How common implant failure is, and the two kinds
Implant failure is not common, but it can happen. In a large ten-year clinical study of 511 implants in 303 patients, 98.8% of the implants were still in place and 97% were counted as successes. Peri-implantitis, which is infection around the implant, showed up in 1.8%.
Other studies report more failures, especially in smokers and people with other risk factors. So the answer depends on who is asked and how success is measured. What you can count on is this: most implants placed in healthy mouths do well, and early problems are much easier to treat than late ones.
Early failure happens in the first weeks or months, before the bone has locked onto the implant. The implant never fuses. This is usually linked to infection, too much pressure on the implant during healing, poor bone, or smoking.
Late failure happens months or years after the implant was working fine. The most common cause is an infection of the gum and bone around the implant. It can also come from too much force, such as heavy grinding.
Warning signs to watch for
Call your dentist if you notice any of these, even if they seem small:
- Pain or discomfort that does not fade, or that returns after it had stopped
- Swelling or redness around the implant
- Gums that bleed when you brush or floss around it
- Pus or a bad taste near the implant
- Bad breath that does not go away with brushing
- Gums that are pulling back and showing the metal
- An implant or crown that feels loose or moves when you press on it
- Trouble biting down or a change in your bite
The most common cause: peri-implantitis
Peri-implantitis is an infection of the gum and bone around an implant. It works a lot like gum disease around a natural tooth. Plaque builds up, the gum gets inflamed, and if it is not treated, the bone starts to shrink away.
An earlier stage is called mucositis. Only the gum is inflamed and the bone is fine. At that point, better cleaning and a professional treatment can often turn things around. That is why a bleeding gum around an implant should never be ignored.
If you are told your implant has a problem, ask three things: what is the cause, what are the choices, and what will each one involve. A clear answer should come with a picture, such as an X-ray, that you can see too. Ask how long treatment would take and whether the area can be saved.
Keep a short note of what you notice: when it started, whether it comes and goes, and what makes it better or worse. This helps your dentist work out the cause faster. Photos of swollen or bleeding gums taken on your phone can help too.
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What raises the risk
Some risks are in your hands, and some are not. These come up in the research:
- Smoking. A review of about 150,000 implants found smokers had about 2.4 times the odds of failure. Cleveland Clinic says smoking or vaping can disrupt healing.
- Gum disease that was not treated first
- Poor cleaning at home
- Diabetes that is not well controlled. The ADA's mouthhealthy.org notes that chronic illness can interfere with healing.
- Heavy teeth grinding or clenching
- Not enough bone, or bone that was not built up before the implant
- Skipping checkups
What your dentist will do
At the visit, your dentist will look at the gum, test whether the implant is firm, check your bite and take an X-ray or a 3D scan. This shows if the bone around the implant has changed.
What happens next depends on what is found. If it is only gum inflammation, the answer may be a deep cleaning around the implant, better home care and a short follow-up. If infection has hurt the bone, treatment can include cleaning the surface of the implant and, in some cases, rebuilding bone. Sometimes the implant is not salvageable and has to be taken out. Even then, the area can often be healed and another implant placed later.
Please do not try to fix it yourself or wait it out. A loose crown can sometimes be tightened. A loose implant is a different problem. Either one needs a dentist.
How to protect your implant
The best protection is boring and works: brush twice a day, clean between your teeth every day, keep your cleanings and exams, and wear a night guard if you grind. If you smoke, quitting helps your odds. If you have diabetes, keep it under control.
Tell your dentist about changes in your health or your medicines. And do not skip a visit because the implant feels fine. Early infection often does not hurt.
What an early problem looks like, and myths to skip
Real life is rarely dramatic. Most patients with an early problem describe something small: a gum that bleeds when they floss around the implant, a tender spot that comes and goes, a bit of a bad taste in the morning. It is easy to shrug these off. Please do not.
A good rule: if the gum around an implant bleeds, swells or tastes bad for more than a few days, make an appointment. It is a quick visit, and a gum check costs far less than fixing bone loss later.
If you ever have a high fever, a face that is swelling fast, or trouble swallowing or breathing, do not wait for an appointment. Call the office or go to an emergency room.
A few ideas worry people more than they should, and a few comfort them too much.
- Myth: a failed implant always hurts. Not true. Early infection can be painless.
- Myth: if it was fine for five years, it will be fine forever. Gum infection can start at any time, so checkups never stop.
- Myth: failure means you can never have an implant again. Often another can be placed after the area heals.
- Myth: it is the dentist's fault or the patient's fault. Often it is neither. Healing is partly out of anyone's hands.
Where to turn in Kendall
If something feels off, call KDA at 305-271-1421. We are at 8833 SW 107th Ave in Miami, open Monday to Friday, 8:00 AM to 5:00 PM. Emergency care is available 24/7, so if you have severe pain, swelling that spreads or trouble breathing or swallowing, call right away or go to an emergency room.
We plan implants from a 3D scan taken in our office, and Dr. Alfredo Calderon has over 15 years of experience in implants, surgical and prosthetic. We accept most dental insurances and most Medicare supplemental plans, and financing is available.
Common questions
What are the first signs of implant failure?
Bleeding or swollen gums, pain that does not fade, pus, bad breath or a loose feeling. Call your dentist if you notice any of these.
Can a failed dental implant be replaced?
Often, yes. After the area heals, and sometimes after a bone graft, another implant can often be placed. Your dentist will tell you for your case.
Does a failing implant always hurt?
No. Early infection around an implant can be painless. Regular checkups catch it.
Is a loose implant crown an emergency?
It needs a dentist soon. If the crown is loose, keep it safe and call. If the implant itself moves, call the same day.
Can gum infection around an implant be treated?
Yes. Caught early, it can often be treated with a professional cleaning and better home care. Later stages may need more.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: dentistryiq.com, my.clevelandclinic.org, pmc.ncbi.nlm.nih.gov, mouthhealthy.org.