If an Implant Fails

The Signs an Implant Is Failing

• Pain or tenderness around the implant that doesn't settle, especially when you bite
• The implant or its crown feels loose, or you can move it
• Gum that's red, swollen or bleeds when you brush, or pus around the implant
• A bad taste or smell that cleaning doesn't shift
• The gum shrinking back so you can see the metal of the implant
• Bone loss around the implant on an X-ray, which you won't feel but a dental examination will show

A loose crown isn't the same as a loose implant: a crown screw can loosen while the implant underneath is solid, and that's a ten-minute fix. Either way, don't wait. The sooner a problem is seen, the more likely the implant can be kept.

Why Implants Fail

Published studies put long-term implant survival well above nine in ten, and our own record is a success rate above 99% across more than 2,000 implants,⁵ so failure is the exception. When it happens there are usually three reasons.

• Early failure: the implant never bonds with the bone in the first weeks or months. Causes include infection at placement, bone that was too thin or soft for the implant chosen, movement during healing, or smoking. It shows as looseness and discomfort before the final crown goes on.
• Peri-implantitis: the implant equivalent of gum disease. Plaque builds at the gum line, the gum becomes inflamed, and if it isn't cleaned away the inflammation reaches the bone, which shrinks back from the implant. It's the commonest cause of late failure and the most preventable.
• Overload: a crown or bridge that takes more force than the implant can carry, often from grinding, a bite that was never balanced, or too few implants carrying too many teeth. It shows as loosening screws, chipped crowns and, eventually, bone loss.

Poor planning sits behind more failures than people realise: an implant placed without a CT scan, in the wrong position or angle, has less bone around it from day one. That's why every implant here is planned on our own scanner and placed with a guide.

What We Do First

• Listen and look. When the implant was placed, by whom, with what, and what's changed. Then an examination of the implant, the gum and your bite.
• CT scan (£160), which shows exactly how much bone is left around the implant and whether it's still fused to it. An ordinary X-ray can't tell you that.
• An honest answer. Some implants can be saved with a deep clean around them, treatment of the gum and a change to the crown or bite. Some can't, and we'll say so.

The assessment is free, with a £40 deposit refunded within 7 days of attending, whether the implant was placed here, at another practice or abroad.

If the Implant Can Be Saved

Early peri-implantitis responds to professional cleaning around the implant, sometimes with a short course of antibiotics and a change to how you clean at home. A loose screw is tightened or replaced. An overloaded crown is adjusted or remade, and a night guard protects it if you grind. After that it's hygiene visits every three months and a check of the bone on an X-ray, so the problem doesn't come back.

If It Needs to Come Out

• Removal. A failed implant is usually easier to remove than it was to place, under local anaesthetic, with sedation if you'd like it.
• Healing. The site is cleaned, often grafted at the same time to rebuild the bone, and left to heal for a few months.
• A temporary tooth for a visible gap: a simple denture from £495 or a stick-on bridge at £675.
• A new implant, planned on a fresh CT scan, in the best position the bone now allows, sometimes a different size or angle from the first.
• A new crown once the implant has bonded.

Replacing a failed implant has a high success rate when the cause is dealt with: the infection treated, the smoking stopped, the bite balanced. Our guide to bone grafting explains the rebuilding step.

What It Costs

If the implant was placed here, our guarantee covers what the consent form sets out: a 5-year guarantee for non-smokers who attend hygiene visits every 3 months. If it was placed elsewhere, replacement is quoted after the scan and set out in a written plan: a new implant and crown from £2,775, with a bone graft at £535 or £998 where needed, and sedation at £500 if you want it. Treatment from £1,500 can be spread with Chrysalis Finance.

One practical point: a new crown or bridge on an existing implant needs parts that fit that implant system. If you know which system was used, tell us; if you don't, we can usually identify it from the X-ray, but it takes longer.

Implants Placed Abroad

We see the same problems in implants from any source, but implants placed on a compressed timetable abroad fail for a predictable reason: final teeth fitted before the implants had bonded. If you've had treatment abroad and something isn't right, bring whatever paperwork you have and we'll assess it like any other. Our guide to treatment abroad covers what to check before you book, and what to do if you already have.

Keeping It From Happening

• Don't smoke. It's the single biggest risk to an implant, before and after placement
• Clean around the implant every day, with interdental brushes and a water flosser under any bridge
• Keep hygiene visits every three months, so inflammation is caught while it's still reversible
• Wear a night guard if you grind
• Tell us early about bleeding, looseness, pain or a change in your bite

Our guide to how long implants last goes through the care that keeps them.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.