A tooth that no longer feels secure
The crown, the connecting part or the implant's anchorage could be responsible. Avoid checking it with your fingers. Call and tell us whether the change was sudden, followed an impact, or happened gradually.

A failing implant can bring in a surgeon, a periodontist and a restoring dentist. For anyone coming from Puslinch, we explain the diagnosis, who would do what, and how the stages fit together before you commit.
Implant problems sometimes call for skills from more than one dental field. One clinician may treat the gum and bone, another may remove or place the implant, and another may make the crown. That can feel complicated, so it helps to know from the outset who is responsible for each part and why.
It starts with naming the problem. A loose crown, a broken or worn part, inflamed tissue and loss of bone support each point to different care. Replacing the implant is considered only when findings show it should not be kept, and taking it out and placing another remain two decisions, shaped by cause, remaining tissue, the planned tooth and your wishes.
When you come to us from Puslinch, we examine the area, review imaging and records, and explain what we see. If a specialist's opinion would help, we tell you why and what that referral would involve. You hear about every option, and who would provide it, before deciding anything.

Rough dates for the implant and crown help, along with the names of the offices involved. Copies of X-rays and treatment notes make coordination smoother.
The crown, the connecting part or the implant's anchorage could be responsible. Avoid checking it with your fingers. Call and tell us whether the change was sudden, followed an impact, or happened gradually.
Bleeding, swelling, soreness or a strange taste near an implant should be examined, even if it feels firm. Describe what you notice while cleaning and any discharge. The exam shows whether the gum alone or the bone too is affected.
If another dentist or specialist has already raised a concern, ask for their findings and images. Comparing these with older records helps everyone understand the change and avoids repeating work unnecessarily.
A crown issue does not decide whether the implant must come out. The responsible part is identified first.
A careful assessment determines whether the implant can be maintained or should be removed. If replacement is planned, each clinician needs to work from the same understanding of what caused the first problem, so the new plan addresses it rather than assuming a fresh implant will fare better by default.
The interim period needs a named owner too. Ask who will provide your temporary tooth, how the gap will look and what you can eat during healing. Seeing that stage, any further procedures and the final crown as one sequence helps you decide whether another implant is worth pursuing.
Patient information: ITI — assessing implant complications and removal
Ask whether the problem is biological, mechanical, positional or a mixture, and make sure each clinician describes it the same way. You do not need the technical terms to understand which part needs care.
Bone and gum condition affect replacement. Ask whether grafting or healing time is needed, who would provide it and how that affects the order of appointments.
Compare the replacement route with alternatives, including maintenance, temporary teeth and fees, and note which clinician is responsible for each part. Clear roles make the comparison much more useful.
Care may move between our team and a specialist over several visits. Ask who leads each stage, how information will be shared and when the plan will be reconsidered.
We go over your symptoms and examine the implant, crown, gum and stability, with appropriate imaging. Implant details and old X-rays help. Mention health changes, smoking, grinding, past treatment in that spot and cleaning difficulties.
Repair of a part or treatment of the tissue may be enough, and that is discussed first. If removal is advised, you should know why and what the alternatives involve. A specialist may be asked to assess complex cases.
The clinician carrying out removal explains the procedure, its risks and home care, and whether grafting or a healing period will follow. A new implant may be placed later, not automatically on the same day. Who provides the temporary tooth is agreed in advance.
A new implant and crown have their own evaluation and follow-up, possibly by different clinicians. Healing may revise the plan. Ask when you can chew normally and who will handle long-term maintenance.
Assessment, removal, grafting and a new implant each come with different home care. Keep written instructions from every stage, with the contact number of the clinician who gave them.
Until it is assessed, chew on the other side and do not attempt to tighten or remove anything. If a part has already detached, store it safely and take it to the appointment.
After any procedure, follow the advice on cleaning, eating and temporary appliances from the clinician who did it. Ask before wearing an older denture over the site. If instructions from different offices seem to conflict, call to clarify.
Reviews track the tissue, parts and new tooth. New movement, discharge or rising soreness should be reported promptly to whoever is treating you at that stage. Mention any cleaning problems.
Patient information: Cambridge University Hospitals — implant care and complications
Ask for the diagnosis and the sequence in writing, with each clinician's role noted. It makes shared care much easier to follow.
Book a review at our Bronte Street practice. If you can, gather records from the offices involved, and come with your questions. We will explain the problem, further assessment, any referral and your options.
Please phone about a moving implant, severe pain or swelling. Online requests are only for non-urgent questions.