A dental implant is designed to be a permanent tooth replacement, functioning as an artificial root made from titanium that has fused directly with the jawbone. This biological fusion, known as osseointegration, anchors the implant fixture securely, meaning it should never move once fully healed. Discovering any sensation of movement or instability indicates a mechanical or biological complication has occurred. Because a loose implant can quickly lead to damage of the surrounding bone, this situation requires immediate professional evaluation.
Identifying the Origin of the Movement
The first step is determining which of the implant’s three components is loose. The system consists of the fixture (the titanium post embedded in the bone), the abutment (the connector piece), and the crown (the visible, artificial tooth).
In most cases, looseness originates in the prosthetic components above the gum line, specifically the crown or the abutment. This is often due to the loosening of a retaining screw, a mechanical complication accounting for up to a third of all post-implant issues. A loose crown or abutment may feel like the top part of the tooth wiggles, but the underlying titanium post remains solid.
A more concerning scenario is when the entire titanium fixture is mobile, indicating a complete breakdown of the connection with the jawbone. If the entire post moves within the gum tissue, this signifies a loss of osseointegration. This failure requires complex treatment because the implant’s biological foundation has been compromised, putting surrounding bone at risk.
Biological Causes of Fixture Failure
The most frequent biological reason for a fixture losing its stability is a progressive infectious disease called peri-implantitis. This condition is similar to periodontal disease, where a bacterial infection causes inflammation in the soft tissues and leads to the gradual destruction of the supporting bone. This loss of bone structure weakens the osseointegration, causing the fixture to become mobile over time.
Another cause is the failure of the titanium fixture to fully integrate with the bone, known as failed osseointegration. This occurs shortly after placement surgery, often due to insufficient bone density or premature loading with excessive force. If the jawbone is too soft or thin, the implant cannot achieve the primary stability needed for fusion, leading to early failure.
Excessive occlusal force, such as chronic teeth grinding or clenching (bruxism), can contribute to fixture failure. The constant stress creates micromovement, disrupting the bone-to-implant connection and leading to bone resorption. Overloading can also result from a misaligned bite or a prosthetic design that concentrates too much force on a single implant.
Certain systemic health conditions can interfere with the body’s ability to maintain the bone support around the implant. Poorly managed diabetes, for example, impairs blood flow and the healing process, making patients more susceptible to infections like peri-implantitis. Additionally, some medications that affect bone turnover, such as specific bisphosphonates, can increase the risk of an implant failing to maintain its osseointegration long-term.
Immediate Patient Action and Diagnosis
If you notice any movement in your dental implant, contact your dental professional immediately for an urgent appointment. This is not a situation that can be put off, as even minor movement can rapidly accelerate bone loss and increase the risk of infection. Early intervention significantly improves the chances of saving the implant or simplifying the repair process.
You must avoid all temptation to manipulate the implant, whether by wiggling it with your tongue or attempting to tighten any visible components. Manipulating the loose fixture can cause further trauma to the surrounding bone and soft tissue, potentially complicating the eventual treatment. Stop chewing on the side of the mouth with the loose implant and stick to a soft diet until you have been seen by the dentist.
When scheduling your visit, be prepared to provide a detailed history of the problem. Your dentist will need to know when the looseness began, if you have experienced associated pain, swelling, or discharge, and if there was any recent trauma. This information, combined with a physical examination and X-rays, allows the clinician to accurately diagnose whether the issue is mechanical or biological.
Professional Treatment and Repair Options
The treatment pathway for a loose dental implant is entirely dependent on the source of the instability identified during the diagnostic phase. If the movement is confined to the crown or the abutment, the fix is usually straightforward and involves correcting the prosthetic components. The dentist will access the retaining screw, clean the internal components, and then tighten the screw to the manufacturer’s specific torque setting.
If the screw is stripped or fractured, it will be replaced, and the crown or abutment may be exchanged for a new one to prevent future loosening. This mechanical solution is the least invasive and allows the patient to return to normal function quickly. No surgery is required, as the titanium fixture remains stable in the bone.
If the entire fixture is loose due to loss of osseointegration, the treatment becomes more involved. If bone loss is minimal and peri-implantitis is in its early stages, non-surgical therapy may be attempted, involving deep cleaning and local antibiotic application. Procedures may also be performed to clean the implant surface and apply bone graft material to regenerate lost tissue, aiming to stabilize the fixture.
However, if the fixture is significantly mobile, or if there is advanced bone loss and severe infection, the implant must often be removed in a procedure called explantation. Leaving a mobile, infected fixture in place would lead to further destruction of the jawbone, compromising the site for future restorative options.
Following explantation, the patient needs a waiting period, typically several months, to allow the bone and gums to heal. Bone grafting is often necessary to rebuild lost density before a new implant can be considered. Once the foundation is stable, a new implant can be placed, or the patient may choose an alternative like a dental bridge or removable partial denture.