Are There Any Preventive Measures to Reduce the Chances of Bone Loss Following Dental Implants?

Could taking Fosamax or other osteoporosis medications decrease the amount of risk?

Doctor Answers (17)

Preventing Bone Loss Around Implants

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If you have osteoporosis or osteopenia and your Primary care physician prescribes these medications for you, that would be the only reason for taking them. There is no indication to take them for preventio of oral bone loss.  There are two main reasons for bone loss around dental implants: one is peri-implantitis and the other is extreme lateral bite forces on the tooth.  The first one can be avoided by regular dental visits and cleanings by your dentist.  The second one is actually caused by an incorrectly adjusted crown on the implant.  When a crown is placed on an implant the dentist adjusts the bite according to your chewing direction and forces, if this is not done correctly, bone loss can occur because the tooth and implant is beig "pushed" sideways, implants are not capable of enduring these forces


Phoenix Oral & Maxillofacial Surgeon
5.0 out of 5 stars 10 reviews

Lateral Forces can create bone loss around an implant

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One of the main reasons we see bone-loss around an implant is because the tooth or 'crown' which is connected to the implant is not engineered or designed properly. Sometimes the tooth or crown receives too much pressure from an opposing tooth or a lateral force from an opposing tooth.  This can over time create tension in the bone around the implant leading to bone loss around the implant.

Another main reason that we see bone loss around implants is poor hygiene.  Plaque or calculus around implants which is not properly professionally scaled off every 3-6 months can accumulate and start to cause bone loss around implants.  Also if a dental cement was not able to be completely removed, this irritant will lead to a foreign body inflammation around the implant which will lead to bone loss. 

There is no literature that supports that taking supplements or any other drugs will help prevent bone loss around dental implants.  

My advice is make sure the 'bite' on the implants tooth is perfect and keep it clean.

Giri Palaniswamy, DDS
Beverly Hills Cosmetic Dentist
5.0 out of 5 stars 3 reviews

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Bone loss after dental implants is unpredictable

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Fosamax is actually considered a contraindication with dental implants.  For the most part, it is a guessing game on if there will be significant bone loss after dental implant placement.  SOME is considered normal.  The restoration of a dental implant (the crown or whatever the implant is supporting) can be a factor as well, so the dentist should be sure to not "overload" the implant.

Lance Timmerman, DMD
Seattle Cosmetic Dentist
5.0 out of 5 stars 3 reviews

Bone loss and Implant Failure....Fosomax

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There are three determinative factors that could cause implant failure. One would be the improper placement of the implant itself by the periodontist, which you have no control over. Second, would be the overall health of your body and oral health before having this procedure and third, is the amount of force that is placed on the implant during the healing stages.  Make sure you go to a good periodontist who does and knows about implants and can do them in his sleep!  Prior to placing the implants, make sure you have no issues that inhibit the healing process in the body and bones.. Make sure you are in good health, take calcium, magneseum and Vitamin D supplements and avoid any medication like Foxomax, which have been shown to help with osteoporosis but long term use of this drug often causes an adverse reactions in the jaw area and prevents healing!  Make sure after placement of the implants your bite is checked to avoid  unwanted stress and pressure on this area. Also the health of your gums before the procedure and after the procedure needs to be maintained. Brush and floss regularly and check up and cleaning with the periodontist should be scheduled every three or four months. Periodontal disease is a huge factor in loosening of implants and causing faliure.  I recommend the use of a product called Rotadent to get in hard to reach places.  With all this said....good luck and always find out about the side effects of drugs like Fosomax.

George Koutsoukos, DDS
Valencia Cosmetic Dentist

Bone loss

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The oral hygiene is the most important factor in preventing the bone los.

You are supposed to brush twice a day and floss at lest twice a day. Make sure you brush the gingiva.It is very important that you brush the gum with gentle strokes. I would really recommend, in most of the cases, to use a soft tooth brush.

Having a good oral hygiene, is the key to preventing the bone loss.

Antoaneta Barba, DDS
Santa Ana Cosmetic Dentist
5.0 out of 5 stars 1 review

Hope this Helps

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The majority of implants that fail do so prior to restoration as a result of poor placement techniques, medical issues that inhibit healing or over-exertion of forces on the implant during the healing phase( heavy pressure from an overlying denture or flipper appliance). In order to prevent bone loss around your implant be sure that your mouth is free from any disease processes before placement.  Next, be sure that the implant is placed at a depth where the cement can be removed completely after the crown is inserted.  If it is too deep a custom abutment must be used to bring the margin of the crown/implant close to the soft tissue margin where the cement can be removed.  Today, residual cement is the number one reason why implant bone blows out and it sometimes takes years to occur.  The other alternative in deep margin cases is to use a screw retained crown where no cement is necessary. Finally, be sure that the bite is adjusted properly as are the contacts (flossing areas) with adjacent teeth.  In order to keep your new implant restoration healthy, your home care must be exceptional.  We recommend using proxabrush's (in posterior areas only) when necessary and daily use of a water pik with a pik pocket attachment to irrigate the gum tissue surrounding the implant.

Gary Nack, DDS
Philadelphia Cosmetic Dentist

Implants and bone loss

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Biologically, the implant will loose some of the surrounding bone at there neck regardless of the manufacturer. The problem is that all the new generations of dental implants have a roughened surface all the way to the neck o f the dental implants which will be exposed to the oral environment with the bone loss. For this reason, oral hygiene at home alone is not sufficient but needs to be coupled with a professional periodontal maintenance every three months on an alternated basis between the general dentist and the periodontist that have placed the implant. It is imperative that a periodontal office follow-up on the health condition of the dental implant and it's surrounding bone as well the surrounding soft tissue. please visit my website for more detailed publications on that subject under the category of peri-implantitis ( edgardelchaar dot com)

All the best

Edgard El Chaar

Edgard El Chaar, DDS
New York Cosmetic Dentist

Preventing Bone Loss around Implants

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The best way to prevent bone loss around dental implants is to maintain proper dental hygiene which would include flossing.  This would help prevent  gum disease which will lead to bone loss in implants in the same way it would with natural teeth.  Regular periodontal maintenance (cleanings) and checkups by your dentist are a must.  Another factor to bone loss could be a none ideal bite which generally causes grinding (bruxism).  

Dan Haas, DDS
Toronto Cosmetic Dentist

Bone Loss Prevention for Implants

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Stay away from the medications unless absolutely medically necessary for other reasons.  The biggest cause of bone loss around implants is excessive loading of the implants.  Home care is important but if the implant is asked to carry an excessive load the bone around the implant will break down over time and the implant can be compromised or lost.

Donald L. Wilcox, DDS
Phoenix Cosmetic Dentist
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.