# How dental implants work

> What a dental implant is, how treatment usually proceeds in stages, who it may not suit and what the risks are. General information with sources, from the website of Dr Nazem Al Ioussef, General Dentist in Dubai.

Source: https://www.nazemalioussef.com/en/clinical-interests/dental-implants/  
Updated: 2026-09-28

Clinical interest

A dental implant replaces the root of a missing tooth. It sits in the jawbone and, once the bone has healed around it, carries a crown, a bridge or a denture.

From the professional website of Dr Nazem Al Ioussef Published 27 September 2026 Last reviewed 27 September 2026

## What an implant is

An implant is a small post, usually made of titanium or a titanium alloy and sometimes of a ceramic called zirconia. It is placed in the jawbone where the root of the lost tooth used to be.

As the area heals, bone grows into close contact with the implant's surface. This bond is called osseointegration, and it is what lets an implant carry a tooth. A connecting piece, the abutment, then joins the implant to the crown that shows in the mouth.

A natural tooth is held in its socket by a thin ligament that gives slightly under pressure. An implant has no ligament: it is fixed directly in the bone.

### A natural tooth beside an implant-supported crown

1. **Crown.** The visible part of the tooth. On an implant it is made in a dental laboratory.
2. **Abutment.** The connector that passes through the gum and joins the crown to the implant.
3. **Implant body.** A threaded post in the bone, in the place of a root.
4. **Gum.** It seals around the neck of a natural tooth, or around the abutment.
5. **Jawbone.** It grows against the implant surface as it heals.
6. **Natural root and its ligament.** The fibres that hold a natural tooth; an implant has none.

Simplified drawing, not to scale.

## Who it may suit, and who it may not

Implants are one of several ways to replace missing teeth. Bridges and removable dentures are others, and leaving a gap is sometimes reasonable too. Whether an implant is suitable depends on the amount and quality of bone, the health of the gums, general health and habits.

Some things make implant treatment less predictable or call for extra care:

- smoking;
- diabetes that is not well controlled;
- gum disease that has not been treated;
- some medicines that affect bone, such as certain treatments for osteoporosis or cancer;
- radiotherapy to the head and neck;
- heavy grinding or clenching of the teeth.

Implants are not usually placed in children or teenagers whose jaws are still growing.

## How treatment usually proceeds

1. **Assessment.** An examination, X-rays and often a three‑dimensional scan (cone‑beam CT) to measure the bone and locate structures such as the nerve in the lower jaw and the sinus above the upper back teeth.
2. **Preparation, when needed.** Treating decay or gum disease first. Where there is not enough bone, a bone graft or a sinus lift may come before the implant.
3. **Placement.** Under local anaesthetic, the implant is placed in the bone. It may be covered by the gum while it heals, or left with a small healing cap showing.
4. **Healing.** The bone bonds with the implant. How long this takes differs from person to person and from one part of the mouth to another.
5. **Restoration.** An impression or digital scan is taken, and the crown, bridge or denture is made and fitted on the abutment.
6. **Maintenance.** Daily cleaning around the implant and regular check‑ups, as for natural teeth.

## Risks and limits

Like any surgery, implant placement can be followed by pain, swelling and bruising, and carries a risk of bleeding and infection. Other risks include:

- injury to the nerve in the lower jaw, which can cause numbness or tingling of the lip, chin or tongue that may be long-lasting;
- in the upper jaw, an implant entering the sinus;
- the implant not bonding with the bone, or being lost later;
- inflammation of the gum and bone around the implant (peri‑implantitis), which is more likely in smokers and in people who have had gum disease;
- a loose screw or a chipped crown that needs repair.

How long an implant lasts differs from person to person. It depends a great deal on cleaning, on not smoking and on regular check‑ups.

## Looking after an implant

An implant cannot decay, but the gum and bone around it can become inflamed in much the same way as around a natural tooth. Brush twice a day with a fluoride toothpaste, clean between the teeth and around the implant with interdental brushes or floss, avoid smoking, and keep to the check‑ups your dentist recommends.

Teeth are most often lost to decay and to [gum disease](https://www.nazemalioussef.com/en/patient-guides/gum-disease/), and a tooth whose pulp is infected can sometimes be kept with [root canal treatment](https://www.nazemalioussef.com/en/patient-guides/root-canal-treatment/). Caring for the teeth you have matters as much as replacing the ones that are gone.

Step by step

## How an implant is placed

A simplified drawing of what usually happens when a dental implant is placed in the jaw. Scroll to follow the steps in order.

1. A narrow drill Once the area is numb and the gum is opened, a narrow drill makes a small starting channel in the bone, in the position and direction planned beforehand from X-rays.
2. Widening the channel Slightly wider drills follow in turn, enlarging the channel a little at a time to the size of the implant, while water cools the bone as they work.
3. The implant goes in The implant is a small screw-shaped post, usually made of titanium. It is turned into the channel until it sits firmly in the bone.
4. Bone grows onto it Over time, bone grows onto the implant's surface and fuses with it. How long this takes differs from person to person.
5. Abutment and crown Once the implant is fixed in the bone, a connecting piece called an abutment is attached, and a crown made to match the neighbouring teeth is fitted on top.

## Questions patients ask

**Is an implant the same as a crown?**

No. The implant is the post in the bone that takes the place of the root. The crown is the tooth‑shaped part you see in the mouth. On an implant, the crown is attached to the implant through the abutment.

**Does having an implant placed hurt?**

It is done under local anaesthetic, so the area is numb while the implant is placed. Soreness, swelling and some bruising are common for a while afterwards, and the dentist advises on pain relief and care of the area.

**How long does the whole treatment take?**

It depends on the bone, on whether grafting is needed and on where the implant goes. Assessment, placement, healing and the final crown are separate stages, and together they are often spread over several months.

**Can I have an implant if I smoke?**

Smoking raises the risk of an implant not bonding with the bone and of inflammation around it later. Dentists usually advise stopping, or at least cutting down, well ahead of treatment and while the implant heals.

**Can the gum around an implant become diseased?**

Yes. Plaque around an implant can inflame the gum (peri‑implant mucositis) and, if it continues, the bone that holds the implant (peri‑implantitis). Daily cleaning and regular check‑ups lower the risk.

**What if there is not enough bone?**

Where the bone is too thin or too low, it can sometimes be built up first with a bone graft, or in the upper jaw with a sinus lift. Other options, such as a different implant size or a bridge or denture instead, may also be discussed.

## What this page rests on

This page rests on published patient guidance and professional consensus, listed below. It is not based on a single study or on personal opinion. Whether an implant is suitable for a particular person can only be judged at an examination.

General health information, not a diagnosis or a treatment recommendation for any individual.

### Sources

1. Oral Health Foundation — [Dental implants](https://www.dentalhealth.org/dental-implants)
2. Berglundh T, et al. (2018) — [Peri‑implant diseases and conditions: consensus report of the 2017 World Workshop. J Clin Periodontol 45 Suppl 20](https://doi.org/10.1111/jcpe.12957)
3. NHS — [How to keep your teeth clean](https://www.nhs.uk/live-well/healthy-teeth-and-gums/)
4. World Health Organization — [Oral health fact sheet](https://www.who.int/news-room/fact-sheets/detail/oral-health)

## Related pages

- [Bone grafting and sinus liftWhen there is not enough bone to hold an implant, and how it is built up.](https://www.nazemalioussef.com/en/clinical-interests/bone-grafting-and-sinus-lift/)
- [Impacted wisdom teethWhy wisdom teeth get stuck in the jaw, and when removal is considered.](https://www.nazemalioussef.com/en/clinical-interests/wisdom-teeth/)
- [Exposing impacted teethWhen a tooth, often an upper canine, stays buried, and how it is uncovered and guided into place with a brace.](https://www.nazemalioussef.com/en/clinical-interests/exposing-impacted-teeth/)