The prevalence of dental implant treatment raises the question: What factors may challenge osseointegration? The dental literature presents two main approaches, which are well-documented: loss of bone around the implant due to infection and a presumed association between implant load and bone loss. This article discusses the effect of load or overload on the bone loss around dental implants. The dental literature is reviewed to assess the scientific evidence related to the effect of occlusal load on osseointegration. Recommendations found in the literature for occlusal schemes for implant-supported prostheses are examined and discussed, and statements regarding implant occlusion are assessed for their validity today, after more than four decades of implants service in prosthetic dentistry.