A dental implant works like a replacement tooth root. A titanium post is placed in the jawbone, the bone grows against it, and a crown is fixed to it.
Key points
- A dental implant works like a replacement tooth root: a titanium post in the jawbone, an abutment and a custom-made crown, bridge or denture.
- Over the months after placement, bone grows against the metal and bonds to it, which holds the post firmly.
- Because the post is held by the bone, a single implant crown does not need the teeth on either side.
- A review of 26 studies found that 96.8 percent of implants supporting single crowns were still in place after five years.3
- Smoking, untreated gum disease, too little bone, some health conditions and grinding can reduce the chance of a good result.
To understand why implants can feel so different from dentures or bridges, it helps to look at what holds a natural tooth in place. A tooth has a crown above the gum and one or more roots below it. The roots sit in sockets in the jawbone and are held by fibres that act like tiny shock absorbers. When a tooth is lost, the root goes with it, and the bone that surrounded it is no longer put to work, so it gradually shrinks. An implant replaces the root, and that is the main reason it behaves differently from other replacements.
The three parts of an implant
The post. This is the part placed in the jawbone. It is usually made of titanium, a metal that the body generally tolerates well and that bone can bond to. It is shaped like a small screw so that it can be held firmly while the bone heals around it.
The abutment. This is a small connector that attaches to the post and passes through the gum. It holds the visible tooth in place. In some designs the abutment and post are made as one piece, and in others they are separate parts joined by a screw.
The crown, bridge or denture. This is the visible, custom-made part. One crown replaces one tooth. A bridge replaces several. A full set of teeth can be fixed to several posts. NHS patient information describes how, once the post is steady, a custom-made crown, bridge or denture is fixed to it, so the new tooth can be used for biting and chewing much like a natural one.1
How the bone bonds to the post
The key step happens after the post is placed. Over the following months, bone grows against the metal and holds it firmly. This process is called osseointegration, which simply means the bone and the implant join together. NHS patient information puts the healing at about three to six months, and longer if a bone graft was needed.1
During this period the implant is protected. Your dentist may cover it with the gum, fit a temporary tooth that does not take hard biting, or ask you to avoid chewing on that side. This matters because an implant that moves while it heals may not bond.
Why the bond makes such a difference
Because the post is held by the bone, a single implant crown does not need the teeth on either side. With a conventional bridge, the neighbouring teeth are shaped to carry crowns. With a denture, the teeth sit on the gum and can move. An implant is held by the jaw itself, which is why many people find it feels and works more like a natural tooth.
Bone that is used tends to be maintained. The implant passes the forces of biting into the jawbone, and that stimulation is the reason implants are often discussed as a way to help preserve bone. Your dentist can explain what to expect in your own case, because bone changes depend on many factors.
What the evidence says about how well they work
Large reviews give a reasonable picture of how long implants last. A review of 26 studies found that 96.8 percent of implants supporting single crowns were still in place after five years.3 A systematic review of studies that followed patients for at least ten years found that 94.6 percent of implants were still in place after 13.4 years on average.4 These are group figures, not promises for one person, and the implants studied were followed up.
What can affect the bond
Implants do not suit everyone equally, and some things reduce the chance of a good bond.
- Smoking. NHS guidance says smokers have a much greater failure rate and asks patients to stop at least six months before treatment.1
- Untreated gum disease. Infection around the teeth can spread to the implant site, so gum treatment comes first.1
- Too little bone. A bone graft can build up the site, but it adds at least four months and can bring swelling, bruising and pain.12
- Health conditions and medicines. Some conditions and medicines affect healing, so tell your dentist about all of them.2
- Teeth grinding. Grinding can overload an implant.1
Where the crown comes in
When the bone has bonded, the abutment is attached and an impression or scan is taken so that the crown can be made to match your bite and the colour of your other teeth. The crown is then fixed on. Over the years the crown or screw can wear or loosen and may need repair, which is why regular check-ups matter.2
Looking after the result
An implant itself cannot decay, but the gum and bone around it can become inflamed if plaque is left in place. Brush twice a day, clean around the implant with interdental brushes and attend check-ups, which NHS guidance puts at every three to six months.1
If you are weighing implants against other options, our comparison of bridges and implants and our dental implants page are good next steps. You can also read the full complete guide to dental implants.
Is an implant likely to suit you? An at-a-glance check
Only an examination can tell, but these points give a rough idea.
| Point | Favours an implant | Needs more planning |
|---|---|---|
| Bone | Enough height and width | Thin or short bone, so a graft may be needed |
| Gums | Healthy | Untreated gum disease, which must be treated first |
| Smoking | Non-smoker, or ready to stop | Smoker, since the failure rate is higher |
| Health | Stable | Conditions or medicines that affect healing |
| Grinding | None | Grinding, since it can overload implants |
| Cleaning | Careful and regular | Difficulty cleaning around the implant |
If several items fall in the second column, an implant may still be possible, but the plan will need more steps or a different design.
What to expect at the first consultation
At the first visit, the dentist asks about your health and medicines, looks at your teeth and gums and takes X-rays or a 3D scan. They explain what they found and what your options are, including leaving the gap, a bridge or dentures, as well as implants. You should hear about the stages, the healing time, the risks and what you will need to do. You should be able to ask questions, and you should not be pressed to decide. Leave with a written plan if you can, and take time to think.
Common questions about materials and brands
Many people ask what implants are made of and which brand is used. Titanium is the most widely used material for the post, and other materials exist. Different systems vary in size, surface and parts, but your dentist chooses based on your bone and the position of the tooth, so you do not need to pick a brand. What matters is that your dentist can tell you which system is used, and that a record is kept, so that a future dentist can match parts and maintain the implant.
Myths and facts
Myth: an implant is a screw that holds a tooth by itself. The post is held by the bone, and the crown is held by the post, so the bone bonding is the key step.
Myth: implants are for the very old. Age is not the deciding factor, health is.
Fact: preparation is half the story. Scans, gum treatment and sometimes a graft come before the post.
A glossary of terms
| Term | Meaning |
|---|---|
| Osseointegration | The bonding of bone to the implant post |
| Abutment | The connector between the post and the crown |
| Crown | The visible tooth |
| Graft | Bone or bone-like material added to build up a site |
| Peri-implantitis | Inflammation of the gum and bone around an implant |
Frequently asked questions
Is an implant a real tooth?
No. The post replaces the root, and the crown replaces the visible tooth. Once the bone has bonded to the post, the new tooth can be used for biting and chewing much like a natural one.1
What is an implant made of?
The post is usually titanium. The crown is made by a dental laboratory from ceramic or a similar material and matched to your teeth.
Can an implant get a cavity?
The crown itself does not decay like natural enamel, but the gum and bone around an implant can be inflamed by plaque, so cleaning remains important.
How long before I can chew normally?
The bone usually needs about three to six months to bond to the post, and the final tooth is fitted after that.1 Your dentist will say when to start using the tooth.
How is an implant different from a bridge?
A bridge uses the neighbouring teeth, while an implant is held by the bone. Our guide bridge or dental implants compares them.
What does the gum do around an implant?
It forms a seal around the abutment, and keeping it healthy is part of long-term care.
Are dental implants painful?
The surgery is done under local anaesthetic, so you should feel pressure but not sharp pain. Afterwards, soreness and swelling for a few days are expected and are managed with painkillers and rest.
How do I know whether I have enough bone?
A 3D scan shows the height and width of your bone, and your dentist will explain whether it is enough, or whether a graft or a different design would help.
About the author
Dr Anupam Sinha, BDS, MDS – Orthodontics. BDS (2002), KLE Vishwanath Katti Institute of Dental Sciences, Belgaum. MDS in Orthodontics (2006), SDM College of Dental Sciences, Dharwad. His thesis work won a national research award in 2005, and he holds a certification in aesthetic dentistry. He sees patients at Orion Dental Clinic in Greater Kailash 1, South Delhi. Read the full profile of Dr Anupam Sinha.
Sources
- 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/
- Guy's and St Thomas' NHS Foundation Trust. Dental implants (patient information). https://guysandstthomas.nhs.uk/health-information/dental-implants
- Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clinical Oral Implants Research, 2008;19(2):119-130. https://pubmed.ncbi.nlm.nih.gov/18067597/
- Moraschini V, Poubel LA, Ferreira VF, Barboza EdS. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. International Journal of Oral and Maxillofacial Surgery, 2015. https://pubmed.ncbi.nlm.nih.gov/25467739/
Medically reviewed by Dr Anupam Sinha, BDS, MDS – Orthodontics, on . 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.