Dental Implant Problems & Causes of Failure

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

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

All is not lost if a dental implant fails. An oral surgeon can attempt the procedure again after the area has had some time to heal.

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What People Are Paying - Recent Comments

  1. MICHAEL ZAWODZINSKI says:

    My implant post is loose. Can it be fixed? What can be done? Thanks

  2. Annie says:

    Hi Michael yes your dentist should be able to replace the post . I would go in as soon as possible so you don’t swallow it

  3. MICHAEL ZAWODZINSKI says:

    WHAT DOES A DENTIST DO IF A POST IS LOOSE? DOES HE TAKE OUT THE OLD ONE AND PUT IN A BIGGER POST?

  4. John Linder says:

    I have had two implants. The 1st one came loose after about two months. The dentist is building up the bone structure for that tooth. The second tooth implant is now coming loose and he wants to build up the bone structure for the second tooth. The time period will be almost two years. I have been warned that I might lose the rest of my teeth if I don’t proceed. I have spent a lot of money for two implants. I am 83 years old. What should I do in this situation?

    • Admin says:

      I am sorry to hear about your situation. I have a couple of questions so I can get a better idea of your options:

      Did your dentist check to see if the bone in your jaw was strong enough to hold the implants? Did they tell you beforehand that there were risks due to your age and your bone density that the implants might fail? If they didn’t, I think you should consider looking for a new dentists or get a second opinion.

      If they did, I would give the dentist a chance to build up the bone structure around your implants as long as they aren’t charging too much and they truly believe that the bone grafting procedures will do the trick. I would ask if you could get the work done at a reduced price (or free) since the implants failed so soon after being put in. Check to see what the agreement you have with the dentist says.

      Lastly, given your age and the fact that both implants haven’t been able to integrate with your bone properly, you might have to consider looking into other options such as dentures and bridges. These options could be cheaper in the long run as you might otherwise have to pay for bone grafts on a regular basis in order to keep the implants in place.

  5. Mark Erickson says:

    I know what you mean. I’ve probably spent 7k on one molar. Dentists like to scare their patients needlessly. The fact that your dentist recommended implants at your age seems irresponsible to me. Like the realtor who sold my dad a house when he was 85. A dental bridge is less expensive, but you need two healthy teeth to support it. That’s what I wanted, but I only had one healthy tooth to support it. Good luck!

  6. Sankarankutty says:

    I had an implant surgery three weeks back. The implant post actually came out today. How long will the process of healing take so that the surgery can be done again?

  7. Karen says:

    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.

  8. Ralf says:

    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.

  9. Babs says:

    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

    • cvz says:

      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?

  10. greg says:

    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 !

  11. Kristine says:

    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~

    • Rick Lobsing says:

      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.

  12. Liz says:

    I noticed my gumline started to recede over my implant (upper molar) and visited my periodontist immediately. He wasn’t sure that it was and decided to take another look in 6 months. I also went to my dentist and she took a picture of it. Three months later, it was obvious. The periodontist decided to wait another 3 months and then decided to do a bone and tissue graft to “fix that.” However, he didn’t do a tissue graft, only yhe bone graft. My gumline has receded further and exposes the entire implant and post. I also have smallbone fragments protruding from my gum. Went for a 2nd opinion. It all has to come out and will have to be redone which will probably take a year or so with removal, healing, bone and tissue graft, healing, etc, or I could lose my teeth. Lesson learned …. don’t wait to “watch” to see what happens. I’ve wasted thousands of dollars on top of insurance, and now it will cost me even morethousands again bc insurance certainly won’t pay again.

  13. jan schmitt says:

    There is nothing better than your own teeth. Even if they are rotten. Dentists are too anxious to pull and replace with screws. As long as your teeth dont hurt keep them. The Lord giveth and Man taketh.
    I lost me teeth at an early age of 18. Who has bad teeth at 18. No one who was born here in this country. Only bad dentists. At age 75 I had 4 implants and so far they are wonderful. Of course I had no bone and I was eating that sticky stuff. How long will they last? Well of course I heard nothing but good things before I got them. After you get them you find out about all the bad stuff. And oddly enough no one is responsible. Buyer beware. They just removed my bottom teeth and I am angry as hell and esp. at myself. Keep going to Dentist till you find someone who will help you keep your own teeth.

  14. Pat Penrod says:

    I had two implants 10/5 and the pain was immediate. I waited two days and went back and found I had an infection and had to be lanced and drained and a drain put in for four days along with more antiobiotics and prednisone. Drain out on Tuesday and went back on Thursday. I also went to my dentist and had them look at it. They said it looked okay but made me a $450 mouth guard for clenching (I’m in pain, duh). I have a knot on my jaw and it tingles like the anesthetics are wearing off and I have been in pain every minute, with IBprophen and tylenol every four hours keeping me from screaming. I am getting on an airplane Wednesday and the surgeon doesn’t want to see me until I get back in a week. Please give me some comments.
    Worst decision I ever made to do this. Should have just let missing teeth alone.

    • tamara anderson says:

      If pain is not getting better by taking antibiotics, steroids and pain medication- I would consider just having them removed. I had my 2nd try at 2 implants on 10/13- and I am going to go in to have them taken out today. Constant pain that is not improving is not for me. It stinks to be one of the 5% that this procedures doesn’t work for.

    • Trudy Penrod says:

      Hi pat penrod. I’m Trudy penrod. It’s 630 in the morning and I’m going through the same thing as you did thought it was funny we have the same last name and going through the same painful experience only a month apart. I have been back to the oral surgeon 3 times in 3 weeks in massive pain. I have a goose egg knot on my right lower side can’t even turn my head. If I’m not better by Monday I’m pulling them out this pain bad! Real bad wonder if we are related and went to the same oral surgeon! I’m in California where are you from ? This is crazy! Are you better yet? I sure hope so like you I wish I never had done this.

      • connie vanzandt says:

        Trudy. I had the all on 4 implant surgery 10/28 and still have the red goose egg knot on my chin. Also my bottom lip has nerve issues and on right lower side, and wont move when I smile. I was so sick a month out of implant surgery I was admitted to the hospital. Major 10 on pain scale with severe jaw pain and unbearable headache. I was told by a member of office staff this was “NORMAL”. My white count was 22,000 and my BP was 165/110. NOT normal. I am still in pain and on antibiotics. Wish I had saved my money amounting to a Mercedes Benz and gotten dentures. Doctor told me I am overly sensitive to pain. BP doesn’t lie…. NORMAL.. my primary dr. told me I was in dangerous shape when he read reports and saw cat scan when I was in hospital with IV antibiotics and pain meds every 2 hrs IV. We know our bodies.

  15. Pam says:

    I have two dental implants. The one for tooth number 19 has been in some years now with no problems. This past February I started feeling pain when I chew with it. The pain is getting worse. I have had the crown taken off for a short time for a thorough examination. Tests have been done which show a healthy implant, perfectly placed. What concerns me is the possibility of early implant failure, but I have seen two dentists, my oral surgeon, and an entodontist already! I’m on disability for lupus and can’t afford implant disaster. Also I have osteoporosis and I want to find out what this implant problem is before going on biphosphonates. Help!

  16. Sharon says:

    I had 2 implants put. In on April 15/14 I have been on antibiotics ever since including 2 weeks of interveinous antibiotics I had me bottom denture put in the same time as the posts. The first one I pulled out with my denture2 weeks later I have developed a big lump on my gum and check where the 2 nd implant came out just had a biopsy done the are calling it endeocartilege so know what can be done i have one base that they say is good and the other side they are waiting till December to see if it will heal more since it have. A large gap in my jaw. Now where the big lump is. Have you heard of this? I also have a tingling feeling like half of my jaw is just starting to come out of freezing. Can you give me any advise on what to do? This is a real pain I have to chop my food almost to baby food cause I can’t chew. I guess I will be with out my bottom denture for a lot longer.

  17. LM says:

    and this is why I quietly go to the bathroom to floss & brush my teeth immediately after I eat anything (or brush only after I drink anything other than water), no matter where I am. Barring unexpected surprises (of course!), I will never know what dental fear, pain, sensitivity, inflammation, bleeding, infection, chronic bad breadth, root canals, crowns, onlays, bridges, implants, dentures, oral surgeries or extractions are, and will likely die with the same original 28 natural healthy teeth I had in my teens a few decades ago (except the original 5 small cavities I developed in childhood before I learned the truth about real oral health)…. and the few times I do visit a dentist every few years, I am in total control (not them) and they do exactly as I say or the highway (I usually request just a light surface cleaning, and maybe some x-rays where I choose)… and why such power/control from me? cuz I KNOW my natural teeth are good, I KEEP them that way… thus tactics/games/warnings coming from dentists don’t work on me….. and soooo…. for that 95% of you who don’t have genetically bad teeth, floss/brush every time you eat (no exceptions)…. or pay the price… a steep price indeed…

  18. Jt says:

    Under the infection section of this article it says that the implant will probably need to be removed. Are you able to retry the implant after a course of antibiotics if the pain goes away? What are the odds of success?

    I just had one pulled after a few days because the pain was so severe. I am paranoid about going through that again. Will antibiotics and time let the bone “calm down”? I had severe pain when drilling, inserting and even worse pain upon removal of this implant. I really don’t want to go through that again.

    It was replacing a smaller implant with a wider deeper one to encourage more bone growth and be stronger in case of clenching. First time was mild pain but nothing like this. It did hurt removing old one too.

  19. KJ says:

    My dentist today recommended I see my periodontist as there is a 5mm gap between my implant and gums; apparently the gap was 4mm last year. There was also some bleeding when she prodded around at it. My implant is 8 years old and I have had no trouble with it – except that there was some movement of the tooth early on (could push forward a little. I told my dentist about that at the time but was more or less told I was wrong and that it wasn’t happening).
    Can anybody tell me what may cause the gap and what can be done?
    Thanks.

  20. J says:

    I had a badly fractured tooth extracted and implant installed in May 2013 and I waited for the implant to heal until 8/13 at which point the periodontist removed enough gum to put in screw. No pain, no problems. A few weeks later the dentist removed the screen and put in the hardware to create mold for crown (still no pain, movement). A few weeks later I go back to the dentist to install the crown and as he is tightening everything, I felt pain around the implant and it moved. I go back to the periodontist and they say that it still looks good and that I need to try not to use the new tooth and see if it can re-attach. It doesn’t hurt but it does wiggle a little bit. I’m ok with waiting for a few months to see if it does get more solid but if not, not sure I want to start the whole process all over and who is to say that the same thing doesn’t happen again.

  21. miriam lynn says:

    Just had an implant removed a month after it was inserted. It felt fine, until it didn’t. The pain was excruciating. Dentist has no explanation

  22. Mary says:

    Anybody have screw in sinus? X-rays show it is in sinus. I do not feel pain, just a little pressure. I go to periodontist in a week and would like to know your outcome if you had implant removed from sinus.

  23. Betty Crudup says:

    I decided to get implants after having a bridge fail and damage one of the teeth (a molar) holding it in place. I had to have bone and tissue grafts. One graft did fine, and the post seems okay. The second “socket” got an infection after the post was in place. I’ve had the second post removed, and a second bone/tissue graft inserted. Today, I looked at the area, and the gum does not seem to be closing over the bone (bone looks exposed). I have an appointment tomorrow to have stitches removed … this is a three week check-up. What would cause the gum tissue not to close over the bone implant? I’m thinking maybe I wont have that second post re-installed

  24. Nicki Cathcart says:

    Feel so relieved that I found this site! Had a tooth pulled 4.5 years ago because apparently a root in my tooth cracked (37 yrs old at time). So, used a flipper until had an implant put in, after letting it take to my jawbone for 8 months, finally got the crown and abutment. A few years later my crown came loose, my dentist tightened and replaced crown. Now crown is loose 3rd time and my dentist told oral surgeon he was 100% sure my implant turned when he tightened the abutment. So, they tell me implant has to come out. So, go to dentist today for him to remove loose crown and then to surgeon for him to remove implant and do bone graft. He cuts open my gum and determines that implant is good!!!! What the heck! Surgeon states that wrong abutment may have been used both times and that is why it went loose. No trust left in my dentist! Guessing once my stitches come out I have to go back to dentist for 3rd try on this. Anyone ever experience this?

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