Do Dental Implants Hurt? Pain, Anaesthesia and Aftercare

Under local anaesthetic, most people feel pressure and vibration while an implant is placed, but little pain. In one study, patients rated the pain they actually felt at about half of what they had expected (1). Afterwards, soreness is usually mild to moderate, worst in the first day or two, and settles within days (2, 3).

How much it hurts depends more on what is being done than on the implant itself. Several implants, a bone graft or a sinus lift mean more swelling and soreness than a single implant. This guide covers what you feel during and after surgery, sedation, painkillers, flying home and the signs that something is wrong.

Dental implant pain at a glance

Sources for the table: (2, 3, 4, 5).

During the procedure: what you actually feel

Most implants are placed under local anaesthetic, the same numbing injection used for fillings and extractions. Once it works, you feel pressure, vibration and the sound of the instruments rather than sharp pain. If anything does hurt, say so: the dentist can give more anaesthetic.

What patients report backs this up:

• In a study of 60 patients having implants under local anaesthetic, people expected pain of 48 on a 0 to 100 scale and rated what they felt at 25. Anxiety was the strongest predictor of how much it hurt (1).
• In a smaller study, average peak pain during surgery was 2.3 out of 10 and a quarter of patients felt none. Of those who did feel pain, 72% said the anaesthetic injection was the worst part (2).
• In a questionnaire study of 287 patients, implant placement was rated less unpleasant than surgical tooth removal or root-end surgery, and the anaesthetic stage was the least pleasant part of all three (6).

So if you have had a tooth taken out surgically, a straightforward implant is often no worse, and sometimes easier (6, 7).

Sedation and general anaesthetic

Dental anxiety is common: around one in nine UK adults has high dental anxiety, and women are more than twice as likely as men to report it (8). If that is you, sedation is given alongside the local anaesthetic, not instead of it. In the UK, the standard options are (9):

• Inhalation sedation: nitrous oxide and oxygen ("gas and air") through a nose piece. It wears off quickly.
• Intravenous (IV) sedation: a sedative through a vein in the hand or arm. You stay conscious but deeply relaxed, and many people remember little afterwards.
• Oral sedation: a sedative taken by mouth before the appointment.

For any sedation other than gas and air, you need a responsible adult to take you home and stay with you for the rest of the day (9, 10). After sedation, do not drive for 24 hours, drink alcohol or sign important documents (11). So do not plan to travel on the day you are sedated.

In the UK, general anaesthetic is not given in dental practices, only in hospital settings (9, 10). If a clinic offers you a general anaesthetic for implant surgery, ask who gives it, where, and how you will be monitored.

Pain after surgery, day by day

Pain after a straightforward implant is usually mild to moderate and short-lived:

• In one study of 41 patients and 131 implants, pain was mostly mild and peaked within about six hours of surgery for many patients. Swelling peaked at around 48 hours (3).
• In a smaller study, pain peaked about two hours after surgery as the anaesthetic wore off, and had largely gone by two days (2).
• In a 7-day diary study of 108 patients, 14% had no pain, 56% had mild pain and 31% had moderate to severe pain at some point (12).

Swelling is usually at its worst 2 to 3 days after surgery and settles within 7 to 10 days. Bruising can take up to two weeks to fade (4). After that, the implant spends a few months fusing with the bone, usually around four (5), and this stage is not normally painful.

Why some implants hurt more than others

Our page on All-on-4 dental implants covers what a full-arch treatment involves.

Painkillers and antibiotics

For most healthy adults, ibuprofen and paracetamol are the usual painkillers after dental surgery. Cochrane reviews found ibuprofen works better than paracetamol, and the two together work better than either alone (17, 18). Ibuprofen is not suitable for everyone, for example if you have had a stomach ulcer, have asthma made worse by anti-inflammatories, are pregnant, take blood thinners, or have kidney or heart problems (19). Follow your dentist's instructions on which painkillers to take, how much and how often, and tell them about every medicine you take before surgery.

Some dentists give a single dose of antibiotic shortly before surgery. A Cochrane review found this reduced early implant failures (20), although a later systematic review found little benefit from routine use (21). A course of antibiotics after a straightforward implant has not been shown to reduce pain, swelling or complications (22). If you are prescribed antibiotics, finish them as directed.

Aftercare in the first two weeks

• Swelling: cold packs in short spells during the first day or two may reduce swelling a little, though the evidence is limited (23, 24).
• Food: soft or liquid food in the early days, avoiding hard and spicy food (24). Chew on the other side where you can. After a bone graft, a soft diet for a week or so is usual (13).
• Drinks: avoid drinking through a straw while the site heals (24).
• Cleaning: follow your clinic's instructions on rinsing and brushing around the site.
• Smoking: smokers are roughly twice as likely to lose an implant (25). Stopping well before surgery and through healing gives the implant the best chance.
• After a sinus lift: do not blow your nose, sneeze with your nose pinched, play a wind instrument or blow up balloons until your surgeon says the area has healed (13).

Flying home after implant surgery

No clinical trials have tested when it is safe to fly after implant surgery, so the guidance comes from expert reviews. A review in the British Dental Journal recommends waiting at least 72 hours after implant placement, ideally a week, and at least two weeks after a sinus lift, ideally up to six, because pressure changes in the cabin can affect a healing sinus (26). The British Association of Oral Surgeons advises not flying after a sinus lift until it has healed (13).

If you had sedation, do not travel that day either. Agree your flight date with your surgeon before you book, especially if a bone graft or sinus lift might be needed. Our page on dental implants explains how treatment is usually split across two trips.

What's normal and what's not

Can a dental implant hurt years later?

Yes, though pain is not a reliable warning sign. The most common long-term problem is peri-implantitis, an infection of the gum and bone around the implant. It affects about one in five patients (31, 32), and it can develop without pain. Bleeding when you brush around the implant is the sign to act on (33). Pain, swelling or a loose implant or crown also needs checking by a dentist (29).

Good cleaning is the best protection: brush for two minutes twice a day, clean around the implant the way your dentist shows you, and have regular professional checks (33, 34). Our article on whether dental implants abroad are safe covers the other factors that decide how long an implant lasts.

Frequently asked questions

How painful is a dental implant on a scale of 1 to 10?

In one study, average peak pain during surgery was about 2 out of 10, and a quarter of patients felt none (2). Afterwards, most describe mild soreness, though about a third rate it moderate to severe at some point (12).

Which is worse, a tooth extraction or an implant?

Studies suggest a straightforward implant is often no more uncomfortable, and sometimes less, than a surgical extraction (6, 7). Bone grafts and several implants at once can change that.

Will I be awake for dental implant surgery?

Usually, yes, with local anaesthetic numbing the area. Sedation can help if you are anxious. In the UK, general anaesthetic is only given in hospital settings (9).

How long does pain last after a dental implant?

For a straightforward implant, pain usually peaks in the first day and settles within a few days. Swelling peaks 2 to 3 days after surgery and settles within 7 to 10 days (3, 4).

What is the worst part of getting an implant?

For many people, it is the anaesthetic injection. In one study, 72% of patients who felt pain said the injection was the worst moment (2).

When can I fly after dental implant surgery?

Expert guidance suggests at least 72 hours after implant placement, ideally a week, and at least two weeks after a sinus lift (26). Agree the date with your surgeon before booking.

What can I eat after a dental implant?

Soft or liquid food such as soup, yoghurt and eggs in the early days, chewing on the other side where you can. Avoid hard and spicy food, and drinking through a straw (24).

Why does my implant hurt years later?

Possible causes include infection around the implant (peri-implantitis), a loose crown or screw, or bite problems. See a dentist promptly, and do not ignore bleeding around an implant either (29, 33).

Next steps

If you are considering implants, ask for a written plan before you travel: which anaesthetic or sedation you will have, whether a bone graft or sinus lift might be needed, which painkillers to take, and when you can safely fly. Istanbul European Clinic does not provide dental treatment; every clinical decision is made by your independent partner dentist.