About 30% of my practice is treating failing implants, removing them, rescuing them. Let’s talk about why, and why did your implant fail or why do they hurt?
There is no one reason why dental implants fail. Reasons can range from anatomical – not enough bone or gums – to problems with the bite and mechanical issues and the type of bone you have.
Other reasons for failure may be related to the care and maintenance of implants. They need to be brushed, flossed and cleaned just like any other tooth.
For more details watch the video below and if you have questions or comments, please post them below and subscribe to my channel to get more information about dental implants.
Why did my dental implants fail?
Video transcript lightly edited for easier readability.
Why do implants fail? About 30% of my practice is treating failing implants, removing them, rescuing them. Let’s talk about why, and why did your implant fail or why do they hurt? Sometimes that’s the path that went to failure first. First off, there’s no one reason. But oftentimes the anatomical reasons are you didn’t have enough bone, you didn’t have enough gum, one or both of those. Those are the primary factors. Just having enough space for the implant to hold into. Other things I’ll talk about is your bite, and the mechanics and the type of bone that you have.
Let’s just jump right into it. So, with regards to the bite, having a bite that’s too strong, or a bite that’s poorly designed with the crown, or let’s say an all on full-mouth restoration. If the bite is too heavy, it will completely damage and destroy the implant. You’ll lose bone around it. We call that peri-implantitis, where the tissue can become really red around it. That’s the first sign. They call that mucositis.
So the bite is a big factor. Maybe you don’t have enough implants, too many teeth are attached to the bridge. Maybe an all on four should have had six implants instead, or maybe some zygomatic support or sinus grafting. Maybe you just don’t have enough implant so there’s just more load than the implants can hold. And the bone itself, there’s poor quality bone and there’s good quality bone. Poor quality bone is really soft, and I’ve written many articles on this. A soft bone has a higher failure rate. Typically, you need more implants longer, different ways, densifying the bone to put it in. And on the opposite side, very hard. It doesn’t have enough blood. It’s somewhere in the middle where the bone is medium hardness with regards to the design of your teeth. So that can make or break everything. The skill of the restorative dentist, the experience of the lab, the whole experience of the team. Let’s say you have an all on four, or just a crown that has really bad contours, it snags floss, it’s got a big ledge, stuff gets stuck underneath it, and you just can’t clean it out.
Maybe it’s failing because you don’t clean it enough. Dental implants need to be brushed, and flossed, cleaned, maintained, and have x-ray checks and everything else. It requires proper hygiene. There are some people who thought they did not have to brush implants at all, and have let them go and never gone back to the dentist after they were put in. The design of the bridge is really important. The design of the tooth. It really takes an expert lab technician.
I work with an expert team, and they’re my partner on the other side. Every single case I do is very particular in its design process. Like I said, the experience of the whole team, that includes the lab as well. Switching labs, trying to find the lowest cost materials and the people that work with, those just end up in disaster. And again, about 30% of what I’m doing is removing implants. In fact, last week I took out more implants than I put in. It was really just a bad week. There was some treatment done from out of the country, some right here in Southern California as well.
Maybe it was the actual surgery itself. The procedure wasn’t done with a high degree of sterility. It was just a dental bib and no antibiotics for something major. Antibiotics are not necessary for all cases, but most cases that require grafting, or big cases require some sort of antibiotics for you to be able to prevent and fight infection. Because it’s a large opening for a long time. Materials wise, there is a hybrid, there are plastics, acrylics, the dentures are made of different materials. Zirconia versus metal, how this is designed, and how the bite is supported so that when you grind your teeth it protects itself. We call that a mutually protected bite. When you grind from one side to the other, the right side protects the left side and vice versa when you bite up and down. All of these things, the inclination of the implants, the slant or the abutments fitting properly, or are they the right screws? Are they aftermarket parts? There are original parts with really good implant systems, and some very good complimentary parts as well. And then there are some knockoffs.
There are parts sold on Amazon and eBay, believe it or not, it’s crazy. I can’t even believe it. Other things that I talk about with patients are the quality of your gum. So the gum should have a certain thickness to it. It should have certain durability to it. As the skin of your hand is very durable. It has something called keratin in it to make it tough. You can bang it and it doesn’t get cut or beat up, while the skin of your eyelid is very delicate. So we have a similar relationship in our mouth where we have eyelid skin, and skin around our palm of our hand. And if you have more like eyelid movable skin, we call that mucosa, around the implant, it’ll be really sensitive when you brush. It’ll all be red, and that’s not durable over time. So you start to lose bone, it begins to hurt, and this is part of the failure process. Most failures don’t happen instantly. Some failures, most of them happen very slowly.
Some failures happen right after the surgery, a month out the implant becomes a loose, some of them are are a year, three to five years out, gradual bone loss, gradual redness, plaque accumulation, and then you’re losing bone. There’s an abscess, there’s an infection, recurrent antibiotic treatment over and over only to then lose the implants. My best advice is get it done right the first time. Maintain it with a practice that’s all they do is implant dentistry, and that they care about you like they would their own family. But this is just one of the many reasons why dental implants fail, and just something to know about. Dental implants are not permanent.
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Dr Amin- Husband trying to consider choice to replace teeth extracted in upper free end saddle – anchor tooth would be only on one side I assume if a partial is chosen.- last molar and bicuspid and canine were removed on upper left side). He is trying to decide between upper flexible partial or bridge supported implant ( 2 implants) or do nothing ( he is at age 79 now , soon to be 80). Also bone graft and tissue regeneration was suggested. Health considerations are mild diabetes which is controlled, hypertension and cholesterol issues ( on meds for both ) and some knee osteo issues limiting mobility at times. . He is concerned about being able to maintain the aftercare of implants as he ages further. Would appreciate your thoughts as to possibility of success if he decides on implants- thank you.
Occasionally, older patients express concern that their age may prevent them from enjoying the benefits of dental implants. However, health is more of a determining factor than age. If you’re healthy enough to have a tooth extracted, you’re probably healthy enough to receive dental implants. Age is rarely a consideration in dental implant treatment. I have implanted patients as young as 16 years, and as old as 94. Certain chronic diseases may contraindicate implant treatment.
Age is not a factor! The time to have implants is when you are healthy. I placed an implant into my mom at age 80 and she will age with all her teeth ❤️
I have had a two bridge implants on my upper left side of my mouth. The dentist says the implants have to come out because only one implant is holding the two teeth in my mouth. When the dentist put these teeth in, I noticed some black on the teeth showing on the top. I have already spent a lot of money on my teeth and I don’t want to pay more. He is going to send the bridge to the lab. He says I have no infection. He said it was the lab’s fault but I don’t think so. What should I do to fix this??
Do the implants in the bone need to be removed?
Or just the bridge ?
I forgot to mention that although it is an ache it’s not really painful
Hello doctor,
I am a 21 year old female. I had a bone graph done in 2019 on #10. The doctor told me that the bone that grew was poor, he said that it could happened because I was missing this tooth ever since I was 13. He did put an implant in 2020 and after three month he removed it because when he was testing i a felt a slight pain but he did say the implant was sturdy. After that, he left the area to heal for 4 months and placed another one. It has now been one month since I’ve had it placed
But my concern is that I’ve been feeling a slight ache in the area that would come once or twice and would last a quick second but during the majority of the day it feels normal. I use to feel that little ache every day but the last 2 days I havent feel anything but I felt it again today. I remember I even felt it from time to time when I had the first implant and even when he removed it. Around that time he told me that if it wasn’t painful then I had nothing to worry about, and after a couple months it did go away. But now I’m back to feeling it again since the implant have been placed. Do you think that there could be wrong?
Thanks you.
I forgot to mention that although it is an ache it’s not really painful
Hi thank you for your response, he did a a regular bone graph. He also put me on another round of antibiotics and the implant do feel normal apart from the little ache. I went to him today and he decided to let it heal for 5 months to see how it is. But the way is there any surgeon you would recommend in the south florida area since you are very far from me sadly.
Hi Tali just wondering if the doctor recommended a surgeon? I am in south Florida too having implant pain for months.
Oh gosh. I can definitely see your concern. A dental implant should have 0 pain. Nothing should hurt at all. The best thing to do would be to get an x-ray of how it is doing right now and may be consider a course of antibiotics. Did you have a block graft? Those are usually very successful in building the bone back
I had a childhood injury to my front upper tooth (#8). At the time the dentist just fixed the chipped tooth with a filling and it never bothered me. I had braces later. Two years ago, 28 years after the injury, I started having pain when biting. I went in and the dentist found a large abscess with a lot of bone loss. It had never hurt before and still had no swelling or redness. The abscess had tunneled back into the palate behind the tooth. I had a root canal and apico, but ultimately ended up extracting the tooth as the pain never went away. The oral surgeon cleaned the area out thoroughly and did bone grafting and a bone block graft. He put the implant in at the time of extraction and grafting but stitched it up over the implant to heal. Six months later he said it looked great and my dentist placed the crown. Since the crown was placed, it has hurt off and on, from mild annoying pain to badly enough I need Tylenol. My surgeon and two different dentists have said it looks great in X-rays and there is no visible sign of infection. It goes weeks without hurting then will hurt for one day or a week straight. My oral surgeon thinks I have atypical facial pain, as well as TMJD. It does not hurt to apply pressure to the implant crown, but the gums behind the crown are always tender and the gums seem to swell at night (I wear a nightguard) then go down during the day. I am worried about infection in the bone again as it had no symptoms last time until it had tremendous bone loss. Will it show up before it is bad?
Laura — take the crown off and have a temp made on the implant. That will rule out the crown being the problem. You can also have ISQ readings done on the implant to see it it is truly integrated or failing. I know it is an expense and hassle but this will solve the mystery for sure. Happy to see you if you can.
Do they use the dentures they made for you to wear the day the implants are put in?
I do not use the denture you have, but most clinics do.
I use face scanning technology to make you a much stronger, prettier customized smile. Nothing is prefabricated.
Learn more from this link.
😉 Stay safe and get the vaccine 😉
Dr. Amin,
I just had full upper dental implants a week ago. I chose implants even if the cost is hard on me because I did not want to worry about my dentures falling off and most importantly all of the pictures we see online or actual models from my 3 other dental consultations on my decision making process show the attachment is the bridge snap in the implants gum on gum with NO PALATE.
My initial problem was that my uppers are all moving and 3-4 have crowns out of 11 teeth. I am 60yrs old. And they said I have gum infection that’s why I have teeth movement or vice versa. I am also a clencher.
I went to 3 different dentists before I decided to go ahead with the procedure with the 4th consultation. All 3 dentists discussed me needing grafting. And where I went said I didn’t need grafting which was a pleasant surprise because it meant my bones were strong enough for the implants. Not needing grafting did not alleviate the cost. Just the same I confirmed that when I am in surgery and they think I might need it that they will just add grafting and they said they don’t think that will happen but yes.
The dentist and staff to where I ended up doing the procedure are all professional and nice and this is completely their expertise as they are not general dentists that is why I decided to go with them.
At the last appointment prior to surgery day was when it was revealed that I will have a small palate which appeared to be needed for screw on and off etc. I was already mentally in my head with the surgery and did not realize how this would affect me. I also really felt like I was already committed to the procedure.
Why did I end up with a bridge that has a palate ? I’ve never had a partial or any foreign object in my mouth except for crowns and this is very foreign to me and is causing me to have great anxiety and panic attacks. I don’t know if these are the right terms to use but it just feels claustrophobic and want to rip them off.
Can they alter the design of the bridge and revert it to how I was expecting it meaning gum on gum with no back palate like practically 100% of pictures that show implants?
They said they cannot remove palate because that is the design of my treatment.
The prosthesis also seem to be biting my cheeks and thicker on one side along the palate. I am also not sure if the bite is correct because I seem to be adjusting my bite. The front seem to also be sitting on my lower lips at rest. And when I am on bite the rest of the teeth seem to be just afloat.
I am practically begging them to replace this with what I was expecting for which I should not be begging. For crying out loud, I am paying a very hefty bill for this which was also the cause of anxiety in the decision making process.
It takes away the joy of looking in the mirror and loving my new teeth and making me happy and comfortable for the rest of my life.
Desperately looking for answers.
Sincerely,
JF
hmmm…. It sounds like you have an overdenture that snaps on and off? I am guessing they were concerned about lip support with a fixed bridgelip support with a fixed bridge? Did you have a full set of prototype/temporaries before going to the final? Something sounds a bit odd here. Links included
Dr Amin,
Thank you for taking time responding and giving some information re my situation.
Can my bridge with palate be replaced with the gum line on gum line kind for my all on 4 implants?
I really cannot live with this! Again the very reason I went for the implant is so there is no palate.
Thank you so much for your time.
Take care
Sincerely
JF
yes –it can! It can be converted to a fixed bridge!
Sorry just correcting my email.
I really want to hear the response to my previous post.
Thanks!
Dr. Amin, I had a titanium dental implant placed on 2/11/2020, and it has been painful since it was placed. The periodontist who placed the implant said that there is nothing wrong with the gums or x rays. Two weeks after placement he had to remove the healing cap because the upper tooth was touching it. I felt a horrible pain when he tried to place a shorter cap, so he just placed a screw cover and let the gum above to close on its own. I have been keeping it cleaned with Peridex mouth wash 3 times a day. The pain fluctuates, and it is throbbing sometimes, and dull another times. Last night it woke me up from sleep. I also feel tingling on the side of my tongue. The periodontist wants to keep watching it, but i wonder if it is causing some nerve damage. What is your opinion? What could have caused this, other than infection? Should he remove the implant right away? I appreciate any help you can give me. Thanks.
It sounds like his of in a month already. It is very likely the implant may be failing. Dental implants typically do not have pain this far out. Take an x-ray. Hopefully by week 6 all pain is gone if not is likely going to fail. Please keep me posted on what happens with this tooth so that a can benefit others as well. Prayers sent!
Hello. I need to make a decision to retreat a root canal #3 or extraction with implant (lasted 15years now infected-infection is at top of a root that was not completely filled).
I’m hesitant to retreat due to a VERY bad experience with a retreat attempt for #14 (failed immediately-I tried to wait 8 weeks but my body was not healing-the infection was practically over taking my body in which I felt sick all over-I was on 8 rounds of antibiotics-my body just was rejecting keeping the tooth). In the end I extracted anyway and is ready for the crown.
#3 is causing severe pain and I need to make a decision ASAP. Endo and oral surgeon think I may have a better chance this time with this tooth so I’m considering re treat. I’m getting another opinion from an Endo who utilized the gentle wave for retreat in hopes I may have a better outcome…do you have any experience with this technology or utilize it?
Any insight or recommendations as to go traditional micro surgery root canal retreat or try this new gentle wave procedure?
Thanks!
I’m sorry this comment went to spam! What did you end up doing? Dr. Amin
Dr. Amin ,
I pray my implants aren’t failing I go to the original dentist that put my implants in . I have all on 4 I just had a X-ray it showed a tremendous amount of bone loss . But what I don’t understand is if I just had a sinus lift with bone , just 2 yrs ago . How could I have lost the bone? I’m so hopeful you will be able to help me ….
I saw your x-ray! You are losing bone on your right side at a rapid rate. The bone that you are losing is not inside of the sinus but rather at the edges where the teeth used to be. Unfortunately this will likely be progressive. Are you a smoker? That will certainly cause the bone to dissolve.
Sorry 😐