I get asked this question quite a bit, and the truth is that every situation is different. The one certainty is that sooner is better once the tooth socket has healed. In fact, often the best time to get an implant is the day that the tooth is removed. Implants and bone grafts tend to preserve the bone contours of your jaw. When you lose a tooth and the area is allowed to heal naturally, some of the bone is generally lost, and that can compromise the ability to replace the tooth with an implant or to place the implant in the best position possible to allow for a more natural look to the implant crown. I generally recommend a bone graft at the time of the tooth extraction if the implant can’t be immediately placed, and if there is no severe infection in the area. Research shows that these grafts cause more symmetrical healing, and prevent loss of bone height. In some cases, this is the difference between being able to eventually place an implant and having to do more bone grafting or give up on an implant altogether. Now, just because you lost a tooth 20+ years ago, it doesn’t mean that an implant isn’t possible. What it does mean is that some bone grafting may be necessary prior to implant placement, and you may have to wait 6-12 months to have the implant placed. Like I said earlier, every situation is different, so you won’t know about your options unless you see a periodontist to allow him or her to evaluate you as an individual to determine the viability of implant placement in your mouth.