Why Dental Implants Fail — and How to Make Sure Yours Last a Lifetime

Dr. Lieblick:
Brandon, one of the questions that often comes up after we’ve talked with patients about the benefits of dental implants is, “What happens if an implant fails?” It’s a fair question, and one we think is important to address directly.

Dr. Rehrer:
Absolutely. Dental implants have a very high success rate — one of the highest in medicine or dentistry — but, like any medical procedure, there are rare cases where things don’t go exactly as planned. Understanding why that happens and, even more importantly, how we can prevent it, is key to long-term success.

Dr. Lieblick:
That’s exactly what we’re diving into today. Welcome to Oral Surgery Insights. I’m Dr. Russ Lieblick, joined by Dr. Brandon Rehrer. Today, we’re talking about dental implant failures — what causes them, how we identify risks early, and the steps we take to help ensure the best possible outcomes for our patients.

Dr. Rehrer:
It’s an important conversation, Russ, because the more patients understand the process and the biology behind implants, the more confident and informed they feel about their treatment.

[Segment 1: What Is Considered an Implant Failure?]

Dr. Lieblick:
Let’s start by defining what we actually mean by an “implant failure.” An implant is designed to integrate — or fuse — with the jawbone in a process we call osseointegration. When that doesn’t occur properly, it just didn’t integrate. In our practice, we differentiate this from a healed implant that fails later. One that has problems after it has been restored with a crown, we call that a failure.

Dr. Rehrer:
Exactly. In our practice we have a 98.3% integration rate. We’re happy to report beating the published statistics by over 2%. But we’d obviously like to be at 100%! Implants that have healed and had a crown placed on it only return to us with a problem at 0.03%! That’s exceedingly low.
And the key point for patients to know is that failure doesn’t always mean something went wrong. There are biological and behavioral factors that can impact success.

[Segment 2: Common Causes of Implant Failure]

Dr. Rehrer:
So let’s go through the major causes. Again, we’re not talking about the initial integration, we’re talking about long term issues. The first and definitely the most common, is implant overload, which is a mechanical problem.

Dr. Lieblick: Yes! Most people don’t know this and dentists don’t talk about it enough, but most dental issues are caused by tooth clenching or grinding at night. Statistics say that 96% of us do it and the forces are extreme. This basically means everyone and aren’t very consistent, so they just didn’t catch a few people in the studies. If you can crack a tooth or cause it to fail because it’s overloaded, you can do the same to your implant.

Dr. Rehrer:
And just like with natural teeth, prevention starts with a custom made, acrylic night guard. All dentists know how to make them and we insist on them for our implant patients. We design every case to distribute force evenly, especially in multi-implant restorations, and we work closely with restorative dentists to ensure that the final prosthetic is balanced and functional. It’s then up to the patient to wear their night guard to protect it.

Dr. Lieblick:
Another cause we often discuss with patients is smoking. Nicotine reduces blood flow, impairs healing, and dramatically increases the risk of implant failure. We always encourage patients to quit smoking before and after implant placement for the best possible outcome.

Dr. Rehrer:
Systemic health also plays a big role — conditions like uncontrolled diabetes, certain autoimmune disorders, or medications that affect bone metabolism can impact healing. That’s why we take a comprehensive medical history and sometimes collaborate with a patient’s physician before proceeding.

Dr. Lieblick: You’ll also see information about peri-implantitis. Yes, this happens. Most often it’s mis-diagnosed and is being caused by mechanical overload. However, if implants are neglected, peri-implantitis can occur, similar to periodontitis in teeth.

Dr. Rehrer: A key component of peri-implantitis is the implant and restorative parts. Some implants are more prone to peri-implantitis. We use an implant very resistant to this. We also insist that our restorative colleagues use OEM components, or in other words components manufactured by the implant company. It’s like putting only Honda parts in your Honda engine, not cheap aftermarket parts.

[Segment 3: How We Prevent Implant Failures]

Dr. Rehrer:
Prevention really starts long before surgery. At Beacon Oral Surgery, every implant plan begins with a detailed digital analysis — bone density, sinus position, nerve mapping — so we can anticipate any challenges.

Dr. Lieblick:
We also take a “biologic first” approach. That means ensuring the tissue and bone are healthy before we ever place an implant. If we see signs of infection, bone deficiency, or other concerns, we address those first through bone grafting or other preparatory procedures.

Dr. Rehrer:
Then there’s the surgical precision aspect. Using 3D planning tools allows us to position implants exactly where the bone is strongest and the forces are most balanced. It reduces guesswork and increases accuracy — which directly improves long-term success.

Dr. Lieblick: Experience also matters. Specialists statistically have a 4% non-integration rate. A study published in the Journal of the American Dental Association on dentists who place implants saw an 18.7% complication rate. It’s important when you have a consultation with a surgeon to ask how many of these they’ve done. 

Dr. Lieblick:
And the follow-up is just as important. We monitor patients closely after placement, provide detailed care instructions, and schedule regular check-ins to ensure proper healing. Long-term success depends on collaboration between the patient, the surgeon, and the restorative dentist.

[Segment 4: What If an Implant Does Fail?]

Dr. Rehrer:
Let’s touch briefly on what happens if an implant does fail. It’s not the end of the road. Most cases can be successfully retreated once the underlying cause is identified and corrected.

Dr. Lieblick:
That’s right. In many cases, the site can be cleaned, the bone rebuilt if necessary, and a new implant placed after proper healing. Our focus is always on restoring full health and function, not just replacing the implant itself.

[Closing Thoughts]

Dr. Rehrer:
So, to summarize — implant failures are rare, but they do happen. The good news is that most causes are either preventable or correctable with the right planning, technology, and follow-up care.

Dr. Lieblick:
And education is the best prevention. When patients understand the factors that support long-term success — like wearing night guards, good hygiene, smoking cessation, and regular check-ups — the likelihood of implant failure becomes extremely low.

Dr. Rehrer:
We hope this episode has shed some light on a topic that isn’t often discussed but is incredibly important for anyone considering dental implants.

Dr. Lieblick:
Thanks for joining us today on Oral Surgery Insights. We appreciate your time and hope this helps you feel more confident about your oral health decisions.

Dr. Rehrer:
Until next time, take care, stay healthy, and keep smiling.