You’ve made the decision. After months of chewing on one side and smiling with your lips closed, you’ve booked an implant consultation. Then the dentist mentions two words you weren’t expecting: bone graft.
Take a breath. It’s one of the most common conversations in implant dentistry, and it rarely means anything has gone wrong. Think of a builder checking the ground before an extension goes up. Sometimes the foundation is ready. Sometimes it needs reinforcing first.
You need bone grafting for dental implants when your jawbone is too thin, too short or too close to the sinus to hold an implant firmly. It’s common once a tooth has been missing for a while, because the bone shrinks. Here’s who needs one, what happens and the alternatives.
What is a bone graft for dental implants?
A bone graft for dental implants is a small procedure that adds bone where your jaw has thinned, so an implant has a solid base. A dental implant is a titanium post that works like a tooth root. As the British Association of Oral Surgeons (BAOS) puts it, “Implants require adequate bone to be anchored securely” (BAOS, 2019).
The graft acts as a scaffold, and over the following months your body grows new bone into it. Graft material comes in four main kinds:
- Your own bone (autograft), usually from another part of the jaw
- Donor bone (allograft), from another person
- Animal-derived bone (xenograft), usually treated cow bone
- Synthetic bone substitute (alloplast)
Guy’s and St Thomas’ NHS Foundation Trust notes that substitutes “do not work as well as your own bone”, though your own bone means a second surgical site (Guy’s and St Thomas’, 2024).
Why does the jawbone shrink after losing a tooth?
The jawbone shrinks after a tooth is lost because that bone no longer gets the pressure of chewing through the root. Without chewing pressure, the bone slowly shrinks.
It happens faster than most people expect. A review of 20 studies found the jaw ridge lost 29–63% of its width and 11–22% of its height within about six months of an extraction, mostly in the first three to six months (Tan et al., Clinical Oral Implants Research, 2012).
So the longer a gap has been there, the more the bone has usually thinned.
Grafting the socket when a tooth comes out (socket preservation) may reduce shrinkage, but a Cochrane review found the evidence very uncertain (Atieh et al., Cochrane, 2021).
Who needs a bone graft before an implant?
You’re more likely to need a bone graft before an implant if your jawbone is too narrow, too short, or too close to a nerve or the sinus. Common reasons include:
- A tooth taken out months or years ago
- Bone lost to gum disease (periodontitis) or infection
- An injury to the mouth
- Years of wearing a denture over the gap
- Upper back teeth, where the maxillary sinus (an air space above the upper jaw) sits close to the bone
Plenty of people don’t need a graft. If a tooth was removed recently and healed well, an implant can often go straight in. Others “do not have enough bone in their jaw” (Guy’s and St Thomas’, 2024).
How do we know if you have enough bone?
A 3D scan shows whether you have enough bone. A normal dental X-ray is flat, so it shows height but not width.
A cone beam computed tomography (CBCT) scan is a 3D X-ray. It shows the height, width and density of your jawbone, and where the nerves and sinus sit. At Warwick Lodge Dental, we use CBCT scans when planning implants.
You’ll then get a written plan covering any graft, the timeline and the cost. As our implant page explains, low bone density is usually not a barrier. Most often, it adds a step.
What happens during bone grafting, and how long does it take?
Most dental bone grafts are done under local anaesthetic, like a filling. The dentist places the graft material, usually covers it with a membrane that dissolves on its own, and closes the gum with dissolvable stitches (BAOS, 2019). For longer or more complex treatment, we also offer IV sedation to help you feel calm.
The main types of graft
- Guided bone regeneration (GBR): graft granules under a membrane widen a thin ridge.
- Sinus lift: the sinus lining is gently raised and graft material placed beneath it, adding height for upper back teeth.
- Block graft: a small block of bone, often your own, is fixed in place to rebuild a larger area.
- Socket preservation: graft material fills the socket when a tooth is removed.
Same day or staged?
For small gaps in the bone, the graft and implant can sometimes go in at the same appointment (BAOS, 2019). For larger ones, the graft heals first, usually for three to six months (Guy’s and St Thomas’, 2024).
Recovery and aftercare
Swelling and soreness usually ease by about day three, but can last up to two weeks (BAOS, 2019). Eat soft food for about a week. After a sinus lift, avoid blowing your nose hard or flying until your dentist says it’s fine.
What we see at Warwick Lodge Dental in Herne Bay
At Warwick Lodge Dental and Implant Centre on Canterbury Road, Herne Bay, checking your bone and gums is part of every implant plan. If a graft is suggested, ask to see your own scan. Seeing where the bone has thinned usually makes the reason clearer.
We also list grafting prices openly on our fees page, and you’ll find them in the FAQs below.
If you’re missing most of your teeth in one jaw, a full-arch option such as All-on-4 may be worth discussing instead.
The Care Quality Commission (CQC), England’s health and care regulator, marked all five key areas of our practice as meeting regulations in its July 2026 report (CQC, 2026).
Grafting suits people who want a fixed tooth and can wait a few extra months. It may not suit people who need the quickest option, or whose health slows healing.
Risks, limits and alternatives to bone grafting
Bone grafting is well established, but like any surgery it carries risks. The main ones are infection, swelling and the graft not taking fully, which can mean more surgery (Guy’s and St Thomas’, 2024). Sinus symptoms after a sinus lift, or bruised nerves, are uncommon (BAOS, 2019).
Smoking raises the risk. A review of 292 publications found smokers had about 2.4 times the odds of implant failure (Mustapha et al., Medicina, 2021). Some health conditions and medicines also slow healing.
Grafting isn’t the only route. A Cochrane review found too little evidence to say whether a sinus lift or short implants work better at one year where bone height is 4–9 mm, but sinus lift sites had more complications (Esposito et al., Cochrane, 2014).
| Option | Who it may suit | Extra time | Main trade-off |
|---|---|---|---|
| Guided bone regeneration | A narrow ridge for one or a few implants | None to 6 months | A small extra procedure and cost |
| Sinus lift | Upper back teeth with little bone height | Usually 3–6 months | More complications than short implants in one review |
| Block graft | Larger areas of lost bone | Usually 3–6 months | May need a second surgical site |
| Short implants (5–8.5 mm) | Bone height of about 4–9 mm | No graft healing | Not right for every site |
| All-on-4 | Most or all teeth missing in one jaw | Depends on your bone | Four to six implants hold a whole arch |
| Implant overdenture | Loose full dentures, limited bone | Varies | Removable, not fixed |
Sources: Guy’s and St Thomas’ NHS Foundation Trust (2024), BAOS (2019), Esposito et al., Cochrane (2014), and Warwick Lodge Dental’s treatment pages.
Frequently asked questions
Does a dental bone graft hurt?
A bone graft shouldn’t hurt during the procedure, because the area is numbed first. Afterwards, most people feel sore and swollen for a few days, and everyday painkillers usually help (BAOS, 2019).
Is bone grafting available on the NHS?
Rarely. NHS implant treatment is usually limited to hospital care for people who meet strict criteria, such as injury, head and neck cancer or teeth that never developed (Leeds Teaching Hospitals NHS Trust, 2024). Most people have implants and grafts privately.
How much does a bone graft cost?
At Warwick Lodge Dental, a bone graft costs £550 and an extensive bone graft £1,002.50. A sinus lift starts from £850, subject to assessment, and an implant CBCT scan is £214 (prices as of November 2026).
Can I smoke after a bone graft?
It’s best not to smoke at all, because smoking raises the risk of graft failure (Guy’s and St Thomas’, 2024). The National Smokefree Helpline offers free support on 0300 123 1044 (England only).
Can a lost jawbone grow back on its own?
A lost jawbone doesn’t usually grow back on its own once a tooth has gone. That’s why getting advice soon after losing a tooth can sometimes mean a smaller graft, or none at all.
Is bone grafting for dental implants right for you?
Bone grafting for dental implants may be right for you if a 3D scan shows too little bone and you can wait a few extra months. Healing and results vary from person to person.
If you’re in Herne Bay, Whitstable, Canterbury or East Kent and want advice on bone grafting, book a free implant consultation with Warwick Lodge Dental and Implant Centre, 44 Canterbury Road, Herne Bay CT6 5DF, on 01227 375 592. A £40 refundable deposit secures your appointment.
This article is general information, not a diagnosis. Book an assessment with a registered dental professional for advice about your own mouth. For severe pain or swelling after treatment, contact your dentist or call NHS 111.