What Is Dental Bone Grafting & What To Expect

Bone grafting

A dental bone graft is often one of the last options that someone has for getting dental implants or making their denture fit better. Bone grafting is sometimes referred to as “augmentation.” Your dentist might recommend a dental bone graft if you have some type of defect in your bone structure, such as resorption/shrinkage of the bone, a cyst, past gum disease, or following a tooth extraction.

For the most part, dental bone grafts are usually needed in situations involving periodontal disease or strengthening the bone in your jaw before dental implants can be installed. [1]

What Is Dental Bone Grafting?

A dental bone graft is when bone material from another part of your body (or mouth), a donor, an animal (usually cow bones), or synthetic material is placed into an area of your jaw where there is not enough bone.

By grafting new bone material into that location, your body naturally integrates with it. In turn, new areas of bone are created, improving the density of your jaw in that space. The integration process can take a little time, but it’s proven effective.[2]

We rely on healthy, dense bone to keep our teeth deeply rooted and secure enough for chewing. Grafting helps reinforce areas of our mouth where tooth mobility or loss is a risk. It’s a brief procedure that can leave a long-lasting impact on your smile.

Why Would I Need A Bone Graft? 

Bone grafts are needed when your jaw doesn’t have enough height, width, or density to support your teeth, dentures, or dental implants. Since bone naturally weakens over time because of infection or tooth loss, it may gradually spiral out of control. By the time you want to place dental implants or wear a denture, the bone loss may prohibit the treatment altogether. Fortunately, a dental bone graft or augmentation procedure can open up the door to numerous possibilities.[3]

Here are three common scenarios where a dentist may prescribe bone augmentation: 

Dental Implants

Just like natural teeth, dental implants need bone to fully surround them in order to hold them in place. No reputable dentist will place a dental implant if there is not dense enough bone there first. When a person has bone loss in the jaw due to periodontal disease, injury, or tooth loss, there may not be enough bone left to securely anchor a dental implant. In these cases, a bone graft can be used to add bone or bone-like material to the jawbone to provide a strong foundation for the dental implant surgery.

Bone grafts can also be used to help stimulate new bone growth in the jaw, which can improve the chances of success for dental implants. Bone grafting can “prep” the implant site ahead of time so that you can have the implant treatment performed a few months later. They might also use the graft with a sinus lift procedure if you’re getting implants further back in your upper jaw.

Gum Disease

Periodontal disease physically destroys the bone around your teeth. If you catch the infection early enough, you can stop the spread of the disease. Unfortunately, bone won’t grow back on its own. If you’re running the risk of tooth mobility (or loss), a bone graft can help reinforce your natural smile.

Bone Loss

Bone tends to shrink away after a missing tooth. Like if you’ve had a tooth extraction for some reason. The shrinking bone may not seem like an issue if you’re not getting an implant there, but it will affect the healthy neighboring tooth next to it!

4 Types Of Dental Bone Grafts 

Even though this isn’t a comprehensive list of every type of dental bone graft, these are the four most common that you’ll probably hear about in a general dentist’s office or if you’re seeing a specialist:[4]

1. Periodontal Bone Graft

This is the type of bone graft you need if you have moderate to advanced gum disease. You may already have teeth that are mobile or at least at risk of becoming mobile.

A periodontal bone graft is usually placed directly under the gum tissues against the root of a tooth after a deep cleaning or periodontal flap surgery. They can be minimally invasive or may require a few days of recovery, depending on which one you’re getting and how your dentist is placing it.

2. Socket Preservation

Socket grafts are very common after a dental extraction, especially if you’re planning to get dental implants placed shortly thereafter. Since extraction sites tend to trigger bone loss after the tooth is removed, the graft is placed immediately following the extraction as a way to counteract normal bone resorption. The primary purpose of a socket graft is to prevent the atrophy of the alveolar bone (jaw bone) before it can occur.

3. Ridge Augmentation

Full dentures require a tight seal against your gum tissue to keep them in place. But the framework that gives your gums their shape is the bone that’s underneath. If your dentures won’t fit properly or you have advanced bone loss from sleeping in your dentures overnight, ridge augmentation—which is bone grafting to build your bony arch back up where your teeth used to be—may be the next step.

4. Sinus Lift

The roots of your upper back teeth reach so far up that they almost touch your sinuses. When they fall out or are extracted, your sinus lining can drop into that area. Before dental implants can be installed, the sinus membrane needs to be lifted and a graft placed to fill in that void.[5]

How Do Bone Grafts Work?

A dental bone graft places new bone or synthetic bone grafting material into your existing bone, programming your body to build new bone in that space. By transplanting healthy bone tissue it makes your existing bone stronger and denser as the graft fuses and integrates. It’s like triggering a natural reaction that’s built into your body, reversing the bone resorption process and strengthening your bone instead.

Bone Grafting Methods

There are traditionally four major types of dental bone grafts that most dentists use. There are also newer techniques coming out (like grinding up your extracted tooth roots and using them as a graft instead!) Even though they have big confusing-sounding names, here’s a breakdown of what your dentist is talking about:

1. Autografts

When you take part of your bone from one area of your body and move it to another (like you would a skin graft), it is called an autograft. The instances where tooth roots are ground down to use them as grafting material are a type of autograft.

2. Allografts

An allograft is a very common type of bone graft that is completely safe. But most people get hung up on where it comes from: someone else. The bone is derived from a person who has previously passed away, but it is medically screened and processed, similar to what you’d expect from an organ donor.

3. Xenografts

A xenograft is bone tissue that comes from an animal source. Usually, it’s a bovine (a cow.) And yes, it is 100% safe and FDA-approved!

4. Alloplasts

These grafts are made out of synthetic material. Synthetic bone grafts don’t come from you or anyone else’s body. Allografts are great for people who have concerns about traditional bone grafts.

What To Expect From Bone Graft Procedure

Your actual bone graft appointment will probably be combined with other treatments, like an extraction, periodontal surgery, or sinus lift. If not, the graft itself is usually a quick in-and-out process that can be closely compared to an extraction appointment.

1. Before Bone Grafting Procedure

Leading up to the bone graft appointment, you and your dentist will discuss the types of augmentation material and techniques applicable to your situation. You’ll probably get a say-so between a couple of options, or you can go with your dentist’s recommendations.

If there are any active infections, those will need to be managed first. For example, you might need a deep cleaning or antibiotics at least a couple of weeks before the graft is placed. Depending on the complexity of your actual treatment, some visits are in-and-out procedures, while others will require planning for sedation (and someone to drive you home.)

2. During Dental Bone Graft Surgery

On the date of your bone graft appointment, you can plan on your dentist numbing the graft site just like they would during any other routine procedure. The local anesthetic will wear off a few hours later.

For the graft to be placed, a small incision will be made so that the bone underneath can be accessed. Then your dentist will place the graft material directly onto the exposed bone or inside of the open socket. After that, the tissue is closed up over the graft and sutured in place.

If you’re having a graft placed on the same day as an extraction, the graft material is usually placed right after the tooth is removed.

3. After Dental Bone Grafting

Now comes the healing process! Grafting doesn’t just “take” overnight. You have to let your body integrate with it, where it fuses the graft in place and forms new bone around it. This might last anywhere from 3-6 months. Your dentist will take X-rays at various intervals to measure the bone density and make sure things are healing properly.

Immediately after your bone graft surgery, you’ll probably be taking some medications and want to take things easy. Plan to eat soft foods and not chew on that side of your mouth. Always follow your home care instructions.

In instances where your dentist places stitches, they might be dissolvable, or you will need to go back to have the sutures removed a week or two later.

Are Bone Grafts Painful? 

The actual procedure won’t be painful because your dentist will numb that area of your mouth beforehand. The local anesthetic will make your mouth feel numb for at least a few hours. However, you can usually expect to need some over-the-counter pain reliever afterward.

Recovering from a dental bone graft is about the same as what you would expect after having a tooth removed. Since the gum tissue is opened up and the bone exposed (then sutured back), you might experience some sensitivity, tenderness, or minor swelling for a few days.

What to Expect from Recovery 

It is super important to pay careful attention to your dentist’s home care instructions. They’re not suggestions! The better you stick to them, the easier your recovery will be. Some of the “rules” they give you might include:

  • Avoiding hot or spicy food for one week
  • Not drinking carbonated, caffeinated, or alcoholic beverages for a week or two
  • Not drinking with a straw for a couple of weeks
  • No smoking
  • Applying an ice pack to the side of your face on and off every 20 minutes for the first 24 hours
  • Keeping your head elevated for the first 1-2 days
  • Taking medication as prescribed, such as an antibiotic or over-the-counter pain reliever

Bone Grafting Risks & Complications 

Just like any routine or surgical procedure, there are always potential risks or complications when you get a dental bone graft. More than likely, your dentist or specialist will even have you sign a medical waiver in the instance that something does go wrong. But rest assured, dentists are highly skilled in bone augmentation, and the risks are small.[6]

1. Anesthesia  

Every bone augmentation treatment will require a local anesthetic at a minimum. This medication numbs the area where the minor surgical procedure is being performed. Some people even elect to have deeper sedation because of other procedures during the same appointment. Anesthesia complications are fairly rare, but they do happen.

2. Can Bone Grafts Fail? 

Yes, a dental bone graft can fail. Particularly if the surgical site becomes infected or the body rejects the bone graft for some reason or another. Your dentist will be able to tell within a few months if the graft “took” or not by taking an X-ray of that area and looking at the bone density.

3. Infection

Any surgical area in your mouth can get infected. After all, there are thousands of bacteria in your mouth at any given time. By carefully following your dentist’s home care instructions, you can significantly reduce your risk of a post-grafting infection. If it does get infected, the graft will likely fail.

4. Heavy Bleeding

Your oral tissues are highly vascular. That’s one reason why your mouth can bleed so easily if you’re injured. Although the tissues over your dental bone graft will likely be sutured in place, you still need to watch for bleeding coming from that area, especially if you just had an extraction immediately prior to the graft being placed.

5. Nerve Damage

There are major nerves that run through your jaw to each of your teeth. Nerve damage is usually more likely during an injection or dental extraction. But if your graft is paired with a sinus lift or the same extraction appointment and you’re worried about nerve damage, be on the lookout for a numb face or temporary facial paralysis.

Does Insurance Cover Bone Grafting?

Getting dental insurance to cover a bone graft is hit or miss. Some types of dental policies will partially cover it, assuming it’s medically necessary, while others don’t. Your dental provider will need to check your benefit schedule to estimate your coverage. You’ll probably need to send an X-ray to the insurance company as proof that you needed the dental bone graft to begin with. 

If you don't have dental insurance, it is a great idea to get a dental savings plan to help save on the overall cost.

If you’re working with a specialty clinic, you might even be able to use your medical insurance. Experts like oral surgeons or periodontists sometimes accept both medical and dental coverage due to the overlap of certain surgical procedures. If that’s the case, they can help you file claims under both plans to limit all of your out-of-pocket costs.

Cost Of Bone Graft

Since there are so many different types of dental bone grafts and situations where they can be performed, the cost of bone augmentation varies significantly from one person to the next. For example, one person might be getting a bone graft immediately after an extraction, while someone else needs surgery on a bone cyst that requires IV sedation. There are multiple factors that go into play—not to mention the cost of the bone graft material itself—which make it practically impossible for a dentist to quote you the cost of a bone graft without seeing you in person. That being said, a bone graft usually starts at around $300, with more surgical procedures involving grafting going up as high as $3,000. Don’t be scared of the potential price tag until you’ve actually seen your dentist or specialist!

A savings plan to help offset up to 10% to 60% off the costs of procedures. Get a discount dental plan here and save!

Talk With Your Dentist About A Bone Graft

If you’re worried that a bone graft is standing between you and healthier teeth or implants, you owe it to yourself to talk to your dentist. The bone augmentation process may be simpler than you realize. Yes, there are complex scenarios where bone grafting is used, but that’s usually a smaller percentage of patients who need it. Considering there are so many options out there nowadays, there is likely a treatment that you can benefit from without feeling too intimidated.

A bone graft can literally save your smile. Ask your dentist how!

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