Yes, an immediate dental implant after extraction is possible for many patients when the socket is free of active infection, the surrounding bone is intact enough and the implant can be held firmly at placement. When those conditions are not met, waiting for the site to heal is safer. A clinical exam and 3D imaging help decide which approach suits you.
An immediate implant is placed in the same appointment the tooth is removed, which can mean fewer surgeries and a shorter overall timeline. It is not right for every tooth. This guide from Tomken Dental explains how immediate and delayed placement differ, what the research shows, who qualifies for same day implant placement, the difference between placing and loading an implant, the benefits and risks, what the appointment involves, and recovery and cost.
Immediate vs Delayed Implant Placement: What Is the Difference?
Immediate placement means the implant goes into the socket right after the tooth is removed. Delayed placement means the socket heals first, often for a few months, before the implant is placed in a second surgery. Early placement sits between the two, after the gum has healed but before the bone has fully filled in.
| Immediate Placement | Delayed Placement | |
| Timing | Same appointment as the extraction | After the socket heals, usually months later |
| Surgeries | Usually one for extraction and implant | Usually two: extraction, then implant |
| Overall timeline | Often shorter | Longer |
| Case selection | Strict: needs good bone and stability, no active infection | Suits more situations, including infected or damaged sites |
| Grafting | Often placed in gaps around the implant | May be done at extraction (socket preservation) or later |
| Survival in research | Similar to delayed in a recent analysis; an earlier review found it lower | High |
Our article on the dental implant recovery timeline shows how each pathway fits into the full treatment.
What Does the Research Say About Immediate Implants?
Research shows immediate implants can perform very well in carefully selected cases. A 2023 meta-analysis in the Dentistry Journal found survival of 97.4% for immediate implants and 97.5% for delayed implants, with no significant difference. An earlier 2017 review found 95.2% vs 98.4%, favouring delayed placement and advising caution.
The 2023 analysis by Patel and colleagues pooled 341 immediate and 359 delayed implants. It updated an earlier 2015 review that had found a higher failure risk with immediate placement. The 2017 meta-analysis by Mello and colleagues in the International Journal of Oral and Maxillofacial Surgery, covering 30 studies, found significantly higher survival for implants placed in healed sockets and advised that immediate placement “should be performed with caution”.
Taken together, the evidence suggests two things. Immediate implants can succeed at high rates, and careful case selection matters, because the risk depends heavily on the condition of the socket and the stability the implant can achieve.
Who Is a Good Candidate for Same Day Implant Placement?
Good candidates for same day implant placement have a tooth that can be removed without destroying the surrounding bone, no acute infection or pus at the site, enough bone beyond the root tip to hold the implant firmly, healthy gums and general health that supports healing. Smoking and uncontrolled diabetes lower the chances.
| Factor | Favours Immediate Placement | Favours Waiting |
| Socket walls | Intact, especially the thin outer (buccal) wall | Damaged or missing wall |
| Infection | None, or minor and controlled | Acute infection, abscess, pus |
| Bone beyond the root | Enough to anchor the implant | Too little for stability |
| Primary stability | Implant feels firm when placed | Implant cannot be stabilized |
| Gums | Healthy; thick tissue in the front of the mouth | Active gum disease; thin tissue in visible areas |
| Health and habits | Non-smoker; well-controlled health conditions | Heavy smoking; uncontrolled diabetes |
| Grinding | Controlled, or protective plan in place | Heavy, unmanaged grinding |
A 3D scan shows the shape and thickness of the bone, the position of nerves and sinuses, and the root shape, which helps your dentist decide before the appointment. See our CBCT 3D Imaging page for how the scan works.
Immediate Placement vs Immediate Loading
Immediate placement refers to when the implant goes in; immediate loading refers to when a tooth is attached to it. Many immediate implants receive a temporary tooth that is kept out of heavy biting, or a healing cap, while the bone bonds to the implant. A same-day tooth on an implant is only possible when stability is high enough.
- Immediate placement, delayed loading: implant goes in at extraction; the final crown follows after healing.
- Immediate placement, immediate temporary tooth: a temporary crown is fitted the same day, mainly for appearance, kept out of strong bite contact.
- Delayed placement: the socket heals first; the implant and crown follow later.
Your dentist chooses based on how stable the implant is at placement and where the tooth is in your mouth.
Benefits and Risks of Immediate Implant Placement
The main benefits of immediate placement are fewer surgeries, a shorter overall timeline and, in the front of the mouth, the option of a temporary tooth so you are not left without one. The main risks are a higher chance of failure in some studies, gum recession in the front of the mouth and the possibility that planned placement must be postponed if conditions at surgery are poor.
| Benefits | Risks and Limits |
| One surgery for extraction and implant in many cases | Not suitable with active infection or major bone loss |
| Shorter total treatment time | Some reviews show more failures than delayed placement |
| Possible same-day temporary tooth in visible areas | Gum recession risk in thin front-tooth tissue |
| Fewer appointments | Plan may change during surgery if the socket is damaged |
What Happens During an Immediate Implant Appointment?
An immediate implant appointment starts with numbing the area, then removing the tooth as gently as possible to protect the bone. The socket is cleaned and checked, the implant is placed into bone beyond the root tip, and any gaps may be grafted. A healing cap or temporary tooth is then placed, depending on stability.
- Planning: exam, X-rays and a 3D scan before the day of surgery.
- Gentle extraction: the tooth is removed in a way that preserves the socket walls.
- Assessment: the dentist checks the walls and confirms there is no infection that would prevent placement.
- Implant placement: the implant is placed and its stability measured.
- Grafting if needed: bone material fills gaps between the implant and socket.
- Cover: a healing cap, or a temporary tooth if stability allows.
If the socket is not suitable once the tooth is out, your dentist may preserve the socket and plan the implant for later. This is a normal, safe change of plan.
Recovery and Cost
Recovery after an immediate implant is usually similar to recovery after an extraction: some swelling and tenderness for a few days, a soft diet and careful cleaning. The implant then needs several months to bond with the bone before the final crown. Cost depends on the extraction, implant, any grafting and the restoration.
Aftercare usually includes:
- Following your dentist’s instructions on rinsing, cleaning and pain relief.
- Eating soft foods and avoiding chewing on the implant side.
- Avoiding smoking, which can impair healing.
- Attending follow-up visits so healing can be checked.
The Canadian Dental Care Plan does not cover implants or implant-related procedures, although it does cover extractions for eligible patients. Our guides to dental implants cost in Ontario and tooth extraction cost in Ontario explain fees and coverage.
Is Immediate Placement Different for Front and Back Teeth?
Yes. In the front of the mouth, immediate placement is often chosen so you are not left with a visible gap, but the thin bone and gum on the outer side of front teeth make careful case selection essential to avoid recession. In the back of the mouth, molars have several roots and wider sockets, which can make it harder to hold an implant firmly on the day.
- Front teeth: appearance matters most; thin tissue raises the risk of the gum line shifting; a temporary tooth may be possible if the implant is stable.
- Premolars: often good candidates when the socket walls are intact.
- Molars: wide sockets and multiple roots can limit stability; some cases suit immediate placement, others are better delayed.
Questions to Ask Before Choosing Immediate Placement
Before you agree to an immediate implant, it helps to understand your dentist’s reasoning and the backup plan if the socket is not suitable once the tooth is out.
- What did the 3D scan show about the bone around this tooth?
- Is there any infection that could affect placement?
- Will I have a temporary tooth, and when can I chew on it?
- What happens if the implant cannot be stabilized on the day?
- How does the cost compare between immediate and delayed placement for my case?
- How many months until the final crown?
Immediate Implants at Tomken Dental
At Tomken Dental in Mississauga, Dr. Ahmed Ameen Al-Obaidi, a general dentist, performs both the extraction and the implant surgery in-house, and we can take CBCT 3D imaging in our office to plan each case. That lets us assess whether immediate placement is suitable before your appointment and adapt the plan on the day if needed. Nitrous oxide is available if you feel anxious.
Learn more on our Dental Implants in Mississauga and Tooth Extractions in Mississauga pages, or read about dental implant cost in Mississauga.
Frequently Asked Questions
Can I get an implant the same day my tooth is pulled?
Often, yes, if the socket has intact bone walls, there is no acute infection and the implant can be held firmly when placed. If these conditions are not met, the socket is allowed to heal first. A 3D scan and exam help your dentist decide before the appointment.
Is an immediate implant less successful than waiting?
Not necessarily. A 2023 meta-analysis found similar survival for immediate and delayed implants (97.4% vs 97.5%). An older 2017 review found lower survival for immediate implants (95.2% vs 98.4%). Success depends mainly on careful case selection, so not every tooth is suitable.
Will I leave with a tooth on the same day?
Sometimes. In the front of the mouth, a temporary tooth can often be attached if the implant is stable enough, kept out of heavy biting while it heals. In other cases, a healing cap is placed and the final crown follows after the bone has bonded to the implant.
What if my tooth has an infection?
An acute infection or abscess usually means waiting. The tooth is removed, the infection treated and the site allowed to heal, sometimes with a bone graft to preserve the socket. The implant is then placed once the area is healthy.
How long until I get my final tooth?
The implant usually needs several months to bond with the bone before the final crown is made. Timelines vary with bone quality, grafting and location in the mouth. Your dentist will give you a timeline for your case at the planning stage.
Book an Extraction and Implant Consultation in Mississauga
An immediate dental implant after extraction can shorten treatment and reduce surgeries when the bone and gums are healthy and the implant can be stabilized. When they are not, waiting is the safer path to a long-lasting result.
If you have a tooth that needs to come out and you are considering an implant, request an appointment through ourcontact page or call us. We will assess the tooth with 3D imaging and explain whether immediate or delayed placement suits you.
This article is general information, not dental advice for your situation. Speak with a dentist about the right option for your tooth.