Early and late dental implant failure

A dental implant is a metal post that’s surgically attached to the jaw bone to support an artificial tooth. Once in place, a restorative dentist or oral surgeon mounts a replacement tooth to the implant.

Dental implants have a high success rate, but some people experience dental implant failure. It’s estimated that about 5 to 10 percent of dental implants fail, either shortly after a procedure or months or years later.

If you’re scheduled to have dental implant surgery, or if you currently have an implant, here’s what you need to know about implant failure and other potential complications.

Numerous factors can affect the success of a dental implant. These include:

1. Gum disease

Healthy gums are a criteria for dental implant surgery, and you can’t have this procedure with active gum disease.

Gum disease is an infection that can damage the gums and jaw bone. An untreated infection could develop around the implant and lead to failure. See a dentist to treat gum disease before getting an implant.

2. Smoking

Smoking can also cause dental implant failure because it restricts blood flow to the gums, slowing the healing process. Multiple research studies show that smokers can have a dental implant failure rate up to 20 percent.

Being a smoker doesn’t mean that you’re ineligible for a dental implant. However, you may have a better outcome if you stop smoking one week prior to a dental implant and if you don’t smoke for at least two months after implant placement.

3. Insufficient jaw bone

A successful procedure is also dependent on sufficient bone to support the implant. Without enough healthy bone, the surgeon cannot surgically place the implant into your jaw.

Bone loss can happen with osteoporosis. This condition develops when bone density decreases. Bones become fragile and there’s the increased risk of fractures. Severe gum disease can also cause deterioration of bones in the mouth.

4. Medical conditions

Dental implant failure is a possibility if you’re diagnosed with an autoimmune disease or conditions like rheumatoid arthritis and diabetes, which causes the body to heal at a slower pace. Slow healing can prevent osseointegration, where the implant fuses or integrates with your jaw bone.

The use of certain medications can also lead to dental implant failure. So it’s important to discuss any medications (prescription and over-the-counter) that you’re currently taking with your oral surgeon.

In 2016, McGill University researchers found that heartburn medications may reduce new bone growth, thus affecting how an implant fuses with the jaw bone. Also in 2016, researchers at the University at Buffalo reported similar results among people taking antidepressant medication.

5. Poor dental maintenance

The ability to practice good oral hygiene after a dental implant also has an impact on the success rate. You’re not an appropriate candidate for a dental implant if you have limitations that affect your range of motion or interfere with the ability to thoroughly clean your teeth.

6. An inexperienced surgeon

Not all surgeons are created equal, and there’s a chance of dental implant failure if you have an inexperienced surgeon. Your dentist may refer you to an oral surgeon, but you can also select your own.

An experienced surgeon knows how many implants to use to support tooth replacement. This is important because too few implants can cause excessive stress on the implant and failure.

Also, working with a skilled surgeon may prevent iatrogenic trauma, which is injury to the periodontal tissue by a dentist’s activity.

Choose a surgeon with many years of experience. Have them go over the process and recovery plan.

Ask questions during your consultation.

Questions you can ask your dental team:

  • How many years of experience does the surgeon have?
  • How many dental implant procedures does the surgeon complete a year?
  • What is the surgeon’s success rate? What do they attribute that to?

Proper planning by a surgeon entails the doctor completing a thorough examination of your mouth to assess the health of your gums and jaw bone.

Dental X-rays give your surgeon and idea of your overall oral health, thus providing clues as to whether a dental implant will succeed.

Planning also involves an understanding of your medical history. This includes any medical conditions you have, as well as any medications you take.

When there’s a lack of understanding or proper planning, a surgeon may proceed with a dental implant even when the person isn’t the right candidate for one.

This can cause improper placement of the implant and stress at the implant site, resulting in the growth of aerobic bacteria which can trigger infections or an abscess.

Careful planning is also how your surgeon identifies issues that could interfere with an implant. For example, you may need a sinus lift before getting an implant to ensure success.

As you look for an experienced surgeon, talk with friends or family who’ve had a dental implant and ask for their recommendations.

Problems or complications from dental implant surgery can happen shortly after the procedure or years later. Early dental failure occurs within the first three to four months of the procedure.

Keep in mind that you’ll experience some degree of pain or discomfort after surgery, which you can manage with pain medication. Even so, speak with your surgeon if pain doesn’t improve after five to seven days. It takes between three and six months to completely heal.

While pain and swelling are common after surgery, keep an eye out for complications that may develop:

Infection at the implant site

An infection can develop during or after surgery. Risk factors for an infection include having an autoimmune disease, smoking, and bad oral hygiene.

Implant micro-movements

Micro-movements of the implant can occur when a dental implant lacks stability, sometimes after an immediate tooth replacement.

Typically, an artificial tooth isn’t attached to an implant until after the jaw bone properly integrates with the implant. But sometimes, a surgeon performs an immediate tooth replacement after implantation.

This method requires fewer doctor visits, but it can also put extra stress on the implant and lead to failure.

Insufficient bone support

Early stage failure can also happen when there isn’t sufficient bone to support a dental implant, yet a surgeon completes the procedure anyway. Without adequate bone, the implant can’t fuse with the jaw.

Allergic reaction

You may develop a reaction if you’re allergic to titanium alloy, a metal in some dental implants. Symptoms of an allergy include swelling, loss of taste, and perhaps a tingling sensation.

Mention a titanium allergy to your oral surgeon. You’ll need an implant that contains a different material.

Failure to follow your doctor’s instructions

Your activities and habits have an impact, too. It’s imperative that you follow your surgeon’s post-surgery instructions to lower the risk of complications. You may be instructed to eat soft foods until the implant site heals, practice good oral hygiene, and avoid hard candy.

Dental implant surgery can be an immediate success, with complications not developing until years later.

Here are some long-term complications of a dental implant:

  • Nerve or tissue damage may occur when a surgeon places an implant too close to a nerve. Signs of damage include numbness or tingling in the tongue, lips, gums, or face.
  • Foreign body rejection doesn’t occur often, but can happen. This is when the body rejects an implant. Signs of rejection include increased pain at the implant site, swelling, fever, and chills.
  • A dental implant placed in the upper jaw may protrude into the sinus cavity.
  • Injury to the area surrounding a dental implant may loosen the implant, resulting in failure.

To minimize the likelihood of long-term problems, continue to practice good hygiene and keep your mouth, implants, and gums healthy. Brush and floss at least twice a day, rinse your mouth with mouthwash, and see a dentist for routine checkups.

If you have early or late-stage dental implant failure, signs of a complication include:

  • difficulty chewing
  • gum inflammation
  • gum recession
  • increased swelling
  • loosening of an implant or a replaced tooth
  • severe pain or discomfort

Even though some dental implant failures can’t be prevented, you can take steps to reduce the risk of failure:

  • Properly care for your dental implants. Brush and floss daily and use mouthwash.
  • Visit a dentist every six months.
  • Stop smoking.
  • Increase your calcium intake to support strong bones. Take a supplement or eat calcium-rich foods like milk, yogurt, broccoli, oranges, and cheese.
  • Ask your dentist about a mouth guard to treat bruxism (teeth grinding).
  • Don’t get immediate tooth replacement after an implant procedure.
  • Avoid habits that damage the teeth (eating ice and candy)

A dental implant can restore a smile, but this procedure isn’t right for everyone. Alternatives to consider include:

Dental bridge

This is a fixed prosthetic device used to fill gaps of missing teeth. A dental bridge might be appropriate for adolescents whose bones are still growing. There are a few types of dental bridges:

Resin-bonded bridge

Also known as a Maryland bridge, it consists of a fake tooth with “wings” on either side of it. The wings are affixed with resin to existing teeth on either side of the gap in the mouth. This type doesn’t require teeth to be ground down or prepared the way that a traditional bridge would.

Traditional bridge

A fixed-bridge also uses existing teeth as supports to a fake tooth. In this case the fake tooth is “bridged” using crowns on the existing teeth on either side of the gap it’s filling. Because existing teeth are capped, this type of bridge is considered sturdier than resin-bonded bridges.

Cantilever bridge

This bridge supports the fake tooth on one side only. Otherwise it’s the same as a traditional bridge, using and capping an existing tooth to support the fake one.

Removable partial dentures

This is a removable replacement for missing teeth and a cheaper alternative to a dental implant.

With a partial denture, one or more replacement teeth are affixed to a gum-colored plastic base that attaches to natural teeth. It sits in the mouth similar to a retainer tray. Complete or full dentures are needed when all teeth are missing.

Dental implants have a high success rate, but they can fail for several reasons.

It’s important to know the potential risks so you can take steps to improve your odds of success. This includes seeking treatment for any gum or bone problems prior to surgery, selecting an experienced surgeon, and practicing good oral hygiene before and after surgery.