Loose dental implant: how to deal with mobility of crown, abutment, and implant itself

Ideally, dental implants should stay on nice and tight. Unfortunately, that is not always the reality. Your dentist can help make sure that your loose dental implant is saved before it falls out or leads to issues that could endanger your life and health. That’s why it’s vital to consult when an issue arises.

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Below you can find a complete fact-sheet on loose dental implants and what should be done when you start to feel mobility. Learn about causes, diagnosis, and treatment.

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How to diagnose a loose dental implant?

Most often the patient is able to determine by his or herself that a part of the prosthesis is loose. Touching it with your tongue or fingers might be enough to recognize a problem. It is important to contact a dentist immediately in order to prevent further damage.

Signs you might be experiencing include:

  • the artificial tooth moving,
  • pain, especially while chewing,
  • sunken-in gums,
  • bleeding upon touch,
  • discoloration in the affected area, and
  • the tooth-cap falling out.
X-ray. A clinical inspection will then reveal which part is moving, as it might not be the implant itself.

More often than not, it is the abutment or crown that are loose. This is good news, as the whole implant fixture may not have to be removed from the bone. All mobility to do with an implant is bad, nonetheless, and should be dealt with as soon as possible.

Diagnosis and treatment may be more difficult in cases when one implant supports two or more crowns or even a denture.

When can a dental implant become loose?

Some issues can arise soon after placement or during the recovery period, while others can become apparent years after. In either case, the complication can be caused by different factors.

Early

  • Surgical trauma
  • Overheating during the procedure
  • Non-ideal placement
  • Complicated wound healing
  • Insufficient stability
  • Initial overload
  • Lack of implant torque

Late

  • Lack of osseointegration
  • Infection
  • Biomechanical overload
  • Faulty design of the implant or component
  • Gum disease

How the problem is dealt with depends on the element that is affected. This could be the crown, abutment, or the implant. Leaving any of these parts loose and untreated could lead to implant failure as well as complications for the entire body.

Most common: loose dental abutment

The abutment is the piece that joins the implant and the tooth cap (crown). This is the part that becomes loose most often, making up 33% of cases. It often comes with no pain and can usually be fixed without causing any further damage to the rod or crown.

Causes

Abutments usually come loose due to trauma, faulty designs, or overload. The last can also be associated with incorrect placement of the rod. This case might require removal of the implant.

Treatment

Ideally, the abutment should be removed along with the crown, which can then be detached outside the mouth. This would involve unscrewing the prosthesis. The tooth cap might be saved, reducing your costs.

Sometimes it is not possible to remove the abutment without damaging the crown. In such cases, it might have to be sectioned or cut off with a drill. Your dentist can attempt to get a hold of a master cast from the lab that made it or make a new one.

You might have to wear a temporary restoration for a few weeks.

Easiest to fix: loose dental implant crown

The crown is the part of the restoration that is visible in the mouth. It can be made of several different materials, the most common being porcelain.

Causes

Crowns become loose due to traumas and fractures. Those can be caused by grinding teeth and injuries. If it is moving, there is likely a crack in the tooth cap itself or in the cement holding it.

Treatment

The treatment is similar to a damaged abutment. It is unscrewed if possible. If not, the crown may be simply extracted provided the cement is fragile enough to allow this. Otherwise it is cut up into smaller parts. The abutment or rod are then thoroughly cleaned.

The crown might be in good enough shape to be simply cemented back in place. This is a simple procedure and it may not require anesthetic.

The situation is more complex if the crown gets damaged. The dentist can try to obtain the cast that was previously taken or make a new one. Either way, you are likely to wear a temporary one for a few weeks.

Screw-retained crowns can sometimes simply become loose leading to a loose crown or abutment. This is very easy to fix by retightening.

Worst case scenario: loose dental implant

The biggest problem emerges when there is an issue with the implant itself. There may be pain, numbness in the lips, and maybe even inflammation in the gums.

These symptoms appear when there is a dental implant infection. Ignoring them could lead to severe complications. You should find a 24/7 emergency dentist near you as soon as possible.

Dr. Nichole McKenna

Inflammation of the hard and soft tissues around an implant can make the ridge too weak to support a restoration in the long term.

Causes

The most common cause of a loose implant is infection combined with bone loss. It can also be caused by trauma or overloading. The first can be triggered by poor oral hygiene, smoking, and some medicines. The second happens if the design is faulty or if the placement was not ideal.

Treatment

Loose dental implants always require complete removal. If there was bone loss, you may need grafting. This includes additional months of healing. The next step is to reattempt implantation or to fit a denture. The dentist will discuss options with you.

In the case that you don’t require grafting, you may be immediately fitted with an implant that has greater dimensions. That way it still has a chance of successful osseointegration after removal. There must not, however, be any infection or periodontitis.

It may be possible to reuse the crown, which can save you significant costs. The removal process will still require proper aftercare, possibly antibiotics and painkillers.

FAQ

Is a loose dental implant an emergency?

Yes. If you notice any mobility in your dental implant you should immediately seek help from a professional.

Loose screws can lead to bone loss, infection, implant fracture, and even implant failure. If you leave it untreated, an infection could spread to other areas of your body, threatening your general health and even life.

What to do if a loose implant has fallen out?

Contact your dentist. Keep the fragment that has fallen out. Avoid eating until the problem has been fixed. Use non-alcoholic mouthwash to disinfect your mouth.

If the piece that fell out is in good enough shape, it may be reattached and the whole thing could be fixed in one visit. Sometimes this is not possible, but the dentist might be able to fit you with a temporary piece until a new one is ready.

How to prevent a dental implant from becoming loose?

Avoid sticky, crunchy, and hard food as much as possible and conduct excellent oral hygiene. Implants can’t get cavities, but the tissues surrounding them are prone to infections. Those can lead to the fake tooth coming loose through bone loss.

Keep up with regular exams and cleanings as recommended by your dentist. The rule of thumb is to come in at least once a year. It is a lot easier to fix issues that are spotted early on.

It’s also a good idea to limit your alcohol intake and quit smoking. Both of these habits can lead to an infection.

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