A failing dental implant can cause a variety of symptoms and feelings in the mouth. Some of the most common signs and sensations of a failing dental implant include:
Pain and Discomfort
One of the first things many patients notice with a failing implant is increasing pain or discomfort in the area. This may start as mild soreness that comes and goes, but tends to progressively worsen over time. The pain may be focused directly on the implant site, or may radiate outward into the jaw, gums, or even up into the face and sinus areas in some cases.
Some describe the pain as a dull, throbbing ache, while others note sharper, more intense pain. The degree of pain can vary from mild to severe depending on the cause and extent of the implant failure.
Loosening
A key sign of implant failure is when the implant becomes loose and no longer feels stable or firmly anchored in the jawbone. This occurs when the bone and tissues supporting the implant begin to break down. Initially, this may manifest as slight movement or rocking of the implant crown or post when pressure is applied while chewing or biting.
As things progress, the loosening becomes more pronounced until the implant eventually becomes very mobile and can almost spin or twist around. This advanced loosening indicates failure of the osseointegration between the implant and jawbone.
Swelling
Inflammation and swelling in the gums around a failing implant are also common. The tissues may look red, puffy and tender. You may notice a buildup of plaque around the area despite brushing. The swelling is usually a sign of peri-implantitis, which is inflammation of the gums and bone loss around an implant.
Bleeding
Unhealthy and inflamed gums around a failing implant often bleed easily. You may notice some bleeding when brushing or flossing around the area. More advanced cases can lead to spontaneous bleeding from the gums around the implant, even without any irritation.
This bleeding occurs as the tissues and bone supporting the implant break down and the gums become inflamed. Poor oral hygiene can contribute to this inflammation and exacerbate the bleeding.
Bad Breath
Failing implants are prone to attracting bacterial biofilm buildup, which can lead to bad breath. No matter how much you brush the implant area, the bad breath persists. This is a sign of active bacteria colonies around the implant, often due to peri-implant disease.
The bacteria produce volatile sulfur compounds that cause unpleasant odors. The diseased tissue around the implant also contributes to foul-smelling drainage and taste in the mouth.
Difficulty Chewing
As an implant becomes loose and fails, chewing ability in that area decreases. The crown or bridge may feel wobbly and unstable when biting down. You may need to chew very cautiously and specifically avoid putting pressure on the implant. In advanced cases, the implant may have no chewing capability at all.
This occurs because the anchoring of the implant in the jawbone has been compromised. The trust between the implant and bone is lost, so it cannot sustain normal bite forces.
Changes in Position or Appearance
Frequently inspecting your implant crowns can help detect failure early. Look for subtle changes in the tooth position, shape, or appearance that can indicate issues. For example, you may notice recession and shrinking of the gums around the implant, exposing more of the metal implant post.
The crown may shift position or appear slightly elevated out of the normal bite alignment. There can also be visible fractures or cracks in the porcelain. The tooth itself may start to feel or appear loose.
Abscesses
Abscesses sometimes form with failing implants, which are pus-filled infections in the gums or bone around the implant. You may notice swelling, purulent drainage, and severe throbbing pain around the implant site. Abscesses require urgent dental treatment since the infection can spread rapidly.
Loss of Sensation
Many failing implants will show a loss of sensation or numbness in the area. This is due to damage to the nerves supplying sensory fibers to the tissues around the implant. The nerve damage usually occurs slowly over time as the implant fails.
In some cases, there is lingering numbness or numb spots even after the failed implant is removed. However, sensation typically improves once the implant is out and healing takes place.
Metallic Taste
Some patients report noticing a persistent metallic flavor in the mouth coming from the area of the failing implant. This can occur when corrosion or micro-fractures take place in the implant hardware. Ions are released that make their way into the saliva.
The dissolving metal ions interact with taste receptors on the tongue, producing a metallic or chemical taste. Rinsing with mouthwash or brushing your tongue can provide temporary relief.
Visible Bone Loss
Advanced cases of implant failure will show obvious bone loss around the implant site. This can sometimes be seen even without an x-ray. The gums may recede to expose more of the implant hardware. Sunken or collapsed areas of tissue around the implant indicate damaged or missing bone.
This bone loss occurs as a result of osteoclast cells breaking down bone damaged by inflammation. It’s the body’s natural healing response, but leaves insufficient bone to hold the implant.
Risk Factors for Implant Failure
A number of factors can increase the risk of a dental implant eventually failing. Being aware of these risk factors can help you take steps to protect the long-term health and stability of your implant.
Poor Oral Hygiene
Poor brushing and flossing habits are one of the biggest risk factors for dental implant failure. Inadequate hygiene allows plaque to build up and breeds bacteria around implants. This leads to peri-implantitis, inflammation, and bone loss.
History of Periodontal Disease
Patients with a history of periodontal disease are at increased risk for developing peri-implantitis and losing dental implants. Underlying bacterial infections can spread to implants and cause similar tissue destruction.
Smoking
Smoking significantly increases the chances of implant failure and complications. The chemicals in smoke interfere with healing and promote inflammation and infection.
Diabetes
Poorly controlled diabetes impairs immune defenses and wound healing, making implant loss more likely. High blood sugar also encourages bacterial growth.
Implant Placement Issues
Problems with the initial placement, position, or alignment of implants can put them at risk. For example, insufficient bone volume or density can lead to inadequate support. Force overload on the implant from occlusion (bite) problems also causes failure.
Biomechanical Complications
Excessive biting forces or occlusion stress on the implant from grinding or clenching can contribute to mechanical failure. Connections between implant parts can also loosen or break.
Bone Damage from Infections
Untreated infections from teeth or gum disease create inflammation that can spread to implant sites. Inflamed tissues release cytokines that activate osteoclasts to start resorbing bone around implants.
Genetic Factors
There are some genetic and immunologic factors that may make certain individuals more predisposed to implant failure and losing osseointegration. Research is still ongoing into these risks.
Diagnosing a Failing Dental Implant
To confirm that symptoms are actually due to a failing implant, your dentist will perform a series of tests and examinations. Common diagnostic procedures include:
Clinical Examination
Visually examining the implant and surrounding tissues for signs of problems. Checking for looseness by rocking the implant crown.
Probing
Using a periodontal probe to check around the implant for pocket depths, which indicate bone loss if exceeding 3-4 mm.
Percussion Test
Tapping gently on the implant crown to check for mobility.
Radiographs
X-rays to look for bone loss, infection, or damage to the implant body. Serial x-rays over time can show progression.
Microbiologic Testing
Swabbing the implant site and lab culture analysis to identify pathogenic bacteria behind infection and inflammation.
Biomarker Tests
Checking levels of biological markers for bone turnover in the gums or saliva can indicate peri-implant disease activity.
CT Scans
3D cone beam CT images help thoroughly assess the condition of the surrounding bone.
Treating a Failing Dental Implant
Treatment options for a failing implant depend on the severity and how far the failure has progressed. Early on, it may be possible to treat peri-implantitis and save the implant. More advanced failure requires removing the implant entirely.
Nonsurgical Cleaning
For mild cases with only minor bone loss, professional dental cleaning and decontamination of the implant surface can help reduce bacteria and inflammation. This may curb early peri-implantitis.
Antibiotics and Chlorhexidine
Oral antibiotics or antibacterial chlorhexidine rinses are sometimes prescribed to treat infection and curb damage from peri-implant disease.
Bone Grafts
Adding bone grafts can help stimulate regeneration in areas of minor bone loss, improving the implant’s stability and prognosis.
Implant Removal
If the implant cannot be salvaged, the dentist will surgically extract it using trephine drills. The site is then cleaned and stitched closed to heal.
New Implant Placement
After thorough healing, it may be possible to place a new dental implant, provided adequate bone remains. Success rates for redoing implants are typically good.
Preventing Dental Implant Failure
While you can never completely eliminate the risk, proper care and maintenance can help prevent your dental implants from failing. Suggested prevention strategies include:
- Practicing excellent oral hygiene with twice-daily brushing and daily flossing.
- Seeing your dentist for professional cleanings and checkups every 6 months.
- Avoiding smoking, which increases failure risks.
- Controlling any medical conditions like diabetes that impair healing.
- Watching for signs of problems and reporting symptoms to your dentist.
- Getting occlusal issues addressed to prevent excessive bite forces.
- Wearing a nightguard if you grind your teeth.
- Having regular dental x-rays to diagnose peri-implant disease early.
Prognosis with a Failed Implant
The prognosis after a failed implant depends greatly on the extent of the problem and amount of supporting bone remaining. Implants that fail soon after placement often have a good chance of successful replacement. Late failures may have poorer prognoses if extensive bone loss has occurred.
Peri-implantitis can be arrested in many cases with proper treatment and care. However, implants with severe infection or advanced mobility usually cannot be saved. Thankfully, new implant placement is quite predictable in most cases provided adequate healing time is allowed.
Cost to Replace a Failed Dental Implant
| Procedure | Average Cost |
|---|---|
| Extraction of failed implant | $500 – $800 |
| Bone grafting | $500 – $2,000 |
| New implant placement | $1,000 – $3,000 |
| Replacement implant crown | $500 – $3,000 |
| Total Replacement Cost | $2,500 – $8,800 |
These estimates depend on the specific work needed, location, and your dentist’s fees. Getting a new implant and crown to replace a failed one can run anywhere from $2,500 to $8,800 or more. Dental insurance may cover a portion of these costs if you have coverage for implants.
FAQs
Why do dental implants fail?
The most common causes of implant failure are peri-implantitis (infection and inflammation of tissues around the implant), poor osseointegration with the bone, excessive biting forces, injury or trauma, poor placement, and inadequate bone volume or density at the site.
How long do dental implants last?
With proper placement and care, dental implants are designed to last for decades. However, average lifespans are often quoted as 15-25 years. Some may fail sooner, while others can last 30 years or longer.
Can a failed implant be saved?
If caught early, peri-implantitis can sometimes be treated with cleanings, antibiotics, and bone grafts to try and save a failing implant. However, implants with severe infection or mobility usually cannot be salvaged.
Is a failed implant painful?
A failing implant is often accompanied by progressive pain and discomfort ranging from mild to severe depending on the cause and extent of failure. Advanced failure can lead to intense pain from infection and abscess formation.
What are the signs my implant is failing?
Signs include pain, loosening, swelling, bleeding, bad breath, changes in appearance, poor chewing ability, metallic taste, visible bone loss, and feeling the implant shift or give way.
Conclusion
Failing dental implants produce an array of concerning symptoms and sensations in the mouth. These can include pain, loosening, inflammation, changes in position, difficulty chewing, and metallic taste. If you notice any signs of implant failure, promptly consult your dentist for examination and treatment. Early intervention may help save a failing implant, but those with severe infection or mobility will likely require extraction and replacement.
