Are Dental Implants Painful? Rating Every Step With A Universal Pain Scale

When you start looking into getting a dental implant, you eventually discover that the process involves a ceramic or metal post being embedded into your jaw bone.

That sounds quite invasive to most people, so it’s natural to find yourself wondering whether there’s a lot of pain or discomfort involved.

In our experience, having spoken with hundreds of prospective patients about dental implants over the years, it’s probably the second or third most common question we receive after “how much do dental implants cost?” and “how long do dental implants last?”

To help you understand the levels of discomfort you can expect, we'll take you step-by-step through the dental implant process using a widely recognized medical tool for assessing and describing pain levels: the Universal Pain Assessment Tool (UPAT).

Setting a standard for pain

Pain means something different to everyone, which makes answering the question "are dental implants painful?" quite complex. 

What one person thinks of as unbearable discomfort might be completely manageable to someone else — it’s very personal.

So, when we talk about pain, there’s always a bit of “wiggle room” involved. That said, there are still useful ways of describing pain levels in ways that just about anyone can relate to.

One of those ways is with the Universal Pain Assessment Tool, or UPAT. First published by the UCLA Department of Anesthesiology, it’s commonly used in clinical settings to help patients express how much discomfort they’re feeling.

Instead of just using a scale from 1-10, it includes information about how the pain can affect your emotional state and ability to complete day-to-day activities so that you have a clearer sense of what you’ll be feeling.

1.) Scans and Exams

The first step in your dental implant journey involves a series of scans and exams. These are vital to check your overall oral health and make sure you’re ready to receive a dental implant. Generally, this phase is practically painless, with the most common procedures being:

X-Rays

Dental x-rays, also known as radiographs, are an essential part of the initial examination when considering a dental implant. They provide detailed images of your teeth and jawbone. There are typically a couple of types of dental x-rays taken for implant surgery:

• Bitewing X-rays
  These are used to check for cavities between teeth and assess the height of your bone support for the implant.

• Periapical X-rays
  These focus on one or two specific teeth, providing a close-up view of the tooth and surrounding bone. They help detect any issues that might require treatment before implant placement.

Dental X-rays are non-invasive and typically painless. The procedure involves positioning a small X-ray sensor in your mouth, which you'll be asked to bite down on for a moment. While you might feel a slight pressure from the sensor, it's generally not painful and is over quickly.

UPAT Pain Level: 0

CT Scan

A CT scan is a three-dimensional imaging technique that provides a more detailed view of your jawbone, making it especially useful for planning dental implant placement. This scan allows your dentist to:

• Assess Bone Quality
  It helps determine the density and quality of your jawbone, crucial for successful implant placement.

• Locate Vital Structures
  It helps identify the precise location of nerves and blood vessels in your jaw to avoid potential complications during surgery.

Similar to x-rays, CT scans are non-invasive and painless. You'll be positioned on a scanning table, and the machine will move around you to capture detailed images. You won't feel pain during the procedure, though you may experience a sensation of lying still for a few moments.

UPAT Pain Level: 0

2.) Pre-Treatment

Once your scans and exams are complete, we might identify the need for some pre-treatment procedures. These may include tooth extractions, bone grafts, or gum disease treatments. Let’s take a look at each one.

Tooth Extractions

Tooth extractions may be necessary before dental implant placement for various reasons, including:

• Irreparable Damage
  If a tooth is severely damaged or decayed beyond repair, it may need to be extracted to create space for the implant.

• Impacted Teeth
  In cases of impacted wisdom teeth or other teeth that haven't fully erupted, extraction might be required to make room for the implant.

• Crowding
  If your mouth is overcrowded, extractions may be necessary to ensure proper spacing for the dental implant.

The level of discomfort during a tooth extraction can vary depending on the complexity of the extraction. Simple extractions, where the tooth can be removed with forceps, are usually less painful. You will be given local anesthesia to numb the area, making the procedure relatively pain-free. 

Complex extractions, like those involving impacted teeth, might be more uncomfortable, but you will still be numbed to minimize pain.

UPAT Pain Level: 2-4

Bone Grafts

Bone grafting is a procedure to augment or regenerate bone in your jaw. It’s commonly done when the jawbone lacks the necessary density or thickness to support a dental implant. The primary reasons for bone grafting include:

• Bone Loss:
  Over time, bone loss can occur in the jaw due to factors like tooth extraction, periodontal disease, or injury.

• Insufficient Bone Volume
  Some individuals naturally have less bone volume, so they need extra bone mass to be added to provide adequate support for the implant.

The pain associated with bone grafting can vary based on the type and extent of the procedure. It typically involves local anesthesia, so you should not feel any significant pain during the surgery.

However, after the procedure, there may be some discomfort or swelling. Your dentist will provide instructions for managing post-operative pain with over-the-counter pain relievers.

UPAT Pain Level: 3-4

Gum Disease Treatments

Treating gum disease before dental implant surgery is crucial for the long-term success of the implant. Gum disease treatment may involve:

• Scaling and Root Planing
  This non-surgical procedure is often the first step in treating gum disease. It involves thorough cleaning of the tooth roots to remove plaque and calculus.

• Periodontal Surgery
  In more advanced cases, surgical procedures may be needed to address gum disease. This might include gum flap surgery or gum grafts.

The discomfort associated with gum disease treatments is typically mild. Local anesthesia is used during the procedures to ensure minimal pain during the treatment. 

Post-treatment, you may experience some soreness and swelling, but it’s generally manageable with over-the-counter pain relief and by following your dentist's post-operative care instructions.

UPAT Pain Level: 2-3

3.) Drilling and Implant Placement

The surgical procedure for placing dental implants might sound scary, but with the use of local anesthesia or conscious sedation, most patients experience minimal pain. Here's what to expect:

Local Anesthesia

Before the actual drilling and implant placement, your dentist will administer local anesthesia to numb the area where the implant will be inserted. This is essential to ensure you are comfortable and pain-free throughout the procedure.

The administration of local anesthesia involves a small needle for an injection. You may feel a brief pinch or stinging sensation at the injection site. However, this discomfort is usually minor and short-lived.

UPAT Pain Level: 0-1

Implant Placement

Once the anesthesia has taken effect and the area is thoroughly numb, your dentist will proceed with the implant placement. This is the core of the procedure and involves several steps:

1. Incision
   A small incision is made in your gum tissue at the implant site. This exposes the jawbone, allowing access for the implant to be inserted.
   
2. Drilling
   Your dentist will use specialized drills to create a small hole in your jawbone for the implant. The depth and diameter of the hole will be precisely determined based on the implant's size and your bone structure.
   
3. Implant Insertion
   The dental implant, which is a small, screw-like fixture made of biocompatible materials such as titanium, is carefully placed into the hole created in the jawbone. The implant is designed to act as a replacement for the tooth's root.
   
4. Closing the Incision
   After the implant is securely in place, your dentist will close the gum tissue over the implant site with stitches. These sutures promote proper healing and protect the implant during the initial recovery period.

During this phase, you might feel pressure and vibrations from the drilling, but it's essential to note that most patients describe this sensation as discomfort rather than pain. The anesthesia ensures that you don't experience pain. 

The procedure is relatively quick, usually taking an hour or less for a single implant, and your dentist will keep you informed and reassured throughout.

UPAT Pain Level: 0-1

4. Recovery Period

After the implant placement surgery, you will enter the recovery phase. Some discomfort and swelling are common, but it can be managed with over-the-counter pain relievers and prescribed medications. 

Your dentist will provide specific post-operative care instructions, which will help you to manage:

• Pain
  You'll likely be prescribed pain medications to manage any post-surgical discomfort. Over-the-counter pain relievers are also recommended.

• Swelling
  Swelling around the implant site is normal and typically peaks within the first 48 hours. Cold compresses can help minimize swelling.

• Oral Hygiene
  You'll receive instructions on how to care for the surgical area to promote healing and minimize the risk of infection.

• Follow-up Appointments
  Your dentist will schedule follow-up appointments to monitor your progress and ensure that the implant is integrating well with the bone.

All-in-all, there generally *is* a moderate level of discomfort during the recovery period, especially in the days immediately following the implant placement surgery. For most people, though, it can be managed with prescription or over-the-counter painkillers.

UPAT Pain Level: 4-6

5. Crown Fitting & Placement

The final stage of your dental implant journey is the placement of the permanent crown — the visible “tooth” part of a dental implant. This is generally a pain-free process. Here's what you can expect:

Impressions

Before the permanent crown can be fitted, your dentist will need to take impressions of your mouth. These impressions are crucial for creating a customized crown that fits perfectly on your dental implant. The process usually involves:

• Taking Impressions
  Your dentist will either use a moldable, quick-setting material or a digital scan to take an impression of the area where the crown will be placed. 

• Bite Registration
  In addition to the impressions, a bite registration is taken to ensure that your new crown will fit comfortably within your bite.

• Shade Matching
  If the crown will be visible in your smile, the dentist will also help you choose the appropriate shade to match your natural teeth for a seamless appearance.

Overall, each of the steps involved in collecting impressions is painless. Some steps may cause a sensation of pressure in your mouth, but it's generally not painful.

UPAT Pain Level: 0

Temporary Crown Placement (if applicable)

In some cases, especially if the implant is in a visible area of your mouth, a temporary crown may be placed before the permanent one. The temporary crown serves both functional and aesthetic purposes while you wait for the permanent crown to be created.

Placing a temporary crown is a straightforward process that usually doesn't involve pain or discomfort. You may feel a small amount of discomfort as your dentist works around the implant site to place the temporary crown in a secure, natural-looking position, but there won’t be any significant pain.

UPAT Pain Level: 0-1

Permanent Crown Placement

Once your customized permanent crown is ready, your dentist will proceed to attach it to the dental implant. This is the exciting final step of the dental implant process, and it typically involves:

• Checking Fit and Aesthetics
  Your dentist will first ensure that the permanent crown fits properly on the implant and looks natural. Any necessary adjustments will be made to ensure a perfect fit.

• Attachment
  The crown is securely attached to the implant using a small screw. Your dentist will make sure it's stable and properly aligned.

• Final Polishing
  After attachment, the crown is polished to a high shine, making it smooth and aesthetically pleasing.

• Bite Adjustment
  Your dentist will check your bite to ensure that it's comfortable and doesn't put excess pressure on the implant or the surrounding teeth.

Overall, the placement of the permanent crown is typically painless. You might feel a bit of pressure and manipulation in your mouth, but any discomfort is usually minimal.

UPAT Pain Level: 0-1

The short answer to "Are dental implants painful?"

While some discomfort and mild pain are normal parts of the process, any pain from getting dental implants can generally be managed with proper preoperative preparation and post-operative care.

In terms of the UPAT, most steps will be between no pain and mild pain (0-3), and at the very worst you’ll probably only feel moderate pain (below a 7).

Is the discomfort worth it? 

You can ask just about anyone who’s received dental implants: they’ll almost certainly tell you that the benefits of restoring your smile far outweigh any temporary discomfort you may experience.

Now that you understand each phase of the procedure, you can approach the process with confidence, knowing that the pain is typically minimal and manageable.

Wondering what your treatment process would be like?

Getting dental implants is a big decision, both for your life and - in many cases - your finances as well. In a situation like that, it only makes sense to get as much information as you can.

Here at Glen Dental Centre, we have a team of 6 Coquitlam dentists to make sure you’re as informed as you can be about your treatment. With over 100 years of combined clinical experience, it’s like getting a second, third, fourth, and fifth opinion without having to drive all over the city.

Our consultations are always 100% no pressure and no obligation — we’re here to answer your questions and help you make the right decision for your oral health, not pressure you into getting something you don’t want.

If you’re ready to find out more about your path back to a complete smile, call us at (604) 552-2241 or contact us online.