Can I get dental implants if I have been told I do not have enough bone?

What bone loss means for implants, and the options that may still be open to you.

Dr Bill Kalis — Saturday 14 November 2026

Often, yes. Being told you do not have enough bone does not always rule out dental implants. A 3D scan shows exactly how much bone you have, and in many cases bone can be rebuilt with a graft or the plan can be changed to suit the bone that is there.

I am Dr Bill Kalis, principal dentist at Padstow Dental in Padstow, Sydney. This is a question I am asked often, usually by people who lost a tooth years ago.

Why does bone shrink after a tooth is lost?

Jawbone needs the pressure of chewing through a tooth root to stay in shape. Once a tooth is removed, the bone in that spot slowly shrinks. Gum disease, infection and long-term denture wear can speed this up.

How do you measure how much bone I have?

We use a 3D scan (CBCT), taken on site. It shows the height, width and density of the bone, and where nerves and sinuses sit. An ordinary flat X-ray cannot show this fully. A 3D scan at Padstow Dental is $175.

What is a bone graft?

A bone graft adds bone material to an area that is too thin or too short to hold an implant. Over several months your own bone grows into it. A small graft can sometimes be done at the same visit as the implant. A larger graft is done first and left to heal before the implant is placed.

What is a sinus lift?

A sinus lift is a type of bone graft for the upper back teeth, where the sinus sits close to the jaw. Bone is added below the sinus to make room for an implant. Not everyone needs one, and your scan will show whether you do.

What is piezo surgery, and how does it help?

Piezo surgery uses a fine ultrasonic tip, in place of a conventional drill or saw, to cut bone with a high level of control. It is designed to work on bone while being gentle on the soft tissue around it, such as nerves and the lining of the sinus. I have a surgical piezo unit at Padstow Dental and use it for more complex cases.

It makes several procedures possible at our practice:

• Bone splitting: a ridge that is too narrow is gently widened to make room for an implant

• Minimally invasive sinus lifts: bone is added beneath the sinus through a small opening

• Removing very difficult teeth while preserving the bone: the tooth is eased out with as little bone loss as possible, so the site is ready for an implant

Is it better to preserve bone than to rebuild it?

Yes. It is always better to keep the bone you have than to wait, lose it and then try to rebuild it. Bone starts to shrink once a tooth is lost, and rebuilding it takes more surgery, more time and more cost.

If a tooth cannot be saved, the best time to plan its replacement is before it comes out. Removing the tooth carefully and preserving the socket often means a simpler implant later. If you have been told a tooth needs to be removed and you may want an implant, ask about bone preservation first.

What if a graft is not right for me?

There are other options, depending on your scan:

• A shorter or narrower implant

• Placing implants where the bone is better and bridging between them

• An implant-retained denture, which can need fewer implants

• A conventional bridge or denture

Does grafting add time and cost?

Yes. A graft usually adds several months of healing and an additional fee, which we quote after your scan. Smoking, poorly controlled diabetes and some medications affect how well grafts heal, so we discuss your health first.

Fees are a guide only. Treatment costs are confirmed after your consultation.

Common questions about bone and implants

Is bone grafting painful?

It is done under local anaesthetic, with IV sedation available. Some swelling and discomfort afterwards is normal and is managed with the pain relief we prescribe.

Where does the graft material come from?

Several materials are used, and we explain the options and what we recommend for you before you decide.

Am I too old for a bone graft?

Age alone is not a barrier. General health and healing matter more.

I have been told my tooth has to come out. Should I plan the implant now?

Yes, if you can. Planning before the tooth is removed gives the best chance of preserving the bone.

Is a second opinion worthwhile?

Yes. If you have been told implants are not possible, a 3D scan and a second opinion are reasonable next steps.

Find out where you stand

Book an assessment on 02 9773 4775, or read about dental implants at Padstow Dental and what happens before an implant is placed.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Written by Dr Bill Kalis, Principal Dentist at Padstow Dental. BDS (Hons), University of Sydney, 1994. Graduate Certificate in Clinical Dentistry, University of Adelaide, 2007. Past State and Federal President of the Australian Society of Implant Dentistry. Dr Kalis is a general dentist with a focus on implant, surgical and IV sedation dentistry.