The weeks after an implant is placed can feel like nothing is happening, but this is when the most important part of the treatment takes place. Bone cells are growing onto the surface of the implant and locking it into the jaw, a process called osseointegration. For a conventionally loaded implant, that healing period is usually planned at around three to six months before the final crown is attached, and sometimes longer when the bone needs extra help.
Once fused, the implant behaves less like something sitting in the jaw and more like part of it. That is why it can take normal chewing forces, and why the healing time is rarely worth cutting short.
Bone grows onto the implant surface, it does not just grip it
An implant is a small threaded post, usually titanium or a titanium alloy, sometimes zirconia, placed where the tooth root used to be. When it goes in, it is held mechanically by the bone around the threads. That first grip is called primary stability, and it gradually gives way to a biological bond.
In the first days and weeks, bone-forming cells settle on the implant surface and lay down a quick, loosely organised layer of new bone, known as woven bone. Over the following months this is remodelled into denser, more ordered lamellar bone, the same mature bone found elsewhere in the skeleton. By the end of this process the bone is in direct contact with the implant surface, with no soft tissue layer in between.
The idea that titanium can bond this closely with living bone dates back to work by Per-Ingvar Brånemark's group in Sweden. One of their landmark reports, a 15-year study of osseointegrated implants in people with no teeth in one or both jaws (Adell and colleagues, International Journal of Oral Surgery, 1981), helped establish implants as a long-term treatment.
Healing time depends on the jaw, the bone and the plan
A Cochrane review of implant loading (Esposito and colleagues, 2013) describes the conventional approach as keeping implants free of load for about 3 to 8 months while osseointegration is established. Many single implants fall at the shorter end of that range. Several things shift the timeline:
- Upper or lower jaw. The bone in the upper jaw is often softer and less dense than in the lower jaw, so upper implants are commonly given longer to heal.
- Bone grafting. If the site needed a graft or sinus lift to create enough bone, the graft has to mature as well, which adds time.
- How firm the implant was on the day. An implant with very good primary stability in dense bone may suit a shorter healing period, or in selected cases a temporary tooth fitted early.
- General health. Smoking, poorly controlled diabetes and some medicines can slow bone healing.
In the trials it included, the same Cochrane review found no convincing difference in implant failure between immediate, early and conventional loading, but earlier loading is not the right choice for everyone. Your dentist will explain which approach fits your bone and your bite. If a tooth was taken out some time ago, our guide to getting an implant years after an extraction explains how bone changes over time affect planning.
Too much force too early can stop the bond forming
Bone grows best onto a surface that is not moving. If an implant is put under heavy chewing load before it has integrated, tiny movements at the bone surface can encourage soft tissue to form instead of bone. The implant may then never become firm and may have to be removed.
This is the reason for the soft-food advice after surgery, the temporary tooth or denture that is kept off the implant, and the review appointment before the crown is made. At that review the dentist checks that the implant is firm and comfortable, and may take an X-ray to look at the bone around it. Once integration is confirmed, the abutment and crown can be fitted. Our article on the parts of a dental implant shows how those pieces connect.
Smoking is the risk factor patients can change most easily
A systematic review of 107 studies (Chrcanovic and colleagues, Journal of Dentistry, 2015) found implant failure in about 6.4% of implants placed in smokers compared with about 3.2% in non-smokers, along with more infections and more bone loss around the implant. The authors noted that other factors in the studies could have affected these numbers, so the figures are a guide rather than a precise risk. Stopping, or at least cutting down, around the time of surgery is one of the most useful things a patient can do.
Other factors that can slow or disturb healing include:
- diabetes that is not well controlled
- active gum disease elsewhere in the mouth, which is usually treated before an implant is placed
- thin or soft bone at the implant site, which is why 3D imaging is part of planning
- heavy clenching or grinding, which can overload a new implant
If you are worried about how a healing implant feels, our guide to the signs of a failing implant lists the symptoms that are worth a call to the practice.
Still deciding whether an implant is the right step
Some teeth can be saved, and for others an implant is the more predictable choice. Our comparison of an implant versus root canal treatment covers how dentists weigh that decision, and our article on whether getting an implant hurts describes what the surgery and the first few days usually feel like.
Common questions
Will I have a gap while the implant heals?
Not necessarily. Many people wear a temporary tooth, such as a small removable denture or a bonded tooth, during healing. It is designed to sit off the implant so the implant is not loaded too soon.
Can I chew on the implant side?
You will usually be asked to avoid biting directly on the implant site in the early weeks, then return to normal eating gradually once your dentist is happy with healing.
What happens if the implant does not integrate?
It may feel loose or tender. In that case the implant is usually removed, the site is left to heal, and a second implant can often be considered later, sometimes with a bone graft first.
Does osseointegration finish once the crown is fitted?
The bone around an implant keeps remodelling throughout life, as bone does everywhere in the body. Keeping the gum around the implant healthy with daily cleaning and regular reviews helps protect that bone over the long term.
Talk through your own timeline
Every implant plan has its own healing schedule, and the best way to know yours is an assessment with 3D imaging. Lumi Dental offers a free implant consult, and you can read more about treatment on our dental implants page or see the current offers.
This article is general information and not a substitute for an individual dental assessment.
