DENTAL BONE GRAFT

Pros

• Bone and tooth decay (and loss) can alter the look of your face, causing your mouth area to sink, so restoring lost bone can improve your facial structure. 
• A dental bone graft can save you from losing more teeth. Strengthening the jawbone will help stabilize your at-risk teeth. 
• Dental bone graft pain is minimal, both during and after the procedure.
• Synthetic bone graft materials are FDA-approved and come with no risk of rejection. 

Cons

• Dental bone graft side effects and complications include infection or abscess, nerve damage, and sinus problems. 
• If you had a tooth extracted before your bone graft, there’s a risk of dry socket, which can start three to four days after the extraction. 
• One graft isn’t always enough, and it’s possible to have dental bone graft failure.

RealSelf Tip: Any capable dentist can perform dental bone grafting, but Dr. Jamali suggests seeking out a board-certified oral and maxillofacial surgeon, who will have had more experience with the procedure and its potential complications.

• Average Cost:
• $600

• Range:
• $250 - $3,000

At your consultation, ask for a quote and confirm that it includes your surgeon’s fee and sedation or local anesthetic. 

Other factors include the experience level of your surgeon, their practice location, and what your procedure involves. “It depends on where you live and the extent of the procedure—how much reconstruction has to be done,” Dr. Jamali says. 

Dental insurance may cover some or all of the cost of bone grafting, but it typically won’t cover the cost of an implant. Check your individual plan for details. 

One alternative to dental bone graft surgery, a dental bridge, costs considerably more: $4,325, on average. 

A laser-assisted new attachment procedure (LANAP) tends to run about $1,000 for each quadrant of the mouth. Read on for more information about these other procedures.

See our complete guide to dental bone graft costs

An oral surgeon should be able to perform a bone graft if you have: 

• Lost bone due to an infection or previously extracted teeth
• Periodontal disease that has caused your gums to recede
• Relatively healthy remaining bone

If you have excessive bone loss and plan on getting a dental implant, doctors on RealSelf say you’ll need to wait up to a year, until you know your bone graft has been successful.

Dental bone grafting takes about 45 minutes. It’s done in your dentist's or oral surgeon's office. 

At a prior consultation, your oral surgeon will have discussed the procedure, examined your mouth, taken X-rays, and determined whether you can be awake with local anesthesia or if you’ll need to be sedated. If you’re having more than two or three teeth extracted prior to the graft, you may be more comfortable with IV sedation, he says. “The decision typically comes down to the patient’s anxiety level, the number of teeth you’re having extracted before the graft, and the extent of the procedure,” says Dr. Jamali.

On the day of your procedure, you’ll be given anesthesia. Once it takes effect, your surgeon will extract any teeth that need to be removed. They will then make an incision in the gum to reach the bone and clean out any infected tissue. 

If the graft will be done using your own bone, your surgeon will need to make a second incision in another part of your jaw or body (commonly the hip) to harvest the healthy bone.

Then they’ll transplant the bone material into the area of loss. They’ll top it with a collagen membrane, to prevent the gum from growing into the bone, before suturing the gum closed. 

After you recover from the sedation, you’ll be sent home with instructions for care. You’ll be groggy, so make sure you have someone there to take you.

You’ll have two to three days of downtime after dental bone graft surgery, but full healing will take longer. Swelling typically occurs three or four days post-procedure and lasts for two or three days, says Dr. Jamali. Your stitches will dissolve in about a week. 

Stick to a liquid diet for the first few days and eat only soft foods for two weeks. When you’re sipping liquids, skip the straw: the sucking motion can dislodge the graft and encourage more bleeding.

If you’ve had teeth extracted, you’ll receive instructions on how to rinse in order to avoid a dry socket, and you’ll take a course of antibiotics, to prevent infection. 

Avoid exercise for 10 days, since an elevated heart rate can also increase bleeding.

If you’re a smoker, you’ll need to quit for about two weeks before your surgery and avoid smoking for your first two weeks of recovery. The toxins and nicotine in cigarettes are vasoconstrictors, which drastically reduce the blood supply to the surgical site and bone graft. Studies also show that smoking can lead to a slightly higher incidence of dental implant failure.

Alcohol can cause dehydration, which is detrimental to your mouth’s healing process, so you’ll need to avoid consuming alcohol for a week following your surgery.

You can expect some soreness for the first few days of your dental bone graft recovery, but post-procedure pain should be minimal. “The worst pain I had overall was at the injection site on the soft palate, for the anesthetic,” says RealSelf member dee910.

Dr. Jamali’s patients manage their pain with ibuprofen, but some dentists offer prescription pain medication.

“If bone is harvested from another site in your mouth, there may be a little more discomfort—but usually no more than the discomfort of having a tooth extracted,” says Dr. Brian Dorfman, an oral and maxillofacial surgeon in Anthem, Arizona.

If pain lingers (or gets worse) beyond one week, it may be an indication of infection. Call your surgeon.

You’ll likely notice only “minor facial changes via bone graft,” Seattle dentist Dr. Lance Timmerman says in a RealSelf Q&A. It takes at least six months for the transplanted or synthetic graft to start facilitating bone growth and regenerate your own bone.

You’ll see much more dramatic results once you get a dental implant. 

If your graft fails, you may require multiple procedures. “Depending on your situation, it’s possible to do multiple grafting procedures on a site in order to achieve the ideal result,” says Dr. Moris Aynechi, an oral and maxillofacial surgeon in Beverly Hills, California.

The grafted bone supporting the implant can last 20 to 30 yearsi—f the dental implant was done relatively soon, you practice good dental hygiene, and you maintain good general and oral health.

Studies show that various factors can contribute to implant stability, including the type of bone used in your graft, your age, your gender, and the implant placement site.

If the dental implant isn’t placed within one year of your dental bone graft, the regenerated bone will atrophy again and won’t be able to support an implant. You’ll need a second graft.

A dental bridge can be used instead of a bone graft and dental implant, if you’ve lost a tooth or had an extraction. With a bridge, the dentist uses two or more surrounding teeth (or implants) as anchors for a false tooth, placing crowns on the existing teeth. 

There are several types of bridges, but many have porcelain or metal framework. The bridge has fallen out of favor since implants came on the scene, because it involves three crowns and an implant as opposed to a single implant, says Dr. Jamali. “These days, people rarely choose a bridge, because it’s harder to clean underneath—and an implant lasts longer,” he says. And if you decide to do an implant at a later date, reconstruction of the bone may be even more expensive, because you no longer have the socket anymore, adds Dr. Jamali. However, a dental bridge may be a good option for someone who smokes, or if the teeth surrounding the missing tooth are already in bad shape. 

For bone loss due to gum disease, you might consider LANAP to regenerate gum and bone using the PerioLase MVP-7, an Nd:YAG dental laser that’s FDA-approved for periodontal disease. The light from the laser kills the bacteria affecting the gums and stimulates stem cells to form new tissue, collagen, and bone.

Bhatavadekar N., Gharpure A., Clinical Efficacy of Tooth-Bone Graft: A Systematic Review and Risk of Bias Analysis of Randomized Control Trials and Observational Studies (2018)

Choi H., Kim Y., Oh J., Park J., Shin S., The rate and stability of mandibular block bone graft in recent 5 years (2017)

De Moraes M., Mazzonetto R., Moreira R., Stabile G., Sverzut A., The influence of tobacco on early dental implant failure (2008)