Dental Implant Failure Rates: What the Research Actually Says (And What It Means for You)

You have heard implants are the gold standard. You have also heard horror stories. So what is the truth?

The research is clear. And the numbers are better than most people expect.

The Big Picture: Implants Work

Dental implants have one of the highest success rates of any surgical procedure.

A 2022 study published in the Journal of Oral Medicine and Oral Surgery found that dental implants have a 97% success rate at 10 years. Even at 20 years, the success rate holds at 75%.

Think about that. Three out of four implants placed today will still be working two decades from now.

A 2024 meta-analysis published in Clinical Oral Investigations looked at 20 years of implant data. The researchers found that approximately 4 out of 5 implants survive the full 20-year period. They called this “remarkably good” for any medical procedure over such a long time frame.

These are not marketing claims. These are peer-reviewed clinical studies tracking thousands of patients over years and decades.

Short-Term Success Is Even Higher

Most implant failures happen early. If your implant makes it through the first year, the odds are strongly in your favor.

A large cohort study published in 2021 tracked 10,871 dental implants in 4,247 patients for up to 22 years. The cumulative survival rates tell the story:

• At 3 years: 98.9%
• At 5 years: 98.5%
• At 10 years: 96.8%
• At 15 years: 94.0%

The pattern is consistent across studies. Early failure is rare. Long-term failure happens slowly over time. And most implants last for many years without problems.

What “Failure” Actually Means

When researchers talk about implant failure, they mean the implant had to be removed. This happens for a few reasons.

Early failure occurs within the first few months. The implant does not fuse properly with the bone. This is called failed osseointegration. Causes include infection, poor bone quality, or excessive movement during healing.

Late failure happens after the implant has been functioning. The most common cause is peri-implantitis, an infection around the implant that destroys supporting bone. A 2021 study found peri-implantitis present in about 34% of implant patients at some point, though not all cases lead to implant loss.

Other late failures come from mechanical issues. Cracks in the crown. Loosening of components. Problems with how the bite fits together.

The good news: most of these issues can be prevented or caught early with proper care and regular checkups.

Risk Factors That Matter

Not everyone has the same odds. Research has identified several factors that increase the chance of implant failure.

Smoking

This is the biggest controllable risk factor. A 10-year retrospective study found that smoking was associated with 37% of implant failures. Smokers have significantly higher failure rates than non-smokers.

Smoking reduces blood flow to the gums and bone. It slows healing. It increases infection risk. If you smoke and want implants, quitting before surgery improves your odds.

Diabetes

Uncontrolled diabetes affects healing and increases infection risk. The 22-year cohort study found that diabetes was positively correlated with implant failure.

However, well-controlled diabetes does not necessarily rule out implants. Work with your dentist and doctor to optimize your blood sugar before and after surgery.

Bone Quality

The density of your jawbone matters. A study published in the Journal of Family Medicine and Primary Care found that implants placed in Type IV bone (the softest, least dense category) had a 20.6% failure rate. Implants in denser bone performed much better.

If you have low bone density, your dentist may recommend bone grafting before implant placement. This builds up the foundation and improves success rates.

Implant Size

Smaller implants have higher failure rates. The same study found that implants with diameter less than 3.75mm and length less than 10mm failed more often. Larger implants have more surface area to bond with bone.

Your dentist will choose implant size based on your anatomy and the tooth being replaced. In some cases, bone grafting allows for larger, more stable implants.

Location

Implants in the upper jaw (maxilla) fail more often than those in the lower jaw (mandible). One study found that 83% of failed implants were in the upper jaw. The bone in the upper jaw is often less dense, especially near the sinuses.

What About All-on-4?

Full arch implant systems like All-on-4 use just four implants to support an entire set of teeth. Some patients worry this approach is less stable.

The data says otherwise.

According to industry statistics, All-on-4 dental implants have a cumulative prosthetic survival rate of 98.8%. This is comparable to or better than individual implants in many studies.

The key is proper planning and placement. When done correctly, these systems distribute force across the implants in a way that promotes long-term success.

Questions to Ask Your Dentist

Before getting implants, you want to know your personal risk level. Here are questions that help:

How many implants have you placed? Experience matters. Dentists who place implants regularly have better outcomes.

What is your success rate? A good implant dentist should track their own data. Ask for specifics.

Am I a good candidate? Be honest about your health history. Smoking, diabetes, medications, and bone density all affect planning.

Will I need bone grafting? If your bone is thin or soft, grafting may improve your odds. Ask if this applies to you.

What happens if the implant fails? Most failed implants can be replaced after healing. Ask about the process and any costs involved.

What does aftercare look like? Implants need maintenance. Ask about cleaning, checkups, and what to watch for at home.

The Bottom Line on Risk

No surgery is 100% guaranteed. But dental implants come close.

With a 97% success rate at 10 years and around 80% still functioning at 20 years, implants outperform most other tooth replacement options. Bridges typically last 10 to 15 years. Dentures need regular adjustment and replacement.

Implants also protect your jawbone. When a tooth is missing, the bone beneath it shrinks over time. Implants stimulate the bone and prevent this loss. That benefit lasts as long as the implant does.

Reducing Your Risk

You have more control than you might think.

Quit smoking. This is the single most impactful change you can make. Even reducing how much you smoke helps.

Manage chronic conditions. Work with your doctor to control diabetes, blood pressure, and other health issues before surgery.

Choose an experienced provider. Implant success depends heavily on planning and placement. Find a dentist with specific training and a track record.

Follow aftercare instructions. Keep the surgical site clean. Take medications as prescribed. Attend all follow-up appointments.

Maintain your implants long-term. Brush and floss around implants just like natural teeth. See your dentist regularly for cleanings and checkups. Catch problems early.

Implants Are an Investment

Dental implants cost more upfront than bridges or dentures. But they also last longer and protect your oral health in ways other options cannot.

When you look at the research, the value becomes clear. A 97% success rate. Decades of function. Preserved bone. Stable, natural-feeling teeth.

The failure stories get attention because they are rare. The success stories are so common they barely get mentioned.

If you are considering implants, the data is on your side.