what happens if a dental implant fails

Implant failure is uncommon, but it does happen, and knowing what it looks like and what comes next takes away much of the fear. A failed implant is a setback, not usually a disaster, and most people still end up with a working tooth.

Early failure and late failure

Early failure happens in the first weeks or months, before the crown is fitted. The bone simply does not fuse with the implant. Common reasons are infection at the site, smoking, poorly controlled diabetes, too little bone, overheating of the bone during drilling, or too much pressure on the implant while it was healing, for example from chewing on it or a denture pressing on it.

Late failure happens after the implant has been working, sometimes for years. The main culprit is peri-implantitis, an infection that destroys the bone around the implant. Heavy grinding, a crown that takes too much bite load, and poor cleaning add to the risk.

Signs to watch for

• The implant or crown moves when you press it or bite.
• Pain on biting that is new or getting worse.
• Swelling, bleeding or pus around the implant, or a constant bad taste.
• Gum receding so that metal shows.

A loose crown is not the same as a failed implant. Often it is only the small screw that holds the crown, which is a quick fix. Your dentist can tell the difference with an examination and an X-ray.

What happens next

1. Assessment: examination and X-rays to see how much bone is left and why the implant failed. Finding the cause matters, or the next implant faces the same problem.
2. Removal: a failed, loose implant usually comes out easily under local anaesthetic. Discomfort afterwards is often less than the original surgery.
3. Cleaning and grafting: any infected tissue is removed. A bone graft is often placed to rebuild the site.
4. Healing: typically a few months before a new implant can be considered.
5. Re-placement or another option: many sites can take a second implant, sometimes a slightly wider or longer one. If the cause cannot be controlled, a bridge or partial denture may be the more sensible choice.

Can an infected implant be saved?

Sometimes. If peri-implantitis is caught early, before the implant is loose, deep cleaning, antiseptic treatment and sometimes gum surgery can stop the bone loss. That is the work of a gum specialist; see our periodontics department. Once the implant moves, it cannot be re-fused and needs removal.

Reducing the chance of failure

• Stop smoking and all tobacco, at the very least around surgery.
• Get blood sugar controlled before surgery if you are diabetic.
• Follow the healing instructions; do not chew on a new implant until you are told it is ready.
• Wear a night guard if you grind.
• Keep cleaning and check-ups going for life.

Ask before you start

Before agreeing to any implant, anywhere, ask what happens if it fails: who removes it, what a replacement would cost, and which parts of that are covered. Get the answer in writing in your treatment plan. A clear answer is a good sign. If you need to compare options for a gap, see our missing tooth replacement page, and if an implant becomes painful or swollen, call 8484 990 678.