7 min read • By Dr. Kevin Baharvand, Diplomate, American Board of Orthodontics
SHORT ANSWER
In almost every case, orthodontics comes first and the implant afterward. An implant is anchored into bone and cannot be moved by braces or aligners, ever. So we straighten the natural teeth, open the exact space the implant needs, and only then does your dentist or oral surgeon place it. Doing it the other way round locks a tooth into a position that may turn out to be wrong, and limits what orthodontics can achieve for the rest of your mouth.
ON THIS PAGE
I get this question almost every week, usually from an adult who is missing a tooth, already knows they want an implant, and is trying to work out the order. It is a good question to ask before anything starts, because this is one of the few sequencing decisions in dentistry that is genuinely hard to undo.
Why an implant almost always waits
A natural tooth sits in a socket, suspended by a periodontal ligament. When we apply gentle pressure, that ligament signals the bone to remodel: bone dissolves on one side and rebuilds on the other, and the tooth moves. That process is the entire basis of orthodontics.
A dental implant has no ligament. The titanium post is fused directly to the bone, which is exactly what makes implants so stable and so successful. It also means orthodontic force accomplishes nothing. You can push on an implant indefinitely and it will not move.
So an implant placed before orthodontics is a permanent decision made before you know where the teeth are going to end up. If the plan later calls for that space to be a millimeter wider, or slightly further forward, or angled differently, the implant cannot accommodate any of it.
This is the opposite of the crown answer, which is why the two get confused. A crowned tooth still has its natural root and moves normally, so crowns can usually wait until the end. The difference is anatomy, not procedure.
The space problem nobody expects
Here is the part people find genuinely surprising. When a tooth has been missing for a while, the neighbouring teeth drift into the gap. They tip toward it at the crown and, importantly, their roots often tip too, sometimes in a different direction than the crowns.
So the space might look about the right width in the mirror, while the roots underneath are leaning into it. An implant needs adequate room between the roots, not just between the visible crowns. Placing one into a space that is only superficially adequate risks damaging the neighbouring roots.
Part of what orthodontics does before an implant is upright those roots and create genuinely parallel space of the right dimension. That is invisible work in a mirror and it is often the main clinical reason for treating first.
If you already have an implant
This is common and it is not a barrier to treatment. It changes the planning, because the implant becomes a fixed point that everything else has to be organized around.
Sometimes that is an advantage. An immovable anchor is genuinely useful in orthodontics, and we occasionally place temporary anchorage devices deliberately for exactly that purpose. An existing implant can serve a similar role.
Sometimes it is a constraint that means accepting a compromise elsewhere. If the implant sits where the ideal plan wanted a tooth to move, something has to give, and it will not be the implant. I would rather explain that clearly at the consultation than have you discover it later.
When an implant might come first
There are real exceptions, and they are worth naming so this does not read as an absolute rule.
| Situation | Why the order can change |
|---|---|
| Bone is actively being lost | Bone in an empty site resorbs over time. If waiting two years would mean losing the site or needing a graft, placing sooner can be the better trade. |
| The implant is needed as an anchor | Occasionally an implant is placed deliberately in a position that will serve as anchorage for the orthodontics that follows. Planned jointly, not incidentally. |
| The site is far from the work | A back molar implant in an area orthodontics will not touch may be safe to place first. |
| Limited orthodontic treatment only | If the plan is genuinely confined to a few teeth elsewhere, the implant site may be unaffected. |
Every one of those requires the orthodontist and the surgeon to have discussed it. The bad outcome is not choosing the wrong order deliberately. It is nobody choosing an order at all.
Living with the gap in the meantime
The practical objection people raise is entirely reasonable: they do not want a visible gap for two years. Fair, and it is manageable.
During treatment, a temporary tooth can be attached to the archwire or built into the aligner so the space is filled while it is being shaped. Afterward, and before the implant is placed and healed, a retainer with a tooth built into it does the same job. Neither is as good as the final implant, and both are considerably better than a gap.
Holding the space is not optional either way. Teeth drift into any gap left unattended, which is what created the problem in the first place.
Plan it together, not sequentially
The single most useful thing you can do is get everyone talking before anything starts. Your orthodontist knows where the teeth are going. Your surgeon knows what the site needs. Those two facts have to meet before the first bracket or the first drill.
Ask both providers directly whether they have discussed your case. It is a completely normal request, it takes one call, and it is the difference between a coordinated plan and two good plans that happen to conflict.
An implant is permanent from the day it integrates. Decide where it goes after you know where everything else ended up, not before.
Frequently asked questions
Why can braces not move a dental implant?
Because an implant is fused directly to bone, a process called osseointegration. Natural teeth sit in a socket cushioned by a ligament, and that ligament is what allows bone to remodel and the tooth to move. An implant has no ligament, so orthodontic force does nothing to it.
What happens if I already have an implant?
We plan around it. It becomes a fixed reference point, which is sometimes genuinely useful as an anchor and sometimes a constraint that limits what the final result can be. Either way, tell us at the consultation and we will show you what it means for your case.
Can an implant be removed and replaced if it is in the wrong spot?
It can, but it is surgery, it often involves bone grafting, and it means healing time before a new implant goes in. That is why sequencing correctly the first time matters so much.
How long after braces before I can get the implant?
Usually a short settling period after the appliances come off, so the teeth stabilize in their new positions. Your orthodontist and surgeon will agree the timing. In the meantime a temporary tooth keeps the space open and lets you eat and smile normally.
What holds the space open in the meantime?
Usually a temporary tooth attached to the appliance during treatment, then a retainer with a tooth built into it afterward. The space has to be actively held, because teeth drift into any gap left alone.
Is this the same as the answer for crowns?
No, and this catches people out. A crowned tooth still has its natural root, so it moves normally and the crown can often wait until the end. An implant has no root and never moves. Different anatomy, different sequencing.
Missing a tooth and considering an implant?
Come in before the implant is placed. Consultations are free. Two Frisco offices plus The Colony.
You may also be interested in these
- Should You Get a Crown Before or After Braces?
- Adult Braces in Frisco: Costs, Insurance, and Timelines
- What Causes Gaps in Teeth and How to Fix Them
Why families trust Elate Orthodontics
1,000+ five-star reviews • 3 offices (two in Frisco, one in The Colony) • D Magazine Best Dentist 2026 • Living Magazine Readers’ Choice 2026
With over 1,000 five-star reviews across three locations, Elate Orthodontics is led by Dr. Kevin Baharvand, DMD, MS, a Diplomate of the American Board of Orthodontics, whose clinical work was recently selected for the cover of the American Journal of Orthodontics and Dentofacial Orthopedics, the most prestigious peer-reviewed journal in the field, and a national speaker on clear aligner treatment. Alongside Dr. Julia Kang, DMD, MS, both Boston University graduates and members of the Omicron Kappa Upsilon national honor society, our husband-and-wife team has been recognized as D Magazine Best Dentist 2026, Living Magazine Readers’ Choice 2026 Best Orthodontist in Frisco & Plano, Readers’ Choice Best Orthodontist in The Colony, Best New Business by the Chamber of Commerce, Nextdoor Neighborhood Favorite, and featured in Orthotown and Authority Magazine.
We serve families through three convenient offices in West Frisco, North Frisco, and The Colony, each staffed by the same trusted team, equipped with advanced technology, and committed to the personalized approach that consistently helps patients finish treatment sooner than expected. From braces and clear braces to Angel Aligners, we offer treatment for every age and every stage of life. We stay in-network with most insurance plans and offer flexible financing to make exceptional orthodontic care accessible for every family we serve.
Need general and family dentistry too? Our sister practice, Tribute Family Dentistry, provides dental care for all ages.
Book a free consultation: 972.538.4343
About the author
Dr. Kevin Baharvand, DMD, MS, is a Diplomate of the American Board of Orthodontics and a national speaker on clear aligner treatment. He practices at Elate Orthodontics in West Frisco, North Frisco, and The Colony, Texas.
