Immediate Implants After Extraction UK: When It Works in 2026

TL;DR

An immediate implant after extraction is placed into a fresh socket the same day the tooth comes out. In the UK in 2026, it works well for carefully chosen single teeth in the front of the mouth with intact bone, healthy gums and no active infection. Fees usually sit between 2,500 GBP and 4,500 GBP per tooth, including the extraction, implant, bone graft and temporary crown. Success rates in good hands are close to conventional placement, but the wrong case can lose the implant or ruin the gum line. Most UK surgeons still delay placement when the socket is infected, the bone is thin, the bite is heavy or the patient smokes.

What an immediate implant after extraction actually means

An immediate implant is a titanium or zirconia screw placed into the tooth socket on the same visit as the extraction. It is often called immediate placement, same day implant or Type 1 placement in the International Team for Implantology classification.

It is not the same thing as immediate load or same day teeth, where a fixed crown or bridge is fitted on the implant during the same visit. You can have immediate placement with delayed loading, immediate placement with immediate loading, or delayed placement with delayed loading. UK surgeons pick the combination that fits your bone, bite and aesthetics, not the one that sounds fastest in marketing.

The Royal College of Surgeons of England Faculty of Dental Surgery restorative standards recognise immediate placement as a valid technique when case selection is strict. The General Dental Council expects any dentist offering it to be trained in surgical implantology and to justify the choice in your notes.

When immediate placement after extraction actually works

Immediate implants work best in a narrow band of cases. UK surgeons trained through the British Society of Oral Implantology and the Association of Dental Implantology tend to agree on the following green flags:

A single upper front tooth, upper premolar or lower incisor being removed because of fracture, root resorption or a failed root canal, not because of active gum disease.
Thick, intact bone walls around the socket, confirmed on a CBCT scan.
Healthy pink gum with no swelling, pus or sinus tract.
A stable bite with no severe grinding.
A non smoker, or a patient who has stopped smoking at least 4 weeks before surgery.
Good oral hygiene, controlled diabetes if present, and no untreated periodontal disease elsewhere in the mouth.

In these cases, the surgeon can place the implant with primary stability, fill the small gap between implant and bone wall with a graft, and often fit a temporary crown that keeps the gum shape. Long term outcomes reported on PubMed indexed studies sit above 95 percent survival at 5 years for well selected single tooth cases.

When immediate placement does not work: cases where UK surgeons wait

Not every failing tooth is a candidate. The following situations usually push a UK implant surgeon towards extraction, socket preservation and delayed placement 8 to 16 weeks later:

Active abscess, pus, mobile bone fragments or a large periapical lesion.
Thin or missing buccal bone wall on the CBCT, which risks recession and a grey shadow through the gum.
Heavy occlusion, bruxism without a nightguard, or a full arch of failing teeth.
Current smoker of more than 10 cigarettes a day, or vaping heavily without a plan to reduce.
Uncontrolled diabetes, active periodontitis, bisphosphonate or antiresorptive therapy for cancer, or recent head and neck radiotherapy.
Molar sockets with three or four wide roots and thin septal bone, where primary stability is hard to reach.

For these cases, the socket is often preserved with a bone graft at extraction, allowed to heal, and the implant is placed later using the standard step by step surgical protocol. Waiting is not a failure of technology. It is often the safest way to protect the final gum line and the bone.

Typical UK costs for immediate implants in 2026

Immediate placement is a technique add on, not usually a discount. Expect the fees to sit at the higher end of the national implant price range for 2026 because the surgeon is doing extraction, graft, implant and often a temporary in one visit.

Indicative 2026 UK private fees, drawn from published clinic price lists and British Dental Association fee survey commentary:

Consultation and CBCT: 150 GBP to 350 GBP.
Atraumatic extraction with socket preservation graft: 250 GBP to 600 GBP.
Immediate implant placement: 1,800 GBP to 2,800 GBP.
Bone graft particulate and membrane in the gap: 200 GBP to 500 GBP.
Immediate temporary crown, if fitted: 300 GBP to 800 GBP.
Final zirconia or lithium disilicate crown at 3 to 6 months: 900 GBP to 1,800 GBP.

A single immediate implant with a temporary and a final crown therefore usually lands between 2,500 GBP and 4,500 GBP in 2026, higher in central London. The NHS does not routinely fund elective implant treatment, and the NHS dental treatment pages confirm implants are only available on the NHS in a small number of specialist referral cases with clear clinical need.

What happens on the day of your immediate implant

A well run UK appointment usually follows this sequence, and takes 90 to 150 minutes:

Local anaesthetic and, if you have chosen it, oral or intravenous sedation.
Atraumatic extraction using periotomes or piezo instruments to protect the bone walls.
Thorough debridement of the socket to remove infected tissue and granulation.
CBCT verification if not already done, or careful clinical measurement.
Guided or freehand implant placement into the palatal or lingual bone, not into the empty socket space.
Bone graft particulate placed in the gap between implant and buccal wall, often with a collagen membrane.
Cover screw, healing abutment or immediate temporary crown fitted, depending on primary stability.
Suturing, written aftercare and a plan for the next review at 7 to 10 days.

You go home the same day. Painkillers, an antiseptic mouthwash and a soft diet are standard. Our guide to what to eat in the first weeks after implant surgery covers the food side in detail.

Healing and loading: the truth about same day teeth

Even when the implant is placed and a temporary crown is fitted on the day, that temporary is almost always taken out of the bite. It is there for looks and to shape the gum, not to chew on. The bone needs 3 to 6 months to fully integrate with the implant surface, as our dental implant healing timeline explains.

Loading the implant too early, or letting it be knocked repeatedly by the opposite tooth, is one of the main reasons an immediate case fails. A responsible UK surgeon will:

Adjust the temporary crown so it is out of contact when you close your teeth together.
Ask you to avoid biting anything hard on that tooth for at least 8 to 12 weeks.
Review at 1 week, 4 weeks and 3 months before fitting the final crown.
Take a follow up radiograph to confirm bone levels before final restoration.

If your clinic promises a permanent, fully loaded crown on the same day of a single tooth extraction, ask for the evidence, ask about the primary stability recorded in Newtons or ISQ, and ask what happens if the implant loosens in the first month.

Success rates and long term evidence

Modern peer reviewed evidence on PubMed shows single tooth immediate implants in well selected cases have 5 year survival rates broadly similar to delayed placement, in the 94 to 98 percent range. The main differences are aesthetic. Immediate cases can suffer 0.5 mm to 1 mm of gum recession on the buccal side in the first year, especially when the bone wall is thin or the patient has a thin gum biotype.

Long term risks include:

Mid buccal recession that shows a grey metal shadow through the gum.
Loss of the papilla between the implant and the neighbouring tooth.
Early implant failure in the first 3 months if primary stability was borderline.
Late peri implantitis if hygiene, smoking or diabetes are not controlled.

Case selection, not marketing, drives the numbers. A skilled UK surgeon working within Faculty of Dental Surgery guidance will refuse borderline cases rather than force them.

What to ask your UK implant surgeon before saying yes

Before committing to an immediate implant, ask the following at your consultation and expect written answers:

Do I have enough intact buccal bone on the CBCT, and how thick is it in millimetres?
Is my gum biotype thick or thin, and does that change your plan?
What primary stability do you expect to record on the day, in Newton centimetres or ISQ?
Will you place a temporary crown, and will it be in or out of the bite?
What graft material and membrane will you use, and where is it sourced?
What is your personal 5 year success rate for immediate cases, and how do you audit it?
What is the written plan and cost if the implant fails in the first year?
Are you GDC registered and specifically trained in surgical implantology?

Getting a written treatment plan is your right under GDC standards. If a clinic refuses to put the cost, materials and contingency plan in writing, walk away.

Frequently asked questions

Can any tooth be replaced with an immediate implant?

No. Immediate placement works best for single failing teeth with intact bone walls and no infection. Multi rooted molars, teeth with active abscesses and cases with thin or missing bone usually need delayed placement after 8 to 16 weeks of healing.

How painful is an immediate implant after extraction?

Most UK patients report the same discomfort as an ordinary extraction, controlled with paracetamol and ibuprofen for 2 to 3 days. Swelling peaks at 48 to 72 hours and settles within a week. Sedation is available in most private clinics if you are anxious.

Will I have a tooth on the day, or leave with a gap?

It depends on the primary stability of the implant and the surgeon's judgement. Options include an immediate non functional temporary crown, a removable temporary denture, an Essex retainer with a false tooth, or a healing abutment with no tooth. Front teeth are almost always temporised in some way.

Do immediate implants last as long as conventional implants?

In well selected single tooth cases, yes. Peer reviewed 5 to 10 year data on PubMed shows similar survival rates. Long term maintenance, hygiene and control of smoking and diabetes matter more than the timing of placement.

Can I have an immediate implant on the NHS?

Almost never. The NHS funds implants only in a small number of specialist cases, usually for cancer, trauma or severe congenital conditions, and referral criteria are strict. The NHS dental treatment pages confirm implants are not routinely offered as a general adult service.

What happens if the immediate implant fails?

Early failures usually show as increasing pain, mobility or the implant coming out with the temporary. The socket is cleaned, allowed to heal and a new implant is placed 3 to 6 months later, often with a bone graft. A reputable UK clinic will replace an early failed implant at reduced or no fee, and the written treatment plan should state this in advance.

How do I know a UK clinic is a safe choice for this?

Check GDC registration for the treating dentist, look for postgraduate implant qualifications, ask how many immediate cases they place a year, request written costs and contingency, and ask to speak to previous patients if possible. Membership of the Association of Dental Implantology or British Society of Oral Implantology is a useful additional signal, not a guarantee.