If you have opted for Implants, you’ve made a great decision. Dental Implants are a miracle of modern dentistry that enable dentists to replace a patient’s missing teeth with natural-looking and feeling permanent “teeth.” But if it feels like you have a loose dental Implant – don’t despair! Something probably is loose – but, I assure you, it’s probably not a loose dental Implant!

As an Implant dentist and adjunct Associate Professor in the Implantology Program at NYU, I frequently see patients for emergency care when an Implant that was once rock-solid is suddenly wiggling. Patients invest a significant amount of time and money to replace a missing tooth (or teeth) with an Implant which typically involves two surgical procedures, as well. The idea, then, of losing an Implant is quite alarming.

If It’s Not Loose Dental Implants, What Is Loose?

Your dental Implant replaced the root of your missing tooth and enables a permanent Crown to be affixed. Dental Implant Tooth Replacement is the clinical term for what you probably refer to as your Implant. Most self-diagnosed “loose dental Implants” are in fact a loosened Crown – the restoration attached to the Implant itself. Here’s the good news: it’s usually is readily fixed without much muss or fuss.

But, before delving into how “loose dental Implants” are fixed, take a look at the image below showing the 4 parts of your Implant and the Crown assembly:

The 4 Parts Of Your Dental Implant & Crown Assembly 

1. The Dental Implant  – The Implant is a post, typically made of titanium, which is surgically placed in your jawbone. It replaces the root of your missing tooth. In the above image, the Implant is called “The Fixture” because it’s been affixed into the bone.
2. The Crown – The Crown is the visible “tooth” attached to the Implant. You may have heard your dentist refer to it as the Restoration.
3. The Abutment – The Abutment is the component that enables the Crown to attach to the Implant.
4. The Abutment Screw – A tiny Abutment Screw is used to attach the Abutment to your Implant.

(Note: A fifth component, a Prosthetic Screw, is often used in complex restorations where numerous teeth or even an entire dental arch are being replaced. Dentists refer to that type of  comprehensive restoration as the prosthesis.)

The 3 Top Reasons It May Feel Like You Have A Loose Dental Implant

Now that you’re familiar with the four components of your Implant, let’s discover what’s causing it to feel loose.

Reason #1: The Abutment Screw Is Loose

The Abutment Screw attaches the Abutment onto the Implant. It’s typically made of titanium and “torqued” into place using a specific calibrated amount of force. If it feels like you have a loose dental Implant, there’s a very good chance that what’s loose is this Screw.

Our jaws exert mighty forces. Every time you bite down, the force is exerted onto the tiny Abutment Screw. Forces are even greater for people who clench or grind their teeth. Over time, all the biting, clenching, or grinding can cause the Screw to jiggle loose, move out of position and thus become unstable. Loose Screw = Loose Crown.

The Fix: There are two ways we can fix a loose Abutment Screw. The right approach depends on how the Crown has been affixed to the Abutment (or Bridge, if you have numerous Implants).

1. If your Crown has been temporarily cemented onto the Abutment, it’s gently removed to gain access to the Screw. The Screw is then tightened and the Crown is re-cemented and you’re on your way!

2. If your Crown was permanently cemented, a tiny hole is drilled to access the Screw, it’s tightened, your Crown is bonded and sealed and you’re good to go. (Occasionally, it is necessary to remove the Crown to get to the Screw.)

Reason #2: The Abutment Screw Is Broken

The second most typical cause of what can feel like a loose Dental Implant is when the Abutment Screw has broken causing the Abutment to partially lift off your Implant. All the biting forces are then concentrated on the tiny Screw and it fractures. At that point your Crown is barely held in place by only a few Screw threads. Eventually it can fall off and hopefully not be swallowed.

The Fix: When the Abutment Screw is broken it must be replaced immediately. But for it to happen, we need to remove the remaining part of the Screw which is lodged within the Implant. Because we do not want to cause any damage to your Implant it is a very delicate procedure. In the right hands and with specially designed instruments called Screw retrieval kits, the wayward “piece of hardware” is gently extricated, the Screw replaced and the Crown affixed.

In the rarest of situations when a Crown has been loose for a long time, the Implant itself can become damaged or fractured. It must be replaced with a new one. Should that happen, the implant will likely need to be removed and ultimately replaced with a new one. (A costly mishap requiring what amounts to a complete do-over- new implant and all.)

Reason #3 The Crown Is Broken

The least common reason for what can feel like a loose dental Implant is when the Abutment Screw has loosened and caused the Crown to shift out of place. In this case it takes only one misaligned bite down and your Crown can break. It’s a rather rare situation but is a lesser evil compared to a broken Abutment.

The Fix: All that’s usually needed to fix this problem replacing the Crown. If the Abutment has been damaged, it will be replaced, too. Your existing Implant stays put and you don’t require additional surgery or more expense.

Feel Like You Have One Or More Loose Dental Implants? Get Ye To The Dentist ASAP!

If your Implant feels loose or wobbly, please call your dentist for an appointment right away. The longer you wait, the more damage can occur. And..the fix can be as simple as “A Turn Of The Screw!”

Related Reading:

• Is There An Age-Limit For Dental Implants?
• Do Dental Implants Last Forever?
• The Cost Of Dental Implants In NYC