What You Need To Know About A Dental Bone Graft

There are several ways dental bone grafting can be done, but the basic procedure is the same: A dentist or oral surgeon makes an incision in the jaw and grafts (attaches) other bone material to the jaw.

A dental bone graft is usually done if someone has lost one or more adult teeth or has gum disease. Both of these conditions can cause bone loss in the jaw.

The preferred approach for dental bone grafting is to use your own bone from the hip, tibia, or back of the jaw. This is known as an autograft. Autografts are usually the “gold standard,” since they increase bony support in the jaw and promote faster healing and new bone formation.

Below are four sources of material for the graft, each of which has its own advantages and risk.

A 2019 analysis noted that we haven’t yet determined ideal bone reconstruction material, but promising bone graft materials using cells, growth factors, and gene-modifying drugs are on the horizon.

Here are some of the most common reasons you may need a dental bone graft.

Implants for missing teeth

People who are going to receive implants in place of missing teeth are common candidates for dental bone grafts.

Dental implants are artificial roots shaped like screws that are placed in the jawbone. A crown that matches nearby teeth is then placed atop the implant.

Often, bone grafting is necessary to provide a strong enough base for an implant. In a 2016 study of nearly 800 people who received implants, more than half of the implant sites required bone grafting first.

Tooth loss or gum disease

Even if you’re not receiving an implant, dental bone grafting may be necessary to support a section of the jaw that has lost bone because of tooth loss or gum disease.

Bone loss can start to affect nearby teeth and gum tissue. Stabilizing the jaw with a bone graft can help prevent further bone loss and the long-term health complications that come with it.

If gum disease isn’t managed effectively, it can lead to further tooth loss and even heart disease.

Bone loss

Other candidates for dental bone grafts include those whose appearance has been affected by bone loss. Losing bone mass in the jaw can cause the face to look shorter than it used to.

If the lower jawbone loses bone mass, it can appear to protrude forward. Without healthy bone structure underneath them, the lips and muscles around them can change in appearance. The skin in the jaw area can appear more wrinkled.

Bone loss in the jaw is more common among older adults, just as the odds of developing the bone-thinning condition osteoporosis increase as you get older.

But a person of any age who has suffered an injury to the jaw or experienced problems related to poor dental hygiene or other health problems, such as major infections, may need a dental bone graft, too.

A dental bone graft that doesn’t involve harvesting bone material from a patient’s own body is a relatively minor procedure.

You’ll be sedated during the procedure, so you won’t feel any pain until after the anesthesia wears off. Then, the pain is usually tolerable with over-the-counter pain relievers for the next few days.

Prescription-strength pain medications may also be appropriate. Depending on how much work is being done, you may experience some discomfort for several weeks during recovery.

But if bone material is obtained from your own body, the recovery can be more painful, as surgery is done in two locations — for example, your hip and your jaw.

The amount of bone that’s harvested and then grafted is usually quite small, so the period of discomfort should be brief.

The costs of a dental bone graft can vary considerably. The complexity of the procedure and the material used are the two main factors influencing the cost.

When bone graft material comes from a cadaver, animal, or synthetic substance, the cost can vary between $400 and $1,200. If bone material is harvested from your own body, the cost may jump to $2,000 or more.

Many insurance providers, including Medicare, don’t cover dental bone grafts in most circumstances.

If your doctor determines that the procedure is medically necessary, your insurer may cover part of the procedure. If the grafting is for cosmetic reasons, it’s unlikely you’ll receive any insurance assistance.

You don’t need to do much to prepare for a dental bone graft. Here’s a quick checklist of what to do before the procedure:

• Avoid eating or drinking anything 8 to 12 hours before the procedure, depending on the type of anesthesia you’ll receive.
• Check with your doctor about the medications you use, especially blood thinners, which raise the risk of bleeding complications during surgery.
• Make arrangements to get home afterward, as you’ll be groggy after the procedure.

Here’s how the typical dental bone graft is done:

1. You’ll receive anesthesia before the procedure, and your vital signs will be monitored throughout.
2. The dental technician will clean the affected area.
3. Your surgeon will make an incision in the gum to separate it from the bone where the graft is to be placed.
4. The surgeon will place the bone material between two sections of bone that need to grow together.
5. The bone graft is secured with a dissolvable adhesive material or membrane or with special screws.
6. The incision is then sewn up to begin healing.

There are three main types of dental bone grafts procedures. Each one is useful for different circumstances affecting the jaw.

Block bone graft

Bone is typically taken from the back of the jawbone, near your wisdom teeth (or where your wisdom teeth once were).

This is usually done in cases where there’s been significant bone loss toward the front of the jaw.

Sinus lift

When bone loss has occurred near the upper molars, allowing the sinuses to move down, a bone graft is done to restore upper jaw stability while the sinuses are also moved back to their proper position.

Socket graft

The bone graft is done at the same time a tooth is extracted to avoid bone loss that might otherwise occur once the tooth is removed.

After a dental bone graft, you’ll probably leave the dentist’s office with gauze packed around the incision in your mouth.

You should be given instructions for changing the dressing during the next 24 hours and a prescription for antibiotics to help prevent an infection. You may also be given a prescription for pain relievers.

Other postoperative care tips include:

• applying ice packs to help reduce pain and swelling for the first day or two
• eating soft, bland foods for the first few days
• sleeping with your head slightly elevated the first night or two to help prevent blood from pooling at the site of the incision

During the initial recovery period, you should avoid:

• hot liquids, such as coffee or soup
• hard or crunchy foods, such as nuts
• any physical activity, such as contact sports, that may put the incision at risk

After a week or so, the dull pain in your jaw should give way to some mild discomfort and should feel like it’s improving.

Your jaw should start to feel normal after a few weeks. But it usually takes a few months before your jaw is strong enough to receive implants.

Plan on periodic visits to your dentist, including at least one round of X-rays, to check on healing during this time.

The most common side effects of a dental bone graft are pain and swelling.

But these can be kept to a minimum with ice packs and over-the-counter pain relievers. Prescription-strength medications may be necessary for some people.

Other normal side effects include minor bleeding and difficulty chewing and speaking for the first few days.

Though this procedure is usually safe and well tolerated, there are always risks.

Infection is a concern with any surgical procedure, so it’s extremely important to take the full course of antibiotics. Other unusual (but serious) potential side effects include:

• blood clots
• nerve damage
• anesthesia complications
• rejection of the bone graft

A dental bone graft is usually a safe and effective procedure. But when complications develop, see your doctor as soon as possible. Signs of trouble include:

• pain that persists or worsens several days after the procedure
• redness and increased swelling around the gums
• persistent tingling or numbness
• an implant that becomes loose, indicating a previous bone graft has failed

Dental bone grafts are done to help prevent long-term health problems associated with tooth loss and gum disease as well as to provide sufficient bone material to support dental implants.

This common procedure is usually safe and well tolerated, though there are risks of side effects and complications.

Following your doctor’s guidance during recovery will help minimize your chances of having problems after the procedure and improve the odds of maintaining good dental health in the years ahead.