Your implant was placed somewhere else, maybe years ago, maybe in another city or another country, and now something isn’t right. The crown feels loose, a piece has chipped off, food keeps packing in beside it, or the gum around it is sore. The first question most people have is who can even look at it. A restoring dentist can, and most implant problems turn out to be in the parts we fix.
The short answer: most implant problems are in the parts on top of the implant, the crown and the small screw that holds it, and those are fixed here, including on implants placed by another office. When the problem is the implant itself or infected bone around it, that goes to a surgeon, and we work it out with them. Either way, the earlier we see it, the more options there are.
The parts of an implant
It helps to know what you’re looking at, because “my implant is loose” can mean three very different things.
- The implant is the post in the bone. Once it has healed, it shouldn’t move at all.
- The abutment sits on top of the implant and connects it to the crown.
- The abutment screw is a small screw that holds the abutment, and with it the crown, to the implant.
- The crown is the tooth you see.
When a crown on an implant feels loose, it’s usually the screw, not the implant. That’s good news, because the screw is the part we can fix.
What we fix here
A loose crown
A crown that wiggles is most often a loose abutment screw. If I can identify the implant system, I can tighten the screw again or replace it. People worry that nobody will know what kind of implant they have, but X-rays together with a direct look at the implant and abutment can often identify it, and that’s easier once the crown is already loose.
If a screw comes loose once, tightening it may be enough. If it keeps coming loose, it should be replaced. Screws fatigue over time, and a fatigued screw can break. A screw that breaks inside the implant is much harder to fix than one replaced before it gets that far, so a crown that keeps loosening is worth coming in for, not living with.
A broken or chipped crown
If the crown on an implant breaks, we replace it.
Food packing in beside it, or a bite that feels different
Teeth drift a little over the years and an implant doesn’t, so a gap can open between an implant crown and the tooth next to it. That’s a crown and bite problem, and it’s worked out here. Why food gets stuck around an implant, and the fix.
What goes to the surgeon
The implant itself is loose
If the post in the bone moves, that goes to the surgeon. Once in a while a failed implant comes out on its own during a visit here, but we don’t try to remove them.
Bone loss and infection around the implant
Implants can get a gum and bone infection around them, much like gum disease around a natural tooth. It’s called peri-implantitis, and it affects about one patient in five who has implants. We look for it with X-rays and at your exams. In general, if there’s bone loss around an implant and it’s infected, it goes to the surgeon, and we stay involved in the plan.
Lee CT, et al. J Dent. 2017;62:1-12.
Implants placed somewhere else
It doesn’t matter where your implant was placed. Restoring implants and looking after them is the part of implant care we do here, so an implant from another office, another city or another country is something to bring in. We’ll evaluate it and, if the problem is one we fix, fix it.
Dental work done abroad: what we see, and what we do about it. For a whole arch on implants, here’s how we look at those.
Don’t wait on these
- A crown that’s loose, or keeps coming loose. The screw is easier to deal with before it breaks.
- Gum around the implant that bleeds, swells, is sore or drains.
- An implant that moves when the crown is pushed, as opposed to a crown that rocks on top of it.
- It’s been a long time since anyone X-rayed it. Bone loss around an implant often doesn’t hurt.
Where to start
Call 702-734-0776. We’ll look at the implant, take X-rays, and tell you which part is the problem and who fixes it. How we plan and restore implants.
General education, and not a substitute for an exam.