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Missing teeth can cause pain, poor alignment of the jaws, impair your ability to eat, and even change the shape of your face. The lack of a confident smile can also cause problems with self-esteem. However, it’s possible to permanently transform your teeth and smile with dental implants.

Dental implants are the best way to replace missing or damaged teeth, giving you the most comfortable and best-looking set of new teeth available. They reproduce the look, fit, and feel of natural teeth perfectly. They also perfectly mimic the function of natural teeth, allowing a person to eat and speak just like they would normally. Dental implants never have to be removed and are a permanent solution to missing teeth.

Dental implants have a lot of advantages over dentures. They fit, feel, and look just like healthy natural teeth. Dental implants allow a person the freedom to eat any type of food they want, without discomfort or pain from a misaligned bite. Unlike dentures, dental implants don’t have to be removed, are durable, and can last a lifetime.

During dental implant surgery a doctor:

  1. Opens gum tissue at a pre-planned site(s) along the jawbone that has enough bone to support the implant itself. Tooth roots must be placed into thick bone tissue to handle the pressure from chewing.
  2. Drills holes into the jawbone. Made of titanium, a biofriendly metal, the implants are placed into the jawbone and will serve as artificial tooth roots; they will become permanently fixed into the jawbone after a period of a few months.
  3. Next, after the implant posts have had time to become thoroughly fused to the jawbone, small connectors called abutments are placed on top of the implants. They join the implant to the artificial tooth itself, called a crown or bridge (when there are multiple adjacent fake teeth).
  4. Finally, the dental implant crown is placed. Dental crowns are made of zirconia, a tough, natural-looking material that will last the lifetime of the implant.

Bad Dental Implants Are Preventable

When properly emplaced, dental implants have an enviably high success rate—98 percent—over 3 to 5 years post-surgery. However, it’s possible for dental implants to fail for a number of reasons:

The Importance of an Expert Consultation

Seek oral surgeon: The first step in seeking dental implants is to choose who you want to perform your implant surgery. While there are many types of dental healthcare professionals (e.g., general dentists, prosthodontists, periodontist, oral surgeons, etc.). for the best dental implant results, you should only consider oral surgeons for dental implant surgery. Oral surgeons have significant advantages over regular dentists, prosthodontists and other dental specialists since oral surgeons are the only ones trained in complex surgical techniques and are able to provide IV sedation anesthesia.

Oral surgeons’ ability to give IV sedation anesthesia makes dental implant surgery painless. Non-oral surgeons have to resort to other pain management techniques such as injecting topical anesthetics, like Novocain, throughout the procedure.

Thorough consultation: In addition to finding an oral surgeon, it is also important to have a thorough consultation. This expert consultation allows the oral surgeon an opportunity to review your dental and medical histories, while assessing any current conditions that might affect getting dental implants.

Getting an accurate and complete dental and medical history is a big part of your consultation with a dental expert. Many conditions affect how well a person’s body heals, and while the great majority of people are candidates for dental implants, some health conditions will require specialized consideration.

Your doctor will also take detailed 3-D CT scan digital images of your mouth and jawbones, to assess how healthy, thick and dense the bones are. For an implantation to be successful, the bone tissue has to be sufficiently thick and dense enough to support the implant.

These digital scans also allow the doctor to see the exact shape and contours of your jawbones, which assists in planning the ideal site for implant placement.

During an expert consultation for dental implants, your doctor will also develop a treatment plan that works as a roadmap for the different processes and steps that are required for the implant process.

Don’t Skimp on Quality

Dental implant surgery is a complex procedure that requires a doctor to choose the right locations for the implants, properly assess a person’s medical and oral health, and carry out the surgery itself. It is designed to produce a life-long solution to missing teeth.

The success of dental implants also depends on the doctor using high-quality name-brand implants that are the right size and proper length for the client. Furthermore, implant crowns made of durable and strong zirconia, instead of acrylic or porcelain, also contribute to the success of the surgery.

What Can Go Wrong with Dental Implant Surgery?

Albeit unlikely, below are some additional and more specific things that can go wrong:

Osseointegration Failure

Osseointegration is the process by which bone fuses to the titanium implant; osseointegration gives dental implants their unrivaled stability, particularly when compared to dentures.

If this process of osseointegration fails, the implant will not fuse into the jawbone, causing the implant to lack sufficient stability to hold the crown securely in place.

This situation is referred to as dental implant failure. This may lead to the implant coming out on its own.  or coming out partially. In the case of dental implant failure, the implant may fall out on its own, or you may need to have it removed. If your dental implant fails, you and your dentist can decide if you should replace the implant or try another option.

Osseointegration failure can be caused by improperly placed implants or crowns, the use of low-quality implants, medications or conditions that prevent healing, and/or noncompliance with postsurgical care instructions and procedures.

Sloppy Implant Placement

An inexperienced dentist can place the implant into a less than optimal location. The doctor may also over-drill or under-drill the hole in the bone, causing the implant to be too loose or too tight, both of which can lead to complications and total implant failure. The implant may become loose, fail to integrate into the jawbone, or fuse at a bad angle. Sloppy implant placement will lead to the implant needing to be removed and replaced.

Nerve or Tissue Damage

Nerve damage is rare in dental implant surgery, but it can have long-lasting consequences. It typically results from implant holes being drilled too deeply into the jawbone. This type of damage is preventable with high-quality X-rays and other digital imaging that locates the location of nerves in the oral cavity.

Low Quality / Poor Impression Molds

Dental implant crowns are shaped from impressions molded by the dentist and made by a lab. Molds show the exact location of each implant and adjacent and opposing teeth, so the attachment site on the crown is perfectly aligned with the implant. Even a tiny misalignment can cause the implant to fail.

Allergic Reaction

Allergic reactions to the materials used for dental implants and crowns are very rare. Dental implants are made of titanium, which is one of the most biocompatible and hypoallergenic metals known. Less than 1 percent of the population has an allergy to titanium, making it the metal of choice for all forms of joint prosthetics, as well as the highest quality of dental implants.

However, although rare, some people may develop an allergy to their dental implants. Signs of this type of allergy may include swelling around the gums, patchy dry skin in the mouth, and a loss of taste.

Complications from Certain Medications

At the initial consultation, it’s important to let your doctor know what medications you’re taking, as some classes of drugs have a powerful effect on how bone tissue heals. These include:

  • Osteoporosis medications. These medications, called bisphosphonates, include Fosamax, Boniva, and Reclast. They alter the ways in which bone cells grow and are used to treat thinning of the bones commonly associated with aging, called osteoporosis. Bisphosphonates carry a small risk of preventing bone from correctly fusing to the titanium implants.
  • Antidepressants. Selective Serotonin Reuptake Inhibitors (SSRIs), such as fluoxetine and sertraline can also interfere with the process of osseointegration, but is very rare.
  • Chemotherapy drugs. Getting dental implants during chemotherapy is not recommended. Waiting at least six months after finishing a course of chemotherapy is generally recommended because it can cause the bone to fail to fuse to dental implants and also there is a higher risk of infection.
  • Proton-pump inhibitors (PPIs). PPIs treat gastroesophageal reflux disease (GERD) but also can prevent the body from properly absorbing, iron, magnesium, calcium, and vitamin B12. These nutrients are required for bone healing.

What to Do for Bad Dental Implants

A bad dental implant must be removed and the area may require bone grafting to reconstruct the site. After a few months of healing, a new implant will need to be placed.

Signs of Bad Dental Implants

Pain

Mild to moderate discomfort is not uncommon during the days after dental implant surgery. This type of pain is normal and can be controlled with prescription or over-the-counter pain medications. However, the type of pain that comes with a dental implant failure can be intense, throbbing, and comes in waves and typically starts in the first 1-3 months after placement. Unlike the pain from a new, healing dental implant, the pain associated with a failing implant can also come a long time after initial healing is complete.

Swelling / Inflammation of Gums

Some bruising and minor swelling of the gums is to be expected after the dental implant procedure. This type of inflammation and swelling should go aware after a few days. When swelling lasts longer than that, it can be a sign of trouble, particularly an infection. Infection often causes swelling and inflammation and can spread beyond the site of the dental implant surgery. This type of infection demands immediate treatment, as it can cause damage to the gums and even spread into the bloodstream.

Movement in Dental Implant

One of the most valuable aspects of dental implants is their stability. When a dental implant has been properly emplaced, it has the same steadiness and stability as a natural tooth root. There will be no movement of a correctly installed dental implant, so if a dental implant is shifting position, even slightly, it’s a sign of implant failure.

A dental implant that moves when you eat or speak, or that can be moved by touching it, calls for an immediate consultation with your doctor.

Long-term Effects of Bad Dental Implants

Infection

Like pain, a bit of swelling around the surgery site is normal after getting dental implants. It should go down after the first few days, though. Increased swelling and redness, especially when accompanied by fever and visible pus are signs and symptoms of infection.

Some additional signs and symptoms of infection include:

  • A constant bad taste in your mouth. When pathogenic (disease-causing) bacteria invade gum tissue, they produce chemicals that irritate and destroy oral tissues. This leads to a bad taste in the mouth that won’t go away. Persistent bad breath may also accompany the bad taste.
  • Bleeding gums or pus leaking from the gums. Infected gums cause an immune response that floods the affected tissues with white blood cells that will attempt to fight off the infection. This leads to small amounts of blood and pus—dead white blood cells—leaking from the affected areas. Bleeding gums are always a signal to visit your doctor, especially if have had dental implants placed.

Gum Complications

A poorly-performed dental implant procedure can cause damage to your gums, leading to infection which can eventually cause the implant to fail. A dental implant that shifts in position can also create gaps to develop between the artificial tooth root and gum tissues that become infected, also leading to implant failure.

Implants Don’t Stay in Place

If implants are not placed into the thick bone, they won’t stay firmly in place. They may also become loose if the dentist under or over-drills the insertion hole. If a dental implant is mobile to any degree, you should consult your doctor immediately. Until you have dental implants that are completely secure and immobile, you won’t get any of the benefits of dental implants. Dental implants that aren’t stable will cause misalignment of the dental crowns, leading to pain and difficulty when eating.

Peri-implantitis

Peri-implantitis is a type of infection that’s similar to gum disease. It occurs when bacteria colonize the gum tissue surrounding a fresh dental implant, resulting in localized infection, bone loss, and inflammation of the gums. Peri-implantitis can cause the complete loss of a dental implant.

Peri-implantitis is more common in people with a history of gum disease, but smokers are also at an elevated risk of peri-implantitis. People with poor oral hygiene, as well as people who don’t observe their doctor’s instructions during the healing process, are likewise at an increased risk of peri-implantitis.

Luckily, peri-implantitis is a treatable condition, which involves surgery to clean the areas immediately adjacent to the implant and between the gums. The surgeon will also put topical antibiotics in place, prescribe oral antibiotics, and prescribe the use of a medicated oral rinse.

Are You a Good Candidate for Dental Implants? – How to Avoid Bad Dental Implant Issues

Most people who wish to replace one or more missing teeth are good candidates for dental implants. In addition to seeking out qualified oral surgeons (who are the only people we work with here at America’s First Dental Implant Centers), adhering to good oral health as well as overall health practices can help you minimize the risk of bad dental implants:

Good Oral Health

A good candidate for dental implants will have healthy gum tissue, but you can still get dental implants even if you have periodontal disease. After all, the most common cause of tooth loss is gum disease.

Practicing good oral hygiene with twice-daily brushing and flossing, keeping all appointments with your oral surgeon, and observing all the

Good Overall Health

A good candidate for dental implants doesn’t need to be an Olympian or have flawless health. Being in good general overall health is sufficient for dental implant placement.

Who Should Avoid Dental Implants?

Rarely do patients need to avoid dental implants altogether, since the benefits vastly outweigh the risks. However, people with certain underlying conditions may need to exert caution and discuss whether dental implants are right for them with their doctor:

Diabetics

Well-controlled diabetes does not present a barrier to getting dental implants and is not associated with a great risk of dental implant failure. Uncontrolled or poorly controlled diabetes could lead to greater rates of post-implant infections and implant failure. This happens because diabetes impairs and slows tissue healing. If you have diabetes, make sure to let your doctor know before pursuing dental implants.

Cancer

If you’ve had cancer, it’s important to speak with your doctor and oncologist before proceeding. Some medications given for chemotherapy, as well as radiation therapy, can cause thinning of the bones, as well as lowered functioning of the immune system. Many people going through chemotherapy experience a high rate of aggressive tooth decay and gum disease, and unfortunately end up needing teeth extracted and replaced with dental implants.  Proper coordination with your oncologist and other physicians will allow successful outcomes with your dental implants.

Gum disease

You can still have dental implants if you’ve had or have periodontal disease, also called gum disease. Gum disease is the most common cause of tooth loss among adults and is the reason many people seek dental implants.

Your oral surgeon can treat your gum disease with antibiotics, as well as remove damaged or diseased teeth. Practicing good oral hygiene, following your oral surgeon’s instructions, and keeping all appointments with your oral surgeon will ensure that gum disease doesn’t keep you from getting dental implants.

If you’ve lost significant amounts of bone tissue because of gum disease, in most circumstances you can still receive dental implants through a procedure called a bone graft.

Smokers

Although a minor risk, smoking increases the risk of dental implant failure for several reasons. It decreases the function and effectiveness of the immune system, making gum tissue more vulnerable to infection. Smoking also makes it more difficult for your gums to heal any type of damage or surgical incisions. As well, smoking reduces blood flow to gum tissue, reducing the level of nutrients available.  

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How to Take Care of Dental Implants

There are minimal differences between the necessary oral hygiene practices required for natural teeth and those habits important for dental implants. Practicing all-around good oral hygiene helps keep gum tissue healthy and free of bacteria, while helping implants look their best.  

To take care of your dental implants, practice these habits:

  • Brush and floss twice daily and after meals with a low-abrasive toothpaste. Use only a soft-bristle toothbrush.
  • Use dental tape or floss made for implants.
  • Use an alcohol-free mouth rinse twice daily.
  • Keep regular dental appointments for professional in-office cleanings.
  • Follow all instructions given by your doctor.

Dental implants are not at risk from tooth decay, but the gum tissues around dental implants are susceptible to plaque and bacterial infection and so it’s important to practice good oral hygiene.

Author

  • Dr. Ryan Grider, DDS

    Dr. Grider is an Oral and Maxillofacial surgeon who specializes in full mouth (full arch, teeth in a day, All-on-X) dental implant procedures. Dr. Grider earned a Bachelor of Arts degree from DePauw University, majoring in Biology and Pre-medical studies. Subsequently, he went to Indiana University School of Dentistry and earned a Doctor of Dental Surgery (DDS) degree. Post dental school, Dr. Grider completed an additional 4 years of residency at the University of Miami School of Medicine at Jackson Memorial Hospital in Oral and Maxillofacial Surgery.