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ASK YOUR DENTIST 11. - Dental Implant infection

“Hi, I’m Susan and I don’t know if you can help me. I have gotten dental implants to replace my canines, and am having some issues. At first I thought my dental implants were too tight, and were causing an itching sort of sensation weeks after the implantation has occurred. I am a shy person, and did not contact my dentist, as he is very loud and not pleasant, albeit a great medical professional. Anyway, the itch went away after a while, but pretty soon the implant felt a little bit loose. This was two years ago, and now the dental implant can move about. Is there any solution to this problem? I have ample jawbones, maybe it can be tightened or drilled deeper?”

Hi, Susan,

I am very glad you contacted me with this problem, because it is quite serious. You sound like you may have an infection, or possibly some sort of peri-implantitis. I want to go over parts of your letter and explain why each of them is a problem, because this letter has a lot of issues in it, and all of them need to be addressed.

First of all, I am worried about the relationship between you and your dentist. While being ‘nice’ is not necessary to clinical success and is certainly not a prerequisite of medical school, there are limits. If you are afraid to contact your dentist when you have a problem, than you need to get a new dentist, it is just that simple. An itch is usually a sign of some kind of tissue irritation, either from bacteria attacking the tissue, friction, or something else. There should be no itching, and if it persists for more than two days, you absolutely NEED to contact your dentist, or else the damage will be done, as I am sad to report is the case with you.

help

 

The fact that the itch went away leads me to believe one of two things happened, both of them extremely bad. One is that the itch was a result of a bacterial infection in the implantation site. The tissue was damaged far enough that it now no longer responds to stimulus, as too much of it, and possibly the nerve, has been eaten away by bacteria.

The other option is that the itching was due to friction, and that the dental implant was placed in loosely, and was damaging the tissue around it, causing a condition known as peri-implantitis. If this is the case you no longer feel the itch because the tissue that was itching is now completely gone.

Either way, the dental implant now needs to be removed, and the area needs to be checked out. If there is a bacterial infection, antibiotics and topical ointments need to be used to treat the site. Later on, re-implantation may be an option, depending on what condition the implantation site is in. If the cause is friction, re-implantation is very unlikely, perhaps with the aid of bone augmentation methods. There is no chance of drilling the dental implant in deeper, as this may cause nerve damage, which can result in paralysis and loss of feeling in the face, neck, lip, mouth and tongue. I would recommend seeing a dentist immediately, and getting the dental implant removed as soon as possible, to avoid any further damage that it may cause.

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