A dental implant replaces a missing tooth and consists of three parts: a titanium post (fixture) placed in the jawbone, a connector (abutment), and the visible prosthetic tooth (crown). If any component feels unstable, professional attention is required immediately. While the sensation of looseness can be alarming, prompt contact with a dental professional is necessary to ensure the best possible outcome for saving the restoration.
Determining What Is Loose
Looseness can originate from three different points in the implant system, each indicating a different level of concern. The least serious issue typically involves the crown, the visible portion that functions like a natural tooth. A crown is retained either by dental cement or a small screw; if either loosens from normal function, the crown will feel wobbly, often without significant pain.
The abutment is the connector that links the crown to the implant fixture embedded in the bone. If the abutment screw loosens, the movement is usually more noticeable than a loose crown and may sometimes result in a clicking sound or feeling. This requires prompt tightening by a dentist, but the underlying fixture remains stable.
The most serious situation is when the fixture itself—the titanium post anchored in the jawbone—exhibits mobility. The fixture is meant to be fused directly to the bone through osseointegration, creating a rigid foundation. Any movement in the fixture indicates a failure of this bone-to-implant connection, which necessitates urgent evaluation to determine the cause of bone loss.
Immediate Steps Before Seeing the Dentist
If you detect movement or instability, contact your implant dentist immediately to schedule an urgent appointment. Do not attempt to self-diagnose or postpone the visit, as early intervention significantly increases the chances of a successful repair. Delaying treatment can allow a minor issue to rapidly progress into a more complex problem.
Until you can be seen, avoid placing pressure on the affected area by strictly refraining from chewing on that side of your mouth. If the crown or abutment has completely detached, gently clean it with water and store it safely to bring to your appointment. Never attempt to force the component back into place or use household adhesives, as this can cause irreparable damage to the implant site.
Underlying Causes of Implant Failure
Instability can stem from mechanical issues related to the hardware or more serious biological complications. Mechanical causes are often the easier fixes, primarily involving the loosening of the small screw that connects the crown or abutment to the fixture. These screws can gradually vibrate loose from the repetitive forces of chewing, a problem especially common in patients who grind or clench their teeth (bruxism).
The failure of the cement used to hold a cemented crown onto the abutment is another mechanical cause. This cement can degrade over time, leading to the crown simply falling off, which is a straightforward repair. However, if the implant fixture itself is loose, the cause is almost always biological, indicating a breakdown of the osseointegration process.
The primary biological cause is peri-implantitis, a bacterial infection similar to gum disease that targets the tissues and bone surrounding the implant. This infection leads to chronic inflammation and progressive bone loss, diminishing the support around the titanium post until it becomes mobile. Excessive biting forces, or occlusal overload, can also contribute to bone breakdown and subsequent loosening, particularly if the initial implant placement was not optimally angled or positioned.
Professional Repair and Restoration Procedures
Fixing a loose dental implant depends entirely on the component involved and the underlying cause identified through X-rays and clinical examination. For mechanical failures, the procedure is often swift and non-surgical, involving the removal of the crown to access the underlying hardware. The dentist will then use specialized tools to tighten or replace the retaining screw connecting the abutment to the fixture, immediately restoring stability.
If the issue is a loose cemented crown, the professional will thoroughly clean the crown and abutment surfaces before re-cementing the crown. When the diagnosis points to early-stage peri-implantitis, the non-surgical treatment focuses on eliminating the infection. This involves deep scaling and debridement of the implant surface, often combined with local or systemic antibiotic therapy to reduce the bacterial load and inflammation in the surrounding gum tissue.
Advanced biological issues, particularly fixture mobility due to significant bone loss, require more complex surgical intervention. If the bone loss is moderate, the dentist may perform a procedure to clean the exposed implant surface and potentially apply bone graft material, a technique called guided bone regeneration, to encourage bone support. However, if the fixture is severely loose and compromised, the implant must be surgically removed, a process called explantation. After a period of healing, which often includes a bone grafting procedure to restore the lost jawbone volume, a new implant can be placed.