Implants may require multiple surgeries and appointments spread out to allow for plenty of time to heal and adjust. The entire process can take nine months or more. Individual surgeries can take one to several hours, depending on factors such as the type of implant used, how many implants are being placed and if any other procedures (e.g., tooth extraction) are occurring at the same time.

The surgery to place the implant in the jawbone may occur in the dental office or in a hospital. It may be performed under local anesthesia, intravenous (I.V.) sedation or, in some cases, general anesthesia. During this surgery, an incision is made in the gums and a hole for the implant is drilled into the bone. The implant is inserted and x-rays may be taken to ensure that it is properly located. Then, a cover screw is placed over the implant and the gum tissue is sutured (stitched) over the implant and bone. The stitches may be resorbable, which means that they dissolve into the gum, or they may need to be removed. If they need to be removed, this usually occurs around 7 days after the surgery.

The area will be sore and the gums will be tender and swollen after the surgery. Dentists generally prescribe pain medication to ease this discomfort. Antibiotics may also be prescribed to prevent infection. The patient will need to eat soft foods while the gums are healing and the area needs to be treated very gently. It is typically recommended that the patient does not attempt to clean the immediate area for a week or two while it heals. Dentists may provide an antibacterial rinse to help with oral hygiene and generally advise the patient against spitting, drinking with straws or smoking. Patients may be given a temporary bridge or denture to wear so that they do not have to be without teeth during the healing process.

The next surgery takes place from two to six months later, after the jawbone has fused with the implant, firmly anchoring it. In this surgery, the abutment that will support the restoration is attached. This surgery is less invasive than the first, but still requires  local anesthesia. An incision is made in the gum to expose the head of the implant. Then, the cover screw is replaced with a healing abutment, which protrudes above the gum. This allows the gum to heal in the correct shape around the abutment before the crown, bridge or denture is attached. Since this is not as extensive as the surgery to place the implant, the patient will typically feel less discomfort. However, the dentist will still usually prescribe pain medications and recommend soft food during the healing process.

Lately, some surgeons have been using a one stage technique where a healing abutment is attached to the implant at the time of insertion, thereby eliminating the need for a second uncovering procedure. After a period of healing, the restoration (e.g., crown, bridge, denture) is attached to the abutment. Sometimes, the restoration is immediately attached to the implant (immediate loading)  but this may not be feasible in all cases

If the implant appears to be loose during this surgery, it is considered to have failed and will be removed. The dentist may attempt to immediately insert another implant (after widening the hole in the bone slightly) or may seal the area to allow it to heal before making another attempt.

Patients with implants should continue to have regular dental examinations and be diligent about their oral hygiene. With such maintenance, implants can last a very long time.