If an Implant Fails
How to recognise an implant in difficulty, the three reasons it usually happens, what can be saved and what can't, and what a repair involves, whoever placed the implant originally.
My Dental Implant Seems to Be Failing. What Are the Options?
Caught in time, a struggling implant can frequently be rescued, most often by clearing up infection in the surrounding gum or adjusting a crown that is carrying too much bite. Where the implant has already come away from the bone, it is taken out, the socket is given time to heal (frequently with a graft), and a few months later a replacement is placed. Ferry Smile Studios will assess any troublesome implant, whether it was placed by us, by another practice in Scotland or overseas, at a consultation that costs nothing, adding a CT scan (£160) where one is needed.
Implant Trouble, or Crown Trouble?
Working out which component is at fault comes first, because the solutions differ enormously. An implant is made up of three parts: the titanium fixture inside the bone, a connector known as the abutment, and the crown that sits on top, generally fastened together by a small screw.
When the tooth moves, the culprit is very often that screw having loosened while the implant beneath remains rock solid. Tightening or swapping the screw is a short appointment. A crown that has chipped or cracked can be remade on the existing implant. The implant itself is only failing if the fixture in the bone is mobile, or the bone surrounding it is being lost.
Symptoms to Watch For
- Gum beside the implant that bleeds on brushing, appears red or swollen, or discharges
- An unpleasant taste or odour from one particular place that brushing won't shift
- Tenderness when biting on that tooth, or a dull, intermittent ache
- The gum receding so that grey metal becomes visible
- Any movement in the tooth, even the slightest
- Bone loss picked up on an X-ray during a routine examination, frequently with no symptoms whatsoever
Each of these deserves a prompt look. The sooner a problem is identified, the greater the chance of holding on to the implant.
Something Not Right with Your Implant?
Arrange a free assessment at our Broughty Ferry practice. Bring any records you have, plus the make of implant if it's known.
The Reasons Implants Fail
Implants have an excellent long-term record, and failure is rare. When it does occur, it usually belongs to one of three categories.
| Type | When | Typical causes |
|---|---|---|
| Failure to integrate | Within the opening weeks or months | Infection while healing, bone that's thin or soft, an implant bumped or loaded prematurely, smoking |
| Peri-implantitis | Months or years on | Plaque at the gum margin that inflames the gum first and the bone after it; likelier where there's a history of gum disease, smoking, or hygiene appointments that were missed |
| Overloading | Any time once the crown is on | Grinding, an uneven bite, or more teeth than the implants can carry |
All three are influenced by planning. An implant angled wrongly or set too near the edge of the bone begins life with less support, which is why we plan every case on a CT scan and place the implant through a printed guide.
What Happens at Your Assessment
We begin with questions: when the implant was placed, by whom, which system was used if you happen to know, and what has changed recently. Next, the gum and crown are examined along with how your teeth come together, followed by a CT scan at £160. This reveals in three dimensions how much bone still surrounds the implant, something a flat X-ray cannot show with any reliability.
Next we set out, in everyday language, what is going on and which options are realistic, including anything we would steer you away from. There is no charge for the assessment; a booking deposit of £40 is refunded within 7 days of your visit. Where the implant was originally placed makes no difference.
Rescuing the Implant
Picked up early, inflammation around an implant frequently settles once the implant surface has been cleaned thoroughly by a professional, home cleaning has improved, and on occasion antibiotics or a medicated rinse. A loose screw is swapped for a new one. An overloaded crown can be reshaped or replaced, and if you grind in your sleep a night guard (£210) will protect it.
After that, three-monthly visits to our hygienist keep the area under control. Small X-rays taken along the way confirm whether the bone level has steadied.
Fitting a Replacement Implant
- Removing it. Under local anaesthetic a loose implant usually comes away without difficulty, and sedation can be arranged.
- Cleaning and grafting. Infection is cleared from the site and, where bone has gone, it is rebuilt with a graft.
- Healing. Generally a few months. A gap at the front can be disguised with a temporary denture at £495, or with a bonded bridge at £675.
- Replanning. A new CT scan, and a new position for the implant chosen to fit the bone as it is now.
- The replacement implant and crown. Guided placement, with the crown added once integration is complete.
The replacement stands a good chance of succeeding, so long as the reason for the first failure, be it smoking, gum disease or the bite, has been addressed. The rebuilding stage is described in our bone grafting guide.
The Cost of Putting It Right
Where the implant was ours, our 5-year guarantee for non-smokers who attend hygiene visits every 3 months applies, on the terms your consent form sets out.
Where it was placed elsewhere, the cost depends on what the assessment turns up, and we put it in a written plan once we have the scan. As a rough guide, a replacement implant with crown starts at £2,605, a small graft is £535, a larger graft £998, and a session of IV sedation is £500.
Worth knowing: a new crown for an existing implant needs components from the same manufacturer. If you know which brand you have, let us know. If not, X-rays will often identify it, though a few less common systems have no supplier in the UK.
Implants Fitted Overseas
Implants from Turkey, Hungary or any other country are assessed in exactly the same way. They fail for the same reasons as any other implant, although one pattern recurs more often: permanent teeth fitted before the implants had bonded to the bone. What we can and cannot put right, and why, is covered in our guide to implants abroad versus Scotland.
Reducing the Risk
- Give up smoking, before treatment if possible, and don't go back to it
- Use interdental brushes round every implant each day, and a water flosser beneath a bridge
- Keep up hygiene appointments every three months, so inflammation is spotted while it can still be reversed
- Wear a night guard if there are signs you grind
- Contact us at the first sign of bleeding, tenderness or looseness
The daily routine is covered in more depth in our guide on how long implants last.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.