When an Implant Fails

Signs an Implant Is in Trouble

• Aching or soreness near the implant that lingers, especially when you chew
• An implant or crown that feels loose or can be moved
• Red, puffy gum that bleeds on brushing, or discharge from the gum beside it
• An unpleasant taste or odour that persists however well you clean
• Gum receding far enough to show the metal underneath
• Bone loss on an X-ray, which you cannot feel but a dental examination picks up

A loose crown and a loose implant are different problems. The small screw holding a crown can work loose while the implant beneath stays rock solid, and that takes minutes to put right. Whichever it is, get it seen promptly. The earlier a problem is caught, the better the chance of keeping the implant.

Why Implants Fail

Research puts long-term implant survival comfortably above 90%, so failure is unusual. When it does happen, one of three causes is usually responsible.

• Early failure. The implant does not fuse with the bone during the first weeks or months. The usual culprits are infection during surgery, a mismatch between the implant and thin or soft bone, movement while healing, and smoking. You notice looseness and soreness before the permanent crown is fitted.
• Peri-implantitis. This is the implant version of gum disease. Plaque gathers at the gum line and inflames the gum; if it is not removed, the inflammation spreads to the bone, which recedes from the implant. It is the most common cause of late failure, and also the most preventable.
• Overload. The crown or bridge puts more force on the implant than it can bear, often because of grinding, a bite that was never properly balanced or too many teeth carried on too few implants. Warning signs include screws that keep loosening, chipped crowns and, in time, bone loss.

Poor planning underlies more failures than most people expect. Put an implant in without 3D planning, slightly off position or angle, and it begins with a thinner wall of bone around it. So each implant here is planned on the CT scanner in our building and inserted through a MegaGen R2 guide.

What We Do First

• Hear the history. When the implant went in, who placed it, which system was used and what has changed. Then we examine it, the surrounding gum and how your teeth meet.
• Take a CT scan (£120). It shows how much bone surrounds the implant and whether the two are still fused, which a standard X-ray cannot tell us.
• Give you a straight answer. Some implants can be rescued with deep cleaning around them, gum treatment and changes to the crown or bite. Others cannot, and we will tell you which yours is.

There is no charge for the assessment itself; we take a £40 deposit when you book and return it after you come. It makes no difference where the implant was placed.

When the Implant Can Be Kept

Peri-implantitis caught early usually settles with professional cleaning around the implant, occasionally with antibiotics as well, plus a better routine at home. We retighten a slack screw or fit a new one. A crown taking too much force is reshaped or replaced, with a night guard to protect it if you grind. From then on, hygiene every three months with our hygienist, Stefanie Goodall, and periodic X-rays of the bone keep the problem from returning.

When It Has to Come Out

• Removal. A failed implant usually comes out more easily than it went in, under local anaesthetic, with IV sedation from Dr Imran Riaz if you would like it.
• Healing. We clean out the site, frequently graft it during the same appointment, and give it a few months.
• Cover for a visible gap. Either a basic denture, from £600, or a temporary bridge bonded to the neighbouring teeth, at £550.
• A replacement implant, planned again on a new scan and positioned where the healed bone is best, which can mean a different size or angle this time.
• A new crown once the replacement has fused.

Replacement implants succeed at a high rate when the original cause has been dealt with: infection treated, smoking stopped and the bite balanced. Our bone grafting guide explains the rebuilding stage.

What It Costs

For an implant we placed, the guarantee applies as set out in your consent form: a five-year guarantee for non-smokers who keep up three-monthly hygiene visits. For one placed elsewhere, we quote after the scan and put the figures in a written plan:

Fees are confirmed in writing.² Chrysalis Finance is available on treatment from £1,500; over 12 months at 0%, an implant and crown is £188 a month.⁴

One thing to know: if you are keeping the implant, any new crown or bridge on it needs parts designed for that particular system. If you know the brand, tell us. If not, we can usually identify it from an X-ray, though it takes a little longer.

Implants Placed Abroad

The problems we see are the same whatever the source, but implants placed on a rushed schedule abroad tend to fail for one predictable reason: the final teeth went on before the implants had fused. If you had treatment overseas and something feels wrong, bring any records you have and we will assess it as we would any other case. Our guide to dental treatment abroad explains the checks to make beforehand, and your options if you have already had treatment.

Preventing It

• Do not smoke. It is the biggest single threat to an implant, both before and after it is placed.
• Clean around each implant daily with interdental brushes, and with a water flosser beneath any bridge.
• See the hygienist every three months, so any inflammation is found while it is still reversible.
• Protect the implant with a night guard if you clench or grind.
• Let us know promptly about bleeding, looseness, pain or any change in your bite.

For the full care routine, read our guide to how long dental implants last.

Questions

This guide explains the options in general terms. Only an examination can tell you which of them suits your own teeth.