#8: What To Do If Your Implant Is Loose
Transcript
Dr. Tanner Townsend 0:05 So have you ever felt your dental implant and thought, did that just move? Should I be worried about that? And so, in this episode today, we’re going to talk about what you should do if you feel your dental implant move, and if it’s a true emergency, or if it’s something that needs to be addressed, but isn’t a major concern. So today, let’s say, let’s kind of set the scene here, Dr. Muir, and let’s say it’s been either a few weeks since you had your dental implant surgery, and or a few months since you got your surgeon, you now have your implant crown, or it’s been several years and something kind of just feels a little bit off, feels like the gums are being pinched, maybe a little bit, or you feel something move, and you’re like, oh, that felt different than it has before. When is it a time to panic, or I guess not panic, but when is it a time to be concerned versus not be concerned? And how do you differentiate the two?
Dr. Josh Muir 1:00 Yeah, great question. I mean, with both of them, anything that feels different from what your normal is, you should be concerned. The question is, how should you respond to that concern? So, patients typically do one of two things: one is they call us 10 times in a row, the other is they don’t call us at all until something major happens weeks or months down the road, and so, which one of those is the right way to do it? Well, really, neither. What they need to do is just give us a call, we’ll get back to them quickly, typically, and it just depends on what the problem is.
Dr. Tanner Townsend 1:40 Now, we typically see two classes of problems, right? You see an issue with the crown, which is the tooth part itself, or the implant, which is in the bone, and typically it’s the crown. So, what are the two kinds of, if you could dive a little deeper into what the two typical culprits of the problem are, and how we kind of figure out which one it is when you come in.
Dr. Josh Muir 2:03 Yeah, so the implant itself goes up inside the bone. The patient will never see the implant, but they do see the crown part, that’s the, that’s what looks like a tooth when someone smiles. So basically, if that top part, the crown is loose, then that’s okay. The crown is hooked to the implant using a little screw, and sometimes, if it’s been jostled in the right ways for the right amount of time, that screw can loosen. So they need to give us a call and say, “Hey, I think my crown is loose, and we’ll get him in as soon as we can. In the meantime, they just need to leave it alone, you know. Obviously, don’t bite into a hamburger with that tooth, just be really careful with it. And we can, in most cases, just tighten that. Sometimes it requires a little reshaping or something, but yeah, we just tighten it, and they’re on their way. The other scenario is that, hey, this is this feels weird. It’s wiggling, but it feels like it’s deeper, and if it feels like it’s up in the bone, or like the gums are moving, that might be that the dental implant itself, up in the bone, has failed.
Dr. Tanner Townsend 3:15 So, in terms of when we see this kind, these kind of problems, when something feels loose. If you were to categorize it, how often would you say it’s a crown problem versus the implant itself?
Dr. Josh Muir 3:27 It’s almost always a crown problem. And so, two, you know, two case in point things. I had a call from another office a week ago. They said, “Hey, Dr. Muir, we’ve got this patient and their crown is loose. Do you have a screw that you can give to us so we can replace the screw? I said yes, I do have a screw. I sent it to him. I said, look, it’s probably what’s happened is you need to adjust how that crown is hitting the opposing teeth, and so they put the screw in, they tightened it down, and they adjusted it, so it wouldn’t hit it in the same way. That’s typically what would be done in that situation. Now, the other one, let’s say, so recently we had a patient that called, I believe it was your patient, and you had done an immediate implant, so take the tooth out, put an implant in the same day, put a temporary crown on there at the same time, and you tell the patient, “Hey, don’t chew on this, this is during the healing, you can’t, you can’t mess with this at all, don’t even look at it, you know, and if they break that rule and they’re chewing on that implant that’s healing, then that implant itself can get loose. Now I don’t actually know what was what the rest of your phone call was, but I know the beginning and I thought, oh man, if she’s been chewing on that, that’s not typically good during healing. So those are the two things. If the crown’s loose, that’s something we can typically fix easily, if. Implants loose, then that’s something where we’d have to start the process over.
Dr. Tanner Townsend 5:04 Yeah, and I think you hit it right on the head. Typically, it’s a crown problem, usually it’s not an implant problem. So don’t necessarily freak out if that, if you feel something loose, but definitely you want to give us a call, and we want to get you in right away, regardless of if it’s the crown or the implant. So we kind of talked about how to fix both of those. What are some sensations that you kind of typically feel that point you in the direction of the crown versus points you in the direction of the implant? You kind of touched on it already, but let’s go a little deeper.
Dr. Josh Muir 5:35 Typically, if the crown is loose, there won’t be any pain, meaning it’s just they’re kind of like getting something stuck between your teeth, it’s just something, and you can feel a little with your tongue, and you can kind of feel it moving a little bit, like, what is that? Hey, I think something’s loose, something’s wiggling, that’s typically the sensation. Now, as it gets worse, though, or if it’s been there for months or years, the gum tissue can start to grow under that loose part of the crown, and it’ll start pinching that new gum tissue, and we see that happen sometimes. So, the answer there is, guys, even if it’s not hurting, just call us and let’s, let’s get you in. Worst-case scenario, we take a look at it and say no, it’s just fine.
Dr. Tanner Townsend 6:18 Yeah
Dr. Josh Muir 6:19 But at least then it’s not being broken, or you know, having something else happen.
Dr. Tanner Townsend 6:24 And if you let the crown go for too long, too, that is a real problem that either inside the implant can break because it’s putting forces on things it shouldn’t, or the crown will break.
Dr. Josh Muir 6:34 Or the little screw holding them together can break any number of things.
Dr. Tanner Townsend 6:38 All of those are expensive fixes, so don’t let it go too long that way, so just to kind of summarize, what would be the
Dr. Josh Muir 6:46 Let me answer the rest of your question, you were saying about the sensation,
Dr. Tanner Townsend 6:50 Oh yeah, sensation.
Dr. Josh Muir 6:52 If an implant is moving, you’re going to feel something sliding in there, and it’s going to be deeper, and it’ll probably have a little tenderness to it. Yep, like, oh, oh, wait, hold on. Did that, did that hurt? And you touch it again. Oh, yeah, that did hurt a little bit. What’s going on there? Leave it alone. Call us, and at that point, you know, let us know what you found, what you’ve experienced, and we’ll probably have to take that implant out.
Dr. Tanner Townsend 7:19 So, if you have to take the implant out. What’s the procedure? We’ve sometimes people get all worked up in their head of the implant has to come out. What’s the procedure, and how do you kind of handle that with your patients?
Dr. Josh Muir 7:31 Yeah, so if this is a patient that we’ve seen, especially recently, and did the implant, this is something we work with the patients on. We get you numb, honestly, at that point, the implant just unscrews, and I know I say words like just unscrews, just unscrews from your bone, it sounds awful, but it’s really not. We just get you numb, it unscrews, we let it heal for a while. There’s probably a grafting bone, grafting we would do later to help it heal, and then we would place a new implant, so. But as crazy as is sounds, it’s really not that bad.
Dr. Tanner Townsend 8:04 Agreed. So, to kind of summarize, a loose crown is typically a quick fix. Implants a little bit longer fix if we have to deal with that. Both of them are manageable scenarios most of the time. Anything else you would like to add before we kind of close out this podcast, about if you’re feeling something loose with your implant?
Dr. Josh Muir 8:25 Yeah, guys, it’s better to be safe than sorry. I mean, in most things, it’s better to be safe than sorry, and so take that precaution, give us a call, we’re happy to take a look at it. And then the other thing, everything we do comes with a warranty, and as long as you’re following the rules and getting the checkups like you’re supposed to, then that warranty stays, and the work that we do, we do it the right way, and it should last, but if there’s ever a situation where it’s not lasting in the right way, then we’ll make it right.
Dr. Tanner Townsend 8:57 Yeah, love that. So, if you’re sitting there right now, wondering, like, hey, should I go in? Should I call? Because I’ve got this implant that feels a little loose. Give us a call. Our number is 406-259-7115 And book a free consult. We’re happy to see you, and we’d love to kind of go through the different processes of determining if it’s the crown or the implant and help you figure out what the problem really is and get you the solution. Well, that is it for today’s episode. In our next episode, we’ll talk a little bit more about diabetes, and can you even get implants with diabetes? We’ll talk through that, and we will catch you all in the next episode. Thanks again.