Implant failure isn't random, and it isn't usually one big mistake. It tends to come from a small number of well-understood causes, some early, some years down the line.

Early on, the most common issue is what's generally called rejection: the bone simply doesn't integrate with the implant the way it should. This happens in roughly 3% of cases on average. When it does, it's usually straightforward to address. The implant comes out, the area is cleaned and grafted, and treatment starts again. Loading an implant with force too early, before it's had time to properly integrate with the bone, is another early cause, which is part of why there's a healing period built into the process before a permanent tooth goes on.

Longer term, hygiene is one of the biggest factors. Implants develop a condition called peri-implantitis, essentially gum disease around the implant, when plaque and tartar are allowed to build up around it. Implants don't attach to surrounding tissue the same way natural teeth do, so a standard flossing technique doesn't fully clean around them. We teach a specific crisscross flossing technique for implant patients for exactly this reason, looping floss through both sides of the implant and sawing it back and forth to flush out anything trapped underneath.

Clenching and grinding is another long-term driver, which is why implant crowns are designed with a slightly different bite than natural teeth: enough contact to function normally, without constant force sitting on the implant every time you close your mouth.

The last major factor is planning that didn't account for long-term stability, not enough bone around the implant, or a loss of the dense connective tissue that naturally surrounds a healthy tooth. Both of these can usually be corrected with grafting, but they're much easier to get right the first time than to fix afterward.

None of these causes are surprising once you know them. They're also almost entirely preventable with the right planning and the right maintenance.