Tobias K. Boehm (May 20, 2025)
Dental implant diagram (Alexmit art, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons)
Generally, dental implant treatment works for most individuals. Compared to many dental procedures, it has a high likelihood of succeeding, comparable to dental fillings and root canal treatment. Studies on successful dental implant therapy outcomes in patients often center on survival of the implant, which simply means that the implant is still present in the mouth. Few studies focus on implant success, meaning that the tissues around the implant are completely healthy, the implant functions as intended and supports a normal appearance of teeth and gums. As example, the common single implant – ceramic crown combination replacing a single missing tooth has an implant survival rate of over 96% and a success rate of 63% over 30 years in a dental school clinic setting (1).
Common experiences
While dental implant therapy generally works, there are risks. Most of these risks are related to having oral surgery done and are better described as common experiences that are possibly unpleasant, but most likely short-lived. These experiences are to be expected after surgery, and to some degree are normal and unavoidable:
- Pain: It is normal to have some pain immediately after numbing agents used during surgery wear off. Pain is a normal part of healing after surgery. In my experience, individuals who had implant surgery often describe this as “sore” and “throbbing”. This usually lasts a few days, and relieved to a bearable level with ice and medications like Ibuprofen or Acetaminophen. The pain after surgery is typically less than the pain experienced after having the teeth removed. If you have pain that gets worse 2 days after surgery, keeps you up at night or is just unbearable, reach out to your implant surgeon it may suggest a problem such as an infection.
- Discomfort during the surgery: While numbing agents are used for surgery, it does not prevent all discomfort. You may feel the vibrations and noises that are part of the surgery. Occasionally, you may feel some deep-seated pressure or bone pain when the dental implant engages your bone, or you may feel pressure or pain in your jaw joint from having your mouth open for long periods of time. If you have neck or back problems, you may feel sore sitting in a dental chair for long periods of time. You may feel you need to use the bathroom during the procedure. In some individuals, numbing agents may wear off quicker than expected, and more numbing agent is needed. If you feel discomfort during surgery, let your implant surgery team know. Many times, they can help ease your discomfort.
- Numbness: Unless being put to sleep for the surgery, you will experience numbness in parts of your face and jaws during the surgery. This will feel as tingling, swollen or wooden sensation similar to the numbing you receive for other dental procedures. The numbness should wear off within a few hours of the implant surgery. Reach out immediately to your implant surgeon if the numbness does not wear off after 24 hours. In my experience, the few cases I have observed were related to excessive swelling after bone grafts in the lower jaw region near the premolars, and these resolved on their own with healing after several weeks to few months. This can also be a rare side effect of local anesthesia agents, signal an infection or nerve injury. In the case of nerve injury, time is the essence for treatments.
- Bleeding: You will taste some blood during or after implant surgery. This is normal and unavoidable as it is part of surgery procedures. Bleeding usually is minor but may feel a lot since your spit mixes with blood. After surgery, your spit may appear pink or light red for about 24 hours. This may also happen when stitches fall out by themselves or are removed at a follow-up visit. If you experience bleeding, see our article on “How to stop bleeding after oral surgery”. Reach out to your implant surgeon if you see blood dripping or flowing from the surgery site and firm pressure with gauze does not stop it within 15 minutes. Seek immediate medical care if you feel lightheaded or are throwing up blood, as this would be extremely unusual.
- Swelling: Inflammation during healing after surgery is normal and to be expected. With bone grafting and growth factor products used during surgery, this can be very pronounced. Applying ice often helps decrease the swelling, and the swelling usually resolves within few weeks. Reach out to your implant surgeon if the swelling continues to become larger 2 days after surgery as it could signal continued bleeding or an infection.
- Bruising: Depending on the surgery and your own experience with past surgery, this can happen after any surgery. In my experience, bruising is more likely to happen with large surgeries, older individuals and individuals who have bleeding disorders, take blood thinners or have thin, fragile skin. Bruises typically resolve within a few weeks after surgery.
- Bad taste: Blood, numbing agents and other materials used during surgery have metallic, bitter or other unpleasant tastes or smells. You will likely taste salt water during surgery as this is commonly used to keep your tissues cold during drilling. You may feel sand-like particles in your mouth after bone grafting or as result from drilling inside bone. All these are normal experiences. Reach out to your implant surgeon if you taste foul, metallic or salty material 5 or more days after surgery as this may suggest delayed healing or an infection.
Long-term, crowns, bridges and dentures attached to implants wear from daily chewing over many years. Typically, the failure rate of implant ceramic crowns is less than 1% per year (2). This means that while crowns can last a long time, it is a good idea to expect to have to replace an implant crown eventually.
References:
(1) Sarzynski I, Pfeffer J, Nowakowski A, Pesun I. An up to thirty-year retrospective study on the success and survival of single unit and splinted implant-supported crowns in a dental school setting. J Prosthet Dent. 2024 Oct;132(4):703.e1-703.e5. doi: 10.1016/j.prosdent.2024.05.036. Epub 2024 Jul 4. PMID: 38969577.
(2) Wierichs RJ, Kramer EJ, Reiss B, Roccuzzo A, Raabe C, Yilmaz B, Abou-Ayash S. Longevity and risk factors of CAD-CAM manufactured implant-supported all-ceramic crowns – A prospective, multi-center, practice-based cohort study. Dent Mater. 2024 Nov;40(11):1962-1969. doi: 10.1016/j.dental.2024.09.008. Epub 2024 Sep 24. PMID: 39322444.
A note about evidence-base: It seems there is little research about common experiences after implant surgery, probably because they are common place and assumed to be well known. I am writing here based on my own experience having done thousands of surgeries in my professional career.
About the author:
Tobias K. Boehm, DDS, PhD, MBA, PC, DABP, DICOI, FGDIA is the founder of The Dental Institute, executive director at The Defeating Epilepsy Foundation and a professor at Western University of Health Sciences where he teaches and practices a periodontal specialist.