Dental Implants: Can They Be Removed and What Happens Next?

Dental implants have transformed the approach to replacing missing teeth, offering a reliable and visually appealing solution.

Years ago, we used to tell our patients that they last forever - but clearly, this isn't true.

There are several reasons that a dental implant may need to be removed, sometimes its infection (peri-implantitis), sometimes the implant actually breaks, sometimes it has been put in so badly that we need to remove it and start again.

Understanding Peri-Implantitis

Loss of bone around the implant is a common reason for it needing to remove dental implants.

This is the same process as gum disease, and if you get gum disease around a dental implant, we call it peri-implantitis.

Periimplantitis is probably the most common reason to remove dental implants.

Sometimes it is possible to treat the condition, rather than removing the dental implant - but its often a losing battle.

The Procedure for Dental Implant Removal

The difficulty with removing dental implants is that the implants are often fused (at least partially) to the jaw bone.

This is the main benefit of dental implants, (that they are so strongly fixed to the bone), is the same thing that can make their removal more difficult.

The good news is that most modern dental implants are screw shaped. Because of this, we are able to put an unscrewing force on the implant, and I estimate about 50% can be removed like this.

Sometimes, the bond to the bone is too strong, or some very old implants had different shapes, and even holes in them to allow bone to grow into them. This makes them almost impossible to rotate out.

So we need a plan B.

This is what we call surgical removal of the dental implant.

Like the name suggests, we need to make a cut in the gum, and use more complicated techniques to remove the implant.

This approach takes longer, and there will be more swelling and bruising after the treatment.

Another downside to this treatment is that it involves bone removal. So if you wanted another dental implant in this position, then you may need some bone grafting before the new dental implant can go in.

What Happens After Removal?

After any surgical treatment, expect pain, discomfort, swelling, and the neighbours to ask you if everything is okay at home.

Often the swelling makes things look worse than they feel, you may need a few painkiller - the pain often is not terrible.

We often recommend that we wait for 3 months before doing anything. If the implant removal was particularly tricky, then we may recommend waiting longer.

This 3 month window will allow new bone to fill in where the dental implant was, and it lets your gum fully heal.

Bone is the only tissue in the human body that will 100% recover without any scar tissue - but we need to give it time to do this.

If the implant is in the front (and visible), then a conversation about what you can have as a temporary solution is critical, there are several options.

On the odd occasion, we have removed a dental implant, placed a new one, AND done a bone graft AND a tissue graft, AND we placed a temporary tooth on the dental implant - all at the same time!

I only feel comfortable doing all this stuff if there is no sign of initial infection, so in the case that I am thinking of, we removed the dental implant because its position was wrong - there was no periimplantitis.

Every situation is different and needs to be planned carefully.

Important Considerations for Dental Implant Removal

Over the years, some patient have come to us, and asked for all their dental implants to be removed because of pain.

And when we look, there is no sign of any problems with the dental implants. There is no sign of infection, we cannot press anywhere to make the pain come on or see anything on any x rays.

We need to be careful in these situations, as there may be something else going on, and we have had some success in referring these patients to external services.

We have also removed dental implants that seemed to be healthy, but the patient complained of a certain pressure from the dental implant. Removing the dental implants helped here - but this is just 1-2 patients - and I still do not know what was actually causing the pain in these situations!

Final Thoughts

These days, it seems that every dental practice will be keen to offer dental implant placement, but we find that removal is something that most places will shy away from.

It does take an additional skill set and experience to remove a dental implant, especially if you aim to preserve as much bone as possible, so that you have the option of a new dental implant in the future.