When you’re looking for the best solution for missing teeth, dental implants provide the look, feel, and functioning of natural teeth. As well, dental implants enjoy an enviable success rate that other tooth replacement methods can’t match, but there are rare occasions when a dental implant will need to be removed.
Reasons for Dental Implant Removal
Dental implants are artificial tooth roots made of titanium, a strong, resilient metal with the unusual ability to encourage bone tissue to fuse to it. Doctors drill small holes into specially chosen sites in a person’s jawbones and place dental implants into these holes, which allows the implant posts to become firmly emplaced because of a biological process called osseointegration.
In osseointegration, the bone tissue in the space around the dental implant’s socket fuses to the titanium metal of the implant, creating a remarkably strong, secure bond. It’s this tight bone-to-metal connection that gives dental implants their famed stability and reliability.
Anything that interferes with osseointegration can cause dental implants to fail, making dental implant removal necessary. When dental implants need to be removed within the first 6 months of their placement, it’s referred to as early dental implant failure.
Several conditions can impede osseointegration, including:
- Poor implant placement. Dental implants that are angled incorrectly will not become firmly fused into the jawbone.
- Infections. Any oral infection can impede osseointegration.
- Smoking and using other tobacco products. Tobacco use is a major cause of early dental implant failure, as smoking slows down healing. Nicotine constricts blood vessels, reducing the amount of oxygen and nutrients oral tissues receive during osseointegration, causing a weak bond between the titanium implant post and surrounding bone tissues.
- Auto-immune disorders. Multiple sclerosis, lupus, celiac disease, and rheumatoid arthritis are examples of disorders that can contribute to dental implant failure. Although these conditions do not directly affect the implants, they can slow healing and interfere with osseointegration, leading to dental implants needing to be removed.
- Osteoporosis. Osteoporosis is a condition that causes bone to become thin and brittle that also slows bone growth, which makes osseointegration less successful.
- Uncontrolled type 1 or poorly controlled type 2 diabetes. Diabetes is another condition that can significantly impair healing, leading to slow or incomplete osseointegration. Diabetes damages tiny blood vessels throughout the body, including those that provide oxygen to healing tissues, like those found in the gums and bones of the jaw.
- Periodontitis. Unlike another form of oral infection called peri-implantitis, periodontitis affects gum tissue throughout the mouth, not just at the site of a dental implant. Periodontitis can move from damaging gums into the bones of the jaw, placing natural teeth and dental implants at risk.
- Nerve or tissue damage. Although this is a rare cause of implant failure, when implant holes are drilled too deeply into the bones, nerve tissue can be damaged.
- Poor implant placement. An inexperienced dentist may place the dental implant at a site in the jaw that’s suboptimal or drill the hole too deeply or not deeply enough. This can lead to the implant becoming loose, fusing at a bad angle, or failing to join to surrounding bone tissue, requiring the implant to be removed and replaced.
- Sinus rupture. It’s important to seek the best oral surgeons when having dental implants placed, especially those in the upper jaw. Inexperienced doctors can accidentally pierce the sinus membrane when placing a dental implant in the upper arch.
There are situations when a dental implant may need to be removed after osseointegration has finished. Some of the conditions that can cause late failure of a dental implant include:
- Peri-implantitis. One of the most common reasons dental implants need to be removed is a bacterial infection of the gums around the dental implant site. Called peri-implantitis, this infection starts with plaque building up on and around the surface of the implant. This causes swelling, which leads to the gums pulling away from the implant, creating pockets in which more bacteria thrive. Once the bone tissues that support the dental implant are damaged or eroded, the implant post will become loose in its socket, requiring dental implant removal.
- Bruxism. Teeth grinding places a great deal of pressure on dental implants, which can lead to their failure.
- Trauma. Any severe trauma to the face or jaws can lead to a dental implant becoming loose, which may result in an implant needing to be removed long after the traumatic damage took place.
- Infection. Peri-implantitis is not the only oral infection that can cause a dental implant to fail. Infections of the gums can also lead to a dental implant failing.
A doctor has several options for removing a failed dental implant. One method uses a trough bur, a specialized cutting instrument. It removes a tiny bit of bone tissue holding the implant in the jawbone, which loosens the dental implant. The doctor is then able to remove the implant. Troughing is the most common means of removing a dental implant.
Another approach uses an adapter, which is a high-torque device that can loosen and remove a dental implant without requiring any bone to be removed.
After the implant is removed, the oral surgeon will cleanse the area and evaluate whether a bone graft will be necessary to replace any of the bone mass. Bone grafting may be necessary when preparing the site for a future dental implant.
Dental implant removal is not painful when the procedure is carried out by an oral surgeon. Oral surgeons are trained to administer IV sedation, which allows a patient to sleep comfortably through the entire process.
The national average expense of removing a dental implant varies, with $500 to $1000 per implant a typical range. America’s First Dental Implant Centers has rates that are typically 10-20% less expensive than others on various dental procedures, including dental implant removal.
America’s First Dental Implant Centers includes the cost of removing old implants in the standard full-arch restoration fee. A full-arch restoration replaces an entire upper or lower jaw of teeth with a new arch of teeth and can be done in the same visit in which the old implants are removed.
Recovery from having a dental implant removed is much the same as the recovery from having a dental implant placed. You’ll need to avoid hard, chewy, crunchy, or sticky foods for 1 to 2 weeks. You’ll also need to avoid smoking and using straws.
Immediate recovery from removing a dental implant takes 3 to 5 days for the oral tissues to recover. However, full healing of the jawbone itself will take longer.
Some people may require a bone grafting procedure to replace the bone that might have been removed. Bone grafting can also help prepare the jawbone for a future attempt at placing a dental implant at that site. Healing from a bone graft takes from 3 to 6 months.
You do not have to replace an old dental implant with a new one, but this is a desirable option for many people so that they can regain the functionality of the implant tooth. Bone grafting can replace any bone that was removed during the procedure and will provide more bone mass and a higher density of bone tissue for a new dental implant to be placed into.
If a person’s oral tissues are free of infection, a bone graft can be performed on the same day as the implant removal.
Avoiding the need for dental implant removal doesn’t have to be hard. Here are some preventive measures you can take to make sure your dental implants stay healthy,
When you get dental implants, your doctor will provide you with instructions on how to take good care of your mouth and gums during your recovery. If a person fails to follow those instructions, there’s a chance osseointegration will not happen or will not be completely successful.
Practice good oral hygiene
Dental implants can last a lifetime if you practice good oral hygiene. Brushing and flossing twice daily helps keep your gums healthy and removes bacteria from the surface of your implants.
Quitting smoking will help your overall health, as well as preventing the need for dental implant removal. Smoking constricts blood vessels, reducing the amount of oxygen, nutrients, and infection-fighting blood cells that can reach the delicate tissues of the gums. Smokers have a much higher rate of implantation failure than non-smokers.
Know the signs and symptoms of peri-implantitis
Peri-implantitis is a common cause of dental implant failure. Signs of peri-implantitis include:
- Pus from the gum around the implant. Sometimes this shows up as a persistent bad taste in a person’s mouth, as pus may not easily be visible
- Bleeding gums
- A receding gum line around the implant
- Redness, pain, and swelling in the gum tissue surrounding the implant
- Wobbling or loosening of the implant
- Soreness in the jaws
If you develop any of these symptoms, see your doctor immediately. Peri-implantitis can be stopped if caught early.