Can “Failing” Dental Implants Be Saved?

Dental implants consist of replacement tooth post “roots,” usually made from titanium, that are surgically inserted into the jawbone. Single crowns, a fixed dental bridge, or partial dentures are possible attachments. These teeth replacement solutions are undoubtedly today’s best choice for individuals with damaged teeth or teeth loss who are looking to regain full chewing and speaking capabilities with totally natural-looking smiles.

In fact, dental implants are considered among the top restorative procedures in the entire field of dentistry. The success rate for dental implants, by some estimates, is up to 98%. So, what about that other 2%?

Start with the Best

One of the best ways to make sure your dental implants succeed is to only place your faith (and your mouth!) in the best hands. Find a periodontist with a great track record, one who has excellent educational credentials and positive online reviews. Be sure to do your homework: For instance, do they use premium or non-premium brand implant systems? Do they understand detailed issues such as dental bridges vs. implants?

Avoid Dental Tourism

“Vacation dentistry” trips to foreign countries for mini-vacations and dental work may seem, at the time, like cheap ways of obtaining dental implants. But what happens when you arrive at a foreign office and realize you aren’t comfortable with the practitioner? What if complications arise and you’re already on a plane flying back home? Are you going to hop back on a plane for follow-up care? There are so many red flags involved in dental tourism. You’re much better off choosing a local board-certified surgeon who you know guarantees his or her work.

Peri-Implantitis is Rare But Possible

Peri-implant diseases, as described by the American Academy of Periodontology, are destructive inflammatory conditions that affect both the hard and soft tissues around dental implants. If your periodontist notices no jawbone loss, the label is peri-mucositis, which can be reversible. If not treated, the issue becomes peri-implantitis which could lead to implant failure. You may not even know you have peri-implantitis if you’re not regularly seeing your periodontist for follow-up care, as peri-implantitis is typically painless. The worst scenario is that there can be such extensive bone loss that you require regenerative procedures prior to replacing the implant.

Signs of Peri-Implantitis:

Your dental implant should feel just like regular teeth. Signs of peri-implantitis can include:

• bleeding when brushing or probing
• inflamed or tender gum around the implant
• gums that seem to recede around the implant
• increased probing depth
• noticeable plaque buildup
• X-ray evidence of jawbone loss

Risk Factors That Can Lead to Peri-implantitis

• Tobacco usage
• Poor oral hygiene
• Uncontrolled systemic health issues like diabetes and osteoporosis
• Uncontrolled tooth clenching or grinding
• Premature loading of the implant before the gum area has healed

Can Infected Dental Implants Be Saved?

If your mouth is overall healthy, and your periodontist catches the infection early, the dental implant can often be saved. That’s another reason you should keep up with regular periodontal maintenance checkups with specially trained periodontal hygienists and doctors to check for any early signs of inflammation. An experienced periodontist can often remove infection to allow the gum and bone tissue around the implant to stabilize. If the implant is already loose from infection and your periodontist sees significant bone loss, the implant will need removal and you’ll need to allow time for the area to heal before additional steps can be taken.

The Best Path to Dental Implant Success

If you’re a smoker, it’s strongly encouraged that you stop. Some specialists may even refuse to place dental implants in a heavy smoker since the chances of failure increase dramatically. Smoking reduces blood flow and impedes healing. Some studies show that failure is twice as likely. Keeping up with maintenance appointments, seeing your regular dentist at least twice a year, making sure you brush and floss as directed each day, and quitting smoking are ways you can help ensure success.

Philip L. Fava, II, DMD, MDSc  is a periodontist and dental implant surgeon who practices at the Pennsylvania Center for Dental Implants and Periodontics, with two locations at Einstein Center One, Suite 211-212, 9800 Bustleton Avenue, Philadelphia, PA 19115 and 140 East Butler Avenue, Ambler, PA 19002. The practice offers “All-on-4™ dental implants; SameDay Smile® or “Smile Zone” dental implants; implant, crown and bridge implant restorations; Pinhole® gum rejuvenation; reconstructive dental surgery, as well as LANAP® and other treatments for gum disease.