The short answer
You can book with any dental office in Ontario without a doctor's referral. After an exam, your dentist usually sends you for a 3D scan, often at a separate imaging centre, then gives you a written plan and estimate. Surgery is usually done in a dental office under local anaesthetic, followed by a few months of healing before the final crown, bridge or denture is made. Some steps may happen at a specialist's office.
The eight stops
Most people go through the same stops in the same order. Some get skipped, some take longer, and a couple may happen somewhere other than your dentist's office.
- Your own dentistOr any dental office you choose. No doctor's referral needed.
- The assessmentHistory, exam, ordinary X-rays and a first talk about options.
- Imaging and referralsUsually a 3D scan, often at an imaging centre.
- The written planStages, any preparatory work, and an itemized estimate.
- SurgeryPlacing the implant, usually in a dental office.
- HealingA few months while the bone bonds to the implant.
- The final toothA crown, bridge or denture made with a dental lab.
- MaintenanceHome care and regular check-ups, for as long as you have it.
1. Starting with your own dentist
In Ontario you can call a dental office directly and ask for an implant consultation. You don't need a referral from a family doctor, and you don't need to start with a specialist.
If you already have a dentist, they're the natural first stop. They know your history and have your old X-rays. Some general dentists plan, place and restore implants themselves. Others do the planning and the final tooth and refer the surgery out. Either arrangement is common, and it's fine to ask which one your dentist uses.
Do you place implants yourself, or would you refer part of the treatment to someone else?
2. The assessment
The first visit is an exam and a conversation. The dentist goes over your health and medications, checks your gums, bite and the space itself, takes ordinary dental X-rays and talks through options, including bridges, dentures and waiting. Nothing surgical happens.
Our sister site has a detailed guide to what happens at an implant consultation.
3. Imaging and referrals
Flat X-rays can't show how wide the bone is or exactly where a nerve or sinus sits. That's why professional guidelines recommend cross-sectional imaging, usually a cone beam CT (CBCT) scan, when an implant is being planned.
Many offices don't have a scanner, so your dentist may refer you to a dental imaging centre. The scan is quick. The images and a report then go back to your dentist, and you'll usually see them at your next visit rather than on the day. Our guide to imaging and referrals in Ontario explains who orders the scan, who reads it and how the records move between offices.
4. The written plan
With the scan in hand, your dentist decides whether the site can hold an implant, what size and position would work, and whether anything has to happen first. A complete plan usually spells out:
- How many implants, where, and what they'll carry (a crown, a bridge or a denture)
- Any preparatory work: taking out a failing tooth, a bone graft, a sinus lift or gum treatment
- Who does each stage, and where
- Whether sedation is proposed for the surgery
- The risks, the alternatives and an itemized estimate for each stage
Preparatory work is where timelines stretch. A grafted site has to heal before an implant goes in, and how long that takes depends on how big the graft is, what material is used and how you heal. Sometimes the graft and the implant go in at the same appointment. Ask which applies to you.
If you have dental benefits, this is the point to send the estimate to your insurer for a pre-determination. Our guide to dental implant costs in Ontario covers estimates and insurance.
Will I need any preparatory work, and does it add a separate healing stage?
5. Surgery
Placing an implant is a planned surgical procedure, usually done in a dental office under local anaesthetic, with you awake and the area frozen. Some people also have sedation. In Ontario that is regulated by the Royal College of Dental Surgeons of Ontario (RCDSO): the dentist needs RCDSO authorization for the method used, and offices offering moderate or deeper sedation need a facility permit. The details are in our guide to sedation and anaesthesia rules in Ontario.
If a specialist is doing the surgery, this stop happens at their office, and you go back to your own dentist afterwards.
6. Healing
After placement, bone grows onto the implant surface. This is called osseointegration, and it's what lets an implant carry a tooth. Conventionally, the implant is left to heal for a few months before the final tooth goes on, with short check-ups along the way.
In selected cases a temporary tooth can be attached at or soon after surgery. A Cochrane review found this can work well when the implant is very stable at placement, but it isn't suitable for everyone, and the final tooth still comes after healing. For what the weeks after surgery feel like, see the healing and recovery timeline.
7. The final tooth
Once the implant is stable, your dentist records its position with scans or impressions, and a dental laboratory makes the crown, bridge or denture. Expect a fitting visit or two while the bite is checked and adjusted.
8. Maintenance
An implant can't decay, but the gum and bone around it can become inflamed if plaque builds up, and that inflammation is the main long-term risk. Daily cleaning, regular hygiene visits and periodic checks of the implant and bite are what keep it healthy.
Systematic reviews report implant survival of approximately 94 to 96 percent at ten years. Individual results vary, and survival isn't the same as being trouble-free, which is why the check-ups matter.
Who does what
Examines you, refers you where needed, makes the plan and usually coordinates the rest.
Takes the 3D scan and sends the images and report back to your dentist.
A periodontist or oral and maxillofacial surgeon may do grafting or surgery on more complex cases.
Makes the crown, bridge or denture from your dentist's records.
Know who's coordinating
When more than one office is involved, ask at the start who is responsible for the overall plan, and make sure each office knows who else is treating you. It's the simplest way to avoid repeated X-rays and missed steps.
Who is coordinating my treatment, and who do I call if I have a question between visits?
How long the whole thing takes
Several months is typical. The things that add time are specific: an extraction that needs to heal, a graft or sinus lift, gum disease that has to settle, or a referral that adds an extra round of appointments. The treatment timeline guide shows where each of those fits. Your own dentist can only give you real dates after the exam and scan.
Common questions
Do I need a referral to get dental implants in Ontario?
No. You can contact a dental office directly. Referrals happen inside the process instead: your dentist may send you to an imaging centre for a scan, or to a specialist for part of the treatment.
Is implant surgery done in a hospital?
Usually not. Most implant surgery is done in a dental office under local anaesthetic, with or without sedation. Offices that provide moderate sedation, deep sedation or general anaesthesia need an RCDSO facility permit for that level.
Can my regular dentist do the whole thing?
Some general dentists plan, place and restore implants themselves, and refer only more complex cases. Others refer the surgery and do the final tooth. Ask your dentist how they work.
Can I change dentists partway through?
Yes. Ask for copies of your records, including the scan and the treatment plan, so the new office can pick up where things left off without repeating imaging unnecessarily.
References
- Tyndall DA, Price JB, Tetradis S, Ganz SD, Hildebolt C, Scarfe WC. Position statement of the American Academy of Oral and Maxillofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(6):817-826.
- Buser D, Sennerby L, De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontol 2000. 2017;73(1):7-21.
- Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Interventions for replacing missing teeth: different times for loading dental implants. Cochrane Database Syst Rev. 2013;(3):CD003878.
- Moraschini V, Poubel LA, Ferreira VF, Barboza ES. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. Int J Oral Maxillofac Surg. 2015;44(3):377-388.
- Howe MS, Keys W, Richards D. Long-term (10-year) dental implant survival: a systematic review and sensitivity meta-analysis. J Dent. 2019;84:9-21.
- Heitz-Mayfield LJA. Peri-implant diseases: diagnosis and risk indicators. J Clin Periodontol. 2008;35(8 Suppl):292-304.
- Royal College of Dental Surgeons of Ontario. Standard of Practice: Use of Sedation and General Anesthesia in Dental Practice (approved November 2018; checked October 2026). rcdso.org
