9 Common Causes of Bad Dental Implants

Dental implants have been growing in popularity as a means of replacing missing teeth. With this method, oral surgeons or periodontists (a dentist who specializes in procedures for gum disease and dental implants) permanently affix natural-looking false teeth customized and color-matched to fit into your smile. This multi-stage procedure has a very high success rate, with 90%-95% of implants lasting without an issue for 15 years or longer.

In other cases, however, dental implant failure can cause the implant to feel loose and contribute to chewing difficulties and pain, among other symptoms. Many factors can increase the risk of this happening, such as having certain medical conditions, infection at the implant site (peri-implantitis), or complications of the surgery.

This article provides an overview of what can go wrong with dental implants, what you can do if you experience implant failure, as well as how to prevent this issue.

Signs

Signs that your dental implant is failing include:

• Implant feeling loose: Implants are comprised of a crown (the false tooth) affixed to a post that’s embedded into your jaw bone called an “abutment.” Looseness, or the feeling that the tooth is moving or twisting, arises when these elements aren’t properly affixed.
• Difficulty chewing: If the dental implant hasn’t set into the right position, your teeth end up out of alignment. Among other issues, this makes properly chewing, speaking, or even just opening your mouth more difficult. Furthermore, this can arise if there’s numbness due to damage to the nerves as a result of the procedure.
• Gum inflammation or recession: An additional sign of dental implant failure is inflammation and bleeding in the gums around the affected area. In some cases, this can advance to gingivitis and periodontitis (an infection of the gums) and cause the gums to recede. This can expose the abutment, among many issues.
• Swelling: Facial swelling can also be a sign of dental implant failure. While some is expected in the first 72 hours after surgery as you recover, if this persists after that you need to let your oral surgeon or periodontist know. This swelling may be a sign of peri-implantitis.
• Pain or discomfort: You’ll likely experience some pain and discomfort in your mouth in the week following dental implant surgery. Your oral surgeon will prescribe pain medications and give you other tips for managing this. Pain lasting longer than 10 days may be a sign of dental implant failure. In this case, call your dentist or seek care.  

Causes of Dental Implant Failure

There are two primary types of dental implant failures. Early implant failures occur due to problems with the procedure itself, or osseointegration, the process by which bone material grows around the abutment and integrates it into the structure. Late implant failures tend to be the result of other health factors as well as pressure placed on the prosthetic tooth.

Teeth Grinding

Clinically referred to as “bruxism,” teeth grinding or gnashing can challenge the success of a dental implant. The pressure placed on the implant early in the process can affect osseointegration, causing instability and implant failure. Managing this condition may be critical in ensuring success of the tooth replacement.

Allergic Reaction

In rare cases, people have allergic reactions to the titanium used for the abutment. As the implant undergoes osseointegration, titanium ions may spread to surrounding bones and tissues. In those with sensitivity, this can cause:

• Hives on the skin or in the mouth
• Eczema, redness, and itching on the skin or inside the mouth
• Swelling (edema) in the face or mouth

In severe cases, allergy to titanium has systemic effects, leading to necrosis (cellular death in the bone), neurological problems, chronic pain, and other issues.

Poor Impressions

The crown of the dental implant (the false tooth) needs to be perfectly matched to the surrounding teeth; there needs to be a perfect fit. Critical for this is that the dentist take a good impression, which is a cast that’s used to create a replica of your teeth.

If something goes wrong with this process, there’s a chance the prosthetic tooth will not properly fit into your mouth, which can cause a range of issues and lead to implant failure.

Infection

Infection of the gums around the dental implant, or peri-implant diseases, can also lead to failure. In a similar fashion to periodontitis, bacteria in the mouth form along the abutment at and below the gum line, eventually irritating and damaging the surrounding tissue.

There are primary types of peri-implant diseases:

• Peri-implantitis mucositis: This is when there’s inflammation and infection only in the gums surrounding the implant. It’s characterized by redness and tenderness in these areas, and bleeding when brushing. It is generally treatable and reversible.  
• Peri-implantitis: If allowed to advance, the infection can begin to affect the underlying bone structure as well. This significantly destabilizes the implant and is much more severe, requiring surgery to correct it.

Nerve Damage

If something goes wrong during dental implant surgery, surrounding nerves can become impacted or damaged. This can lead to persistent pain, numbness, tingling, or loss of sensation in the mouth. These cases may warrant work with an orofacial pain specialist, a dentist who specializes in pain disorders of the mouth, jaw, and face.

Implant Micromovement

Slight shifts in the position of the implant can also be a cause of failure. This happens during the period of osseointegration—which can take over two weeks—as the abutment remains mobile and susceptible to pressure. This instability can worsen and impacts the incorporation of the dental implant.

Bone Support Issues

The bone of the maxilla (upper jaw) or mandible (lower jaw) needs to be strong enough to support the dental implant. This essential bone material can weaken due to periodontal disease, trauma or fracture, tumors, and other health conditions. Insufficiency here can cause failure and warrants treatment.

Medical Conditions

Underlying conditions can also lead to dental implant failure, which is why a health evaluation is a necessary pre-requisite for surgery. Your body needs to be in good enough shape to take on the impact and recover from implantation. 

Several factors increase the likelihood of complications and failure:

• Uncontrolled diabetes
• Osteoporosis
• Certain cancers
• Autoimmune diseases
• A history of radiation therapy on the head and neck
• Smoking
• Poor dental health; gingivitis and/or periodontitis

An Inexperienced Surgeon

When it comes to a complicated, multi-stage procedure like dental implant surgery, there isn't a lot of room to make even small mistakes. Some dental implant failures are the fault of the oral surgeon, occurring due to poor placement of the abutment, or unintentional damage to surrounding tissues and bone.

What to Do if Your Dental Implant Fails

The first step in taking care of an issue is knowing when to call for help. If you’ve had a dental implant, call your oral surgeon or healthcare provider if you experience any of the following:

• Speaking, chewing, or mouth opening difficulties
• Facial swelling after the first two days
• Persistent or worsening toothache and/or mouth pain
• Bad breath
• Swelling and pain in the gums
• Loose teeth or gaps in your smile
• Discharge (pus) from the affected area

Replacement

If the dentist has determined your implant is likely to fail, replacement can be considered. Depending on the case, the existing prosthetic can be either pulled out like a tooth or extracted with surgery.

You’ll need to undergo a significant period of healing before a new abutment can be put in; it takes six months or more for your bone and tissues to recover. Additionally, underlying health factors that lead to the failure need to be addressed.

Bone Grafting

If the bone surrounding a failed implant doesn’t heal well or isn't strong enough, your oral surgeon may consider bone grafting. The goal of this procedure is to reinforce the jaw with transplanted bone material. This can be either harvested from another part of the body, grown from tissue in a lab, or made of synthetic materials.

Following successful recovery from this procedure, a new dental implant can be positioned.

Alternative Methods

There are other options for replacing missing teeth, worth considering if replacing your dental implant seems like a risky option. These options include:

• Dental bridges: One or more prosthetic teeth are permanently affixed to surrounding ones. Additionally, dental bridges can be affixed to implants.
• Partial dentures: Partial dentures, also known as removable false teeth, are another common means of correcting a smile. These are taken out at night and when eating.
• Full dentures: When most or all of a set of teeth are missing, full dentures can be worn as a replacement. As with partial dentures, special care needs to be taken with these.  

Prevention

Preventing dental implant failure means being attentive to your oral surgeon or periodontist’s recommendations and keeping up with good oral hygiene. This means:

• Brushing properly, at least twice a day
• Flossing once a day
• Not smoking or drinking alcohol
• Coming back for follow-up appointments
• Having regular check-ups and cleanings

Summary

Dental implants are a common solution to replacing missing teeth. While most dental implants are placed without issue, it is possible for them to fail.

Reasons for dental implant failure include teeth grinding, an allergic reaction to the materials used, poorly made dental impressions, infection, nerve damage, movement of the implant, issues with underlying jawbones, and various medication conditions. There are methods to fix these reasons for failure, but it can be a long and invasive process.

Your dentist can help you determine if dental implants are a good fit for you. They may recommend that you go with an alternative method such as dental bridges, partial dentures, or full dentures.

A Word From Verywell

Having a dental implant is about more than just enhancing your smile, it can help prevent the many health issues associated with missing teeth. However, a range of factors can increase the chance of dental implant failure, which is why the decision to undergo this procedure shouldn’t be taken lightly. If you’re thinking about filling that gap in your teeth, talk to your dentist about your options.