Dental Implant Complications and Risks (UK Guide)

Most dental implants heal and work well, but complications do happen, and some can end with the implant being removed. Cambridge University Hospitals NHS Trust tells patients that over 90% of implants bond successfully to the jawbone and gives a success rate of 80 to 95% over 15 years in healthy mouths. The problems to know about are infection and bone loss around the implant (peri-implantitis), implants that fail to bond, nerve damage in the lower jaw, sinus problems in the upper jaw, and wear or damage to the crown on top. Your own risk depends heavily on smoking, gum health and how well the implant is looked after.

What are the main complications of dental implants?

They fall into problems around the implant (gum and bone), problems during or soon after surgery, and problems with the parts above the gum.

Peri-implantitis and mucositis

These are the main long-term threat to an implant. The Cambridge leaflet describes mucositis as inflammation around the gums and peri-implantitis as loss of bone around the implant, and says both can occur if implants are not cleaned properly and often need further treatment. A Royal College of Surgeons of England briefing describes peri-implantitis as a disease that causes loss of the bone supporting the implant and often implant loss.

It is not rare. A systematic review of fifty-seven studies in BMC Oral Health found peri-implantitis in 19.53% of patients and 12.53% of implants, with large differences between studies depending on how the disease was defined.

The implant does not bond with the bone

Sometimes the bone does not fuse with the implant while it heals. Cambridge says this happens occasionally, the implant has to be removed, and depending on the reason it may be possible to place a new one after a healing period. The flip side of its figure of over 90% bonding successfully is that a small share do not.

Nerve damage in the lower jaw

Nerves run through and beside the lower jaw, and an implant placed close to them can bruise them. Cambridge’s leaflet on implant surgery says this can cause tingling or numbness in the lip, chin or tongue, and more rarely altered taste, and that the numbness usually recovers after a few months and is rarely permanent.

The Royal College of Surgeons briefing, written for a House of Lords debate in July 2014, estimated about 10,000 lower jaw implant procedures a year in the UK and about 100 reported chronic nerve injuries a year from them. It said many nerve injuries can be prevented through better planning and execution of procedures. Ask how your surgeon will check the position of the nerve before placing a lower implant.

Sinus problems in the upper jaw

Implants at the back of the upper jaw sit below the sinus, and Cambridge notes that many people who have lost their upper back teeth do not have enough bone there, so a sinus lift is used to add bone first. Cambridge’s sinus lift leaflet gives these risks:

Sinus lift risk	External (window) approach	Internal approach
Sinus membrane punctured or torn	19%	3.8%
Infection	2.9%	0.8%
Graft exposure	3% (not split by approach)

Rarer but serious risks listed include numbness over the cheek and upper gums (usually temporary, very rarely permanent) and an opening between the sinus and the mouth. Our bone graft guide explains sinus lifts in more detail.

Problems with the crown and other parts

The crown can chip or come loose. In a long-term study in Clinical Oral Implants Research, the technical problems across crowns and bridges on teeth and implants included chipping (20.2%) and loss of retention (10.8%). The authors found these were less likely to lead to losing the implant or tooth underneath than biological problems such as gum disease.

Appearance and healing problems

Cambridge also lists aesthetic failures, such as metal showing, which usually depend on your anatomy. After surgery, some bleeding is normal; the implant surgery leaflet says renewed bleeding at home can usually be stopped by pressing for at least 10 minutes with a rolled-up handkerchief or swab, and that infection is uncommon, particularly when antibiotics are used.

Which risk factors make complications more likely?

Smoking and a history of gum disease have the clearest evidence. The table summarises what the sources say.

Risk factor	What the evidence says	What to do
Smoking	Pooled relative risk of implant failure 1.92 in a meta-analysis of 51 studies; peri-implantitis about twice as common in smokers (Royal College of Surgeons)	Cambridge expects smokers to stop at least six months before treatment
History of gum disease	Up to four times more likely to develop peri-implantitis (Royal College of Surgeons); success 80 to 85% over seven years (Cambridge)	Have gum disease treated and stable before implants
Radiotherapy to the head and neck	Pooled relative risk of failure 2.28 in the same meta-analysis	Discuss timing and risks with your cancer and dental teams
Diabetes	The meta-analysis found no clear effect on failure (relative risk 0.90, from five studies), but the Royal College lists diabetes among conditions linked to a greater risk of peri-implantitis	Tell your dentist and keep it well controlled
Osteoporosis and bone medicines	Osteoporosis showed a direct but not significant effect (relative risk 1.09). The NHS lists jawbone damage as a rare side effect of alendronic acid	Tell your dentist about every medicine you take or have taken
Teeth grinding	Cambridge warns it can overload implants and reduce success rates	Mention it at your consultation

On bone medicines, a review in the International Journal of Molecular Sciences concluded that implants may not be linked to a higher risk of osteonecrosis of the jaw in patients on low-dose bone-modifying drugs, but it was based on only five studies. The NHS page on alendronic acid advises regular dental check-ups while you take it.

Warning signs to report to your clinic

Contact the clinic that placed the implant if you notice any of these. They are drawn from the Cambridge leaflets above.

Bleeding that does not stop after at least 10 minutes of firm pressure.
Tingling or numbness in the lip, chin or tongue after a lower jaw implant, once the anaesthetic should have worn off.
After a sinus lift, a feeling that graft material has been dislodged after sneezing or blowing your nose.
Later on, inflamed gum around the implant, which can be the start of mucositis or peri-implantitis.
An implant or crown that feels loose.

How can you lower your risk?

Stop smoking well before treatment.
Get gum disease treated first and keep it under control.
Give your dentist a full list of your health conditions and medicines.
Take any antibiotics you are prescribed after surgery and keep the area clean, as the Cambridge leaflet advises.
After a sinus lift, do not blow your nose for two weeks.
Once the implant is in, see your dentist or hygienist every three to six months.
Choose a clinician who explains the risks, the planning and the alternatives before you sign. Our guide to choosing an implant clinic lists what to ask.

What if something goes wrong?

Go back to the clinic first and ask for a written explanation and plan. A failed implant can often be removed and replaced after healing, sometimes after a bone graft. If you cannot resolve a complaint about private treatment with the practice, the Dental Complaints Service offers a free and impartial service across the UK for private dental care. For NHS care, raise it with the practice first, then with NHS complaints services where you live.

For more on how long implants last once they have healed, see how long dental implants last. Implant systems are compared in our brand comparison, and complex cases such as zygomatic implants have their own guide.

Frequently asked questions

What is the failure rate of dental implants?

It depends on the patient and the follow-up period. Cambridge University Hospitals NHS Trust says over 90% of implants bond successfully to the jawbone and gives a success rate of 80 to 95% over 15 years in healthy mouths, or 80 to 85% over seven years for patients with gum disease.

What is the most serious long-term complication?

Peri-implantitis, which destroys the bone supporting the implant and often leads to losing it. A review of fifty-seven studies found it in 19.53% of patients and 12.53% of implants. Good cleaning and regular checks lower the risk.

Does smoking affect dental implants?

Yes. A meta-analysis of 51 studies found a pooled relative risk of implant failure of 1.92 for smokers, and the Royal College of Surgeons of England says peri-implantitis is about twice as common in smokers. Cambridge expects smokers to stop at least six months before treatment.

Can nerve damage from an implant be permanent?

It can, but it is uncommon. Cambridge says bruising of the nerves in the lower jaw can cause tingling or numbness in the lip, chin or tongue that usually recovers after a few months and is rarely permanent. Report any numbness to your clinic straight away.

What are the risks of a sinus lift?

Cambridge University Hospitals gives a 19% chance of the sinus membrane tearing with the external approach and 3.8% with the internal approach, infection in 2.9% and 0.8% respectively, and graft exposure in 3% of cases.

Who do I complain to if my private implant treatment goes wrong?

Raise it with the practice first. If that does not resolve it, the Dental Complaints Service offers a free and impartial service across the UK for complaints about private dental care.

Dental Implant Complications and Risks: What UK Patients Need to Know