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When to Bone Graft After Tooth Extraction?

When should bone grafting be done following extraction of a tooth? It is a question often asked by patients and also some dentists. The procedure is called extraction site bone preservation and augmentation grafting. It is highly recommended for any patient having tooth extraction, to inquire about bone grafting from the oral surgeon and discuss the plan with the restoring dentist. It will make all the difference during dental implant replacement and the outcome. We have had great success with our grafting technique and choice of materials giving us the ability to replace missing teeth with ideal cosmetic results.

Results from grafting or not grafting:



Three simple rules for grafting:


Here are three simple rules when bone grafting should be done after a tooth is extracted:

  1. Existing bone loss due to periodontal disease or abscess: If the bone has already been lost from inflammation or infection, it is best to graft the site immediatlely following tooth extraction. It is much easier and cheaper to correct the defect at the time of tooth extraction than reconstructing it later which requires more invasive and expensive procedures.

  2. Following extraction of teeth in the upper front area (smile zone): The bone is extremely thin in this area and following tooth loss, the bone almost always shrinks and diminishes in dimension. This results in inadequate bone and gum tissue and poor aesthetic results, no matter what the replacement option. Immediate bone grafting will prevent bone and gum tissue shrinkage and the unsightly defects that results. Bone graft will preserve the bone dimension and gum line creating a natural and cosmetic result following implant replacement.

  3. Delayed implant placement: If a tooth has been extracted, and there is normal healthy bone, but the patient does not desire implant placement right away for whatever reason; then the site should be grafted. This is done to preserve the bone and prevent it from shrinking. An implant can be easily placed later with predictable results. If not grafted, a defect can result, making it much more difficult and more costly to correct later.


Dental bone grafting is a predictable and highly successful procedure when performed properly by a skilled surgeon. It has given us amazing opportunities to rebuild lost bone and gum tissue and provide our patients with the kind of results they want to look great and keep eating well.