is still soft and immature. Waiting this long gives a minor infection time to settle and gives the surgeon more gum tissue to work with when closing the site. It is a common choice for front teeth that were not suitable for same-day placement. Bone grafting at the time of implant placement is usual at this stage because the socket has not filled in yet.
Three to four months later
The socket has now largely filled with new bone, so the implant has something firm to be placed into. This is a sensible default for back teeth, for teeth lost to a long-standing infection and for extractions that were difficult or left the socket walls damaged. Healing is more predictable. The cost is a longer wait with a gap, and some shrinkage of the ridge will already have happened.
After four months
This covers everything from about four months to teeth that were lost years ago. The bone is mature, but the ridge is usually narrower and lower than it was, especially in the first year after an extraction. In the upper back jaw, the sinus can also drop into the space where the roots used to be. A bone graft or sinus lift is more often needed before or during placement at this stage.
| Stage | Typical timing | Often chosen for | Main drawback |
|---|---|---|---|
| Immediate | Same visit | Front teeth with good bone and no infection | Strict conditions, more demanding surgery |
| Early | 4 to 8 weeks | Front teeth that needed a short healing period | Bone still immature, grafting common |
| Delayed | 3 to 4 months | Back teeth, infected or damaged sites | Longer gap, some ridge loss |
| Late | 4 months or more | Teeth lost long ago, complex sites | Most ridge loss, grafting more likely |
If you would like to know how the socket can be supported after an extraction, our guide to socket preservation after tooth extraction explains when it may be recommended.
Keeping the space for later
If the implant will not go in on the day, the socket can be filled with a bone graft material straight after the tooth is removed and covered with a membrane. This is called socket preservation. The graft holds the space while your own bone grows into it, so there is less collapse to fix later.
It is most useful when the tooth is at the front, when the outer bone wall is thin or already broken, or when the implant is planned for several months later. It is less often needed when the implant goes in the same day, or when there is plenty of bone in every direction. It is a smaller procedure than a full bone graft or sinus lift, which are used when a lot of bone has already been lost. Our article on bone grafts and sinus lifts explains those in more detail.
What we look at before deciding
We plan implant timing from a clinical exam and a CBCT scan, which is a 3D X-ray of the jaw. The scan shows how thick the bone is on each side of the root, how much there is beyond the tip and how close the nerve in the lower jaw or the sinus in the upper jaw sits.
The other things that change the plan are why the tooth is being lost, whether there is infection, how thick the gum is at the front, whether you smoke and whether you have a condition such as diabetes that slows healing. Gum disease elsewhere in the mouth also needs to be under control first, because it raises the risk of problems around the implant later.
Implant timing and the time until you have a tooth
These are two different clocks. Even when the implant goes in on the day of the extraction, it usually needs around three months to fuse with the bone before the final crown is made. With a delayed approach you might wait three to four months for the implant and then another three months for the crown. So the full treatment can take anything from about three months to nine months or more, depending on the stage chosen and whether grafting is needed.
If the gap is visible, we can talk about a temporary tooth for the waiting period. Options include a small removable plate or, in some cases, a temporary bonded to the neighbouring teeth.
For what to expect in the fortnight after a tooth comes out, see our extraction recovery timeline. If you are weighing up an implant, you can read about dental implants at Lumi Dental or book a consult, where we take the scan and go through the timing that suits your tooth.
Questions we are often asked
Is same-day placement better?
Not in every case. It can help keep the gum shape at the front of the mouth, but research has shown that placing an implant into a fresh socket does not by itself stop the outer bone from thinning (Araújo and colleagues, Journal of Clinical Periodontology, 2005). It depends on the bone you start with and how the site is grafted.
Where does the four-stage system come from?
It was set out at an International Team for Implantology (ITI) consensus conference and published by Hämmerle, Chen and Wilson in the International Journal of Oral and Maxillofacial Implants in 2004. It is still the common way dentists describe implant timing.
Can an implant go in if the tooth had an abscess?
Sometimes, but it usually means waiting. A small, well-contained infection can clear quickly once the tooth is out. A large or long-standing one is normally left to heal for a few months first.
Does waiting longer make the implant less likely to work?
Not usually. Success rates are high across all four stages when the case is chosen well. Waiting longer mainly affects how much bone is left and whether grafting is needed.
