What Causes Jawbone Loss After Tooth Extraction?
The jawbone starts to change shape as soon as a tooth is gone, because the bone that used to support the tooth root no longer has a job to do and the body begins to remodel it. A systematic review of 20 studies measured how much the ridge changes in the six months after an extraction: an average horizontal reduction of 3.79 mm, alongside a smaller vertical reduction of about 1.24 mm on the outer (buccal) side of the ridge (Tan et al., 2012, Clinical Oral Implants Research). Most of that horizontal change happens early, with around 32% of it occurring in the first three months alone.
This matters for anyone considering a dental implant, because an implant needs a minimum width and height of bone to sit in safely. The longer an extraction site is left before an implant is planned, the more the ridge may have narrowed in the meantime, which is one reason a dentist assesses bone volume with imaging rather than by eye. The same resorption process also explains why a denture that fits well in the first year after extractions can start to feel loose later: the ridge underneath it keeps changing shape even after the initial six-month period Tan and colleagues measured.
Bone remodelling after extraction is a normal biological response, not a sign that anything has gone wrong with healing. It happens whether or not a tooth is ever replaced, which is why the timing of any implant plan, not just whether to have one, is part of what a dentist weighs at the first consultation.
Do I Need a Bone Graft Before an Implant?
Sometimes, and the answer depends entirely on the individual site rather than a general rule. A bone graft is needed only when the dentist's examination and imaging show that the remaining ridge cannot safely host the implant at the planned position and angle. Where the bone volume is already adequate, an implant can go ahead without a graft.
There is no reliable published figure for what proportion of implant patients end up needing a graft, since the decision is made case by case rather than following a fixed rate. Treat any claim that "most patients need a graft" or "most don't" as unsourced, and rely instead on what the imaging shows for a specific site. The mechanism behind the decision is the ridge resorption described above (Tan et al., 2012): a graft rebuilds the volume the bone has lost since extraction, so the implant has enough width and height to be placed correctly.
Types of Dental Bone Grafting Materials
Bone grafts used before or during implant placement fall into three broad classes, and the choice between them depends on the site and how much volume needs to be rebuilt.
| Graft type | What it is | Typical use |
|---|---|---|
| Autograft | Bone taken from elsewhere in the patient's own body | Larger defects where the dentist wants the patient's own living bone cells |
| Allograft | Processed donor bone from a human tissue bank | Common general-purpose option; avoids a second surgical site |
| Synthetic bone substitute | A manufactured, biocompatible material that acts as a scaffold | Smaller defects, or combined with allograft material |
The dentist selects the material based on the size of the defect, the site, and the volume of bone needed to support the planned implant. None of these materials guarantees a faster result over another; the choice is a clinical one made at the treatment-planning stage, not something to research and request independently.
As with any surgical procedure, bone grafting carries risks that a dentist will explain before treatment: these can include graft failure to integrate, infection at the site, or the graft resorbing faster than planned, any of which may mean the graft needs to be repeated before an implant can proceed. These are known possible outcomes rather than the expected result, and the dentist's own assessment of a specific site is what determines how likely they are in an individual case.
Bone Grafting Procedure & Healing Duration
A bone graft is placed under local anaesthetic, either as its own appointment before the implant or at the same time as implant placement, depending on how much rebuilding the site needs. Afterwards, some soreness and swelling in the area is normal, and the clinic will give instructions on managing it; contact the clinic directly if swelling is severe, spreading, or accompanied by fever.
The graft material needs time to consolidate with the existing bone before an implant can be placed safely, and the site has to be assessed as stable on review. The treating dentist sets that interval individually rather than working to a fixed number of weeks or months, since healing speed varies by graft type, the size of the defect, and the patient's own healing response. Ask the treating dentist what their own review process looks like for a specific case rather than expecting a single standard timeline.
Some cases combine the graft with the implant placement in one appointment, when the dentist judges the site is stable enough to support both at once; others need the graft to heal on its own first, with the implant placed as a separate procedure afterwards. Which pathway applies is decided from the imaging and the size of the defect, not chosen in advance of the examination.
What Happens If You Skip Bone Grafting?
If the imaging shows the ridge does not have enough width or height to anchor an implant safely, going ahead without a graft is not simply a shortcut: the implant may not have adequate bone to integrate with, which is the same osseointegration process a standard implant depends on for its long-term stability. That is why a dentist who has recommended a graft for a specific site is responding to what the imaging shows, not applying a default step.
Where the imaging shows adequate bone already, a graft is not needed and skipping it is not skipping anything, since there is nothing to compensate for. The distinction is always site-specific, which is the reason this page does not give a general answer to "do I need a graft" without imaging first.
It is worth being cautious of any provider who proposes placing an implant into a site with known inadequate bone volume without a graft, or without imaging to confirm the volume at all. An implant placed without enough surrounding bone is more likely to run into the kind of integration or stability problems covered in signs of implant failure, which is a harder and more expensive problem to fix than grafting would have been at the outset.
Bone Grafting Cost in Tasmania
A bone graft is itemised separately from the implant itself. The Australian Dental Association's Schedule of Dental Services lists item 243 for an osseous graft per tooth or implant site, on top of whichever implant items apply (684 or 688 for the post, 672 for the crown once it is fitted).
As with the rest of implant treatment, there is no official schedule of private dental fees in Australia, so no statewide graft price exists; the fee is set by the practice doing the work. Ask for a written, itemised quote that shows item 243 separately from the implant items, so it is clear what portion of the total is the graft. For the full cost structure of an implant case, see dental implant cost in Tasmania.