Restoring Implant Health in St. Louis

Signs Your Implant May Be in Trouble

A healthy dental implant should feel and function just like a natural tooth — no pain, no movement, no inflammation. Contact our office if you notice any of the following:

• Bleeding or pus around the implant
• Swelling, redness, or tenderness in the gum tissue nearby
• A loose implant crown, abutment, or implant body
• Gum recession exposing the metal of the implant
• Bad taste or persistent bad breath near the implant
• Pain when chewing
• Visible bone loss on X-rays

Symptoms can range from subtle to severe. Earlier intervention almost always means more treatment options and better outcomes.

What Causes Implants to Fail?

Implant complications generally fall into two categories:

1. Biological Problems

• Peri-implant mucositis — inflammation of the gum tissue around the implant. Reversible if treated early.
• Peri-implantitis — a more advanced condition involving bone loss around the implant. Progressive if left untreated.
• Infection — often related to bacterial buildup, poor oral hygiene, or compromised tissue health.

2. Mechanical Problems

• Loose or fractured crown or abutment screw
• Fractured implant body
• Excessive bite force or teeth grinding
• Inadequate bone support at the time of placement

Risk factors include smoking, uncontrolled diabetes, poor oral hygiene, a history of periodontal disease, and certain medications.

How We Diagnose Implant Problems

Every case starts with a thorough evaluation that may include:

• Clinical examination — checking for mobility, inflammation, probing depths, and bleeding
• X-rays and CBCT imaging — to assess bone levels, implant position, and the integrity of surrounding structures
• Review of placement history — when possible, we coordinate with your original implant provider to understand the implant system used and any relevant surgical records

Treatment Options

Treatment is matched to the severity of the problem.

Non-Surgical Treatment

For early-stage peri-implant mucositis and mild peri-implantitis, non-surgical options may be sufficient:

• Professional deep cleaning around the implant with specialized instruments
• Antimicrobial therapy (topical or systemic antibiotics)
• Improved home care coaching

Surgical Treatment

When bone loss or infection is more advanced, surgery may be needed to save the implant:

• Open flap debridement — gently lifting the gum tissue to thoroughly clean the implant surface and surrounding bone
• Regenerative procedures — including bone grafting and membrane placement to encourage new bone growth around the implant
• Implant surface decontamination — using specialized techniques to remove bacteria from the implant threads

Implant Removal and Replacement

If an implant cannot be saved — for example, if the implant body is fractured, severely mobile, or has lost most of its supporting bone — removal may be the best path forward. In many cases we can:

1. Remove the failing implant
2. Graft the site to rebuild bone volume
3. Place a new dental implant once healing is complete

In select cases, an immediate implant may be placed at the same visit.

Preventing Future Problems

Once your implant is healthy again, keeping it that way comes down to a few consistent habits:

• Brush twice daily and floss around the implant
• Use an antimicrobial rinse if recommended
• See your general dentist for regular cleanings and exams
• Avoid smoking
• Address teeth grinding with a nightguard if needed
• Contact us quickly if any symptoms return

Why Patients Trust Gateway Oral and Maxillofacial Surgeons

Treating a failing implant requires advanced training and careful judgment about what can — and can't — be saved. Dr. Hiran Fernando, board certified in Oral and Maxillofacial Surgery, and Dr. John Chiapel bring decades of combined surgical experience to every case, and our practice is known for its thorough patient education and warm, supportive atmosphere.

We treat patients referred by general dentists, periodontists, and prosthodontists from across Greater St. Louis and communities in Missouri and Illinois. Visit our Referring Doctors page for referral resources.