Reply To: Abutment & Crown Fell Out – Risk of Leaving a Hole?

Thank you for providing the additional details.

It sounds like the abutment (post that connects the implant and the artificial tooth) is the component that is coming loose while it is still attached to the crown/artificial tooth. Please reference the image below to confirm that this is the problem you’re describing.

Next, make sure the implant isn’t loose. As long as the implant isn’t, the bone and gum tissue around it forms a tight seal that prevents any bacteria from seeping down and getting stuck between the implant and your bone and causing bone loss and implant failure. If it is, you should see your dentist ASAP.

Food can get easily get trapped down inside the “hole” that has been left behind by the abutment/crown. If it isn’t removed completely from inside the implant or between the gums, bacteria will grow and you could develop an infection. Your situation isn’t necessarily high risk (you’ve been fine for 2 years), but definitely there is always a chance and you’re at a higher risk than if you had an abutment/crown properly in place.

An abutment/crown that is poorly positioned or loose can also provide a space for food to be trapped in and cause an infection. For this reason, I would suggest not trying to re-attach and use the artificial tooth yourself even though it seems intuitive to try to put it back in when it falls out.

To reduce the risk of infection, be sure to brush and floss regularly and visit your dentist on a consistent basis to get them to check on the status of your implant. Make sure you gently and thoroughly clean all food particles from in and around the “pocket” so that there is nowhere for bacteria to thrive.

If you notice swelling, bleeding, receding, discolouration or pain in your gum tissue, consult your dentist immediately as you might be developing a peri-implant disease. If left untreated, the bacteria will start to damage the gum tissue and eventually cause bone loss around the implant. Damage to the gums may be successfully treated and is reversible if caught early on, but damage to the bone structure requires surgery to correct. See: http://www.perio.org/node/509

Finally, it is important to note that your jawbone needs constant stimulation in order to maintain its form and density. The hundreds of chewing-related stresses that a tooth experiences every day prompt the bone beneath it to continually rebuild and change. Since you are missing an active tooth/implant, you’ll start to lose the width and height of alveolar bone in the area. An average of 25% of width is lost in the first year after a tooth is lost and 4mm in height is lost in the next few years.

Please note that I am not a professional on the matter and that this is for informational purposes only. Please consult your dentist if you notice any problems.