Dental Implant Failure Signs: What to Watch For and What to Do

The clearest sign of dental implant failure is an implant that feels loose. Other warning signs are pain when biting, and gums around the implant that bleed, swell, recede or leak pus. The FDA advises telling your dental provider right away if an implant feels loose or painful, and notes that implant failure is usually defined as looseness or loss of the implant (FDA). Failure is not common: in a review of 18 studies, about 96% of implants were still in place after 10 years (Howe et al., 2019).

Warning signs and what they may mean

Sources: the FDA lists a loose or twisting feeling from abutment screw loosening, implant body looseness, bite problems and post-surgical numbness from nerve damage among implant risks. Signs of gum disease around implants come from the 2017 World Workshop consensus.

Early failure vs late failure

Early failure (first months)

After placement, the jawbone needs to grow onto the implant. This process, called osseointegration, can take three to nine months (Cleveland Clinic). If it doesn't happen, the implant stays loose and usually has to come out. Early failure can show up as ongoing pain, movement or an implant that never feels solid.

A review of failure causes linked higher failure rates with things like lack of initial stability, poor bone quality or small bone volume, short implants, placement in the upper or back jaw, inexperienced surgeons and heavy smoking (Chrcanovic et al., 2014).

Late failure (years later)

Implants that fused well can still fail later. The main cause is gum disease around the implant. The FDA notes that complications can appear soon after placement or much later (FDA).

Gum disease around implants: the most common problem

Experts recognize two stages (Berglundh et al., 2018):

• Peri-implant mucositis. Inflamed gums around the implant. The main sign is bleeding on gentle probing; redness, swelling or pus may also show up. Plaque is the cause.
• Peri-implantitis. Inflammation plus ongoing loss of the bone holding the implant. Signs include bleeding or pus, deeper pockets, gum recession, and bone loss seen on X-ray.

These problems are common. A review estimated that about 43% of people with implants had mucositis and about 22% had peri-implantitis, though results ranged from 1% to 47% depending on how studies defined the disease (Derks and Tomasi, 2015). Peri-implantitis became more common the longer implants had been in place.

Because bone loss can be silent at first, the consensus report recommends that dentists take baseline X-rays and measurements once the implant crown is finished, so later changes can be spotted (Berglundh et al.).

Who is at higher risk

• Smokers. A 2024 review found smokers had about twice the risk of early implant failure, with the strongest effect in the upper jaw (Fan et al., 2024). The FDA also notes smoking may affect healing and long-term success (FDA).
• People with uncontrolled diabetes. The FDA lists implant failure from infection as more likely in patients with uncontrolled diabetes.
• People with untreated gum disease or hard-to-clean implants. Both appear on the FDA's list of implant risks.
• Older adults. In the 10-year review, people 65 and older had a higher risk of losing an implant (Howe et al.).

What to do if you notice a warning sign

1. Call your dentist. Describe what you notice and when it started. Getting checked early gives you and your dentist more options.
2. Expect an exam and X-ray. The dentist will check for movement, bleeding, pockets and bone levels, and compare them with earlier X-rays if they exist.
3. Know the possible fixes. A loose crown or screw may only need tightening or a new part. A failed implant may need another surgery to remove or replace it (FDA).
4. Report device problems. The FDA encourages people to report problems with an implant system through its MedWatch program, including the implant brand and the date it was placed.

Can a failed implant be replaced? Often, yes. A review of replacement implants found about 89% of second attempts survived over an average of about 3.5 years, though third attempts did worse (Zhou et al., 2016). The authors stressed controlling risk factors such as smoking and oral hygiene first.

How to lower your risk

• Follow the cleaning instructions your dentist gives you. The FDA says regular cleaning of the implant and the teeth around it is very important for long-term success (FDA).
• Keep regular dental visits, even if nothing hurts. Bleeding on gentle probing, the first sign of trouble, is something a dentist checks for.
• If you smoke, talk to your dentist about quitting before surgery, given the higher early failure risk in smokers.
• If you have diabetes, work with your doctor to keep it under control before and after treatment.

Thinking about implants and comparing prices? See our dental implant cost guide.

Normal healing vs a problem

Some discomfort after surgery is expected. The ADA lists bleeding, pain, swelling and infection as risks after dental surgery and stresses follow-up care to make sure healing is on track (ADA). Talk to your surgeon about what is normal for your case, and ask when pain or swelling should be getting better. Pain or swelling that gets worse instead of better, fever, pus, or an implant that moves are reasons to call.

If your implant was placed abroad

Implant problems can appear months or years after you get home, so it pays to prepare before you travel:

• Keep the implant details. The FDA recommends asking which brand and model of implant system is used and keeping that information (FDA). A U.S. dentist needs it to find compatible parts.
• Bring home your records in English, including X-rays and scans (CDC). Final X-rays give a baseline for spotting bone loss later.
• Line up a local dentist first. The ADA suggests arranging U.S. follow-up before you travel and checking what your insurance will cover (ADA).
• Ask how the warranty works. Find out if it covers the implant, the crown and labor, and whether you must fly back to use it.

Our questions to ask your dentist cover warranties and implant brands. For destination-specific checks, read Is it safe to get dental implants in Mexico? and Is it safe to get dental implants in Turkey? For what insurance does and doesn't pay for after treatment abroad, see what insurance covers abroad.

The bottom line

Most implants last for many years, but they need care. Watch for movement, pain on biting, and bleeding, swollen or pus-filled gums, and get them checked early. Regular cleanings and X-rays catch gum disease around implants before it costs you the implant.