How long do dental implants last? What affects them over time

An implant treatment usually has two main parts. The implant itself (sometimes called the fixture) is the post in the jawbone. On top of it sits the restoration: a crown, a bridge, a full arch or the attachments for a denture, often connected by a small part called an abutment.

These parts wear in different ways. The implant in the bone is designed to stay in place long-term if the bone and gum around it stay healthy. The restoration on top is exposed to biting forces every day. Crowns can chip, screws can loosen, denture clips wear and bridges may need repair. Needing to repair or replace the restoration does not mean that the implant has failed, but it is a normal part of planning for the long term.

Implants cannot decay, but the gum and bone around them can become inflamed. Peri-implant mucositis is inflammation of the gum around an implant, without loss of the supporting bone. A key sign is bleeding when the area is gently cleaned or checked. It is usually caused by plaque and can often be treated with professional cleaning and better home care.

Peri-implantitis is more serious: the inflammation affects the gum and leads to loss of the bone that supports the implant. Signs can include bleeding, swelling, pus, gum that seems to pull back, and in later stages an implant that feels loose. It may not be painful at first, which is one reason regular check-ups matter. Treatment is possible, especially when it is found early, but lost bone does not always grow back.

Many factors play a part, and they affect each person differently. The ones dentists most often ask about are listed below.

• Plaque control and maintenance: people with poor plaque control who do not attend regular maintenance are at higher risk of problems around implants.
• A history of gum disease: people who have had severe gum disease (periodontitis) have a higher risk of peri-implantitis and usually need closer follow-up.
• Smoking: smoking affects healing and gum health, and dentists usually advise stopping or cutting down. Ask your dentist how it applies to you.
• Diabetes and other health conditions: conditions such as diabetes, especially if poorly controlled, can affect healing and gum health. Tell your dentist about your health and medication.
• Grinding or clenching (bruxism): heavy forces can chip or loosen crowns and bridges. A dentist may suggest a night guard.
• The design of the restoration: teeth that are easy to clean around tend to be easier to keep healthy. Ask how you will clean yours.

Cleaning implant teeth is similar to cleaning natural teeth, but the area where the gum meets the implant needs particular attention. Brush twice a day with fluoride toothpaste and clean around each implant every day with the aids your dental team recommends, such as interdental brushes, special floss or a water flosser. Full-arch bridges and overdentures often need specific cleaning aids; ask to be shown how to use them before you leave the clinic.

Contact a dentist if you notice bleeding, swelling, a bad taste, a loose crown or a change in your bite. Small problems are usually easier to treat early.

Implants need regular check-ups and professional cleaning for life, in the same way as natural teeth. The dentist or hygienist will check the gum around each implant, check that the restoration is secure and may take X-rays from time to time to look at the bone. How often you need these visits depends on your mouth and your history of gum disease.

If you were treated abroad, ask the clinic before you leave how often they recommend check-ups and whether a dentist at home can carry them out. Many people find it practical to have routine maintenance near home and to keep the treating clinic informed.

Implants come from many manufacturers, and the parts that connect to them are often specific to the system. If a crown needs to be remade or a screw replaced years later, the dentist will need to know exactly which implant was used. This is especially important if you were treated abroad, because the dentist who sees you later may not be able to contact the original clinic easily.

Before you leave the clinic, ask for a written record — sometimes called an implant passport or implant card — and keep it with your dental records.

• The implant manufacturer, system and model, and the size (diameter and length) of each implant.
• The position of each implant in your mouth and the date it was placed.
• Details of the abutments, screws and restoration, including the materials used.
• Copies of your X-rays or scans, before and after treatment.
• Any guarantee, and its conditions in writing.