Fact Checked

9 Signs of a Failed Dental Bone Graft

Written by Fernanda Elizalde

April 03, 2023

Medically Reviewed

By Dr. Greg Grillo, DDS

In the United States, dental implants have become more common with 5.7% of the population having at least one tooth implant. For many of these implants, the first step is to get a dental bone graft to help the implant process.

Dental bone grafts are complex procedures, and the process can fail. But what are the signs of a failed bone graft? Learn more about what a dental bone graft is and how to tell if it has failed.

What Is a Dental Bone Graft?

A bone graft is a procedure that adds density and volume to your jaw in areas where you have experienced bone loss. The bone grafting material many times comes from your own body, but it can also come from an animal tissue bank or a human tissue bank. There are also instances when the bone graft material can be synthetic.

When you have missing teeth, you can experience bone loss in your jaw. This loss occurs because the alveolar bone, which is the portion in the jaw responsible for anchoring and supporting tooth roots, along with the surrounding tissues and ligaments, shrinks back from missing teeth. The process is bone resorption.

Your jawbone strengthens and builds up with chewing pressure, so experiencing bone loss in this region can lead to deeper deterioration of bone under tooth roots.

A dental bone graft works a bit like a scaffold on which your bone tissue can grow.

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Who Needs a Dental Bone Graft?

A person who has experienced bone loss in their jaw typically needs a dental bone graft. This is the case for those who require dental implants to replace a missing tooth.

If you need to go through a tooth extraction, you may also need a dental bone graft to offer the implant the support it needs.

Those who need to get dentures might also need to build up their jawbone before being able to do so. If you suffer from gum disease and have experienced bone loss, a bone graft can also be necessary.

Types of Dental Bone Grafts

There are different types of dental bone grafting procedures.

Socket Preservation

Socket preservation, also called ridge preservation, is a bone graft procedure in which your oral surgeon places the graft into the socket right after the tooth extraction. It fills in the void the missing tooth left behind, preventing the sides of the socket from caving in.

Ridge Augmentation

This procedure is the best option for people who have had missing teeth for a while. In that case, the supportive jawbone can be thinner than it was. A ridge augmentation bone graft increases the volume and width of the jawbone, making it a more stable foundation on which to place dental implants or perform other procedures.

Sinus Lift

Right above your upper back teeth sits the maxillary sinuses. If you have teeth missing in that area, the jaw bone can shrink and leave minimal bone between the mouth and sinuses. This does not allow for the placing of dental implants because of the risk of damaging the sinus membrane.

A sinus lift can address this problem by adding bone in the base of the sinus. Your oral surgeon then places a bone graft under the sinus, forming a solid foundation.

Periodontal Bone Graft

Gum disease, including infections, can eat away at your jawbone. This causes teeth to become loose. To support the teeth and give them a firmer foundation, your oral surgeon might choose a periodontal bone graft, which goes around the tooth and reduces mobility.

Signs of Failed Dental Bone Graft

If you have undergone a bone graft procedure, you want to ensure that the dental bone graft surgery was successful. In some cases, however, there can be complications when dental bone grafts fail. There are some signs of failed bone graft procedures to watch for.

1. Pain

You may experience some discomfort after a bone graft, especially in the first three or four days, but you should not feel pain. If you feel severe pain that radiates into other parts of your mouth or into your throat, or if you experience throbbing pain, it can mean a dental bone graft failure.

2. Swelling

Gum swelling is a common sign of bone graft failure. The gum tissue in the area can appear as if you have gingivitis or periodontitis, with swollen and bleeding gums. Having a bit of inflammation for a few days after receiving dental bone grafts is normal, but if the swelling does not get better, it can point to dental bone graft failure.

3. Tooth Sensitivity

If you have a graft next to a tooth root, especially if you have periodontal disease and your surgeon wants to save the tooth, you may experience tooth sensitivity. This sensitivity can get worse if there is an infection present. Tooth sensitivity feels more like an ache or soreness than pain.

4. Discharge

If the dental bone graft failure led to an infection, you might see pus or other types of drainage. The drainage can taste salty and sour. The color of the fluid can have a white color, or it can be clear. In some instances, you may also see yellow discharge and blood.

5. Gum Recession

Another sign of dental bone graft failure is seeing receding gums. Gum tissue rests right on the bone tissue beneath it. If you experience bone loss, your gums can start to recede. After a dental bone graft, your gums should start feeling higher and fuller in the area of the procedure.

If they do not feel better or have lost some volume, it can point to a possible failure of the bone graft.

6. Sinus Problems

If you have experienced what feels like allergies, with a runny nose and a sinus headache, after the dental implant, it can mean there is a complication. You may have a bone graft infection that involves the rupturing of the sinus lining at the location of the bone graft.

7. Bone Particles Falling Out

When there are loose bone fragments in your jaw, they may work their way out through your gum tissue. That can point to a bone graft that did not stay in place.

8. Irregular X-Ray

For some people, the only way to know whether the graft was successful is to have an X-ray. They may not experience any symptoms after bone graft surgery, but a follow-up X-ray can reveal if there are any irregularities. Your dentist or surgeon may see that the bone graft dissolved, that it is partially missing, or that there is a change in the shape of the bone tissue in the area of the graft.

9. Nerve Damage

If you lose sensation in the areas where the bone grafts are, this can also tell you there may be a problem. It occurs most often when you get a dental implant placement in the same location.

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Dental Bone Graft Failure: Why It Happens

A bone graft failure may occur for a variety of reasons.

One of the most common problems after oral surgery, especially after a bone graft, is poor aftercare. You always want to follow the aftercare instructions your surgeon provides, including taking antibiotics. Most of the time, you will need to avoid smoking as well as eating crunchy food, and you need to cleanse your mouth as the dentist tells you to.

If you put excess pressure on your gums by clenching, you can damage the sutures from the oral surgery and might even damage the bone graft. If you are someone who tends to grind or clench your teeth as you sleep, you may need to consider using a mouth guard as the surgical site heals.

Infection at the bone graft site is another very common reason why the procedure may fail. If you have an infection in your gums or bone tissue, everything around them can also be at risk. Most of the time, the infection is a sinus one caused by leakage from the sinus lining. Dental plaque can also be a cause.

Dental bone graft healing requires care. Poor dental hygiene can also cause bone grafting failure. Your oral health depends on maintaining a high level of hygiene because bacteria can infect teeth close to the graft and can even enter the bloodstream. Without proper hygiene, including using the right toothbrush and toothpaste, you can cause an infection.

Another potential culprit after a bone graft failure is low blood flow. Low circulation deprives the area of the bone graft of the oxygen and nutrients it needs to heal. Sometimes, the surgery may have damaged blood vessels, restricting the amount of blood flowing to the site.

In some instances, your own body may reject or absorb the bone graft. If you see that your gums shrink away from the graft, it can mean that they are rejecting it.

Maximize Oral Health After a Bone Graft

To help prevent infection and other complications after a dental bone grafting, one of the most important things you can do is maintain a high level of oral hygiene. At Snow, you can find the essentials you need to take care of your mouth. Visit Snow today to see the options available.

Bone Graft Frequently Asked Questions

If you need a dental bone graft, there are some common questions you may have.

How Do You Prepare for a Dental Bone Graft?

To prepare for the procedure and help prevent a dental bone graft failure, you must avoid drinking or eating anything 8 to 12 hours before the procedure. The specifics will depend on the type of anesthesia you will need.

There may be medications your surgeon will require you to stop taking, like blood thinners. Remember that you will also need someone who can drive you home after the bone grafting procedure because you will still be drowsy from the anesthesia.

How Long Is the Bone Graft Recovery Process?

Bone grafts can take a few days to a few weeks to heal. The majority of people need about two weeks to be back to normal, but it can depend on the kind of bone graft you had and the size of the area that needed bone grafting.

Can You Talk After a Dental Bone Graft?

Although you can talk after bone grafts, it is better to avoid doing so for a while. Give your jaw a chance to rest by avoiding chewing and talking.

Can You Have a Dental Bone Graft if You Are Sick?

It is best to reschedule the dental bone graft surgery if you have a cold or another illness. You want to lower the risk of dental bone graft failure, and that means reducing the number of bacteria at the surgical site. Give your body time to heal before a surgical procedure.


A dental bone graft can help you get the dental implants you need. Dental bone graft failure can occur, however, and it is vital to know the signs. If you see or taste pus, have an infection, have nerve damage, notice sinus problems, have tooth sensitivity, or feel severe pain, you need to contact your dentist immediately.