A dental implant is a surgical fixture, typically made of titanium, placed into the jawbone to serve as an artificial tooth root. This fixture fuses with the bone through osseointegration, providing a stable foundation for a replacement tooth or crown. While these restorations are highly reliable, experiencing pain when chewing is a clear signal that something is wrong. This discomfort requires immediate professional attention from a dental specialist. Ignoring the pain can allow a minor problem to escalate, jeopardizing the long-term success of the implant.
Pain from Hardware and Bite Misalignment
Pain when biting down or chewing is often related to mechanical issues involving the prosthetic components or how the implant crown meets the opposing teeth. Unlike a natural tooth, which is cushioned by a periodontal ligament, a dental implant is rigidly fixed to the bone. The full force of chewing is transmitted directly to the implant and surrounding bone if the bite is not perfectly balanced.
If the implant crown makes premature or heavy contact with the opposing tooth, a condition known as occlusal trauma, it creates an overload that causes pain. This uneven distribution of pressure can occur immediately after the crown is placed or develop later if adjacent natural teeth shift position. The discomfort felt under load is a result of the excessive pressure on the bone surrounding the implant.
Another common source of chewing pain involves loose components within the restoration. The implant system consists of three main parts: the implant post, the abutment (connector), and the crown. If the abutment screw, which connects the crown to the implant, loosens, the crown can shift slightly under the force of chewing. This movement irritates the surrounding soft tissues and can cause an audible clicking or popping sound, leading to sharp or dull pain.
Pain from Infection and Osseointegration Issues
More serious causes of pain related to chewing involve biological failure or bacterial infection around the implant site. The most frequent biological complication is peri-implantitis, which is an inflammatory condition similar to gum disease in natural teeth. This disease is caused by bacterial buildup that infects the gum and supporting bone tissue around the implant.
When peri-implantitis is present, the chewing forces exacerbate the inflammation and put pressure on the infected, compromised bone, resulting in deep, throbbing pain. Common signs that differentiate this from simple mechanical pain include redness, swelling, bleeding, or the discharge of pus from the gum tissue surrounding the implant. If left untreated, the infection progressively destroys the supporting bone, leading to implant instability.
The ultimate biological failure is the loss of osseointegration, meaning the titanium post has failed to fuse or has detached from the jawbone. If the implant has not fully integrated, or if the fusion is compromised by infection or trauma, the implant becomes mobile under chewing pressure. This instability causes pain and a noticeable feeling of looseness when biting down. In these cases, the entire implant fixture is moving, which is a much more serious issue than a loose crown or screw.
Seeking Diagnosis and Treatment
If you experience pain when chewing on your dental implant, the immediate action is to stop using that side of your mouth completely and contact your dental professional right away. Avoid trying to manipulate the crown or implant and stick to soft foods until your appointment. Prompt evaluation is the best way to prevent the condition from worsening and to save the implant.
During the professional visit, the dentist will perform a clinical examination, including gently probing the gums around the implant to check for pocket depth and bleeding, which are indicators of infection. They will also check the occlusion, or bite, using articulating paper to identify any points of premature or excessive contact. Radiographic imaging, such as X-rays, will be taken to evaluate the integrity of the hardware and the level of bone support around the implant.
Treatment paths depend entirely on the diagnosis. If the pain is mechanical, the dentist may simply adjust the bite by carefully reshaping the crown or tighten a loose abutment screw. If peri-implantitis is confirmed, the treatment involves deep cleaning to remove bacteria, often followed by antibiotics, and possibly surgical intervention to clean the infected site and repair bone defects. If the implant has completely lost osseointegration and is mobile, the only treatment option is usually the careful removal of the failed implant fixture.