Dental implants are generally considered a permanent and long-lasting tooth replacement solution. However, like natural teeth, dental implants may be associated with some long-term problems.
What are dental implants?
Dental implants are artificial tooth roots made of titanium that are surgically placed into the jawbone. They are used to support crowns, bridges, or dentures. The bone grows around the implant over a few months, anchoring it firmly in place. This process is called osseointegration.
Once integrated, dental implants are very stable and can last for many years. However, they may still be susceptible to certain long-term issues.
Do dental implants last forever?
With proper care, dental implants can last for several decades. However, they do not truly last forever. The longevity of dental implants depends on several factors:
- Oral hygiene habits – Poor oral hygiene can lead to gum disease and bone loss around implants.
- Regular dental visits – Regular professional cleanings and checkups are important to monitor the health of implants.
- Patient habits – Habits like grinding or clenching teeth put extra stress on implants.
- Placement – The quantity and quality of jawbone where the implant is placed impacts stability.
- Implant material and design – Modern implants made from pure titanium tend to last longer than older types.
With optimal conditions, appropriate care and regular maintenance, dental implants may last for 20-30 years or longer before needing replacement. However, they cannot be expected to last forever.
What are the long-term problems associated with dental implants?
Some potential long-term problems that may affect dental implants include:
Peri-implantitis
Peri-implantitis is inflammation and infection of the soft and hard tissues surrounding the implant. It is caused by plaque accumulation from poor oral hygiene. Peri-implantitis can cause bone loss around the implant and lead to loosening and failure over time. Symptoms include swelling, redness, bleeding from around the implant, and bad breath.
Mechanical wear
Over time, the components of a dental implant can suffer mechanical wear from chewing forces. Screws can loosen, abutment joints may deteriorate, and fracture or breakage of implant parts is possible after many years of function.
Bone loss
After implants integrate, bone levels around them are usually very stable. However, gradual bone loss may still occur over decades of function. Loss of supporting bone can undermine the stability of implants.
Aesthetic changes
As gum and bone levels change slightly over time, aesthetic changes may occur around some implants. For example, more of the metal implant root may become visible or a dark line of shadowing can appear under the gum.
Adjacent tooth problems
Although rare, long-standing implants can sometimes contribute to new dental problems. Damage or increased wear to adjacent natural teeth may develop over time.
Nerve injury
Lingering nerve problems from implant placement are not common. But some patients experience chronic pain, numbness or tingling around an implant due to nerve damage during initial surgery.
Allergic reactions
Allergies to metals used in dental implants are very uncommon. However, localized allergic reactions affecting the gums or bone around an implant can occasionally occur.
Treatment failure
In some cases, dental implants may completely fail over time due to progressive bone loss, infection, fracture, lack of integration, or other factors that cannot be adequately treated or prevented.
How can long-term dental implant problems be prevented?
To maximize the longevity of implants and prevent long-term issues, the following guidelines are recommended:
- Practice excellent oral hygiene with daily brushing, flossing, and use of antimicrobial mouthwashes.
- Have professional cleanings and exams every 6 months to monitor implants.
- Avoid smoking, as it can increase risks for implant failure and complications.
- Wear a nightguard if you grind your teeth to prevent excessive wear.
- Get damaged implants or components repaired or replaced in a timely manner.
- Avoid chewing excessively hard foods that could damage implant restorations.
With diligent at-home care and professional maintenance, dental implants can successfully remain functional for decades. However, regular dental visits are still needed to evaluate implants, treat any issues early, and prevent more significant long-term problems.
What happens if a dental implant fails after many years?
If a dental implant fails after several years of seemingly successful function, there are a few possible solutions:
New implant
Often, the failed implant can simply be removed and replaced with a new implant, if sufficient bone remains. This may be the easiest and most predictable solution.
Bone grafting
If significant bone loss has occurred around the failed implant, bone grafting may be needed to regenerate enough bone volume to place another implant.
Fixed bridge
Rather than placing another implant, a fixed dental bridge anchored to neighbouring teeth may be used to replace the missing tooth.
Removable partial denture
If implans fail in an area without adjacent teeth to support a bridge, a partial denture can restore the missing teeth.
No replacement
For some failed implants, the best option may be no replacement at all. This depends on the location of the implant and needs of the individual patient.
The condition of the surrounding bone and gums also determines what options may be feasible to restore the space of a failed dental implant.
Are preventive maintenance visits recommended for dental implants?
Yes, regular professional maintenance and evaluation of dental implants is very important for long-term success. The following preventive care is recommended:
- Professional hygiene visits every 6 months for plaque removal and polishing above and below the gumline.
- Careful clinical exam at maintenance visits to check for issues like loose implant components, damage or wear, and peri-implant inflammation.
- Periodic x-rays to evaluate bone levels around implant fixtures.
- Early intervention for any implant or gum problems to prevent more extensive complications.
- Checking the fit and condition of implant crowns and bridges.
- Reinforcing proper oral hygiene techniques for patients.
Dental implants can fail gradually over time. With regular professional maintenance and upkeep, implant problems can often be detected at an early stage when they are easiest to treat and curable.
What are the alternatives if someone is not eligible for dental implants?
For patients who are missing teeth but are not candidates for dental implants, some alternatives include:
Removable full or partial dentures
Traditional complete dentures or removable partial dentures can effectively replace missing teeth, but lack the stability and functionality of fixed solutions.
Fixed dental bridges
Fixed bridges can fill small gaps where teeth are missing. Bridges rely on support from adjacent natural teeth and may require their preparation.
Flexible partial dentures
Removable flexible partial dentures are made of thermoplastic nylon material. They have good aesthetic qualities and require little to no preparation of adjacent teeth.
Dental crowns or onlays
Crowns extending across a missing tooth space can be a less invasive alternative to bridges. Onlays provide similar extended coverage a missing tooth gap.
Orthodontic closure of gaps
Orthodontic tooth movement of adjacent teeth can sometimes close a missing tooth gap. This conservative option does not require a prosthetic tooth replacement.
No replacement
Depending on the location, some missing teeth may not necessarily need to be replaced at all. The gap can be left open, avoiding more invasive and costly treatment options.
Conclusion
While dental implants can be very successful long-term, they may be associated with some potential problems years after placement. With excellent oral hygiene and professional maintenance, implants can often function well for decades. However, they cannot be expected to last forever. Regular dental exams are key to maximizing the longevity of implants and addressing any issues early. For patients who are not implant candidates, alternatives like partial dentures, bridges or orthodontic space closure may be considered.
