Implant Side Effects & Complications

Implant side effects are easier to sort into normal and abnormal when you look at when they appear. Swelling, bruising and throbbing in the first 2–3 days after surgery are mostly normal reactions, while looseness or numbness during healing, or gum swelling and bleeding years later, are signs that need to be checked. No surgery is completely free of side effects. Boston Miso Dental Clinic reduces the risk beforehand with 3D CT and a review of your overall health, and explains what might happen before proceeding.

What reactions are common right after surgery (within a week)?

• Swelling and bruising — worst on days 2–3 and subsides within a week. If bone grafting or a sinus lift was done as well, the area involved is larger, so it can take a bit longer.
• Pain — typically manageable with the prescribed pain medication. If it keeps getting worse after day 3, please call us.
• Blood-tinged saliva — common on the first day. If it doesn't stop and keeps flowing even after biting on gauze for 30 minutes to an hour, it needs to be checked.
• Difficulty opening your mouth, discomfort in the throat — this can occur for a few days after surgery on lower back teeth.

What signs mean you should call us right away?

• Numbness or reduced sensation in the lip, chin or tongue continues after the anesthesia has worn off — this may indicate irritation of the inferior alveolar nerve. The sooner it's checked, the more options there are.
• Bleeding doesn't stop even with pressure, especially if you're taking anticoagulants.
• Swelling or pain gets worse instead of better after day 3, or you develop a fever — this may indicate infection.
• Air leaks through your nose after upper jaw surgery, or you have ongoing nosebleeds or a runny nose — this may be related to the sinus.
• The implant feels loose during the healing period — this can be a sign that it isn't integrating with the bone.

Please call us rather than waiting for your next appointment. We're open until 9 PM on Thursdays.

What complications can appear years later?

• Peri-implantitis — a condition where the gum around the implant swells and bleeds and the bone recedes, reported in about 1 in 5 implant patients. It's more likely when the crown's shape makes cleaning difficult. A Case Where the Crown Shape Was the Cause.
• Loose screws or a cracked crown — this happens when biting force is concentrated on one side or when you grind your teeth. Often just tightening the screw is enough, but if it keeps happening, we re-examine the bite. For when tightening is enough and when the cause must be found first, see My implant screw came loose — does the implant need to be placed again? When tightening is enough, and when the cause must be found first.
• Food impaction — the contact point with the neighboring tooth can open up over time, so we check for this at regular check-ups.
• Implant failure — if the bond with the bone breaks down and the implant becomes loose, it needs to be removed and a new one placed. The causes and steps are covered in the Implant Revision Guide.

What conditions raise the risk?

• Smoking — raises the risk of both failure and peri-implantitis. It helps to quit at least around the time of surgery.
• Uncontrolled diabetes — many studies find little difference once blood sugar is controlled, so we check your levels and time the treatment accordingly.
• Osteoporosis medication (bisphosphonates, etc.) and anticoagulants — these don't rule out surgery, but change the timing and method. Please be sure to tell us about any medications you're taking.
• A history of periodontitis or poor oral hygiene — if you've had gum disease, the risk of peri-implantitis is higher, so we schedule more frequent check-ups.
• Teeth grinding or clenching — a common cause of crown and screw problems, so we recommend a night guard when needed.

How does Boston Miso Dental Clinic reduce the risk?

1. We first measure the distance to the nerve canal and sinus with 3D CT. The placement depth and angle are decided before surgery.
2. If bone or gum tissue is lacking, we build it up before placing the implant. We don't force placement into thin bone — Bone Grafting Criteria.
3. We finish with a crown shape that's easy to clean. A custom abutment is used to set the angle at which the crown emerges from the gum.
4. Regular check-ups are a condition of the warranty. The 10-year warranty on Straumann implant posts and 7-year warranty on Osstem SOI both require attending regular check-ups.

FAQ

When does swelling go down after implant surgery?

Swelling is usually worst on days 2–3 and mostly subsides within a week. If bone grafting was done at the same time, it can take a bit longer. If it gets worse instead after day 3, please call us — we'll need to check for infection.

My lip feels numb after surgery — is that okay?

If numbness continues after the anesthesia has worn off, it could indicate nerve irritation and needs to be checked quickly. Most cases recover with time, but the earlier it's checked, the more options there are for managing it.

I'm worried about implant side effects, so I've been putting off surgery.

Much of the risk can be reduced with testing before surgery. We first check your 3D CT, medications, and overall health, then explain what might happen and how likely it is, so you can decide from there.

References

The treatment sequence and criteria described above are Boston Miso Dental Clinic's own principles; the frequency, mechanism and prognosis figures are based on the references below.

※ This guide is general information; risks and timelines vary with each person's oral condition, medical conditions, and habits. Whether it applies to you and your expected schedule will be explained by Dr. Lee, our Clinic Director, after an exam. Listed fees are base prices — see Fees for itemized details.

The clinician responsible for treatment guidance at Boston Miso Dental Clinic is Dr. Jongbum Lee, Clinic Director, a board-certified specialist in Advanced General Dentistry (Korea).