Do Dental Implants Hurt? What the Procedure Actually Feels Like

The short answer

Implant placement is carried out under local anaesthetic, so the area being treated is numb throughout. Because the area is numb, what is typically felt is pressure, vibration and noise rather than pain — but sensation varies between patients. The discomfort comes afterwards, once the anaesthetic wears off.

NHS trust patient information puts it plainly. Cambridge University Hospitals tells implant patients “it is unlikely to be very sore after implant surgery”, with relatively little swelling. Guy’s and St Thomas’ advises regular paracetamol or ibuprofen for the first 48 hours and says you can return to work the day after treatment.

That is not the same as feeling nothing. The two days afterwards are the part worth planning for.

During the procedure

Cambridge University Hospitals puts the surgical time at around half an hour for a single implant, longer if several are being placed. Guy’s and St Thomas’ describes the procedure as lifting the gum, drilling into the jaw bone to insert the implant, and replacing the gum with stitches.

What you actually notice:

• The injection. A few seconds of sting. Topical numbing gel on the gum beforehand and slow delivery of the anaesthetic are commonly used to reduce this.
• Pressure and movement. Local anaesthetic stops the area transmitting pain, but you can still be aware of pressure and movement. That is expected, and is not a sign the anaesthetic has failed.
• Sound. There is noise from the handpiece, though it is not the high-pitched sound most people associate with a filling.

If anything sharp does break through, say so — further anaesthetic can usually be given.

If you are anxious, sedation is an option

Some people are not worried about pain at all. They are worried about being awake for it — a different problem with a different solution.

We offer IV sedation for anxious patients alongside local anaesthetic, given through a small cannula in the hand or arm. You stay conscious and able to respond throughout. Some patients recall little of the procedure afterwards; this varies between individuals. The local anaesthetic still does the numbing; the sedation deals with the anxiety.

Conscious sedation in dentistry is a regulated area of practice. The standards covering training, monitoring and patient assessment are set by the Intercollegiate Advisory Committee on Sedation in Dentistry, a joint committee of the dental faculties of the UK surgical royal colleges and the Royal College of Anaesthetists (published April 2015, updated March 2020).

Two practical points. Sedation requires a pre-treatment assessment — medical history, medications and general health all bear on whether it is appropriate, and it is not suitable for everyone. And it commits your day: Cambridge University Hospitals advises patients who have had intravenous sedation not to drive, operate machinery or sign legal documents for 48 hours afterwards.

The first 48 hours

Painkillers. Take them before the numbness wears off rather than waiting for discomfort to arrive. Guy’s and St Thomas’ recommends starting before the local anaesthetic wears off and continuing for the first 48 hours, with paracetamol or ibuprofen where there is no reason you cannot take them. Avoid hot food and drink while you are still numb — you can burn or bite yourself without noticing.

Swelling. Guy’s and St Thomas’ advises ice packs on the area for ten minutes each hour for the first six hours. Frozen vegetables wrapped in a cloth work; ice directly against skin does not. The same trust says swelling after dental surgery can appear in the first 48 hours and usually lasts five to seven days. Cambridge University Hospitals describes relatively little swelling after implant surgery. Several implants, or a bone graft, will generally produce more than a single fixture.

Bleeding. Guy’s and St Thomas’ says it is common to have some blood in your saliva for a few days after dental surgery. If a site bleeds more than that, the trust advises rolling up a clean handkerchief, pressing it over the wound and holding it there by closing your teeth firmly together for at least 30 minutes.

Eating. Guy’s and St Thomas’ says you should be able to eat normally after treatment, though soft food is often recommended.

The first two weeks

Guy’s and St Thomas’ says pain after dental surgery is usually worse in the first two to three days and then starts to get better. The same trust asks implant patients not to brush the site for a week, using chlorhexidine mouthwash twice daily instead while brushing the rest of the mouth normally, and to return 7 to 14 days after treatment to have stitches removed.

Do not smoke. Guy’s and St Thomas’ advises that dry socket — a painful healing complication — is more likely if you smoke, and asks implant patients to try to stop smoking before treatment and in the long term.

By around two weeks the gum has usually closed over. Healing in the bone underneath continues for considerably longer.

Healing and osseointegration: months, not days

The soreness ends in days. The biology takes months.

An implant works because bone grows into direct contact with the implant surface, a process called osseointegration. Guy’s and St Thomas’ advises that after the implant is placed you usually need to wait at least three months before it can support replacement teeth. If a bone graft is needed, the trust says treatment might take four to six months longer.

The osseointegration period itself is not usually something patients report feeling — the discomfort belongs to the days immediately after surgery, not the months of healing.

Whether a temporary tooth or an adjusted denture can be provided during healing depends on the individual case and would be discussed at your assessment. Osseointegration also bears on how long dental implants last.

How this compares to having a tooth out

Almost everyone has had an extraction and almost nobody has had an implant, which makes it the natural comparison.

University Hospitals Sussex NHS Foundation Trust tells patients having a tooth removed under local anaesthetic that they are likely to need regular painkillers for three to four days, that discomfort is usually worst for the first three days, and that it may take up to two weeks before all the soreness goes. Guidance for implant placement is lighter: Guy’s and St Thomas’ advises painkillers for the first 48 hours and says you can return to work the next day, and Cambridge University Hospitals describes relatively little swelling.

Extraction sockets can also develop dry socket, which Guy’s and St Thomas’ describes as a common problem after dental surgery, more likely in people who smoke.

The comparison has limits. A straightforward extraction can be easier than an implant, and a case involving several fixtures, a sinus lift or a graft is a bigger undertaking than one simple extraction.

When discomfort is not normal

Some soreness is expected. These are not, and warrant a phone call:

• Pain and swelling getting worse after day four rather than better. Guy’s and St Thomas’ says that if you have an infection, pain and swelling will usually get worse about four to six days after surgery.
• Fever, feeling generally unwell, or a bad taste or discharge from the site.
• Bleeding that does not stop after half an hour of firm pressure.
• Numbness or tingling in the lip, chin or tongue still present the day after treatment.
• Difficulty swallowing or opening your mouth, or swelling spreading towards the eye or neck.
• An implant that feels loose or moves, at any stage.

Ring the practice. If you cannot reach us during normal hours, see our emergency dentist in Leeds page. Severe swelling affecting breathing or swallowing is an A&E problem rather than a dental one. Problems after implant surgery are far easier to deal with early than late.

Frequently asked questions

Does the injection hurt? Briefly. Topical gel on the gum beforehand and slow delivery of the anaesthetic are commonly used to reduce it, and it is over in seconds.

How long does a dental implant procedure take? Cambridge University Hospitals gives around half an hour of surgical time for a single implant, longer for more. The appointment itself takes longer than the surgery.

Will I be awake? Under local anaesthetic alone, yes. Under IV sedation you remain conscious and able to respond; some patients recall little of the procedure afterwards, and this varies between individuals.

How long is the recovery? Guy’s and St Thomas’ advises regular painkillers for the first 48 hours and says you can return to work the day after treatment. The same trust says pain after dental surgery is usually worse in the first two to three days. Bone healing then continues for months.

Can I take painkillers beforehand? Discuss it at your assessment. Guy’s and St Thomas’ advises starting them before the local anaesthetic wears off.

Is it worse than having a tooth out? University Hospitals Sussex anticipates three to four days of regular painkillers after a tooth is removed under local anaesthetic; Guy’s and St Thomas’ advises painkillers for the first 48 hours after an implant. Individual cases vary in both directions.

Suitability for treatment depends on a clinical assessment. This treatment may not be appropriate for every patient.

If you are weighing up dental implants in Leeds and pain is the thing holding you back, bring it to a consultation. We can talk through what your case would involve, whether sedation is appropriate for you, and what recovery would realistically look like.

Sources

1. Guy’s and St Thomas’ NHS Foundation Trust. Dental implants: having a dental implant. https://www.guysandstthomas.nhs.uk/health-information/dental-implants/having-dental-implant
2. Guy’s and St Thomas’ NHS Foundation Trust. Dental implants: after having a dental implant. https://www.guysandstthomas.nhs.uk/health-information/dental-implants/after-having-dental-implant
3. Guy’s and St Thomas’ NHS Foundation Trust. Dental surgery and recovery. https://www.guysandstthomas.nhs.uk/health-information/dental-surgery-and-recovery
4. Cambridge University Hospitals NHS Foundation Trust. Insertion of dental implants. https://www.cuh.nhs.uk/patient-information/insertion-of-dental-implants/
5. University Hospitals Sussex NHS Foundation Trust. Removal of teeth under local anaesthetic. https://www.uhsussex.nhs.uk/resources/removal-of-teeth-under-local-anaesthetic/
6. Intercollegiate Advisory Committee on Sedation in Dentistry. Standards for Conscious Sedation in the Provision of Dental Care and Accreditation, published April 2015, updated March 2020. https://www.rcseng.ac.uk/dental-faculties/fds/publications-guidelines/standards-for-conscious-sedation-in-the-provision-of-dental-care-and-accreditation/