Why Do Dental Implants Fail?

Why Do Dental Implants Fail?

Why Do Dental Implants Fail?

About 30% of my practice is treating failing implants, removing them, rescuing them. Let’s talk about why, and why did your implant fail or why do they hurt? 

There is no one reason why dental implants fail. Reasons can range from anatomical – not enough bone or gums – to problems with the bite and mechanical issues and the type of bone you have.

Other reasons for failure may be related to the care and maintenance of implants. They need to be brushed, flossed and cleaned just like any other tooth.

For more details watch the video below and if you have questions or comments, please post them below and subscribe to my channel to get more information about dental implants.

Why did my dental implants fail?

Video transcript lightly edited for easier readability.

Why do implants fail? About 30% of my practice is treating failing implants, removing them, rescuing them. Let’s talk about why, and why did your implant fail or why do they hurt? Sometimes that’s the path that went to failure first. First off, there’s no one reason. But oftentimes the anatomical reasons are you didn’t have enough bone, you didn’t have enough gum, one or both of those. Those are the primary factors. Just having enough space for the implant to hold into. Other things I’ll talk about is your bite, and the mechanics and the type of bone that you have.

Let’s just jump right into it. So, with regards to the bite, having a bite that’s too strong, or a bite that’s poorly designed with the crown, or let’s say an all on full-mouth restoration. If the bite is too heavy, it will completely damage and destroy the implant. You’ll lose bone around it. We call that peri-implantitis, where the tissue can become really red around it. That’s the first sign. They call that mucositis.

So the bite is a big factor. Maybe you don’t have enough implants, too many teeth are attached to the bridge. Maybe an all on four should have had six implants instead, or maybe some zygomatic support or sinus grafting. Maybe you just don’t have enough implant so there’s just more load than the implants can hold. And the bone itself, there’s poor quality bone and there’s good quality bone. Poor quality bone is really soft, and I’ve written many articles on this. A soft bone has a higher failure rate. Typically, you need more implants longer, different ways, densifying the bone to put it in. And on the opposite side, very hard. It doesn’t have enough blood. It’s somewhere in the middle where the bone is medium hardness with regards to the design of your teeth. So that can make or break everything. The skill of the restorative dentist, the experience of the lab, the whole experience of the team. Let’s say you have an all on four, or just a crown that has really bad contours, it snags floss, it’s got a big ledge, stuff gets stuck underneath it, and you just can’t clean it out.

Maybe it’s failing because you don’t clean it enough. Dental implants need to be brushed, and flossed, cleaned, maintained, and have x-ray checks and everything else. It requires proper hygiene. There are some people who thought they did not have to brush implants at all, and have let them go and never gone back to the dentist after they were put in. The design of the bridge is really important. The design of the tooth. It really takes an expert lab technician.

I work with an expert team, and they’re my partner on the other side. Every single case I do is very particular in its design process. Like I said, the experience of the whole team, that includes the lab as well. Switching labs, trying to find the lowest cost materials and the people that work with, those just end up in disaster. And again, about 30% of what I’m doing is removing implants. In fact, last week I took out more implants than I put in. It was really just a bad week. There was some treatment done from out of the country, some right here in Southern California as well.

Maybe it was the actual surgery itself. The procedure wasn’t done with a high degree of sterility. It was just a dental bib and no antibiotics for something major. Antibiotics are not necessary for all cases, but most cases that require grafting, or big cases require some sort of antibiotics for you to be able to prevent and fight infection. Because it’s a large opening for a long time. Materials wise, there is a hybrid, there are plastics, acrylics, the dentures are made of different materials. Zirconia versus metal, how this is designed, and how the bite is supported so that when you grind your teeth it protects itself. We call that a mutually protected bite. When you grind from one side to the other, the right side protects the left side and vice versa when you bite up and down. All of these things, the inclination of the implants, the slant or the abutments fitting properly, or are they the right screws? Are they aftermarket parts? There are original parts with really good implant systems, and some very good complimentary parts as well. And then there are some knockoffs.

There are parts sold on Amazon and eBay, believe it or not, it’s crazy. I can’t even believe it. Other things that I talk about with patients are the quality of your gum. So the gum should have a certain thickness to it. It should have certain durability to it. As the skin of your hand is very durable. It has something called keratin in it to make it tough. You can bang it and it doesn’t get cut or beat up, while the skin of your eyelid is very delicate. So we have a similar relationship in our mouth where we have eyelid skin, and skin around our palm of our hand. And if you have more like eyelid movable skin, we call that mucosa, around the implant, it’ll be really sensitive when you brush. It’ll all be red, and that’s not durable over time. So you start to lose bone, it begins to hurt, and this is part of the failure process. Most failures don’t happen instantly. Some failures, most of them happen very slowly.

Some failures happen right after the surgery, a month out the implant becomes a loose, some of them are are a year, three to five years out, gradual bone loss, gradual redness, plaque accumulation, and then you’re losing bone. There’s an abscess, there’s an infection, recurrent antibiotic treatment over and over only to then lose the implants. My best advice is get it done right the first time. Maintain it with a practice that’s all they do is implant dentistry, and that they care about you like they would their own family. But this is just one of the many reasons why dental implants fail, and just something to know about. Dental implants are not permanent.

Your comments are welcome. To see more videos like this, please subscribe to my YouTube channel.

13 Comments

  1. Traci McKendree

    Do they use the dentures they made for you to wear the day the implants are put in?

    January 13, 2021 at 1:11 pm Reply
    1. I do not use the denture you have, but most clinics do.
      I use face scanning technology to make you a much stronger, prettier customized smile. Nothing is prefabricated.
      Learn more from this link.

      😉 Stay safe and get the vaccine 😉

      January 13, 2021 at 1:24 pm Reply
  2. JF

    Dr. Amin,

    I just had full upper dental implants a week ago. I chose implants even if the cost is hard on me because I did not want to worry about my dentures falling off and most importantly all of the pictures we see online or actual models from my 3 other dental consultations on my decision making process show the attachment is the bridge snap in the implants gum on gum with NO PALATE.

    My initial problem was that my uppers are all moving and 3-4 have crowns out of 11 teeth. I am 60yrs old. And they said I have gum infection that’s why I have teeth movement or vice versa. I am also a clencher.

    I went to 3 different dentists before I decided to go ahead with the procedure with the 4th consultation. All 3 dentists discussed me needing grafting. And where I went said I didn’t need grafting which was a pleasant surprise because it meant my bones were strong enough for the implants. Not needing grafting did not alleviate the cost. Just the same I confirmed that when I am in surgery and they think I might need it that they will just add grafting and they said they don’t think that will happen but yes.

    The dentist and staff to where I ended up doing the procedure are all professional and nice and this is completely their expertise as they are not general dentists that is why I decided to go with them.
    At the last appointment prior to surgery day was when it was revealed that I will have a small palate which appeared to be needed for screw on and off etc. I was already mentally in my head with the surgery and did not realize how this would affect me. I also really felt like I was already committed to the procedure.

    Why did I end up with a bridge that has a palate ? I’ve never had a partial or any foreign object in my mouth except for crowns and this is very foreign to me and is causing me to have great anxiety and panic attacks. I don’t know if these are the right terms to use but it just feels claustrophobic and want to rip them off.

    Can they alter the design of the bridge and revert it to how I was expecting it meaning gum on gum with no back palate like practically 100% of pictures that show implants?
    They said they cannot remove palate because that is the design of my treatment.
    The prosthesis also seem to be biting my cheeks and thicker on one side along the palate. I am also not sure if the bite is correct because I seem to be adjusting my bite. The front seem to also be sitting on my lower lips at rest. And when I am on bite the rest of the teeth seem to be just afloat.

    I am practically begging them to replace this with what I was expecting for which I should not be begging. For crying out loud, I am paying a very hefty bill for this which was also the cause of anxiety in the decision making process.
    It takes away the joy of looking in the mirror and loving my new teeth and making me happy and comfortable for the rest of my life.

    Desperately looking for answers.
    Sincerely,
    JF

    July 3, 2020 at 6:43 am Reply
    1. Ramsey Amin

      hmmm…. It sounds like you have an overdenture that snaps on and off? I am guessing they were concerned about lip support with a fixed bridgelip support with a fixed bridge? Did you have a full set of prototype/temporaries before going to the final? Something sounds a bit odd here. Links included

      July 4, 2020 at 7:49 pm Reply
      1. JF

        Dr Amin,
        Thank you for taking time responding and giving some information re my situation.
        Can my bridge with palate be replaced with the gum line on gum line kind for my all on 4 implants?
        I really cannot live with this! Again the very reason I went for the implant is so there is no palate.
        Thank you so much for your time.
        Take care
        Sincerely
        JF

        July 11, 2020 at 10:39 pm Reply
        1. yes –it can! It can be converted to a fixed bridge!

          January 9, 2021 at 7:36 pm Reply
      2. JF

        Sorry just correcting my email.
        I really want to hear the response to my previous post.
        Thanks!

        July 11, 2020 at 10:40 pm Reply
  3. Simone Tram

    Dr. Amin, I had a titanium dental implant placed on 2/11/2020, and it has been painful since it was placed. The periodontist who placed the implant said that there is nothing wrong with the gums or x rays. Two weeks after placement he had to remove the healing cap because the upper tooth was touching it. I felt a horrible pain when he tried to place a shorter cap, so he just placed a screw cover and let the gum above to close on its own. I have been keeping it cleaned with Peridex mouth wash 3 times a day. The pain fluctuates, and it is throbbing sometimes, and dull another times. Last night it woke me up from sleep. I also feel tingling on the side of my tongue. The periodontist wants to keep watching it, but i wonder if it is causing some nerve damage. What is your opinion? What could have caused this, other than infection? Should he remove the implant right away? I appreciate any help you can give me. Thanks.

    March 10, 2020 at 6:54 pm Reply
    1. Ramsey Amin

      It sounds like his of in a month already. It is very likely the implant may be failing. Dental implants typically do not have pain this far out. Take an x-ray. Hopefully by week 6 all pain is gone if not is likely going to fail. Please keep me posted on what happens with this tooth so that a can benefit others as well. Prayers sent!

      March 12, 2020 at 12:59 am Reply
      1. Stay

        Hello. I need to make a decision to retreat a root canal #3 or extraction with implant (lasted 15years now infected-infection is at top of a root that was not completely filled).

        I’m hesitant to retreat due to a VERY bad experience with a retreat attempt for #14 (failed immediately-I tried to wait 8 weeks but my body was not healing-the infection was practically over taking my body in which I felt sick all over-I was on 8 rounds of antibiotics-my body just was rejecting keeping the tooth). In the end I extracted anyway and is ready for the crown.

        #3 is causing severe pain and I need to make a decision ASAP. Endo and oral surgeon think I may have a better chance this time with this tooth so I’m considering re treat. I’m getting another opinion from an Endo who utilized the gentle wave for retreat in hopes I may have a better outcome…do you have any experience with this technology or utilize it?

        Any insight or recommendations as to go traditional micro surgery root canal retreat or try this new gentle wave procedure?

        Thanks!

        April 14, 2020 at 11:33 pm Reply
        1. I’m sorry this comment went to spam! What did you end up doing? Dr. Amin

          January 9, 2021 at 7:37 pm Reply
  4. Susan Murrell

    Dr. Amin ,
    I pray my implants aren’t failing I go to the original dentist that put my implants in . I have all on 4 I just had a X-ray it showed a tremendous amount of bone loss . But what I don’t understand is if I just had a sinus lift with bone , just 2 yrs ago . How could I have lost the bone? I’m so hopeful you will be able to help me ….

    February 26, 2020 at 1:50 am Reply
    1. Ramsey Amin

      I saw your x-ray! You are losing bone on your right side at a rapid rate. The bone that you are losing is not inside of the sinus but rather at the edges where the teeth used to be. Unfortunately this will likely be progressive. Are you a smoker? That will certainly cause the bone to dissolve.

      Sorry 😐

      March 2, 2020 at 6:24 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!