Dental implant pain can basically occur for 5 reasons: Mucositis (inflammation of the mucosa) around the healing cap, mucositis around the prosthesis, peri-implantitis (infection around the implant), mobility due to lack of osseointegration (when not bone healing occurs around the implant) and hyperesthesia (pain caused by pressure on the inferior alveolar nerve)
1 – Mucositis around the wound healing:
Sometimes, the healing cap comes loose and this can cause bacteria to migrate into the space between the healing cap and the implant. This contamination causes gum inflammation and, consequently, pain. Solution: Remove the healing cap, clean the area and tighten again.
2 – Mucositis around the prosthesis:
In this case, the person has inflammation in the mucosa around the implants caused by mobility or lack of adaptation of the prosthesis but does not have significant bone loss. This movement and or misadaptation allows contaminated oral fluids to enter the space between the abutment and the implant, it is this fluid that contains bacteria that causes gum inflammation and pain. Within this group, simple tightening of the screw and occlusal adjustment (wearing the crown if it is high), in most cases, solves the problem momentarily. The question is: for how long? Because these systems (implants with external and internal hexagon) have a high rate of screw loosening and a high rate of contamination of the connections, therefore, I always recommend the use of implants with a very low rate of screw loosening and stability and precision of the connections: the cone morse implants.
If the problem was not solved by tightening the screw, most likely the region is contaminated and you can try to solve it using an intermediary (piece that is between the implant and the prosthesis). The intermediate is much more precise than the UCLA (a component widely used for screw-retained prostheses, but which has a very high rate of contamination and screw loosening). However, even so, this is not ideal.
3 – Peri-implantitis
It occurs when the infection progresses and bone loss begins to occur. Migration (displacement) of the gingiva and exposure of the implant threads usually also occurs, which causes more contamination, more infection, more bone loss and aesthetic problems since the metal of the implant is exposed. If left untreated, implant loss may occur. I said “if not treated”, however, the treatment is palliative, it has to be done frequently and the hygiene of the region has to be impeccable so that the disease does not advance further. The problem is that there is no turning back. Not even a gum graft.
4 – Mobility due to lack of osseointegration
It occurs quite frequently when the implant does not have a good primary locking (it does not stay firmly in the bone at the time of installation) or is loaded before integration with the bone occurs, which happens in immediate loads (when the implant is placed and the prosthesis in a short period of time).
As there is no fixation of the bone in the implant, it remains mobile and this can lead to pain. The solution is to remove, curet the soft tissues well and install one with a larger diameter again if there is enough bone for that. If not, you need to wait 3 months for bone healing and install a new implant.
5 – Hyperesthesia (pain caused by pressure on the inferior alveolar nerve).
Solution: Removal of the implant.
Dental Implant Pain After Months
Pain in the dental implant may appear months after its installation for the following reasons:
1 – Mucositis around the implant due to lack of hygiene.
Solution: Improve hygiene.
2 – Mucositis due to lack of conditions for the patient to be able to clean properly.
Solution: The professional must create the conditions for the patient to be able to clean. This happens very frequently in protocols with little space between the gum and the prosthesis. The dentist must increase this space so that the person can introduce an interdental brush and so that the water jet can remove the bacterial plate properly.
3 – Peri-implantitis
It occurs when there is contamination of the implant threads and bone loss. If the process proceeds, the implant will become mobile and must be removed.
Questions asked on the internet about dental implant pain
1 – Is it normal to feel pain in the dental implant after years?
Answer: It is not rare, but in most cases there is a solution. The most common causes that lead people to experience pain in the dental implant after years are: mucositis (inflammation of the mucosa around the implant) and peri-implantitis (disease caused by the accumulation of bacteria around the implant).
The treatment of mucositis lies in:
Remove the prosthesis, create conditions for hygiene (if this is not present, which consists, in most cases, of creating spaces so that the patient can enter with dental floss, interdental brush and so that the water jet can access the region)
Instruct the patient on hygiene methods.
The treatment of peri-implantitis lies in scraping the surface of the implant with special curettes, however, the lost bone will not be fully recovered, so the viability of the implant must be evaluated, whether it can be maintained (accompanied) or whether it should be removed.
2 – Is it normal to feel discomfort after placing porcelain implants?
Doctor: No.
In the short term, it may be that the porcelain is pressing the gum, in this case, it should pass with time.
In the long term, it may be that the adaptation of the crown with the implant is not perfect and is infiltrating (entering oral fluids with bacteria) and causing inflammation and pain in the gums. In this case, an intermediary should be used to minimize the problem. We must never screw the crown directly onto the implant, we must always use a piece between the crown and the implant called an intermediate.
3 – Is it normal to feel throbbing pain after installing a dental implant?
Doctor: At least in our office, very few patients report pain after installing a dental implant. In your case, if you are taking all the medications correctly, it may be that the implant is touching the root of the tooth on the side, but this can only be confirmed through X-rays. If this is found, the implant must be removed.
4 – How long is a dental implant painful?
Doctor: In the vast majority of cases, in our office, the patient does not feel pain after implant placement. However, in some cases, they feel and are sore for 2 or 3 days. It rarely hurts for longer than that. If this is your case, it would be good to make an appointment with your dentist to assess what might be going on. The last case we had, for example, the patient reported pain even after 5 or 6 days after surgery. So, we removed the stitches on the seventh day and relieved her prosthesis and she reported a huge improvement.
5 – I have pus on the dental implant. What should I do?
Doctor: Pus is one of the signs of infection. Infection around the implant may have been caused by plaque and calculus (tartar).
If the bone loss was small, the professional should clean the surface and guide you towards proper hygiene, the lost bone will not be recovered, however, it is possible to proceed (follow up to check for stability).
If the bone loss was severe, most likely you have lost your implant.
6 – Hello, good afternoon, in December 2017, I had the implantation of three pins and the placement of 05 crowns, with bone graft, in the upper part, front teeth. the process took 01 year until the completion of the prosthesis, however, although all the imaging exams show that the osseointegration is perfect, from the beginning I report to the dentist a discomfort, a little uncomfortable pain and sometimes a throbbing, the impression that gives is that air enters 01 of the pins,; my question is could it be problems with one of the components, or screws since the pins are very well placed and osteo integrated?
Doctor: Good morning, how are you? Basically it can be three things: 1 – Bacterial plaque and consequently inflammation in the gums, in this case you would need to invest more time in hygiene or, if you are not able to clean it, ask your dentist to improve the local conditions so that you can do it. 2 – Problem with the prosthetic pillar, if this is the case, the dentist has to try to solve the problem with the current pillar or replace the pillar with one that is more suitable for the region. 3 – Non-osseointegration of the implant. In this case there is no way. You have to remove the implant, wait for bone healing and install another one.
7 – Dr Good morning,
After 4 months, the implant pin was finally placed on Tuesday of last week, the 02/02th, and I placed the porcelain. However, on the day it was necessary to open the gum a little more, make several adjustments, to be honest it was quite traumatic. On the same day when I arrived, I had to take medicine because of the pain I felt. But the next day the pain was much better. What worries me the most is that since the 2nd the gingival region around this dental implant is very sore, when I touch or when I chew something I feel sore, yesterday I went back to my dentist and he informed me that it was normal that there was a lot of manipulation of the gums, yes normal? If so, how long will it be sore?
Doctor: Good morning,
The gum, under normal and healthy conditions, after being manipulated and using anti-inflammatories, does not take more than 3 days for the pain to cease. If the pain persists beyond that time period, it could be that something is causing the tissue to become inflamed. This inflammation can be caused by bacterial plaque, in this case it is necessary to better clean the region, or it can be caused by mechanical trauma, in this case, the professional must adjust the piece to stop this aggression.
8 – Doctor, after a week that I put the prosthesis on the implant, I started to feel pain every time I eat something harder, like crackers, snacks or meat. Do you think this means the loss of the implant? Or can without a flaw in the porcelain ? Every time I bite the feeling that the pain is really on top of where the prosthesis is screwed
Doctor: Good afternoon, If the prosthesis is mobile, the pain may be caused by the pressure it is putting on the gum, if the prosthesis is not mobile, it may be that you have lost the dental implant, but this can only be confirmed with a clinical evaluation.
9 – I am undergoing a superior protocol implantation and yesterday I placed the scarring and it hurt a lot. Today it still hurts but a little less. It’s normal? Can I wear the dentures over the healer?
Doctor: Good morning. Yes. You can use dentures.
And what about the pain how long can I still feel?
Doctor: It depends. If there is a problem with the implant, until removing the implant, if it is pressure on the gum, until the gum accommodates, if it is trapping of fluids inside the gum (It can occur with healing abutments for Morse taper implant), until removing the healing abutment, make an incision and put it again. You have to evaluate to know what is causing pain.
10 – I’m at the dentist in a recovery room, she thought it best to remove the implant but she couldn’t because it hurt a lot despite a lot of anesthesia. tried 3 times but the pain was almost unbearable. Donate inside when she tries to take it out. Acute pain.
She squeezed again and now she’s going to schedule surgery.
Doctor: Is the crown firm?
Yes, but it’s the crown that was mobile and the implant is well fixed.
Doctor: According to the tomography, is the implant inside the inferior alveolar canal?
No.
Doctor: If it is an external hexagon, I recommend removing it, but not if it is a Morse taper.
I didn’t think it would hurt more to take it off than to put it on.
Doctor: Did she anesthetize a lot? Back there and on the spot?
It is external hexagon.
Doctor: I recommend removing it because of the other problems it causes. It causes a lot of problems with screw loosening and gum inflammation.
Now it remains to be seen how she will be able to remove it. Every time she tried to remove the pain it was too strong.
Doctor: After she anesthetized him there, did you feel any difference in the lip region?
After about 30 minutes he was anesthetized and the tingling stopped.
Doctor: This is a good sign. It must not have broken completely.
I’m thinking that the pain I felt might be from the nerve that is causing my lip tingling. I’m still resting here and I think I’ll ask her to try again. I’m afraid of breaking the screw.
What do you think? Or would it be better to leave it for another day?
Doctor: You know your mood. Does she have time to work quietly?
I don’t think so.
11 – The two implants have already been removed and the pain and throbbing continue. I only sleep on meds. I live on anti-inflammatories and the dentist doesn’t know what to do. It doesn’t give me a solution. Ending up on Spidufen, Decadron and lyser meds. What I do? Can you help me?
Doctor: I would need to evaluate. I would need to see the exams. Just like that by text you can’t know what to do. I recommend going to another dentist.
12 – Hello! Is it normal for denture screws to hurt?
Doctor: Good afternoon! No. It is not normal.
What could be happening?
Doctor: When you say “screw” I think you mean implant. Correct?
I put in a fixed prosthesis and the screws are hurting my mouth a lot, but it’s been about two years since I put it in.
Doctor: The prosthesis screws only hurt if they stick out of the prosthesis. Do you know if they are?
are not
Doctor: It doesn’t make sense for the prosthesis screws to hurt. Are you sure it’s the prosthetic screws?
Yes
Doctor: It doesn’t make sense. I would need to see a professional to see if that’s the case.
13 – I had a bone graft to place implants for the protocol, I have been undergoing treatment for 2 years, which never works, I have had 6 surgeries, I have had 2 infections at the moment and are currently being treated with antibiotics. Can you help me?
Doctor: Good evening! I suggest you change professionals. Look for someone who is a professor at a college in the field of surgery. That has good reviews on Google.
Thank you dr. I’m going to do this, I paid 32 thousand reais, I’ve already had 6 CT scans and I still have no teeth without being able to even use the prosthesis, I have to work wearing a mask and I can’t eat properly anymore and now I don’t have the money to pay another professional, I’m desperate. My dream turned into a nightmare, I’m afraid of dying, I have another infection, taking amoxicillin + clavulanate for 5 days and I still feel a little pain.
Doctor: Regarding the infection, see a doctor for a second opinion.
It was the doctor who gave me the medication, it has reduced the pain a lot, but I still feel a slight pain, I think that with 5 days of antibiotics I should not feel anything anymore, what do you think?
Doctor: Unfortunately, I have no way of knowing the extent of the infection without a clinical evaluation to tell you about it. But see your doctor immediately if you develop a fever.
Thank you, I’m going to the doctor now
14 – Last year I had the pin placed and this year I placed the crown. But after I put the crown on, I started to feel severe pain in my ear, I went back to the dentist, he made adjustments and put the crown back in place. But even so, I continued to feel severe pain in my ear, gums and implant. Then he removed the implant. But I still continue to feel pain in the region. What could be happening.
Doctor: Do you have the rx?
Yes:
Doctor: Unfortunately, I can’t make a diagnosis based on this image alone. I would need to do a clinical evaluation.
15 – Is there a home medicine for inflamed dental implants?
Doctor: No. If the tissues around the implant are inflamed, it is most likely due to an infectious process that must be investigated. If it is due to infiltration between the prosthetic abutment and the implant, the prosthesis must be removed to investigate the region and adapt it to facilitate hygiene. If it is due to the presence of plaque and calculus around the implant, it must be cleaned and evaluated and the patient must receive hygiene guidance. If the bone loss is severe, the implant will need to be removed.
