So you're finally thinking about getting your dental implant done in Singapore, but spent the last 24 hours reading horror stories on the internet about dental implants gone wrong.
The success rates of dental implants hover around 98%, but the best dental implant procedures really depend on careful treatment planning.
WHAT are the things that can go wrong with dental implants?
WHY do they go wrong?
HOW can you and your dentist prevent them from happening?
I'm here to reveal all the answers to the above that you won't find in any dental implant info leaflets!
1. Infection around your dental implant (peri-implantitis)
What: Peri-implantitis is a condition that involves inflammation of the gum and/or bone around your dental implant, and is one of the most common complications. Patients typically get a swelling or pus collection next to the implant, which can also smell or taste funny. This can result in bone loss and implant failure.
How: Infections can set in when bacteria is present during oral surgery, or any time post-surgery without proper dental hygiene. It can also be caused by incorrectly place dental cement (used to secure crowns onto the abutments).
Causes: Smokers, diabetic patients, and those with poor oral hygiene are at greater risk of developing infection.
How to prevent: Infection sometimes doesn't occur until several months or years following the surgery. Good oral hygiene is key! Daily dental care should include flossing and brushing twice a day - doing so will protect your dental implant against peri-implantitis.
2. Dental implant loosening/falling out (failed osseointegration)
What: Osseointegration describes the formation of a direct fusion between your bone and an artificial titanium implant. This process takes place over the course of several months after the implant is placed.
How: An implant is deemed a failure if it is loose, falls out or shows signs of severe bone loss around it. Failure of an implant is often attributed to the failure of the jawbone to fuse together properly with the implant.
Causes: Several factors can cause this to happen. This includes:
- Incorrect positioning due to lack of skill of the dentist
- Insufficient bone density or volume
- Overloading due to heavy grinding
- Damage to surrounding tissues
- External force/sudden impact
- Implants that have fractured
How to prevent: Before an implant can integrate properly into a jawbone, there must be a healthy volume and density of bone present. For patients who lack adequate bone height, width or length, procedures such as a sinus lift or bone graft can help add space and bone mass, but significantly adds to both the total treatment time and cost.
3. Overloading of dental implants
What: Overloading is the term given to dental implant failure caused by undue pressure, or forces placed on the protruding abutment and/or crown. These forces can easily disrupt the osseointegration process.
How: Your dentist may sometimes decide to perform immediate loading during a dental implant procedure. Immediate loading is a one-stage treatment method where the crown and abutment are placed on the dental implant right after the implant is surgically inserted (especially when the front teeth are involved).
This is an acceptable treatment plan in certain cases, as long as the biting forces are properly managed. When applied in the wrong situations however, this can lead to failure of dental implants.
Causes: Patients who suffer from bruxism (heavy grinding) can cause overloading on dental implants.
How to prevent: It's common for your dentist to recommend loading the implant with a crown 3 - 6 months after the implant surgery is done, to ensure that the healing is complete. This avoids subjecting your dental implant to the stress of biting and chewing.
Your dentist may also recommend wearing mouthguards at night to minimize excessive grinding forces on the dental implants.
4. Nerve and tissue injury
What: Another possible but rare problem is damage to the nerves close to your dental implants.
How: When an implant is placed too close to your nerve, patients may experience chronic pain, tingling or numbness in their cheek, gums, tongue, lips or chin. The nerve damage could be temporary or permanent, and the implant might need to be removed.
Causes/how to prevent: In almost all cases, this problem is caused by mistakes made by an inexperienced dentist. Some bleeding and pain is to be expected for a couple days after the surgery, but if the pain is extreme, or bleeding lasts longer than a few days, you should contact your dentist.
5. Sinus inflammation/infection
What: Sinus inflammation can be an annoying complication when dental implants are used to replace teeth in your upper jaw.
How: To develop a strong bone foundation, your dentist may perform a procedure called a sinus lift with bone graft. This procedure involves lifting the existing bone into your sinus cavity to create enough space for a bone graft.
Causes: If the implant protrudes or perforates into the sinus cavity, the area can become infected and/or inflamed.
How to prevent: In addition to the presence of the sinuses next to your nose, insufficient bone quality and quantity in the upper back jaw can make dental implant procedures in this area difficult.
An X-ray or CT scan can easily detect this problem, and corrective surgery can then be performed. Patients should inform their oral surgeon of sinus issues prior to the implant procedure.
I hope this post helps you to understand some of the potential issues with poorly performed dental implant surgeries.
Having said that, dental implants are one of the best ways to replace missing teeth, and can last a lifetime with proper care.
Do check out this other post to find out more about dental implant costs in Singapore!
Dr Gerald Tan is the immediate past president of the Aesthetic Dentistry Society of Singapore and founder of Elite Dental Group. He has a special interest in bespoke cosmetic dentistry, dental implantology and smile designs. In his free time, he enjoys basketball, tennis and looking after his pet cockatoo.