Implant problems


Just like any medical or dental procedure, dental implants can have problems although not very often. In order to fully evaluate whether dental implants are your treatment of choice, you should be aware of the potential risks. The overall success rate for dental implants in a healthy individual and a well cared for mouth should be around 95% or more over a 20 year period (compare this to less that 25% for bridgework over the same period). Risks of implant failure increase in heavy smokers, diabetic patients and people with poor levels of oral hygiene and some medical conditions. Part of the thorough assessment process undertaken by Adam is to evaluate the risks and put them into context for you. Problems can occur however so here is a list of what can occur:

Loose or lost healing covers


The temporary healing cover that protects the implant during the healing phase can work loose or fall out on rare occasions. If this happens DO NOT PANIC! this is not your implant failing! Simply contact your implant dentist and they will be able to clean the area and replace the healing cover. If you are away from home or on holiday simply keep the area clean with daily mouth rinsing just to prevent food debris collecting in the area; the gum may close over and you can see the dentist on your return. It will not cause any long term problems as the gum often closes over the implant to protect it. I come across this roughly 1 in every 200 implants.

Loose screws


The retaining screw that holds the crown or bridge onto an implant occasional can work loose. This is the commonest problem with implants and is very easily dealt with. The solution to this is a very simple tightening of the screw after it has been checked and cleaned by the implant dentist. If you have an implant and can detect a slight ‘clicking’ sound when chewing, it could be a loose screw. Don’t panic! just contact your implant dentist. This happens much less often with Straumann implants than most other systems due to their unique implant-crown connection.

Infections


It is very unlikey that you will experience an infection around an implant unless you are not cleaning properly. Just like teeth, implants need twice daily brushing and flossing to ensure that food debris and plaque does not accumulate and cause inflammation of the gums. In the same way that teeth can suffer gum disease, implants can suffer in a similar way. The solution is professional cleaning and long term good home care by the patient. Bleeding gums when cleaning around an implant can be an indicator of an infection

Bone loss


If an implant is not looked after and infection is allowed to persist for a long period of time, some of the supporting bone can be broken down. You may be aware of a space appearing in between the implant and the adjacent teeth and possibly some bleeding of the gums. If this occurs please contact your implant surgeon for advice

Problems with the bite


A dental implant should be 100% comfortable to chew on and you should not be aware of the implant teeth hitting harder than the surrounding natural teeth. If you do feel a harder bite on the implants, contact your implant dentist who can check the bite and adjust it if necessary

Failure to integrate


It is extremely rare for an implant not to integrate with the bone. Adam has only had this occur on 11 occasions over the past 12 years out of more than 2500 implants placed and all cases have been in heavy smokers. Smoking reduces the mouths healing response so any smoker wishing to have dental implants should either stop smoking for a minimum of 3 months prior to implant placement or accept the increased risk of failure.

Peri-implantitis


This is a condition with similarities to gum disease that occurs around natural teeth and has similar risk factors. There has been knowledge of this disease for over 8 years and currently lots of research is happening to identify ways to eliminate it. It is now well recognised that patients with existing gum disease on their natural teeth are at a very high risk of developing peri-implantitis but it may not show for some time. For this reason, part of the decision whether implants are offered will be based upon a screening for gum disease. I choose not to place implants in anyone with poor oral hygiene or with pre-existing gum disease. If I notice gum disease in a patient I will refer them to have this treated, typically by a dental hygienist. If the gum disease is treated and the patient is willing to have long term prevention then I may offer implant care. The major risk factors for peri-implatitis are pre-existing gum disease, smoking and poor oral hygiene all of which can be addressed by the patient if they are sufficiently motivated.