Dental implants offer many advantages to patients who have lost or damaged teeth. Not only do they improve your smile, they also comfortably hold dental prostheses in place, mimicking the strength of natural teeth roots.
When dental implants succeed, they give the patient a third set of teeth after the adult set has been lost. Sometimes, however, just like the adult teeth that were lost, dental implants can fail.
How do dental implants fail and is there anything you can do to salvage them? These are two questions that we will address head-on.
Overall, a majority of the problems can be corrected while the existence of chronic health conditions reduces the efficacy of these interventions.
If you take care of your implants with regular cleaning, you can also maximize your chances of keeping your implants and keeping them in working order for a long time.
This article mainly deals with implants that have already integrated with the bone (ie healed sufficiently) but are now losing bone and having problems of inflammation and or infection.
Why Do Dental Implants Fail?
In order to rectify the situation, you must first find the cause of the failure. When it comes to dental implant failure, the culprit is usually among these issues:
- Too much stress on the implant
- Incorrect bite
- Teeth grinding (bruxism)
- Food impaction problems
- Bad oral hygiene
- General health issues like chronic disease
To find the true cause of the dental implant failure, you should see your dentist. Implants rarely give us any discomfort as there are no nerves attached to them. The few signs we may notice to indicate something is wrong are bleeding, swelling, bad odour or discomfort around the gum tissue.
Usually, even these symptoms are mild, which is why I recommend regular check up appointments with your dentist. In some cases, there may not be any of these signs, but the x-ray shows some bony changes or loss of bone.
A medical professional will be able to make a solid diagnosis on your situation and give you the most effective remedy.
As soon as you feel something is wrong, make an appointment. The sooner you find out the cause of your implant discomfort, the sooner you can get advised on the best course of treatment.
If you get help in time, you can potentially reverse the failure and save yourself the cost of corrective surgery.
Too Much Stress
The bone around an implant will be maintained and become more dense as long as the stress that is transmitted to the bone via the implant is within physiological limits.
If this limit is exceeded, there will be bone loss around the implant and this could be the beginning of an implant failure.
The first step to ensure these limits won’t be exceeded falls on your dentist, who will determine the number, size, and placement of implants to support the type and number of teeth being replaced.
Therefore. you need to be mindful of treatment plans that may be “cheaper” because they are using fewer implants, or smaller or mini implants instead of bone grafting to allow for a larger diameter implant. Although these may initially be ok, failures may start to arise between 5-10 years if the teeth are “under engineered”.
As a simple rule, two implants can support up to 3 or 4 teeth. For a full arch of teeth, we need to be cautious using less than 6 implants.
Although there is a lot of marketing about all-on-four systems (four implants to support a full arch of teeth), this was designed for the lower jaw where the bone is much more dense. It can work but case selection is very critical and should something begin to fail the risks are much higher as the entire prosthetics will be affected.
An “Incorrect” Bite
An incorrect bite can strain your dental implants. This is much like the above situation – an incorrect bite may place excessive stress on the implant and cause bone loss. It may be in the form of having a tooth-to-tooth contact in an area where there should not be a contact or a contact that is excessive compared to the other teeth.
If left untreated, there may not only be problems with your implants, but with your gums, jaw muscles, and supporting bone as well.
By adjusting your prostheses/teeth to make sure they are coming together properly may save your dental implants from failure.
This bite issue is something that may be present from the day your teeth are inserted, or it may develop slowly over time as your teeth wear and any natural teeth shift. As mentioned earlier, an “incorrect” bite is not something you may notice as a patient so I cannot stress enough the importance of having your teeth checked periodically.
Tooth grinding is another common problem. Patients often grind or clench their teeth in response to stress while awake or while they sleep.
To save your dental implants from the stress imposed on your implants from this habit, you may need to wear a night guard.
During the day, patients can be instructed to become more aware of their teeth grinding habits and to refrain from grinding their teeth. By taking these two measures you can take away the stress on your implants that result in implant overload and possible failure.
Depending on many factors, as we eat a certain amount of food can collect around our teeth, implants, and gums. If this becomes excessive and or you do not clean the area shortly afterwards, you may develop soreness or pain in your gums, inflammation, infection, bone loss, and potential implant failure.
In some cases, the design of the teeth may increase or lessen this food impaction. In other cases, a certain amount of food “collection” may be inevitable. However, overall, there should be no areas where food gets pushed deep into the gum around the teeth.
When there is a less-than-ideal distance between a tooth and an implant or between two implants, food impaction can occur.
The design of the teeth also plays a role: if the distance between the contact point and alveolar bone crest is less than ideal, a space or “black hole’ may be visible and may be a site of food trapping.
Bad Oral Hygiene
You need to take care of your dental implants just as if they were your own teeth.
If you let your implants and gums go, you will experience gingivitis (inflammation of the gums) and periodontitis (bone loss), both conditions that can cause your dental implants to fail.
The good news is that more thorough cleaning can stop or reverse this process and save your implants.
We recommend using a water pick to really get those hidden spots around your teeth and implants that brushing and flossing can miss. Use your water pick with hot salt water, which contains naturally antimicrobial properties.
If your problem is aggressive, then periodically you can use diluted Dakin’s solution. Your water pick will flush out and clean the pocket around the implant, killing the bacteria that has infected your gums and teeth and caused bone loss.
I have other health issues. How will they affect my attempt to salvage my dental implants?
If you have chronic issues like diabetes, osteoporosis, or a suppressed immune system, your implant failure will be more challenging to remedy, but we will do everything we can to maximize the chances for your implants to succeed.
The best thing you can do is to see your dentist as soon as you notice a problem and to diligently clean your implants from the start. Fortunately, although many of our patients do have the above conditions, I rarely see them affect their implants unless their medical condition becomes very uncontrolled and or they don’t do proper home care.
When is it time to operate?
When all nonsurgical interventions fail, then you will need to go through surgery. In this procedure, we will clean the tissues around the implant and detoxify the implant’s surface.
Then, we can either place graft material to regrow the bone around the implant or smooth and polish the rough surface of the implant that is above the bone. The latter technique is not conducive to bone regrowth, however the new smooth surface won’t collect troublesome bacteria and can stop any further inflammation and bone loss.
What if the dental implant operation fails?
If every intervention fails to restore the functionality of the dental implant, the implant may have to be removed. If this happens, do not lose heart. There is still a possibility to put another implant in its place…and just because you had a problem does not necessarily mean it will repeat.
If you have any other questions about what to do if you have a failing dental implant, contact us.