Yes, in many cases an implant can be placed the same day as the extraction, called immediate placement. Good candidates have enough healthy bone, no active infection, and stable gum tissue. The final crown usually still comes 3 to 6 months later, after the implant fuses to the bone. A CBCT scan and exam confirm whether same-day placement is safe for you.

At Inspire Dental in Tigard, we hear this question almost weekly. A Bull Mountain dad on his lunch break from the Intel commute asks if he can avoid taking two days off work. A retiree from King City wants to know if she can skip the months of waiting her neighbor described. The honest answer depends on what your scan shows, but the timing question deserves a clear walkthrough.

What does "same-day implant" actually mean?

Same-day implant means the implant post is placed into the socket immediately after the tooth comes out, during one appointment. Extraction and placement happen back-to-back. That part is real.

What it usually does not mean is a finished tooth that same day. The titanium implant still needs to fuse with your jawbone before a permanent crown can sit on top. That fusion process, called osseointegration, takes 3 to 6 months according to the American Academy of Implant Dentistry. In some front-tooth cases we can attach a temporary crown the same visit so you do not walk out with a gap. The final crown still comes later.

Two terms, two different things. Immediate placement is the implant. Immediate loading is the temporary tooth. They can happen together, but they do not have to.

The three implant timing options after extraction

Most dentists work from three timing windows after a tooth is removed:

• Immediate placement (same visit): Extraction and implant in one appointment. Bone preservation is at its best, and you have one surgery instead of two.

• Early placement (4 to 8 weeks): The gum tissue closes over the socket and early bone begins to fill in. We then place the implant. This is a common middle path when there was minor infection or thin tissue.

• Delayed placement (3 to 6 months): The socket fully heals before any implant work begins. Often used when there was significant infection, bone loss, or the need for a graft to mature first.

None of these is automatically better. The right choice comes from your CBCT scan, your medical history, and which tooth we are replacing.

Who is a good candidate for same-day implants?

Same-day placement works best when the foundation is already strong. We look for:

• Enough bone height and width at the extraction site to fully cover the implant

• No active infection or draining abscess around the tooth

• Healthy gums with no advanced periodontal disease

• Single-root teeth (front teeth, premolars) more often than wide molars

• Non-smokers, or patients ready to pause smoking through healing

• Well-controlled medical conditions like diabetes

Front teeth are often ideal. The socket shape is narrow, the bone walls are usually intact, and patients understandably want to avoid a visible gap. Molars are trickier because they have wider, multi-rooted sockets that do not always grip a new implant tightly enough on day one.

When you should not get a same-day implant

Sometimes waiting is the smart call. We recommend a delayed approach when:

• There is active infection at the tooth. Per AAOMS clinical guidance, infection is a relative contraindication and usually needs to clear first.

• Significant bone loss means a graft must mature before an implant has anything to anchor to.

• You take high-dose bisphosphonates or have uncontrolled diabetes.

• You smoke heavily. Multiple meta-analyses, including Cochrane reviews, link smoking to significantly higher implant failure rates.

• The gum tissue around the tooth is too thin or recessed to give a good esthetic result.

Pushing a same-day placement when the site is not ready trades a short timeline for a higher risk of failure. Not worth it.

Pros and cons of same-day vs delayed placement

Advantages of same-day:

• One surgery, one recovery

• Preserves the natural bone shape of the socket. Research by Schropp and colleagues showed extraction sites can lose a substantial percentage of bone width in the first 6 months if nothing is placed.

• Shorter total timeline from start to finished crown

• Often easier on working parents and commuters who cannot take repeat time off

Trade-offs of same-day:

• More technically demanding for the dentist

• Not every site qualifies

• You may still wait months for the permanent crown

Advantages of delayed:

• Fully healed bone is predictable

• Infection can be cleared first

• Grafting can be done and matured before placement

Trade-offs of delayed:

• Longer overall timeline

• Possible bone shrinkage between extraction and placement, sometimes requiring a graft you would not have otherwise needed

What the same-day appointment looks like

If you are a candidate, here is the flow at our Pacific Highway office:

Before the visit: A 3D CBCT scan lets us measure bone in three dimensions. The American Academy of Oral and Maxillofacial Radiology considers CBCT the standard for implant planning when good visualization is needed. We plan the implant size, angle, and depth before you sit down.

During the visit: We numb the area, then remove the tooth using techniques that protect the socket walls. The implant goes into the prepared site. If there are small gaps between the implant and the bone wall, we fill them with graft material. A healing cap or, in select cases, a temporary crown finishes the visit.

Going home: Soft diet for a few days. Saltwater rinses. No straws, no smoking. Most patients drive themselves home and return to a desk job the next day. We schedule a quick check within two weeks.

Recovery and next steps after immediate placement

The implant needs 3 to 6 months to fully integrate with bone. During that window you can eat, talk, and work normally. We avoid heavy chewing directly on the site.

Normal sensations include mild tightness, brief tenderness for a week or two, and a sense of the area "settling." Call us right away if you notice increasing pain after the first few days, swelling that gets worse instead of better, a bad taste, or a feeling that the implant is moving.

Once your dentist confirms full integration, the final crown gets placed. From that point, a well-cared-for implant can last decades. Brush, floss, keep your cleanings. Simple as that.

Frequently Asked Questions

Is a same-day implant more painful than a delayed implant?

Most patients report it is roughly the same, or even less, because there is only one surgical recovery instead of two. The extraction itself is usually the more noticeable part. We manage discomfort with local anesthesia during the visit and over-the-counter pain relievers afterward. Most Tigard patients are back to normal activities within a day or two.

Will I leave the appointment with a tooth or a gap?

It depends on the location. For visible front teeth, we often place a temporary crown or a removable flipper so you do not walk out with a gap. For back teeth, many patients are comfortable with a healing cap that sits at the gumline until the final crown is ready. We discuss the plan before the appointment so there are no surprises.

How much does an immediate implant cost compared to delayed placement?

Pricing varies by case, but combining extraction and implant placement into one visit often costs slightly less in total than splitting them into separate surgeries, because there is one surgical fee instead of two. Bone grafting, sedation, and the final crown are billed separately in either timeline. Call our office at (503) 639-4330 for a personalized estimate.

What is the success rate for immediate implants?

Peer-reviewed implant literature reports survival rates for well-selected immediate implants in the range of 94 to 98 percent over 1 to 5 years, comparable to delayed placement. The key phrase is "well-selected." That is what the CBCT scan and clinical exam confirm before we commit to same-day placement.

Can I get a same-day implant if I need a bone graft?

Sometimes yes. Small gaps between the implant and the socket wall can be filled with graft material during the same visit. Larger defects, or sites with substantial bone loss, usually need the graft to heal first, then the implant goes in a few months later. Your scan tells us which path makes sense.

If you are weighing extraction and implant timing, we are happy to walk you through your scan and options. Inspire Dental is on SW Pacific Hwy in Tigard, easy to reach from Bull Mountain, King City, Tualatin, and Sherwood. Call us at (503) 639-4330 to schedule a consultation.