Side effects of dental implants: what to expect and what is not normal

In the first days: expected effects

The guidance we use does not describe the course after implant surgery itself; the nearest is for wisdom tooth removal, which is also surgery in the jaw. The NHS says pain and swelling can last for up to 2 weeks³ and should start to improve after 1 or 2 days. It also mentions bruising of the cheek and a stiff jaw. How much you feel depends on what was done: one implant, several, a bone graft or a sinus lift.

A little bleeding that stains your saliva pink is common on the first day. If it keeps bleeding, press on it with damp gauze for 20 minutes⁴ before checking. If you had sedation, you may feel drowsy for the rest of the day, and someone must take you home: without an escort, UK standards say sedation must not be given⁵ (inhalation sedation in adults excepted). The NHS advises not driving for 24 hours³ after a sedative injection; ask beforehand whether someone needs to stay with you, and for how long. Conscious sedation is not sleep: UK standards require that verbal contact with the patient is kept⁵ throughout. These are standards, not studies of how often problems happen, so they give no complication rate for sedation, and we quote none.

During healing: when an implant does not take

After placement the implant has to fuse with the jawbone. Sometimes it does not: it stays mobile or comes out in the first weeks or months. This is early failure.

• Smoking. A 2024 review of 32 observational studies found an odds ratio of about 2.6 per implant¹ for early loss in smokers. An odds ratio is not the same as a risk that is 2.6 times higher.
• An implant placed straight after an extraction. This can work in selected cases, but one review found survival of 95.2 per cent, against 98.4 per cent⁶ for implants placed into healed sockets. These are survival figures across the studies, not the chance of an early loss.
• Numbness, a separate problem. Numbness of the lip, tongue or chin that lasts after the anaesthetic should have worn off can mean a nerve was affected; contact your dentist promptly. After wisdom tooth removal, the NHS says nerve damage usually gets better but can last a few weeks or months³. The reviews we use do not report how often this happens after implant surgery, so we give no figure.

If a sinus lift or zygomatic implant is part of the plan

In the upper jaw, the sinus lies above the back teeth. Raising its floor for an implant (a sinus lift) can tear the thin sinus lining. In a 10-study review of sinus lifts done through a window in the side of the sinus, with bone graft, the average tear rate across the studies was 29.42 per cent⁷; that is an average across studies, not your personal risk. A tear is usually repaired in the same session. In that review, implant survival after a repaired tear (97.1 per cent⁷) was not significantly different from survival with an intact lining (97.7 per cent), but that does not make a tear harmless. For zygomatic implants, anchored in the cheekbone, sinus inflammation was the most common problem. Pooled from 11 studies it was reported in 14.2 per cent of patients⁸, but the studies ranged from 2.8 to 36.4 per cent and diagnosed it in different ways. This is not a personal risk. The bone grafting page explains the sinus lift.

Once in use: problems around the implant and the parts on top

Inflammation around the implant. Plaque collects on an implant as it does on a tooth. Peri-implant mucositis is inflammation of the gum around it. Peri-implantitis adds loss of the supporting bone, and if it is not controlled the implant can be lost. A 57-study review found peri-implantitis in about 20 in 100 patients and about 12 in 100 implants⁹; the rate depends on the definition used.

Bone level around the implant. Around full-arch implants, a 2026 review found an average bone loss of about 1 mm per implant over five years¹⁰. That is an average across studies, not a safe limit: changes in your own bone level are judged against the baseline X-ray taken when the tooth was fitted.

The parts on top. The 46-study review counted problems over five years around single-tooth implants that stayed in place:

• screw loosening in 8.8 per cent²
• soft-tissue problems in 7.1 per cent, and complaints about appearance in 7.1 per cent
• bone loss of more than 2 mm in 5.2 per cent
• the crown coming loose in 4.1 per cent, and chipped porcelain in 3.5 per cent

A loose screw can usually be tightened and a damaged crown repaired or replaced. These are pooled averages from many studies, not the result of one clinic or implant brand, and not your personal risk.

What makes complications more likely

These links come from observational studies, not proof of cause.

• Smoking. In people smoking more than 20 cigarettes a day, implant loss was about 2.5 times as likely per implant¹¹. No safe number has been shown.
• Gum disease treated in the past. In studies following people treated for periodontitis for at least three years, implants were lost at about 1.75 times the rate¹², and peri-implantitis was about 3 times more common.
• Clenching or grinding. The odds of implant failure were about 2.2 times higher¹³ in people judged likely to clench or grind (an odds ratio).
• Diabetes. The findings are mixed. Two of three reviews found no significant difference in implant loss (2021 review¹⁴; 2016 review¹⁵), and the third found higher odds of implant loss¹⁶ in people with diabetes than in people without. The 2021 review, of type 2 diabetes, tied its reassuring result to strictly maintained oral hygiene. All three found more bone loss around implants in people with diabetes.
• Bone-strengthening medicines. A 21-study review found that in people taking bisphosphonates, implant loss was about 1.7 times more likely per implant¹⁷; the per-patient analysis found no significant difference. Jaw osteonecrosis, the death of jaw bone linked to the medicine, was about 3.5 times more likely per patient. The certainty of the evidence is very low. The review also looked at denosumab, but that result was too uncertain to quote. Tell your dentist about any bone-strengthening medicine, tablets or injections, now or in the past. Do not stop a medicine without asking the doctor who prescribed it.

Lowering the risk

• Do not smoke during healing, and ideally not at all. Your dentist sets the smoke-free period in your instructions.
• Clean daily once the wound has healed, paying attention to the line where the implant meets the gum. While it heals, follow your instructions on cleaning the surgical area.
• Have gum disease and diabetes checked first. Both are linked to more problems (see above); tell your dentist and your doctor, so they can be looked at before the implant is placed.
• Keep your check-ups. When the tooth on the implant is completed, an X-ray and gum measurements are taken as a baseline¹⁸. The European Federation of Periodontology's guideline calls for a care programme with regular assessment¹⁹ once implants are in use.
• Tell your dentist everything about your health, including any known reaction to metals. We have not reviewed evidence on titanium allergy, so we make no claim about it.

The dental implants page explains how treatment is planned around these factors.

When to see a dentist

Contact your dentist if you notice any of these:

• Pain or swelling that is severe or getting worse, when painkillers are not helping
• Pain with a bad taste, a high temperature, or feeling unwell
• Bleeding around the implant, pus, or a bad smell or taste
• The implant, or the tooth on it, moves or feels loose, or the crown chips or comes off
• The gum around the implant recedes, or metal starts to show
• Numbness that lasts after the anaesthetic should have worn off

The NHS lists the first two as reasons to get urgent help³ after wisdom tooth removal. Scottish guidance for extractions says bleeding that has not stopped after a second 20 minutes of pressure, or that does not stop or starts again in someone on a blood thinner, needs emergency care⁴. If you cannot reach your dentist, go to the nearest emergency department.

Emergencies. Go to the nearest emergency department or call 112 if swelling makes it hard to breathe, swallow or speak, or if the area around your eye or your neck swells. The NHS lists these as reasons to go to an emergency department²⁰.

Frequently asked questions