Dental Implant Myths: What Studies Actually Show

Myths about how long implants last

'An implant lasts for life'

No study we use supports that. The 46-study review gives figures for up to ten years: about 97 in 100 implants in place at five years, about 95 at ten. Both are estimates from a statistical model¹ based on studies with a mean follow-up of at least five years, and the ten-year values are less certain than the five-year values. The reviews used here give no pooled figures beyond ten years. The crown on the implant is a separate part and is replaced more often: about 96 in 100 crowns were still in use after five years and about 89 after ten.

'Implants often fail'

The implant itself is rarely lost, but problems with the parts on top are common. Over five years the same review reported screw loosening in 8.8 per cent of implants and soft-tissue problems in 7.1 per cent¹. Aesthetic complaints were also 7.1 per cent, and chipped porcelain 3.5 per cent. Most of these can be repaired: a loose screw tightened, a damaged crown replaced.

'A clinic's success rate is my chance of success'

Published rates are averages pooled from studies in different countries and groups of patients. They are not the result of one clinic, dentist or implant brand, and they are not your personal risk. When you read a rate, ask what was counted (implants, crowns or patients), how success was defined and over how many years.

Myths about care and health

'An implant can't get gum disease'

An implant cannot decay, but the gum and bone around it can become inflamed. Peri-implantitis is inflammation of the gum around an implant together with loss of the bone that supports it. A 57-study review found it in about 20 in 100 patients and about 12 in 100 implants²; the rate depends on the definition used. If it is not controlled, the implant can be lost.

'An implant needs no more care than a natural tooth'

Daily cleaning is similar: brushing twice a day and cleaning between the teeth. The follow-up is not. When the crown or bridge is complete, an X-ray and gum measurements should be taken as a baseline record³, so that later changes can be spotted. After that, the European periodontology guideline calls for a structured supportive care programme⁴. The NICE guideline on dental recall says the interval between reviews should be set for each patient⁵ according to their risk.

'Smoking makes no difference, and diabetes rules implants out'

Both are wrong. In people smoking more than 20 cigarettes a day, implant loss was about 2.5 times as likely per implant⁶ as in non-smokers; no safe number of cigarettes has been shown. Diabetes, on the other hand, does not rule an implant out. Two of three reviews found no significant difference in implant loss (2021 review⁷, of type 2 diabetes with strictly maintained oral hygiene; 2016 review⁸), and the third reported higher odds of implant loss⁹. That does not mean the risk is the same for everyone with diabetes. All three found more bone loss around implants in people with diabetes, so blood-sugar control and regular reviews matter. These are associations from observational studies, not proven cause and effect.

Myths about treatment

'Implant surgery is very painful'

The surgery is done under local anaesthetic, and sedation is an option for some people. Soreness and swelling are common in the first days. The sources used here give no pain timeline for implant surgery itself. For pain after wisdom tooth removal, the NHS advises paracetamol or ibuprofen¹⁰. That is extraction guidance, not specific to implants; follow your dentist's instructions on which to take. If you take blood thinners, a UK leaflet for people on these medicines advises paracetamol and avoiding anti-inflammatories such as aspirin, ibuprofen or diclofenac¹¹. Do not stop or change your blood thinner yourself. Pain that gets worse instead of better is a reason to call your dentist.

'Everyone can have new teeth in a day'

Not everyone. Fitting a tooth on the day of surgery suits selected patients. A Cochrane review of 26 randomised trials found no convincing difference in failure of the implant or of the teeth fitted on it¹² between loading within a week and waiting, over four months to one year; that result was uncertain rather than proof that the two are equal. A review of 39 randomised trials found slightly lower implant survival¹³ with immediate loading. Placing an implant straight into the socket of an extracted tooth is a separate choice: in one review, about 95 in 100 such implants survived¹⁴, against about 98 in 100 in healed bone. These are overall rates across the studies, not five- or ten-year figures. A tooth fitted on the day is usually temporary.

'An implant is always better than saving your tooth'

The evidence does not show that. A review of 143 studies found that teeth kept with root canal treatment and implants carrying a single crown had similar long-term survival¹⁵. Studies comparing the two directly were extremely rare, so neither can be called better in general; for your tooth, the answer depends on whether it can be restored well. If your tooth can be saved, ask what that involves before deciding on an extraction.

How implant treatment runs, stage by stage, is explained on the dental implants page.

When to see a dentist

See a dentist for an examination before deciding on an implant. Ask whether the tooth can be saved, what the alternatives are, such as a bridge or a removable denture, and which risk factors apply to you. Bring a list of the medicines you take, and mention smoking, diabetes, gum disease and clenching. Gum disease is treated before implants are placed. Bone-strengthening medicines such as bisphosphonates were linked with more implant loss per implant¹⁶ and with jaw osteonecrosis, the death of jaw bone linked to the medicine. The evidence for both is of very low certainty. If you take one of these medicines, or denosumab, tell your dentist what it is for and how it is given, and do not stop it yourself.

If you already have an implant, contact your dentist if you notice any of these:

• The implant or the tooth on it moves, a screw feels loose, or a piece breaks
• Bleeding, a bad smell, pus or receding gum around the implant
• Bleeding that does not stop after firm pressure
• Pain or swelling that is severe or getting worse, when painkillers are not helping
• Numbness of the lip, tongue or chin that lasts beyond the anaesthetic

Emergencies. Difficulty breathing or swallowing, rapidly spreading swelling of the face or neck, high fever or swelling around the eye are serious signs. Go to the nearest emergency department or call 112.

Frequently asked questions