why some dental implants fail

The estimated reading time for this post is 6 minutes

Dentadental implant failure diagraml implants are anchors to your jaw that support your bridges, dentures, or crowns, helping them function just like natural teeth. After healing, dental implants can maintain the integrity/bone volume of your jaw and restore your bite.

Though they come with many benefits, sometimes dental implants fail. It is important to note that dental implant failure is not due to the body rejecting it. They do not create antibody-antigen type responses like organ transplants.

Failure occurs for reasons that either stem from local or systemic (general health) factors, the surgery itself or your post-op care.

What Are the Overall Reasons for Dental Implant Failure?

Implant failure can be divided into two categories. Early failure describes the situation when an implant is placed but fails to integrate (become solidly embedded into the bone). Late or long-term failure describes the situation where an implant has integrated solidly, but after many months or years, there is bone loss around the implant.

The causes of both of these failures are very different. In both cases, if we follow certain protocols in diagnosis, treatment planning, surgical protocol, and prosthetics the risk of these failures is still extremely low. Ten-year survival rates of integrated implants are still over 95%.

Nevertheless, that means very little if you happen to fall into the unfortunate 5%. So if that happens to be you, I have written this to try to help explain some of the things that may have contributed to your current problem.

Sometimes the patient may not have taken care of the implants well, allowing bacteria to grow and cause infections. Bruxism or improper bites cause undue strain and pressure on the implants, triggering failure. There are also chances of the surgery being done improperly, resulting in infections.

implant failure chronic health conditionsChronic health conditions like autoimmune disorders, diabetes, or osteoporosis also play roles in implant failure. Certain medications can also put patients more at risk for losing their implants.

Although there are many factors that contribute to dental implant failure, the good news is that a majority of failures can be salvaged with early intervention and proper medical attention. There are two types of failure: early failure and late failure.

Early Dental Implant Failure

Early failure is any dental implant failure that occurs within the first 3-4 months after the procedure.

Surgical protocol is important for any type of surgery. I am an instructor for a 10-month introductory course on dental implants and a large percentage of that teaching is about surgical protocol, from diagnosis to treatment planning to surgical execution.

So it is impractical to write and describe all the aspects of surgical protocol in this blog. Nevertheless, these are a few basic principles:

  • Make sure everything is sterile during surgery. This will avoid any chance of infections that can lead to implant failure. Though infection is a rare cause of failure in early failure, it still should be considered a factor and something to be avoided at all costs.
  • Ensure the patient’s bone is not overheated. Too much heat will cause cell and tissue death (necrosis), resulting in lesions and pain.
  • Use the correct surgical flap design based on the nature of the tissue surrounding the dental implants.
  • Make sure the implant is stable initially. This basic precaution during the surgery is the foundation of the procedure’s success. If there is movement of the implant during the healing phase, it will not properly integrate.
  • Place the implant on a site with adequate bone volume. Some patients may not have enough bone to support a dental implant, so if an implant is inserted anyway, the bone will not be able to integrate with it, resulting in early failure.

I would expect that any dentist placing implants would be well aware of the above protocols as well as much more.

Nevertheless, even the most experienced dentist/surgeon will have some implants that fail to heal properly. Just because this has happened, do not immediately assume they have done something incorrectly. (I would say that any dentist who says they have never had an implant fail to integrate has not placed many implants!).

dental implant integration with jawSometimes, there are implants that won’t integrate with your jaw in spite of everything being done correctly.

This can be due to a few factors:

  • There is a poor blood supply to the dental implant area, resulting in insufficient healing.
  • Certain medications like bisphosphonates (used to treat osteoporosis) can increase the risk of early implant failure (as well as late implant failure).
  • Poor health. An unhealthy body will be less likely to integrate with a dental implant as it is not functioning as well as a healthy body.
  • If there are existing infections adjacent to the implant site (sometimes these can be hidden as in a previous root canal).
  • Sometimes the implant moves or shifts during the healing phase.
  • The implants are not given enough time to integrate, attaching the teeth too soon before they are able to bear the burden.

Having a qualified and experienced implant dentist eliminates many of these factors. Simply having the surgery done correctly decreases the risk of early failure from an incorrect procedure.

Patients also have the responsibility of being completely transparent with their doctor about all medications they take and their current health condition. With both doctor and patient being well-informed and working together, the chances of success are high.

Surgery for dental implants

Characteristics of Late Dental Implant Failure

Late failure happens long after the dental implants have been established and functioning. This failure occurs between 1-10 years after your new teeth are placed.

There are a few common reasons why implants can fail at this stage:

  • The procedure was “under-engineered”. There are too few implants supporting the teeth, which caused excessive stress to the implants.
  • Clenching and grinding teeth. If the patient has bruxism and they do not proactively control this issue with behavioral modifications and a night guard, the dental implants can also endure too much pressure and fail.
  • Poor oral hygiene. This leads to gum disease and other infections.
  • Lack of gum tissue. This particularly pertains to the thick attached gum tissue that provides the seal around the implants.
    Chronic metabolic diseases like diabetes can make one at a higher risk of late failure.
  • Head and neck radiation. Irradiated patients have been reported in studies to have an increased risk of dental implant failure.
  • Lack of bone to support the implant. When excessive bone is lost, bacteria can invade and settle on the implant’s rough surface, becoming a petri dish for bacteria. The location of bacteria is difficult for your body to purge and often this kind of infection will result in the removal of the implant if left unchecked or untreated.
  • Food impaction around the implant. This can break down the seal around the implant, causing discomfort, pain, and infection.
  • Bacterial infections. If bacteria is getting under the gum and causing an infection, you will need to insert a tiny ligament in the gum tissue to seal this area around your teeth and implants can help prevent this problem from persisting. There are especially fewer ligaments around implants compared to natural teeth, so this procedure can help prevent future infections.

If you have more questions about why dental implants can fail, contact us.

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 About Dr. Balogh

Dr. Balogh - Expert in Cosmetic Dentistry and Dental ImplantsDr. Peter Balogh (B.Sc. D.D.S. D.A.B.O.I) is a cosmetic dentist at the Vancouver Centre for Cosmetic Implant Dentistry in Burnaby, BC. He is a Fellow at the American Academy of Implant Dentistry and International Congress of Oral Implantologists. Dr. Balogh has been a practicing family dentist for over 25 years and focuses on cosmetic dentistry and implant dentistry. In the past, he was a surgical instructor at the University of Boston School of Dental Medicine.

40 thoughts on “Why Some Dental Implants Fail

  1. if you have osteoporosis can you still get implants or will they fail they tell me I am a minus 2 when I had bone scan done but don’t have any broken bones at least not yet I been told they will fail

    Reply
    • Dr. Peter Balogh

      Hello Kim

      Thank you for your comment.

      Generally, osteoporosis affects the hips and longer bones before it affects the jaws. Having implants will place stress on the bones and stimulate them to be maintained in volume and density.

      A bone density of -2.5 is just at the borderline of being diagnosed with osteoporosis. If your BMD score was significantly less than that, I might have some reservations or would need to be more cautious. The implants would have to be assessed individually and on a per-site basis.

      I have treated many patients with osteoporosis and have not had any issues. We sometimes have to modify our treatment and healing time takes slightly longer but it has not been a major issue.

      A potentially long-term problem for osteoporosis patients with implants and even dentures is the complications with the medications (Bisphosphonates) that are given to patients with osteoporosis.

      I hope that answered your question.

      Sincerley,

      Dr Balogh

      Reply
    • Dr. Peter Balogh

      Hello, Mitchell

      Thank you for your comment.

      Two weeks following surgery you might have some minor discomfort but it should be significantly better than the first week. You should be noticing an improvement every couple of days. Check with your dentist/surgeon to make sure there is no infection, pressure on the site or something else going on.

      I hope this helped to answer your comment.

      Sincerely,

      Dr Balogh

      Reply
  2. I had a implant fail 3 times. First time the bone graft was coming out after several days and the dentist removed the implant. Second time, same location, the implant fell out. Third time after being in for several weeks exray showed implant to be crooked and it was removed. So # 7 is an empty space and I am out $ 3000. 00. I do have 3 other implants that I have had for over a year or two. I also had a blade implant for 30 yrs.

    Reply
    • Dr. Peter Balogh

      Hello David,

      Thank you for your comment.

      It is difficult to determine why you had issues in this area. Anytime something does not turn out as expected I always look back at my notes and the procedure to see if there was anything that I had done that was different.

      If not then I look at the area. I ask myself, is there something going on with the adjacent teeth? Some unusual history of infection in the surgical site? Something medically that was not noted or missed?

      Sometimes implants do fail, but if we can make adjustments in technique or protocol then usually the next one works just fine. But success comes with understanding what caused the failure in the first place.

      It seems from your description that all three attempts failed for slightly different reasons. I would not give up, especially if the bone in the area is still in good condition; but if it were me I would have a discussion with my dentist.

      Be sure that your dentist thoroughly understood the reasons for the past failures and ask if he feels confident in moving forward. Or ask if alternative solutions should be looked into.

      Reply
  3. Dr. I just had implants uncovered today they had been in for three months of the four that were put in the two right beneath my nose ffailed what can I do? The surgeon Dr o Neil is a stately old gent and well thought of. He did my bottom 4 and one fell out. This was for a 4 on one procedure. He saved me a bundle by being able to spare me the grafting. As it was I spent 8k. I am 66 and on Methadone. He is willing to redo it but I don’t think I can stand the pain. As it was I only used locals and 10 Oxys for post. Will he have to tap a new hole? Won’t that create a Swiss cheese out of my jaw? He was shocked. He said one in 20 fails but sine I lost 50% I feel like I should cut my losses and see what can be done with the two good ones. The procedure was in aug 2017. It is Halloween. Did the lack of bone graft cause it? The ones behind the incisor area were fine. I go back in 2 weeks advise please

    Reply
    • Dr. Peter Balogh

      Hello Walt,

      Thank you for your comment.

      It is difficult to say why those implants failed without knowing more about the site and the surgical steps and protocol. The bone in the upper jaw is not as dense as the lower and being in the front the bone is often thinner so there may be several reasons why they failed.

      You may need more grafting if it was not done at the time the implants were removed. Just because these two failed does not mean you cannot have implants in that site, however, it would be important for your dentist to understand why they failed to avoid a repeat occurrence.

      You may choose to stay with only two implants but the type of teeth and the amount of retention will have to be modified from what was planned using four implants.

      I hope that helped to answer your question.

      Sincerely,

      Dr. Peter Balogh

      Reply
  4. Hi Dr Balogh,

    I have just been to my dentist to check the implant he put in a few months ago to tell me it did not take, so I have the option to revisit a few months time and he hopes the second attempt will be a success. I am reluctant and now I am thinking of a bridge, as the the 2 teeth either side I am putting crowns on them anyway. I am extremely disappointed but I want to make sure the teeth look right as its my front tooth. Any advice would be super ! thanks, Trish

    Reply
    • Dr. Peter Balogh

      Hello Trish,

      Thank you for your inquiry.

      There are times we place an implant and it does not take, however it doesn’t mean it will fail the second time or that an implant is not possible. It’s most important for your dentist to understand what likely caused the first failure so as to avoid another failure, and to ensure the bone is healthy and of adequate volume for the second attempt.

      Even if you are crowning the adjacent teeth, if it were my own teeth I would not give up as in the long term having an implant will give you fewer potential problems than a traditional bridge.

      I hope this helped to answer your question.

      Sincerely,

      Dr. Peter Balogh

      Reply
  5. I had 4 dental implants with overdenture on upper. After 5 years, I had a sudden onset tenderness at one of the posts. When the periodontist took off the overdenture, one of the posts fell out with a second so loose it came out easily. At that time it was found the upper ridge has deteriorated and was gone. Prior to this time I had been seeing my dentist and periodontist alternately every three months during the 5 years without any problems or concerns. A replacement temporary upper denture was made. Due to flat platete, I am unable to keep suction to keep the denture in. I am unable to eat, chew, or maintain. The dentures in my mouth with gagging after time. I am negative for osteoporosis per dexascan. I am looking for possible solution to my problem. Is rim
    augmentation a viable solution with replacement of implants.

    Reply
    • Dr. Peter Balogh

      Hello Diane,

      Thank you for your comment.

      Certainly, the bone can be rebuilt and another implant put in place. A very important point is for your dentist to try to understand why the implant failed in the first place to avoid a repeat occurrence or a similar failure on one of the other implants.

      Most commonly it is overloading of one of the implants or an inability to keep the area clean, although there are other factors/possibilities.

      I hope that helped to answer your question.

      Sincerely,

      Dr. Peter Balogh

      Reply
  6. Hi

    I had 7 implants done 5 months ago , 6 at the top and one at the bottom .
    The bottom one has healed and i now have a tooth in there.

    The top implants are ready except one , i had to wait another month as the one had not healed yet , i went back today and it has failed and he took it out. I am now going to have it re done in 3 weeks in the same place. Will it heal being put back in the same place ? the other 5 are ready and have healed but now i have to wait another 3 to 6 months after the failed one has been re done to have my bridge which is upsetting . Is it correct to re do it in the same place and can trying again work ?

    Reply
    • Dr. Peter Balogh

      Hello Tracey,

      Thank you for your comment.

      Yes, there is no problem in placing the implant back into the same location, just as long as there is adequate bone and no infection in the area.

      In fact, in a few cases, I have found an implant “failed” and after removing it found the bone was healthy, but soft tissue grew all around the implant (instead of bone).

      The implant was removed, the soft tissue thoroughly cleaned out and a new implant put in its place at the very same appointment. Your dentist is being cautious by letting it heal for a few weeks, but otherwise, the protocol is certainly correct and OK.

      I hope that helped to answer your question.

      Sincerely,

      Dr. Peter Balogh

      Reply
  7. All top teeth were extracted and I had 6 implants implanted. I was told I did not have a lot of bone and if they failed I would need a sinus lift. After one month the first implant failed, Dr said it was okay as I still had 5. I requested a bar but said I didn’t need one. After a year another implant failed and Dr gave me a sinus lift and another bone graft and inserted two. I ha e now felt another one loose on the opposite side. That’s the 3rd one to fail! We are in over $30K! My father has been paying. I clean my mouth several times a day because I have a slight pallets on my implant denture…im at a loss. I feel like I want a 2nd opinion to see why these keep failing? Should they even have been done without a sinus lift first? This has been the longest two years of my life. I was miserable with the snap in denture, just had the two on the left side and sinus lift done 3 weeks ago and now another one? I’m so depressed.

    Reply
    • Dr. Peter Balogh

      Hello Danielle,

      Thank you for your comment. I am very sorry to hear about your troubles these past 2 years.

      There are many reasons for why you could be
      having problems. It could include any of the following conditions: minimal bone, prosthetics not fitting, the
      number or size of the implants, bone quality and implant quantity.

      Certainly splinting implants is always a better option because it spreads the weight
      over all of the implants and minimizes one being overloaded which could lead
      to failure. I can’t comment as to whether or not the sinus graft was any
      compromise for the size or length of the implants.

      The bone on your upper jaw is naturally slim and more narrow than the lower jaw. This makes the area particularly susceptible to bone loss.

      I don’t know your medical history so I cannot comment as to whether there might be a systemic issue
      contributing to the bone loss or implant failure. Nevertheless, in most cases, I would say it is either a local
      issue (bone, teeth etc) or surgical/prosthetic protocol.

      Without knowing more it is really hard to say. Definitely, speak to your dentist,
      tell them your concerns and if you do not feel like you are getting a
      straightforward answer do go for a second opinion.

      I am never offended by any of my patients seeking a second opinion. In fact, if they do not feel
      100% comfortable or in agreement with what I have recommended, I
      encourage them to have a second opinion before proceeding with any
      treatment.

      Dentists each have their own approach, there are generally several different treatment options available and when it comes to your teeth, it’s best to feel confident with your decision. Sometimes you need to compare your options to make the decision.

      I hope that this was helpful for you, do get a second opinion and if money is problematic, you can also contact local dental schools. (If there are any in your area.)

      They are often in need of patients for students to work with and the procedures are often substantially discounted. They are also supervised by professionals in the field.

      Sincerely,

      Dr. Balogh

      Reply
  8. I am so disappointed. I think we are mislead into believing implants are the panacea and preferable to dentures.

    I suffered through the loss of teeth 18, 19, & 20 due to bone loss, a very painful bone graft, and then implant surgery.

    My implant surgery was 30 days ago and last night the one in the 20 spot fell out. I returned to the oral surgeon today only to find the one in #18 was loose and had to be removed. So today, I essentially had oral surgery for the third time.

    I am discouraged by this failure most certainly and will never encourage anyone to consider oral implant surgery. Some months ago, I just about made up my mind to get a permanent partial lower after considering the cost of implants end to end. Well-today made up my mind, I’m in the hole now 5k and will have to deal with the pain of recovery for a couple of weeks. Plus the continued embarrassment of wearing a flipper, as soon as I can again.

    Oh sure, I signed and initialed all of the documents indicating I was aware of the risk of failure but the voice over you get from dental professionals is contrary.

    Never again. Keep your money in your pocket. Too much risk associated with dental implants. Just face the facts; you lost some teeth by whatever cause and implant technology isn’t certain enough at this point to risk your bank roll. False teeth were good enough for George Washington and by golly, they’ll be good enough for me.

    Reply
    • Dr. Peter Balogh

      Hello Mike,

      I am sorry to hear about your bad experience. You are correct, implants are not perfect and some do fail.

      I would say to anyone that it is best to keep your own teeth assuming they are in fair to good condition. However, if your teeth are already gone or just not worth fixing, implants are still a much better choice over dentures, for the many reasons I have written about in the past.

      Although it may not make a difference for yourself, for all the others out there who are considering implants some questions to ask your dentist are: What are the risks, Chances of failure, How many implants have they done, How many have failed…. and most importantly: What happens if an implant does fail?

      Although I cannot speak for anyone else but myself, I have been placing implants for over 25 years and during all these years I continue to “guarantee” that the implant will be successful.

      As long as the patient follows my instructions and does not have something unusual such as a traumatic accident, the implants are successful.

      What that means in practical terms is if an implant fails to heal or integrate, I will remove it, graft the site if necessary and replace it with another one at no cost.

      Implants can be an expensive option and I try to take away any worries or risks a patient may have in choosing implants. Although this means that I lose money in some cases, it instills confidence and trust in the services we provide.

      Sincerely,

      Dr. P. Balogh

      Reply
  9. I had four implants done in the summer of 2015. Two on the top right and one bottom left and one bottom right. All required bone grafts. All were successful and are still intact and doing great. Summer 2017 I lost a tooth to infection. Went consult for my 5th implant and scheduled procedure. Implant was placed and after 4 months of healing it failed. Surgeon was just as confused as I was since the first four did great. Wondering though why did the first 4 require bone grafts and the fifth one didn’t. I know without actually seeing x days or in person it would be hard to say but what are the chances there should have been a bone graft done since the others required it.

    Reply
    • Dr. Peter Balogh

      Hello Tony,

      Thank you for your comment.

      Every implant site is completely different, even when it’s in the same individual. If there was not a lot of bone loss from the infection then you most likely had enough bone to place the implant without further grafting. I would say that is the norm.

      Usually, if a tooth has been missing for a long time or there has been a lot of bone loss due to gum disease or infection then the chances of needing a bone graft are much greater.

      There are many alternative reasons for why the implant could have failed. It depends on factors such as where the implant was placed in your mouth, the extent of infection that occurred, whether or not the tissues fully recovered from the infection etc.

      Certainly, talk with your dentist. They can check for bone loss in the area and if that’s the case, a bone graft may be needed. If your past implants have been successful, it’s no guarantee that future implants will be as well, but I suggest you persist and consider other factors at play.

      Sincerely,

      Dr. Balogh

      Reply
  10. Dr. Balogh. Last summer I noticed I had an infection on my upper gum where I had an implant done. There was puss coming out of it and my dentist took the crown off and scrapped the infected area and gave me an antibiotic to take. After two rounds of antibiotics, the infection didn’t go away and an xray showed bone loss around the implant. He sent me to a periodontists and implant specialist and they removed the implant. They told me it would slide out but it didn’t. It was a battle getting it out. She said the hole was big and gave me bone graph but the membrane started coming out so she removed the membrane and put seven stitches in but there is still fluid coming out which i think is part of the infection doesn’t seem to want to go away. I am on my second round of cephalexin 500 mg. I just want the infection to go away. Why doesn’t the antibiotic work? Does this happen sometimes? I am worried the infection may spread to other teeth.

    Reply
    • Dr. Peter Balogh

      Hello Danny,

      Yes sometimes an area can get infected and depending on the situation antibiotics may not work very well. Essentially the graft material is sterile when it is placed, however, if some bacteria gets into the site then they proliferate and the blood supply/immune system to the area may still be less than ideal. If caught early antibiotics will get rid of the infection. However, if too much of the graft has been infected/affected, then sometimes the best solution is to literally remove everything, let it heal (could be anywhere from 2 weeks to 2 months and then graft +/- place the implant). Make sure to place some heat as opposed to cold in the area…warm salt water rinsing is good. IF the fluid is white it is probably an infection, however, if it is a clear yellowish fluid there is a reasonably good chance the area will heal, although there may be some loss of the graft volume.

      Sincerely,

      Dr. Balogh

      Reply
  11. I had a dental implant in March 2017. There was some numbness in lower jaw that lasted for about 6 weeks. Otherwise everything appeared to be fine, but when site was opened for attaching abutement, the bone had grown over the implant and had to be drilled away. Even with anesthetics, it was very uncomfortable. The dentist then could not get the abutement to attach and tried two or three different abutements. It was necessary for me to take an antibiotic as the site appeared to be infected. I fear that the abutements were not cleaned each time before reinserting, but I can’t be sure as it was done behind me. All this time, the pressure on the jaw was very uncomfortable. After a few days, the abutement fell out and had to be reattached, which again was very uncomfortable for me. Finally, the dentist said he would need to order a taller abutement because the gums were growing over the abutement and required cutting away. Inserting the new abutement again required a lengthy procedure with enormous pressure on the jaw. After several weeks, the swelling and soreness finally abated and the form for the new tooth was made. I thought the procedure for attaching the new tooth would be quite simple, but once again I was subjected to a great deal of discomfort in the form of pressure on my jaw and pain to the gums that required several shots to numb. This part of the procedure took about 1 hour. It has now been almost 2 weeks, and although the area looks good, there is a pulsating on the back side of the gums beneath the tooth. I don’t feel I can trust the dentist to find the problem without causing me another very painful visit. What should I do? I am considering seeing an oral surgeon for advice.

    Reply
    • Dr. Peter Balogh

      Hello Joan:
      Firstly, it is not unusual for bone to grow over top of an implant, and it is not such a bad thing. However along as you are well anesthetized with local numbing you should not feel aching other than some vibration. I cannot say for sure, but I’m guessing the problem your dentist had with the abutments was a either too short of an abutment for the thickness of tissue and/or not removing enough bone to allow the abutment to fit securely and tight againts the implant. Sometimes we think the abutment is screwed on tight, but it is really binding on the bone or tissue…then as the tissue or bone remodels the abutment gets loose and falls out. You could see your oral surgeon, however oral surgeons rarely deal with the prosthetic end of things so they might not be aware of what is going on. I don’t think any of the issues are serious and hopefully your dentist has already sorted things out.

      Reply
  12. I started the implant process a year ago. 6 months prior to my visit my dentist noticed an inflammation with a tooth he was concerned about but we put it off “too keep an eye” on it. On the next 6 month visit he said it was worse and sent me to an oral surgeon who ended up pulling it, and started the bone-graft, implant procedure. Do they always hammer like that? I had the bone graft but the first implant didn’t take and the 2nd one he said was wobbly and after giving it more time it was taken out or came out and he said the bone failed to grow around it and that the bone was spongy. I have osteoporosis, I’m not willing to go for the sinus lift. I do want to know if I need more bone graft or how to follow up to zero in on what is going on with the bone. Am I legally entitled to my records and x-rays. Not looking to sue or complain, just want to do more homework and address the bone problem. The dentist was very confident but I’m always skeptical when it’s that easy to say it failed. Could he have done anything more or preventive before the fact. Is there any chance he damaged it when he hammered? What would you suggest?

    Reply
    • Dr. Peter Balogh

      Hello Ester: My understanding is you are entitled to your dental records. You may have to sign a release form but no one can withhold them from you arbitrarily. Regarding your procedure, some implants and some procedures do require some tapping…although as one who has gone through the procedure it literally does feel and sound like hammering! I cannot comment as to why the implants did not integrate and heal properly….it could be that there is minimal bone and the dentist is trying to work with what is available. With your osteoporosis have you ever taken any medications for it? If so, some of these medications may be affecting your bone healing and that could be one possibly, even if these medications were taken years ago.
      Sincerely, Dr Balogh

      Reply
  13. I went to a dentist in my area, who advertised that they do implants. I wanted implants for my bottom dentures. After looking at my xrays, the dentist said i was a candidate for implants and he could put four mini implants in my lower jaw. I have been without back teeth (and teeth on my right side) for several years, (probably since the late 80’s). I’m 56 years old and got full dentures 2 years ago. I had 5 teeth pulled from my lower jaw, and 4 teeth in my upper jaw in the front.

    When i went to my appointment to get my implants (and new dentures), he started cutting and drilled one hole and tried to place an implant in. After about 30 minutes, he stopped and told me that it would not work! He said my bone was too thin to hold an implant (he had already made a comment about how my “ridge” was very thin).

    My question is this, shouldn’t he have known that BEFORE he proceeded with the surgery? Shouldn’t he have been able to know that by looking at the panoramic xray and told me i would not be a candidate (even after looking and feeling my “thin ridge”?

    I just hate that i got my hopes up and missed a day of work (2 days now, because my bottom jaw is swollen and i can’t even wear my regular denture because of the pain and swelling of the one hole he drilled in my mouth)

    I just want to know if he followed correct proceedure or not.

    Reply
    • Dr. Peter Balogh

      Hello Jan: Most xrays are only two dimensional so one cannot tell from a traditional xray how wide your bone is, although there are other methods (ie ct scans etc) that can give more details. I’m guessing is your bone was already very thin, otherwise they may have considered standard sized as opposed to mini implants. Treating very deficient bone does take advanced methods and in some cases bone grafting is required. You may still be able to have implants but your dentist may need to revise his treatment plan accordingly. Unfortunately I cannot comment on the procedure your dentist followed without truly knowing more about the diagnosis, treatment plan and surgery etc. and this is really not the correct forum for that.

      Reply
  14. How painful is the initial bone graph? I’m scheduled to have an upper second from back (#14) molar pulled (its fractured), area cleaned and bone graph done. I’m concerned that even with local numbing shots, this will be painful? or no?

    Reply
    • Dr. Peter Balogh

      Hi Mike: Sorry for the late response. It sounds like you are having what we call a socket graft done. It should not be painful in the least….if it is tell your dentist and they should be able to put in enough freezing to numb the area fully. Afterwards it may be a bit sore but not more than a 3 out of ten.
      Sincerely,
      Dr Balogh

      Reply
  15. I had an implant put in when I was 15 now 11 years later I’m starting to have issues with my implant. The tooth that has the implant would be on my top jaw right in front of my canine. I’m having a lot of gum issues. I’ve been flossing the implant to keep it clean, but it’s still swollen around the implant. I’ve gone to my dentist a couple of times about the issues, but they can’t seem to find any issues. My next visit we will be taking the cap off my front tooth and putting a new one on. The cap isn’t all the way to my gum line and has been like this for 11 years also. So we believe that the cap is creating a shelf for bacteria. My main concern is that this implant is going to fail. I don’t understand why all of a sudden after 11 years I’m having all these issues with it. It’s swollen all the way around the implant and bleeds when I brush.
    Also, I had a plate and three screws in my ankle. Two years ago I had to have that hardware taken out because it had started bothering me a lot and causing issues. I had that plate and screws in my ankle for about 10 years. The thought that keeps running through my mind is that this implant is going to be the same way.
    Any thoughts?

    Reply
    • Dr. Peter Balogh

      Hello Abigail: I cant say for sure but the plates you had in you ankle were probably stainless steel and these can and do cause problems as they do not fuse with the surrounding bone. So I feel the issues with your implant are likely different than the problems with your plates. Im guessing the problem may be bite related, but it could be there has been some bone loss and pocketing around the implant. If the cap does not go all the way to the gum then I don’t feel like the cap would be causing a problem…they are more likely a problem when the cap extneds under the gum as the margin of the cap is the area where plaque/bacteria tends to collect. Best to have the area probed for pocket depth, identify the exact areas of bleeding, identify if there is infection/pus fro=m any sites, and then a ct scan of the implant. It will show jsut how much bone there is around the implant and if there has been any bone loss.
      Sincerely
      Dr Balogh

      Reply
  16. I had an implant on lower left jaw after dentist was unable to stabilize a root canal crown he had replaced.
    2013, he removed the root canal material ,finished the implant. I continued to have minor soreness in the area. 2014,per x-ray, he said part of root canal material was still present. He referred me to surgeon but I was moving and their was no infection. Chewing was fine. New dentist 2016 referred me to surgeon. He drilled out 1/4 inch pebble of bone. No infection. 2018, x-ray shows tunneling in area and movement. Chewing fine and no pain, no infection They want to remove the implant and start over. I’m 74 and tired of this tooth. Since there’s no pain, infection and chewing is fine. Why do anything but keep an eye on it.

    Reply
    • Dr. Peter Balogh

      Hello Ann; If there is no pain, no signs of infection other than a shadow on an xray (which is staying the same), it is not getting worse etc….I would say leave it alone and just have it checked periodically both clinically and with an xray.
      Sincerely
      Dr Balogh

      Reply
  17. Had a tooth extraction and dental implant procedure nearly two weeks ago (13 days). The tooth was infected when extracted and I also needed a bone graft for the implant. How long should I expect to experience pain.

    Reply
    • Dr. Peter Balogh

      Hello Thelma: Sorry for the late reply. The majority of the pain shoudl be gone in 2-3 days, although there may be mild tenderness for up to two weeks
      sincerely
      Dr Balogh

      Reply
  18. Dental trainees conducted my first implant at a dental college. A bone graft was necessary, but the implant and crown was later successfully placed. My dentist did my second implant 6-8 years ago. It did not require bone graft, but with a haphazardly discovered infection, I’m wondering if this implant has failed. Two weeks after having my teeth cleaned, I began having a mouth ache. When I looked at the painful area, I noticed a white pus spot on my gum. Since it was a weekend, I soaked for two days with warm salt water to help with the discomfort. On Monday, I called my dentist and he scheduled me a same day appointment. After looking at the x-ray and hearing my explanation of the spot in my mouth, he assessed the situation. To my extreme discomfort, he began by trying to remove the crown from the implant. When he could not remove it, he gave me an anesthesia and immediately went to scrapping the area of the gum around the implant (initially without providing sufficient anesthesia). It was as if it was an “experimental” procedure. After giving me additional anesthesia, he continued. After a long, uncomfortable session of working in my mouth, he ordered the dental aid to go get some grafting and membrane material. That was placed and then he completed the procedure with sutures. I was horrified! He explained that food or something got trapped in or around the implant, which may have caused the problem. He prescribed me an antibiotic and prescription mouthwash and scheduled me to return in 2 weeks. I was in excruciating pain all night. The next morning, my face was swollen and I felt awful. I called the dentist office to see why the Dentist failed to make his “normal same day follow-up call,” and the receptionist’s explanation was that since it was such a late appointment, he planned to follow-up later. I received a phone call that evening. When I described my pain and questioned why a pain prescription wasn’t prescribed, he opted to write me one. I told him I managed to get through the night and would continue taking the OTC pill for now. The pain continued.
    I returned for the suture removal. Another x-ray was taken. I was given anesthesia and the sutures were removed. He then said that the gum looked better, but had not properly healed. He said more sutures were needed. He sutured me and instructed me to return in 2 weeks. He left the room. Before I could leave, he returned asked to look at my mouth again. He apparently had an epiphany, and decided to do more work. He explained that he wanted to put a different suture in. He did. He released me with instructions to apply the mouthwash directly to the gum line each time I ate because food was still getting trapped in that area. I have followed those instructions, but after 1 week, I am in constant pain and it looks like I have a hole in my gum near the implant. After reading your blog, I would feel more comfortable being referred to an oral surgeon with experience in diagnosing failed implants. What is your suggestion?

    Reply
    • Dr. Peter Balogh

      Hello Robin: Sorry to hear you are having such problems…if you are going to see someone else, I would recommend either a periodontist (gum specialist) who has experience with implants or another implant dentist who has experience/training in gum surgery and treating failing implants.
      sincerley
      Dr Balogh

      Reply

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