As with any other surgical procedure, there are a variety of internal and external factors that cause complications or even total failure of the treatment. Dental Implants are no exception. Dental implants are designed to be a permanent replacement for a missing tooth or teeth and are a popular alternative to removable dentures or fixed bridges. They anchor artificial teeth directly into the jawbone which makes them a more functional and aesthetically pleasing restoration. That said, they are also more expensive and have longer treatment and recovery times.
In This Guide
- Success Rates
- 1) Failed Osseointegration (Loose or Fell Out)
- 2) Peri-Implantitis (Infection)
- 3) Nerve & Tissue Damage
- 4) Overloading
- 5) Sinus Problems
- 6) Foreign Body Rejection
- 7) Failure of the Implant Itself
- 8) Allergic Reaction
- What to do if an Implant Has Failed
While the track record of successful dental implant procedures is impressive, some patients do experience some complications. The following are a few of the possible causes and reasons behind dental implant problems or failure that you should be aware of before deciding to get dental implants or as you start the post-surgery healing period.
Success Rates
More than 95% are completed without incident (up to 98% if they are cared for properly). The majority of the problems that do occur are minor and easily resolved. If something does go wrong, consult your dentist or surgeon as soon as possible. A fast response enables them to take corrective actions before you or the implant is threatened by additional (more serious) problems, which is why it’s important to be aware of the possible complications. Other ways to improve the chance of success include finding an experienced dentist, planning the treatment schedule carefully beforehand and following aftercare and oral hygiene instructions to the letter.
1) Failed Osseointegration (Implant is Loose or Fell Out)
Osseointegration describes the formation of a direct functional and structural connection between a person’s bone and an artificial implant. This process takes place over the course of several months after the implant is placed. Failure of an implant is often attributed to the failure of the jawbone to fuse together properly with the implant. An implant is deemed a failure if it is mobile, falls out or shows signs of bone loss of more than 1 mm after the first year and more than 0.2 mm after the second year. Several factors can cause this to happen including incorrect positioning, insufficient bone density or volume, overloading, damage to surrounding tissues, external force/sudden impact, fractured implants or even a reaction to anesthesia. Several of these causes are described below.
Before an implant can integrate properly into a jawbone, there must be a healthy volume and density of bone present. For patients who lack adequate bone height, width or length, procedures such as a sinus lift or bone graft can help add space and bone mass, but significantly add to both the total treatment time and cost.
It’s interesting to note that the density of bone beneath missing teeth deteriorates over time since it is not being stimulated by the forces of chewing. Patients who have been missing teeth for months or years often require bone grafts before they can get implants.
2) Peri-Implantitis (Infection)
Peri-implantitis, or infection, can set in when bacteria is present during oral surgery or any time post-surgery without proper dental hygiene. It can also be caused by the dental cement used to secure crowns onto the abutments when it escapes from under the crown during cementation and gets caught in the gums.
It is a condition that involves inflammation of the gum and/or bone around the implant and is one of the common complications. A form of periodontal disease, peri-implantitis can cause bone loss and implant failure. It can sometimes be treated, but in most cases the implant must be removed. There are cases where it does not occur until several months or years following the surgery. Patients with diabetes, smokers, patients with thin gums and those with poor oral hygiene are at greater risk of developing the infection. Smoking in particular significantly decreases the success rate of an implant.
3) Nerve & Tissue Damage
Another possible but rare problem is damage to the tissue surrounding the implant, specifically the nerves. When an implant is placed too close to a nerve, patients may experience chronic pain, tingling or numbness in their cheek, gums, tongue, lips or chin. The nerve damage could be temporary or permanent and the implant might need to be removed. In almost all cases, this problem is caused by mistakes made by an inexperienced dentist.
As with other invasive surgeries, some tissue damage will occur during a dental implant procedure. Some bleeding and pain is to be expected for a couple days after the surgery, but if the pain is extreme, the bleeding excessive or they it last longer than a few days, you should contact your dentist.
4) Overloading
In certain cases, the oral surgeon may decide to perform immediate loading during a dental implant procedure. Immediate loading is a one-stage treatment method where the crown and abutment are placed on the dental implant right after the post is surgically inserted. The normal process consists of two stages and provides time for the implant to integrate with the bone before adding the components that protrude above the gums. Benefits of this method if problems do not occur include less post-surgical care, quicker recovery and shorter treatment times. However, this all-in-one procedure can lead to complications since implant integration is incomplete.
Overloading is the term given to failures caused by undue pressure or forces placed on the protruding abutment and/or crown. These forces can easily disrupt the osseointegration process. Patients who have inadequate bone mass may not be eligible for immediate loading.
5) Sinus Problems
Sinuses can be a major challenge for dental implants replacing teeth in the upper row. In addition to the presence of the sinuses, insufficient bone quality and quantity in the upper back jaw can make dental implant procedures in this area difficult.
To develop a strong bone foundation, an oral surgeon may perform a sinus augmentation. This procedure involves lifting the existing bone into the sinus cavity to create enough space that for a bone graft. The goal is to create more bone in that area in order to support a dental implant.
However, if the implant protrudes into the sinus cavity, the area can become infected and/or inflamed. An X-ray or CT scan can easily detect this problem and corrective surgery can then be performed. Patients should inform their oral surgeon of sinus issues prior to the implant procedure.
Other Risks & Causes of Failure
The following are other risks and causes of dental implant challenges for patients to consider.
6) Foreign Body Rejection
Similar to organ transplants, it is possible that a patient’s body will reject the dental implant. In this case, the patient’s body see the dental implant as a foreign object that does not belong and pushes it out.
7) Failure of the Implant Itself
Even though they are made of metal (usually titanium), it is possible for the post to bend or even break. This much less common than it was years ago thanks to advances in implant design and materials, but it is still possible. An implant can crack or fracture if it is subjected to excessive external forces. This could be a sudden impact like a blow to the face or excessive pressure over a period of time like grinding teeth or an unbalanced crown.
8) Allergic Reaction
Most implants today are made of a titanium alloy that contains traces of nickel. While quite rare, some patients can have an allergic or inflammatory reaction to titanium. The symptoms can range from itchiness to Chronic Fatigue Syndrome. The MELISA test is the only scientifically-proven way to determine whether or not you have a titanium allergy and what the severity is.
Contraindications
In addition, there are a number of conditions and external factors that can be reason enough for a dentist to withhold dental implants from a particular patient. There are very few reasons that would absolutely prohibit implant dentistry, but the following points should be taken into consideration.
- Failure to locate a primary nerve in the lower jaw
- Insufficient bone height, width or length
- Uncontrolled Type II diabetes
- Oral or intravenous bisphosphonates
- Bruxism (tooth grinding or clenching)
- Smoking
Summary
While that might seem like a long list of highly-unpleasant problems, remember that serious problems are rare and success rates are 95%+ as long as you find a trusted dentist to do the surgery and look after your teeth. Regular visits to the dentist can help manage most problems easily thanks to early detection. That said, be sure to contact your dentist as soon as possible if you have any of the symptoms mentioned in order to prevent implant failure or at the very least avoid developing more serious health problems.
What to do if an Implant Has Failed
All is not lost if a dental implant fails. It is sometimes possible to save an implant (if help is sought quickly enough) by building up the bone & gum tissue surrounding it. However, in most cases the implant must often be removed and the area left to heal. An implant can be attempted once the area has recovered, which can take up to a year or until the dentist determines that the site is suitable. Depending on how well the area heals, a bone graft might be required to provide a better foundation for the implant and improve the chance of success.
If the implant fails a second or third time, then it’s a sign that either:
- The dentist doesn’t know what they’re doing/isn’t capable of successfully completing the procedure or
- You have insufficient bone density, an allergy or are otherwise unsuitable for implants
The best way to figure out which situation you’re in is to get an honest second opinion from another dentist to see if they think that implants will work for you and to inspect the work the other dentist did.
In the first case, there are two main courses of action:
- Ask for some or all of your money back and start looking for a new dentist.
- Consult a legal professional to determine if you have grounds to sue for negligence or malpractice.
If you fall into the second category (you are the cause of the problem), your dentist should be honest with you and suggest other tooth restoration solutions such as dentures or bridges as implants probably won’t ever work.
In either case, the most respectable dentists will refund you for the failed implants or offer you credit towards an alternative restoration. However, at the end of the day, your dentist’s responsibility depends on what it says in your agreement.
Get Answers to Your Questions
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What to Read Next
- Find a Dentist Using Our Clinic Locator Map
- How to Find a Dentist You Can Trust
- Dental Implant Surgery, Recovery and Aftercare Guide
- How Painful are Dental Implants?
- How to Save Money on Dental Implants
- Dental Bridges vs Implants: Comparison of Costs & Benefits
Over to You
Which of these problems are you experiencing?
I had (2) done with bone grafting. X-rays were taken and my dentist put the crowns on the end of May 2014.
Today is 9/26/14 (3 months after getting the crowns), and one of the implants has FAILED (it is wiggly). My dentist thought it was his crown, but the x-ray shows that the grafting around the implant, is gone. The office is closed but my dentist confirmed this with an x-ray. He told me to “be careful” since I cannot be seen until next week!
He said: “I never saw this before”.
$13,000.00, for 3 months of (2) implants is not a good deal.
I was sick from the antibiotics, and the pain of them being pulled was terrible.
I am beyond ANGRY since I had to dip into retirement savings to pay them all.
NO financing at all……so we pay YOU in full for work that may or may not work?
Be careful people.
Where did it go? I spend $13,000.00 total, on this procedure, that took a whole year.
Now I am back to wondering, what they can do to fix this?
I am not giving them another penny. This is unacceptable for the price and all the PAIN!
How can this be fixed?
Seems like everyone is angry at me. I paid them all.
My periodontist is now, implying that the dentist could be at fault.
“They use a lot of torque when they put the crown on.”
I asked him to save my crown because they are over $1,500.00 each!
He said he cannot save the crown, and I told this to my dentist. He said, they could have.
Now, I have no idea who is going to pay for the crown once I am ready for that.
I know one person who is not paying……..me.
Stand behind your work already. I called many offices and they all stand behind their work forever. Nobody said they would charge all over again.
I guess its just Connecticut, that is gouging.
Good luck to everyone above~
Get a lawyer and sue for malpractice, dentists get away with so much incompetence it is unbelievable, there are many lawsuits against dentists you just don`t hear about them.
Thanks Rick….2 attorneys turned me away, just this .week?
Today, I went to an appointment, to find out what he would do next.
He said, with my husband in the room, :I should have done a sinus lift.”
He also said: “I need to refer you to a surgeon who handles “chronic pain patients”, as that is not my expertise.” (He is uncomfortable prescribing pain medication for SURGERY)
He knew from day one that I was a chronic pain patient, so why did he not refer me to the surgeon to begin with? Get the sinus grafting done, back in 2013? He took my money, knowing he would not manage my pain, and the outcome was bleak WITHOUT the sinus lift. No offer to reimburse, so I called back and left a message, about him doing that, since he should have never accepted me as a patient to begin with.
I actually would rather have that happen then go down the road of a lawsuit.
Going on (3) years of torture and infection & failure, and a TON OF MONEY, for me to be no closer to a remedy.
AMEN!!! I myself, when living in the Chicagoland area about 13 years ago, had issues with thwqo diffewrent dentists within 2 years of each other. In each case it concerned a bridge (two separate areas) and each stopped working and/or came all the way loose under one year. When I found a one dentist after the first mishap/failure, the new dentist took that [picture with the machine that goes all the way around the mouth, and showed clearly that a bridge should never hare been put in at all. He told me what to say to the old dentist. i went back to the old dentist who had put in the bridge and showed him the pic and stated”Here is your mess-up. I will now take my $1300 back right now or I will report you to the dental board.” He wrote me a check immediately, no questions or fight, and I left.
After learning that, and had a similar problem with a new dentist where I now live in the Akron Ohio area, it was no problem for me to tell this newer dentist the bridge did not fit, was seated incorrectly, and caused me to get an infection. He gave me all of my money back no question.
If this does not show how shady many/most (by my own percentages) are, I don’t know what would.
Your unfortunate situation helped me understand that I was also in an unfortunate situation.
I’m scared to death now. I was treated like a queen when I was giving them $3000 for one tooth implant/bone graft/ extraction, but now I can’t get them to return a phone call or email about complications I have post surgery. 3 sutures fell out with in six days.
I have seriously specific discoloration in my gums-in a solid off-white color ( infection?) . I had #19 removed and the tooth next to it suddenly turned black on top-not so before the procedure. The pain is still very difficult.
Is any of this normal? If so why can’t they simply call me back? Anyway thank you
The sutures do fall out on their own. The discoloration and the pain is normal. As far as the black on the top of the tooth next to the implant that is normal also. I had my bone grafts about a year or so ago on my front upper teeth that had a bridge on them for 20+ years due to a car accident. I had implants placed 7 months later. I would just like to say for the record; my case was complicated because the teeth had been missing for so long. After they put the implants in the dentist immediately took an X-ray to make sure they were all in the right spots. One was to close to the sinus/nose area #9 so he took it out on the spot and moved it and packed extra bone in and then sealed it back up. Then he took another X-ray and said it looked good. Everything has gone great in my case because the dentist was excellent. The one thing I will say is that I was bruised and the pain was awful for a few weeks following the bone grafting/splitting or whatever they had to do but it is worth it. Ice packs were my best friend for those weeks. Pain meds were too. So Nancy you probably know by now that all of your problems post op were normal but this is for everyone else who needs to know.
I had full implants done 4 years ago without any complications, but it took 4 months before I got my teeth put in at a cost of over 25000.00 for everything, now my bottom plate has broken for the tenth time at the same tooth and the dentist can’t give me any reason for it happening, hes even replaced the plate with another one and its broken at the same place 4 times in the past 11 months I’m pissed !
I have the same problem! Got two lower implants & my bottom denture keeps cracking near the implants! It’s a nightmare! I have a job & a life. I can’t keep having my bottom teeth crack in half and fall apart! I probably grind my teeth while I sleep, but it shouldn’t crack them, right? I was going to get more implants, thinking there’s too much stress on the front teeth, but now I don’t know what to do!
Dear Jill, Your denture should NOT be “cracking”! I’ve had a full upper bridge & ten implants in my top jaw for 22 years & I have eaten MANY “Jaw Breaker” candies over those years, I chew ice, & other things that I know I shouldn’t do, but NOT once, NOT ever, have I had my upper or lower bridges “crack”! I also have 4 implants in my lower jaws (2 in the back on both sides & only 8 real teeth in the front of lower jaw — so I do ALL my grinding of food, candy etc with artificial teeth aka dentures & NONE of my dentures — upper or lower have ever cracked in 22+ yrs! Your bridges must be made of INFERIOR products — get your money back & go to a well trained & established dentist !!! I DO NOT RECOMMEND eating “Jaw Breakers” or eating/crunching ICE CUBES, but I’m saying you should not have cracking dentures!
I also had bruxism had when I had my natural teeth & possibly when I 1st had my implants installed, but bruxism (grinding the teeth) is usually caused by emotional &/or unconscious stress. To stop grinding your teeth you need to self-teach or self-hypnotize yourself NOT to grind (find a site or a book on self-hypnosis. Also you need to see a PYSCHIATRIST — A MEDICAL DOCTOR of the psyche & he/she can help you to stop bruxism. I say psychiatrist BECAUSE a Psychiatrist can prescribe medications & a psychologist can’t! You will probably need anti-anxiety medication (Klonopin is a good one) and/or an anti-depressant (Wellbutrin is probably the best & safest one out there — don’t let them put you on any drug, especially an anti-depressant, that hasn’t been on the market at least 10yrs & check the net to make sure the drug is doing well for most people & that it has few if any side-effects).
Again, get your money back (threaten a lawsuit & a report to the medical/dental board) if you don’t get your money back, because it sure sounds like INFERIOR QUALITY MATERIALS were used in your dentures! As I said, I have NEVER had any problems with my dental plate in over 22 yrs! and neither should you!
Also ask your current dentist what dental lab he uses to make your denture & check them out with the medical board & make sure your new dentist does NOT use the same lab! Labs & lab techs make very little money from your denture! Most dentists add a whopping charge to the denture price — which they pocket & you “eat” — no pun intended! For example a denture might cost the dentist $150, but he will usually charge the patient at least 2 or 3 times that — about $300 to $450!
But it is NOT your fault these dentures are failing & you can sue & report the dentist to the medical board if you don’t get all or most of your money back! Remember — your dentist WANTS TO KEEP PRACTICING & HE DOESN’T WANT THE MEDICAL BOARD or LAWYERS SNOOPING into his Business! So be strong, be firm & require your money back, but do NOT use my name, you can use my story. Don’t list this site to your dentist either! Best of Luck !
You need a metal mesh placed inside the denture to prevent flexing of the denture and cracking…without it denture will continue to crack. No one will be able to tell but it will strengthen the denture. Second the bite has to be checked.
I had my implant done 3 weeks ago. Have not had a follow up yet – I go in 3 days. For the past couple of days now I started to have pain on the side of my mouth (implant is upper in the back) near the implant. I rubbed my finger back there to see if I had pain in another area but to my surpise I felt the implant protruding out of my gums. (As though a soda bottle was stuffed in an overstuffed garbage bag and the bottle was coming out but did not tear the garbage bag). WHAT ??? What is this about… This can’t be good. I called my dentist and they said that this is normal… “Normal” – I think not… Normal is having a cavity, not something forgein coming out of my gums. Unless they put something else in my gum area by the implant, this can only be the implant protruding… Waiting to go to my appointment tomorrow… Unbelivable
This could be a piece of bone from your jaw. I was told that slivers or pieces of bone could come thru gum after implant is screwed into your jaw bone. The screw in bone could push loose pcs of bone. Also if you had your natural tooth extracted it could pull up pieces of bone. If it is bone… It is normal and your oral surgeon or dentist will remove. How did dentist apt go?
Today was my 3rd try at getting an implant to work. The 2 previous attempts both failed during the expected healing period. Until today my periodontist always said that he was unaware of titanium EVER being rejected. Apparently he was unaware of this website!!! Today he told me that he has become aware of allergic rejection as a cause of failures. I think his office told me that they would refund my payment if they remain unsuccessful.
I have 4 implants for about 2 years now there like rings coming up from the bottom of the implant and moving up and they have spike on them which hurt.