Risks of Dental Implant Surgery: What Every Patient Must Know

Dental implants are highly successful but do have some downsides. They require surgery, which carries a small risk of infection, nerve effects, or sinus issues. They cost more upfront than bridges or dentures. Healing takes 3–6 months. And in patients with poor bone, diabetes, or heavy smoking, the success rate drops. That said, for most patients the long-term benefits — permanent, natural-feeling teeth — far outweigh these drawbacks. Read: dental implant pros and cons.

Yes — but this is uncommon and usually preventable. Peri-implantitis (gum infection around the implant) is the most common long-term issue, affecting around 20% of patients who skip maintenance. Bone loss around the implant can also occur over years if hygiene is poor. The implant itself — the titanium root — very rarely fails after the first year. Annual check-ups and professional cleaning eliminate most long-term problems. Read: understanding peri-implantitis.

The main disadvantages are: higher upfront cost compared to bridges or dentures, the requirement for surgery and a healing period of 3–6 months, and the need for sufficient bone volume (a bone graft may be needed if bone is low). Not every patient is a suitable candidate — smokers, uncontrolled diabetics, and patients on certain medications need extra assessment. See: bone grafting for implants and all ways to replace a missing tooth.

Dental implant surgery carries a 95–98% success rate, making it one of the most predictable procedures in dentistry. Serious complications are rare. Minor issues — like temporary soreness, swelling, or minor infection — can occur but are easily managed. The risk increases significantly with smoking, uncontrolled diabetes, poor bone quality, and an inexperienced operator. With a trained specialist and proper planning, the procedure is considered low risk.

You should avoid or delay implants if you are: a heavy smoker who will not quit, have uncontrolled diabetes (HbA1c above 8), have active untreated gum disease, are on bisphosphonate medications for osteoporosis, have received radiation therapy to the jaw, or are very young with bone still developing. These are not permanent disqualifications — most can be addressed with preparation. Read: checks before dental implant surgery.

A responsible dentist says no — or “not yet” — when the conditions are not right. This includes: insufficient bone without grafting, active gum disease, uncontrolled blood sugar, bisphosphonate use, current chemotherapy or radiation, heavy uncontrolled smoking, or medical conditions that compromise healing. Saying no in these situations protects you from a preventable failure. At our clinic, we assess all of this before recommending any treatment.

The 3-2 rule is a clinical guideline used in implant planning. It refers to maintaining at least 3mm of bone above a nerve or sinus and 2mm of bone between an implant and an adjacent tooth or structure. Following this rule prevents nerve damage, sinus complications, and damage to neighbouring teeth. This is precisely why CBCT 3D planning is not optional — it is mandatory in our protocol. Read: the role of 3D imaging in dental implants.

Most patients wish they had known: that healing takes 3–6 months (not days), that smoking dramatically increases failure risk, that a bone graft may be needed before the implant, that annual maintenance is not optional — it is what makes implants last a lifetime, and that the implant brand and surgeon’s experience matter far more than the price. Read our full pre-surgery guide: what you must know before getting dental implants.

Warning signs of a failing implant include: the implant feeling loose or moving, unexplained pain or discomfort around it, swelling or bleeding at the implant site, difficulty chewing, a bad taste or smell near the implant, and gum recession around the implant. If you notice any of these, contact your implantologist immediately. Early intervention can save the implant. Read: how to fix a failed dental implant.

The most effective steps are: quit smoking before and after surgery, control your blood sugar if diabetic, attend all follow-up appointments, brush and floss around implants daily, use an implant-safe interdental brush or water flosser, and never skip your annual professional maintenance visits. Most implant failures are preventable — they happen due to lifestyle factors or neglected maintenance, not random bad luck. Read: understanding peri-implantitis.

Pain around an implant that was comfortable for years is almost always a sign of peri-implantitis — an infection around the implant causing bone loss. Other causes include the crown (cap on top) cracking or shifting, bite problems, or rarely, a crack in the implant itself. This needs to be evaluated urgently with an X-ray and clinical exam. Do not ignore it — early treatment can save the implant. Book a consultation with an implantologist in Gurgaon.

Titanium, the material used in dental implants, is biocompatible — the body does not reject it the way it might reject a foreign biological material. What happens in implant “failure” is not true rejection — it is a failure of the bone to fuse around the implant (failed osseointegration). This is caused by poor bone quality, infection, smoking, uncontrolled diabetes, or excessive early loading — not by the immune system rejecting titanium. True titanium allergy is exceptionally rare. Read: dental implants with bone loss.

The single biggest cause of early implant failure is poor osseointegration — the bone not bonding to the implant. This is most commonly caused by smoking, uncontrolled diabetes, or infection. The biggest cause of late implant failure (years after placement) is peri-implantitis — a chronic bacterial infection that destroys the bone around the implant, usually from skipped maintenance. Both are largely preventable with the right precautions and follow-up. Read: everything that can go wrong with dental implants and how to fix a failed dental implant.