When is a bone graft needed?
- A tooth has been missing for a long time
- Gum disease has destroyed bone around the teeth
- A tooth was removed and the jawbone shrank
- Trauma or infection damaged the bone
A systematic review of human studies found the ridge lost 29 to 63% of its width and 11 to 22% of its height in the 6 months after a tooth came out.
Why is a bone graft needed before dental implants?
A dental implant needs enough bone height, width and density around it to fuse with your jaw. In bone that is too thin or too soft, the implant may not fuse and can fail. Your dentist may suggest a bone graft to:
- Fill the socket after a tooth comes out
- Build up a jaw that is too thin or too short for an implant
- Add bone under the sinus before an upper back implant
- Support loose teeth where gum disease has destroyed bone
Not every implant needs a graft. Your exam shows whether yours does. Our dental implants page covers the implant itself and its cost.
How much bone is needed for a dental implant?
A dental implant needs a wall of healthy bone around the post on every side. In a study of more than 3,000 implants, bone loss dropped as the outer wall of bone neared 1.8 to 2 mm thick. Thin or short bone can need a graft. The dentist checks the implant size, position and other options for your case.
In the upper back jaw the sinus can limit bone height and call for a sinus lift.
Which bone graft materials are used?
Four main materials are used for dental bone grafts. The dentist picks one to suit your health, the size of the gap and your plan.
- Autograft is your own bone taken from another part of your jaw or body. It needs a second surgical site.
- Allograft is human donor bone from a licensed tissue bank.
- Xenograft is processed animal bone from cows or pigs.
- Alloplast is a lab-made bone substitute.
What happens during a dental bone graft?
A dental bone graft is done with the area numbed, in these steps:
- The dentist checks your gums and bone and takes X-rays if your history and exam show you need them.
- Local anaesthetic numbs the area. Ask the team whether sedation suits you.
- A small cut lets the dentist move the gum back, clean the area and pack in the graft.
- A thin membrane may cover the graft. The dentist tells you whether yours dissolves or comes out.
- Stitches close the gum and you get aftercare instructions.
Does a bone graft hurt?
The area is numbed, so you should not feel pain during the procedure. Tell the dentist right away if anything hurts. Tenderness, swelling and bruising after surgery usually settle within a week or two. Call us right away if they get worse, or if pain is not better within 48 hours.
What should you know about sedation?
The bio of Dr. Reddy, a general dentist, lists an Oral and Nitrous Oxide Sedation License in Ontario. Sedation can slow your breathing, so the team reviews your health history first.
Oral sedation leaves you drowsy and someone must take you home. Do not drive or use machinery for at least 18 hours. Avoid alcohol and other sedating drugs for at least 18 hours, or longer if you still feel drowsy or dizzy.
Nitrous oxide wears off faster. The team will tell you when it is safe to drive.
Which bone graft procedures are there?
Bone graft procedures differ by where bone is missing and how much is gone.
- Socket preservation, or ridge preservation, fills the empty socket when a tooth comes out and no implant goes in right away. It aims to keep more of the ridge's height and width.
- Guided bone regeneration places a membrane over the graft to keep gum tissue out while bone grows in. It is used for small to moderate gaps.
- Block bone graft uses a solid piece of bone to rebuild a larger area of lost jaw.
- Sinus lift, or sinus augmentation, raises the sinus membrane and places bone under it. The membrane can tear, and then it may need repair or time to heal before surgery goes on.
Our tooth extraction page explains the extraction that comes before a socket graft. Block grafts and sinus lifts are complex grafts. The dentist tells you if your case needs referral.
Can a regular dentist do a bone graft?
Yes. Cleveland Clinic says general dentists and dentists with further surgical training do dental bone grafts routinely.
At My City Dental, Dr. Reddy, a general dentist, lists a particular focus on surgery and digital dentistry in his bio. He provides dental implant services including implant placement, restoration and related surgical procedures.
How long do recovery and healing take after a bone graft?
Recovery from a dental bone graft takes about a week. The graft itself needs at least three months to heal, and nine to 12 months for a large graft, according to Cleveland Clinic. For a rebuilt ridge the American Academy of Periodontology gives four to 12 months before the implant goes in.
How do you care for the graft site?
Follow the team's instructions for your case. Cleveland Clinic's general advice:
- Eat soft foods for a few days
- Use an ice pack on your outer jaw and keep your head raised
- Do not spit, rinse hard, smoke or vape
- Skip exercise and heavy lifting for at least 48 hours
- Avoid alcohol for at least two weeks
When should you call after a bone graft?
For bleeding, press firmly on gauze. Call us if the site is still bleeding a lot 4 hours after surgery or if pain is not better within 48 hours.
Swelling can build over the first 24 hours and last 5 to 7 days. Bruising can last up to 10 days. Call us right away for a fever, growing swelling, pus or severe pain.
Call 911 or go to the nearest hospital emergency department if you have trouble breathing or swallowing, swelling that spreads toward your eye or neck, fever with facial swelling, or bleeding that will not stop.
What are the risks of a bone graft?
A bone graft carries the risks of any surgery: infection, heavy bleeding and problems with the anaesthetic or sedation. A 2022 research review found the most common complication is the membrane or graft showing through the gum.
A graft can also fail to take. Warning signs are pain or swelling that gets worse after the first week, pus from the site and gum pulling back. Smoking and some medical conditions raise the chance of failure, so tell the team about every condition and medicine.
Nerve damage is uncommon. It causes numbness, tingling or pain in the lip, chin, gums or teeth. Most cases fade over months, but it can last a long time and in rare cases it is permanent.
What does bone grafting in Vaughan cost?
The cost of a dental bone graft depends on how much bone is missing and how the gap is rebuilt. The fee also changes with:
- The number of sites and the material used
- Whether the graft needs a membrane
- Whether the graft goes in during an extraction or as a separate surgery
- X-rays and any sedation
We found too few clinic fees for one graft type to give a range. Your own cost comes in a written estimate after an exam.
Ask your insurer for a predetermination before treatment: it is an estimate of what the plan may pay, not a promise.
The Canadian Dental Care Plan (CDCP) is accepted here, but the CDCP does not cover bone grafts or ridge augmentation. The government's CDCP dental benefits guide lists both as exclusions. For other services, coverage depends on the service and your eligibility, and some services need preauthorization.
Bone graft questions
Is dental bone grafting worth it?
A dental bone graft is worth it when you need more bone to get an implant or to support a loose tooth. Without enough bone an implant has nothing to fuse with. If you do not plan to replace a missing tooth, ask the dentist whether a graft helps you at all.
How long will a dental bone graft last?
A dental bone graft can last a lifetime once it heals into your jaw, according to Cleveland Clinic. Cleveland Clinic advises getting the implant within six to 12 months after the graft heals, or the new bone starts to shrink.
What is a block bone graft?
A block bone graft rebuilds a larger area of lost jaw with a solid piece of bone. The piece comes from your own jaw or chin or from a donor bank. Bone taken from the chin can leave numbness in the lower lip or chin that lasts a long time in some people. The dentist tells you if your case needs referral.