Dental Implant Moving
One of the most appealing traits of dental implants is their long-term success, so if you notice any movement in your dental implant, something is amiss. The natural teeth move slightly when exposed to pressure, as they are held into the jaw by the periodontal ligament; the periodontal ligament is a strong but flexible soft-tissue fiber that stretches slightly to accommodate the natural forces exerted by biting and chewing. This natural movement should be slight, however, and anything more than slight movement is likely a sign of gum disease and should be addressed by a dentist. Dental implants, on the other hand, are securely held in place directly by the bone, which means that the implant should not move at all once it has healed and fused with the bone. Most dental implants are made of three separate components: an implant fixture, which is the small cylinder that is surgically placed into the bone; an abutment or screw, which is affixed to the top of the implant to hold the crown or other dental prosthetic in place; and the crown or dental prosthetic itself. Following the placement of a dental implant, the bone is given time to heal, and during the healing process, the bone fuses to the implant itself, in a process called osseointegration. This creates a sturdy foundation for the dental prosthesis, much like the root of a tooth securely supports a healthy natural tooth. It’s important to understand that dental crowns and other dental prosthetics that are supported by implants can loosen over time, and, quite often, when a person perceives that their implant is loose, it’s actually just the crown or the abutment that affixes the crown to the implant that has loosened. If, however, an implant does move, it’s usually an indicator that the implant is failing, either due to a structural concern with the implant or an issue with the bone surrounding the implant.
Of course, if you feel like your dental implant is moving, you may not be able to determine whether it’s the crown, the screw, or the implant itself that has loosened. If you notice any movement at all in your dental implant restoration, schedule an appointment with your implant dentist as soon as you can -- preferably within 48 hours -- and be to exercise caution as you await your dental visit. In the interim, take care to avoid chewing with the implant tooth, and avoid pushing or manipulating it with your tongue or fingers, as this will create extra pressure that can affect the bone where the implant is attached and can create even more movement, in addition to weakening and depleting the amount of healthy bone surrounding the implant. Of course, you should never try to remove a loose implant on your own; doing so is likely to lead to even more damage to the oral tissues. If your crown falls out, hang on to it so you can bring it to the dentist with you to see if it can be reattached or repaired. If it fell out because of a loose screw or because an abutment or part of the crown has broken, it may be able to be repaired and replaced relatively simply and quickly.
If, however, a dental implant fractures, it cannot be fixed and must be removed and, if possible, replaced. If the implant itself is loose, you may notice swelling and bleeding around the affected tooth, as well as pain in the gums or sensitivity to extreme temperatures in the natural teeth adjacent to the implant. These symptoms may signal infection, and you should see your implant dentist as soon as possible. You also will probably notice that you can’t chew or bite down properly in the affected area, and it’s best to avoid putting pressure on the implant to avoid causing additional damage. Until you can get in to see the dentist, you may find relief from pain or discomfort by applying an ice pack to the outside of the face, on the cheek adjacent to the implant. Limit your diet to soft foods while you wait to see the dentist, and protect the tooth from additional damage by cleaning carefully around the affected area during your regular oral hygiene routine to prevent additional damage from infection.
Once you can see your dentist, they will remove the crown and examine the implant, both manually and visually and by using x-rays to assess the implant fixture and surrounding bone. They may also remove additional implant components to determine the specific component that is damaged. If the movement is determined to be coming from damage to the crown or abutment, they will tighten, repair, or replace these components as needed. If your implant was placed recently, movement may indicate that there are problems with the way the bone is healing around the implant. If infection is present, your dentist will prescribe antibiotics to treat the infection while determining the best way to repair or replace the implant; the area should be free from infection and fully healed before a new implant is inserted.
Dental implants can fail when the bone can no longer securely support them, due to an overgrowth of gum tissue where bone is supposed to be; this can arise when the bone is resorbed due to inflammation in the gums that is caused by gum disease. When this occurs, the existing implant must be removed so that the bone can be repaired before a new implant is placed. Implant dentists can place different types of bone grafts that encourage the development of healthy, strong bone tissue, and, once this new bone tissue has healed, a new implant can succeed in the same site where one previously failed. Of course, maintaining optimal oral hygiene is the best way to prevent inflammation and gum disease; in addition to cleaning the natural teeth, it’s imperative to clean the gums and other soft tissues in the mouth, and the gumline surrounding an implant should be specifically yet gently cleaned to remove debris and dental plaque that can cause infection in the gums and bones.