A dental implant falling out can be distressing, but dental professionals are equipped to manage it. A dental implant is a multi-component restoration consisting of the titanium fixture (the screw-like post placed into the jawbone), the abutment (which connects the post to the visible tooth), and the crown (the artificial tooth itself). Determining which of these parts has failed is the first step toward a successful resolution.
Immediate Steps for Handling the Implant and Site
The first priority is to retrieve any fallen component, as your dentist will need to examine it. Handle the piece gently, avoiding touching the screw or root surface if possible, to keep it clean for professional assessment. Place the retrieved component in a clean, sealed container with a small amount of saline solution or milk to preserve it until your appointment.
After securing the fallen part, gently rinse your mouth with warm salt water to cleanse the surgical site and reduce the concentration of bacteria. Dissolve half a teaspoon of salt in eight ounces of warm water and swish the solution without excessive force to avoid irritation. If you notice any bleeding from the site, apply light pressure with a clean piece of gauze for a few minutes until the bleeding slows or stops.
For minor pain or discomfort, use over-the-counter pain relievers according to package directions. Avoid chewing on the affected side and stick to soft foods to prevent further trauma to the exposed area. Do not attempt to clean the site aggressively, reinsert the component yourself, or use any household adhesives, as this introduces infection or complicates repair.
Urgent Contact and Professional Assessment
Contacting your dental provider immediately is the next necessary step, as prompt attention can improve the prognosis for the site. When you call the office, be prepared to explain exactly which part of the restoration has fallen out and when the initial implant procedure took place. This information helps the dental team determine the urgency of your situation and schedule you appropriately.
Most cases are not true emergencies, but seek immediate attention if you experience signs of a severe problem, such as uncontrolled bleeding, significant swelling, or a fever. A simple crown detachment or a loose abutment screw is generally a non-urgent situation that can be addressed during regular business hours. Your dentist will perform a thorough examination, often including X-rays, to assess the condition of the remaining implant, surrounding bone, and gum tissue.
Why Dental Implants Fail
Dental implant failure is typically categorized as either biological or mechanical, with causes ranging from initial healing issues to long-term wear. Biological failures often occur when the jawbone fails to integrate with the titanium post, a process known as osseointegration. This failure can happen early due to poor bone density, compromised patient health, or smoking, leaving the implant unstable.
The most common long-term biological cause of failure is peri-implantitis, a slow-progressing infection that mirrors gum disease around a natural tooth. This condition is caused by a buildup of bacteria that leads to inflammation and progressive loss of the bone supporting the implant. If untreated, the bone loss can become significant enough for the implant to lose its stability and eventually fall out.
Mechanical failure involves hardware issues, such as the abutment screw loosening or fracturing, or rarely, the implant fixture itself cracking. Excessive force, often from teeth grinding (bruxism) or a poorly designed restoration, places too much stress on the components. This biomechanical overload compromises the hardware’s integrity, leading to structural failure that causes parts to detach or the entire fixture to become loose.
Repair and Replacement Procedures
Once the assessment is complete, the treatment depends entirely on the cause and extent of the damage. If only the crown or abutment has loosened, and the titanium fixture is stable and healthy, the fix is often straightforward. The dentist can simply clean the components and the internal threads of the fixture before reattaching or replacing the abutment and crown.
For cases involving peri-implantitis, treatment involves decontaminating the implant surface and surrounding tissue, often through scaling and local antibiotic application. If the infection has caused bone loss, a surgical procedure may be necessary to clean the area and potentially graft new bone to stabilize the fixture. In some advanced cases, the infection may have caused too much bone damage, necessitating the removal of the entire implant.
A complex fix or replacement is required when the implant fixture has failed to integrate or is severely compromised. The dentist must carefully remove the failing post, which may require a minor surgical procedure, and thoroughly clean the site. If significant bone loss is present from the failure, a bone grafting procedure is necessary to rebuild the jawbone foundation. This ensures there is enough dense bone to support a new implant, requiring a healing period of several months before a replacement fixture can be placed.