What If an Implant Fails?
Most dental implants last for many years, but not all of them. If yours feels loose, sore or just not right, here is what might be going on, what an assessment involves and what your options are.
What Happens If a Dental Implant Fails, and Can It Be Replaced?
A failing implant usually shows itself as looseness, pain, swelling, bleeding or pus around it, or gum and bone shrinking away. At Comely Bank Dental in Edinburgh we assess it with an examination and imaging, often a 3D CT scan at £160, and then explain whether it can be treated, needs removing, or can be replaced once the area has healed. Many failed implants can be replaced successfully, although sometimes a bone graft is needed first.
What Does It Mean When an Implant Fails?
An implant has failed when it is no longer held firmly by bone, or when it has lost so much supporting bone that it can't be kept healthy. Sometimes the implant itself is loose. Sometimes it is still fixed but surrounded by infection and bone loss that is getting worse.
It helps to separate the implant from what sits on it. A loose crown, a broken screw or a chipped tooth is a problem with the restoration, not with the implant in the bone, and these are usually straightforward to put right. A genuinely failed implant is less common, but it needs a proper assessment rather than a wait-and-see approach.
If you have an implant that feels wrong, the most useful thing you can do is have it looked at early. At Comely Bank Dental in Edinburgh we see patients with implants placed here and elsewhere, including abroad.
Early and Late Failure: What Is the Difference?
Implant problems tend to fall into two groups, and the causes are different.
Early failure happens before the implant has properly bonded with the bone, usually within the first few months. The bone simply doesn't grow onto the implant surface. Typical reasons include infection during healing, the implant moving too much while healing, overheating of the bone during drilling, smoking, or an implant that wasn't stable enough when it was placed. The implant often becomes mobile or uncomfortable before the crown is fitted.
Late failure happens after the implant has integrated and has been in use, sometimes for years. The most common cause is peri-implantitis, a gum and bone infection around the implant. Other causes include too much biting force on the implant, a crown that traps food and plaque, or, rarely, a fracture of the implant itself.
The distinction matters because it points to what needs fixing before any replacement is considered.
Worried About an Implant?
Whether your implant was placed here or elsewhere, we can examine it, take the right images and explain your options plainly. Call the practice or book online.
What Signs Should You Look Out For?
Some signs are obvious; others creep up slowly. Contact a dentist if you notice:
- Movement. Any wobble in the implant tooth. It may be a loose screw or crown, but it needs checking.
- Bleeding when you brush around the implant, or pus.
- Swelling or tenderness in the gum around it.
- Gum shrinking back, so more of the crown or a grey metal edge shows.
- Pain when you bite, or a dull ache that doesn't settle.
- A bad taste or persistent bad breath from that area.
- A change in your bite, or the crown feeling high.
Peri-implantitis is often painless until it is well advanced, so regular checks and X-rays matter even when nothing feels wrong. If you have sudden swelling, fever or pain that is getting worse, book an emergency appointment.
What Is Peri-Implantitis?
Peri-implantitis is to an implant what gum disease is to a natural tooth. Bacteria build up around the neck of the implant, the gum becomes inflamed, and over time the bone that holds the implant is lost.
It starts as peri-implant mucositis: red, puffy gum that bleeds on brushing, with no bone loss yet. At this stage it is usually reversible with professional cleaning and better home care. Once bone loss begins, it becomes peri-implantitis and is harder to treat.
Treatment depends on how far it has gone:
- thorough cleaning of the implant surface, often with Airflow, and close hygiene follow-up;
- adjusting or remaking a crown that is hard to clean around;
- a minor gum procedure to clean the implant surface directly, sometimes with a graft to rebuild lost bone;
- removal, if too much bone has been lost for the implant to be kept.
People who have had gum disease around their natural teeth are more prone to peri-implantitis, which is why gum health is checked and treated before implants are placed.
What Causes Implants to Fail?
Usually it is a combination of factors rather than one cause. The main ones are:
- Smoking. It reduces blood supply to the gum and bone, slows healing and is consistently linked with higher failure rates and more peri-implantitis.
- Gum disease. A history of periodontitis raises the risk, especially if it isn't kept under control.
- Overload. Heavy grinding or clenching, a bite that puts too much force on one implant, or a long crown on a short implant can strain the bone and the components. A night guard may be advised if you grind.
- Diabetes control. Well-controlled diabetes is not usually a barrier to implants, but poorly controlled blood sugar affects healing and resistance to infection.
- Cleaning. Plaque left around an implant behaves as it does around teeth. A crown with an awkward shape or cement left under the gum can make this worse.
- Planning and placement. An implant placed too close to a neighbouring tooth, too shallow or too deep, or in bone that was too thin, is harder to keep healthy.
- Certain medicines and treatments, such as some bone-strengthening drugs or radiotherapy to the jaws, which need careful assessment.
What Happens at an Assessment?
When you come to see me about a problem implant, the first job is to find out exactly what is wrong. I'll ask:
- when and where the implant was placed, and the type if you know it (a treatment record or implant passport is very helpful);
- what you have noticed and when it started;
- about your general health, medicines and whether you smoke.
Then I'll examine the implant and the gum around it, check whether the implant or the crown is moving, measure the pockets around it and look at your bite. A small X-ray shows the bone level along the implant. Where I need to see the bone in 3D, or plan a replacement, a CT scan is taken at the practice for £160.
By the end you'll know whether the problem is with the crown, the gum or the implant itself, and what the realistic options are. Fees for anything further are given in writing before any treatment starts.
Can a Failed Implant Be Removed and Replaced?
Often, yes. A loose implant can usually be removed quite simply under local anaesthetic. One that is still fixed but has lost bone may need a special tool to unscrew it with minimal damage to the surrounding bone.
What happens next depends on what is left:
- Enough healthy bone: occasionally a new implant can go in at the same visit, but more often the site is left to heal for a few months first.
- Some bone lost: a graft at the time of removal or later helps rebuild the area. Our patient guides cover bone grafting in more detail.
- A lot of bone lost, or the cause can't be controlled: a bridge or denture may be the more sensible answer.
Before replacing an implant, I want to understand why the first one failed and correct it, whether that means stopping smoking, treating gum disease or protecting against grinding. Replacing an implant without addressing the cause risks the same outcome. A replacement is planned on the CT scan and placed with a MegaGen R2 3D-printed guide, so its position is based on the bone that is actually there.
Should You Get a Second Opinion?
If you have been told an implant has failed, or you're unsure whether a problem is serious, a second opinion can be reassuring. Implants placed abroad are a common reason people come to us, often because follow-up care is difficult to arrange from home.
We'll look at your implant with fresh eyes, take whatever imaging is needed and explain what we see in plain language. If the original dentist can still help, we'll say so. You can read more on our second opinion page.
Please bring any records you have, especially details of the implant system, as replacement parts differ between brands.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.