Implant process and pregnancy - what is the best way to proceed?

Question

I’m Missing my last two bottom teeth on my right side due to infected root canals. The second to last got pulled December 2024 and the last got pulled January 2026. I was really hesitant on implants because of the price but I’ve decided to do one implant on the second to last and leave the hole on the last tooth. I need To start with a bone graft which between that and the high quality ziconia implant I want, it’s going to be 12k. Insanity. So I’ve put it off but now I want to get pregnant and I’m scared if I wait another year or two to start my implant, there will be too much bone loss. I’m only 26 but have a lot of dental issues from terrible care as a child so now I’m paying for it. My dentist said I could start the bone graft and if I conceive we will just wait till after birth but I read it is not wise to conceive right after a graft for the sake of healing and just in case any medication is needed. I mean healing from a bone graft while trying to create a child doesn’t seem optimal so I get it. There’s just so much conflicting info and I feel like I have to choose between my mental health and growing my family and I hate it. If any one has advice on timing for all this I’d greatly appreciate it

Prashant Nanda, MDS, FICOI · Answer

This is a very common dilemma, and the good news is that time is more on your side than it feels.
Most of the bone loss after an extraction happens in the first few months, roughly the first 6 to 12. Your tooth was removed in December 2024, so most of that change has already happened. Waiting another year or two usually adds only a small amount of further loss, and a graft can rebuild what's needed either way. So you don't have to rush the graft to beat the clock before a pregnancy.
On timing, the usual approach is this. Elective surgery such as bone grafts and implant placement is generally postponed during pregnancy. That isn't because it's known to be harmful. It's to avoid unnecessary X-rays, medications and stress on the body during that time. So you have two sensible options.
1. Do the graft now and allow it to heal (typically about 3 to 6 months) before you start trying to conceive. The implant can then be placed whenever suits you, including after the baby is born.
2. Start your family first and do the graft and implant afterwards. Given how long the tooth has already been out, this is a perfectly reasonable choice too.
What I'd avoid is starting a graft and conceiving during the healing phase, simply because you may need follow-up visits, X-rays or medication during that period.
Two other points. Routine cleanings and treating any active infection are recommended during pregnancy, as hormonal changes make gums more prone to inflammation, so keep up with those. And titanium implants have far more long-term research behind them than zirconia, and are often less expensive. Unless you have a specific reason for zirconia, it's worth asking your dentist about titanium.
Missing the very last molar is often acceptable, as you've decided. Please discuss the timing with both your dentist and your obstetrician, so the plan suits you.

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