Bone Grafts for Dental Implants: When and Why

An implant needs bone to hold it. If there is too little, a bone graft can build it up. This guide explains why a graft is needed, how it works and what it adds.

Key points

• A graft builds up thin or short jawbone so that an implant post can be held securely.
• NHS patient information says a bone graft can add at least four months to treatment and can bring swelling, bruising and pain.¹²
• Common types are socket preservation, ridge augmentation and sinus lift, using your own bone, donor bone, animal-derived bone or synthetic material.
• Some people can avoid a graft with shorter, narrower or tilted posts, or with a denture or bridge. A 3D scan shows which options are possible.⁴
• Smoking affects healing, and NHS guidance asks patients to stop at least six months before implant treatment.¹

An implant is only as stable as the bone around it. If the jawbone is too thin, too short or too soft in the place where a tooth is missing, the post may not be held firmly. A bone graft adds material to the site so that it can carry an implant. Not everyone needs a graft, and your scan shows whether you do.

Why bone is lost

Bone depends on teeth to keep it busy. When a tooth is lost, the bone that surrounded its root is no longer used, and it gradually shrinks. Other reasons include gum disease, which destroys bone, injury, infection and long-term denture wear. Immediate placement of an implant does not stop the bone around the socket from shrinking, because bone loss after extraction is a natural process.³

How your dentist finds out

A 3D scan shows the height and width of the bone and where nerves and the sinus lie. X-rays alone cannot show this well. At Orion Dental Clinic, planning uses a 3D scan (CBCT). The scan tells your dentist whether there is enough bone for a post of a useful size, and where a graft would be needed.

Types of graft

Dentists use several materials, and the choice depends on the site and your case.

• Your own bone, taken from another place in the mouth, such as the chin or back of the jaw, or sometimes from elsewhere in the body.
• Donor bone, processed bone from a human donor.
• Animal-derived bone, processed bone, often from cattle.
• Synthetic material, laboratory-made substitutes.

All of them act as a scaffold on which your own bone grows. Your dentist can explain which they use and why.

Types of graft procedure

Socket preservation. When a tooth is removed, the empty socket is filled with graft material to slow down bone loss, ready for an implant later.

Ridge augmentation. Bone is added to the width or height of the jaw where the ridge has become thin.

Sinus lift. In the upper back jaw, the sinus sits close to the bone. A sinus lift raises the floor of the sinus and adds bone beneath it, so that an implant can be placed. It adds healing time.

How long a graft adds

NHS patient information says a bone graft can add at least four months to treatment, and that it can bring swelling, bruising and pain.¹² Sometimes the graft and the implant are placed together, and sometimes the graft is done first and left to heal. For your own mouth, your dentist can give a timeline.

NHS guidance says the whole implant process could take 6 to 12 months, so a graft is a significant addition.²

What the graft procedure involves

1. Anaesthetic. Usually local anaesthetic, sometimes with sedation.
2. Opening the gum to reach the bone.
3. Placing the graft material, often covered with a membrane that protects it.
4. Closing the gum with stitches.
5. Healing, over months, as your bone grows into the material.

What it feels like afterwards

Expect swelling, bruising and some discomfort for several days. Painkillers help, and a cold pack can reduce swelling. After a sinus lift, you may be told to avoid blowing your nose hard. Your dentist will give written instructions. Our guide to aftercare and recovery tips covers the general advice.

Risks and limits

• Swelling, bruising and pain.¹²
• Infection, which may need antibiotics.
• The graft may not take, and more bone may be needed.
• Healing time is longer.
• Smoking affects healing, and NHS guidance asks patients to stop at least six months before implant treatment.¹

Can you avoid a graft?

Sometimes. Options include:

• shorter or narrower posts, in some cases;
• tilted posts, as in all-on-4, which is described as a way to treat a jaw with little bone in patients who prefer to avoid regenerative procedures such as bone grafts;⁴
• different positions for the posts;
• a denture or a bridge, which need no graft.

Your scan decides which are possible. Our guide to three types of dental implants explains designs for limited bone, and our article on missing molars explains the back of the jaw.

Questions to ask

1. Do I need a graft, and why?
2. Which material do you use?
3. How long will it add?
4. Can the graft and the implant be done at the same time?
5. What are the alternatives?

You can see how a graft fits into the full process on our dental implants page, and our missing teeth page lists other ways to replace teeth.

Preparing for a graft

Good preparation helps healing. Before the procedure:

• give your dentist your full health history, medicines and allergies;
• stop smoking, since it affects healing;¹
• have any gum disease or infection treated first;
• follow instructions about food and drink on the day, which depend on the type of anaesthetic;
• arrange for someone to take you home if you have sedation;
• collect any prescribed medicines before the procedure, so they are ready afterwards.

Signs of normal healing, and signs to report

After a graft, swelling, bruising and mild discomfort are expected, and they usually peak in the first few days and then ease.¹ Small particles of graft material can sometimes be felt or seen in the mouth, which is common, but mention it at your review.

Contact the clinic promptly if you have severe or worsening pain, swelling that increases after the third day, a fever, pus, a bad taste that does not clear or bleeding that does not slow. After a sinus lift, report a heavy nosebleed or fluid coming from the nose when you blow.

Same visit or separate stages

In some situations, the graft and the implant can be done at the same visit. This happens when the bone is stable enough to hold the post firmly while the graft heals around it. In others, the graft is placed first and left to mature for several months, and the implant is placed later once a scan shows enough bone.¹²

Which route is chosen depends on how much bone is missing, where it is, and how stable the post can be. Ask your dentist why the plan has been chosen for you, how long the total timeline will be and what a scan will check before the implant is placed. Our guide to the dental implant procedure shows where a graft fits in the sequence.

Myths and facts about bone grafts

Myth: a graft means the implant will fail. A graft builds up the site so that a post can be held. It adds time and some risk, but it is a standard step for many implants.

Myth: grafts always come from the hip or elsewhere in the body. Many grafts use processed donor, animal-derived or synthetic material, and your own bone is one option among several.

Myth: grafts are always painful. A graft can bring swelling, bruising and pain,¹² but the experience varies and is usually manageable with the medicines your dentist advises.

After a graft

• Follow your dentist's instructions on medicines, rinsing and food.
• Avoid pressure on the area, for example from a denture, unless adjusted.
• After a sinus lift, avoid blowing your nose hard, and sneeze with your mouth open.
• Do not smoke.¹
• Attend your review visits, so the dentist can check healing.

How your dentist knows the graft has worked

A scan after healing shows whether the graft has joined with your own bone and whether there is enough volume for the post. If not, more treatment may be advised. Your dentist will explain what the scan shows.

Frequently asked questions

Does everyone need a bone graft?

No. Your scan shows whether there is enough bone for a post.

Is a graft painful?

It can bring swelling, bruising and pain,¹² and your dentist will explain what to expect.

Will a graft always work?

Not always. Healing depends on your health, your habits and the site, and your dentist will review it.

Can I avoid a graft after losing a tooth?

Sometimes, if the socket is treated or the implant is placed at the right time. Ask your dentist about options.

How long after a graft can I have the implant?

It depends on the type of graft and on how you heal. NHS information says a graft can add at least four months.¹

Does a graft show?

Not from outside. It sits under the gum.

Is there an alternative to grafting?

Sometimes, such as shorter or tilted posts, depending on your scan.⁴

Is it possible to place an implant at the same time as a graft?

Sometimes, if the bone is stable enough to hold the post. Otherwise, the graft is placed first and the implant follows after healing.¹

Can I drive after a graft?

If you have local anaesthetic only, you may be able to, but after sedation you should not. Ask the clinic what applies to you and arrange a lift home in case.

About the author

Sources

1. Cambridge University Hospitals NHS Foundation Trust. Dental implants in restorative dentistry (patient information). https://www.cuh.nhs.uk/patient-information/dental-implants-in-restorative-dentistry/
2. Guy's and St Thomas' NHS Foundation Trust. Dental implants (patient information). https://guysandstthomas.nhs.uk/health-information/dental-implants
3. Lang NP, Pun L, Lau KY, Li KY, Wong MC. A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least 1 year. Clinical Oral Implants Research, 2012;23(Suppl 6):39-66. https://pubmed.ncbi.nlm.nih.gov/22211305/
4. Soto-Penaloza D, Zaragozi-Alonso R, Penarrocha-Diago M, Penarrocha-Diago M. The all-on-four treatment concept: systematic review. Journal of Clinical and Experimental Dentistry, 2017;9(3):e474-e488. https://pubmed.ncbi.nlm.nih.gov/28298995/

Medically reviewed by Dr Anupam Sinha, BDS, MDS – Orthodontics, on 23 October 2026. General information for patients from Orion Dental Clinic, last updated 23 October 2026. It is not advice for one person, so ask a dentist what suits you. To report an error, contact us.