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Dental Implant Pain Causes and Best Treatments

Tooth implant pain and causes

Let’s be honest, no one likes a missing tooth and the last thing you want to hear is someone else telling you “Is your tooth missing?”. To fill the gaps in your smiles, you probably want a dental implant, but the fear of pain is quite daunting. The thought of having a screw drilled into your jaw sounds terrifying. Fortunately, anyone can easily undergo a painless surgery in the hands of the qualified surgeon, careful planning, and proper guidance.

This article is an overview of the pain level, duration, and pain management throughout the different stages of a tooth implant procedure.

What is the pain level of dental implant?

Pain LevelDescription
0No pain
1Minimal (hardly noticeable)
2Mild (pain only felt if attention is paid to it)
3Uncomfortable pain
4Strong persistent pain (medication required)
5Distracting pain only controllable with medication
6Recurring strong pain with distress
7Unmanageable and remission pain
8Periodic and intense pain (cannot talk)
9Severe pain (can barely speak or move)
10Worst pain possible with an inability to move

Pain level during the procedure

During each step of the procedure, the pain level is usually minimal and doesn’t require any medication but if the pain becomes unmanageable then your dentist will prescribe you the medication.

Bone grafting

Bone grafting procedure involves the incorporation of the graft (natural or synthetic bone) to your pre-existing bone to provide adequate support and volume for implant placement. Bone grafting is only required for patients who have reduced bone level and thickness.

Pain level and recommendations

During this procedure your dentist will use local anaesthesia therefore, this is a painless procedure with 0 pain level and little discomfort. After the wear off the anaesthesia, the pain level increases up to 2-3 which is hardly noticeable. The pain subsides within 3-4 days. You can take prescribed medication to relieve pain and discomfort if the pain elevates or persists for a longer duration.

Mostly the placement surgery is performed at the time of grafting. However, if the initial healing is delayed, the placement can take place within 4-12 months. In that case, the follow-up appointments are arranged to make sure everything is moving forward as planned.

Sinus lifting

During sinus lifting surgery, a bone is added to the maxilla (upper jaw) in the space between the maxilla and maxillary sinuses to lift the sinus membrane upward and to provide adequate room for implant placement.

Pain level and recommendations

Typically local anaesthesia is performed for the comfort of patients during the surgery. Following the surgery, the pain level is usually mild (pain level 2-3) and begins to subside within 4 days. Tylenol is recommended to mediate mild pain. If the pain level persists or elevates to a moderate pain level of 4-6, take 800mg of Ibuprofen. Urgent medical care is needed and a visit to your doctor is required if the pain gets severe (pain level 8-9).

Placement surgery

Placement surgery involves the drilling of a hole into the jaw bone for the placement of a biocompatible implant (titanium screw).

Pain level and recommendations

The jaw area where the implant is to be placed is locally anaesthetized with lidocaine with epinephrine (1;100,000) so that the patient won’t feel any pain or sharpness during the procedure. Therefore, the pain level is 0 during this procedure. Although, a patient will feel the vibration and insertion of a drill. If the surgery duration is long then the oral sedation is given to the patient before the surgery to relieve the patient’s anxiety.

After the surgery, follow your dentists’ guidelines promptly such as keep your mouth clean, take a soft diet, and keep hydrated to avoid dental implant failure. Patients can feel the discomfort of pain level 2-3 which can easily subside within a week without having to take prescribed medication. If the pain persists and elevates, consult your doctor immediately.

A patient can have a temporary crown or denture fitted until osseointegration is completed (the healing process of bone and soft tissue).

Pain level and recommendations

If the implant is embedded securely then the pain level can still exceed from slight to the moderate level depending on your threshold. However, if the implant loosens up then discomfort and pain can exceed the moderate pain level. In that case, immediate consultation is required.

The duration of this process is 3-6 months. Smoking is prohibited as it can significantly increase the chances of implant failure. A healing collar is placed for 10-14 days to keep the gums from growing over the implant.

Abutment and crown placement

Once the implant is healed and stable, a dentist will remove the healing collar and will place an abutment over the implant which anchors the implant to the permanent crown or cap. In some cases, an abutment is placed at the same time as the implant while in other cases it may take up to several weeks due to the variable healing duration.

 Duration required for crown placement

crown placement over the upper jaw takes 3 weeks and 1 week for the lower jaw after the abutment. You will have to wait around 1-6 weeks to get a permanent crown over the abutment. Until then, you might wear a temporary one.

 Pain level after the procedure

The survival rate of dental implants is more than 95% and the dental failure is estimated to be 5-10% which can occur soon after the surgery or within a few months and years. The pain level after the procedure is usually controllable especially if a patient follows the basic guidelines to maintain oral health.

Hours after the procedure

The pain level within a few hours after the procedure stays minimal at 3 with slight discomfort. Swelling is common if the implant is placed towards the posterior side of the jaw. More than 40% of patients have reported peak intensity of pain stays for 6 hours maximum.

Causes

The pain is caused within a few hours after the surgery due to increased blood flow around the implant area.

Recommendations

  • Take prescribed medication for mild pain if needed.
  • Apply ice packs at an interval of 10 minutes on the swelling site.
  • Avoid touching the surgical area of the jaw
  • Don’t rinse vigorously
  • Avoid blowing your nose forcefully for 4 weeks after surgery
  • Don’t use a straw to drink
  • Brush the teeth gently and rinse with mouthwash for 2 weeks to inhibit bacterial growth around the surgical site
  • Avoid Smoking

One week after the procedure

At this point, the pain level stays minimal (2). This pain can last for 10 days. Swelling heals within 5 days.

Causes

The hardly noticeable pain is due to the healing process and takes from a few days to a few weeks.

Recommendations

  • Continue to follow the dentist’s instructions. You may feel pressure pain (1-2) while chewing or biting food
  • Take a soft diet
  • Take prescribed medication

Two week after the procedure

At this point, a patient shouldn’t be feeling pain, however, if the pain level is moderate (5-6) then call your dentist immediately and seek medical attention to understand the cause of the pain. The implant is completely healed and there shouldn’t be any bleeding. Some patients still feel tenderness when pressure is applied.

Causes

  • Infection
  • procedural error
  • Inappropriate site of the implant
  • Poor bone quality
  • Lack of primary stability
  • Undiagnosed Allergic to the implant material
  • Poor blood supply
  • Loosening of the healing cap
  • Implant is loose

Recommendations

  • Follow oral hygiene instructions
  • Consult your surgeon if removal of bacterial biofilm is needed
  • If loose then re-osseointegration of the implant by the surgeon
  • Prescribed antibiotics for infection and pain medication

Three months after the procedure

Rarely, a few patients experience moderate to severe pain (5-9).

Causes

  • Poor periodontal care
  • Micromovement of implant
  • Foreign infection
  • Diabetes
  • Autoimmune disease
  • Overloading implant
  • Inexperienced surgeon
  • Implant protrude into the sinus cavity

Recommendations

  • Removal of bacterial biofilm by the surgeon
  • Establishment of an effective plaque control regime
  • Prescribed pain medication

One year after the procedure

Less than 5% of patients feel pain at this stage resulting in late implant failure or pain. The causes are;

  • Bacterial infections
  • Poor dental hygiene
  • bruxism
  • Lack of supporting structures around implant like gum tissue
  • Exposure of bone surrounding implant
  • Radiation to the head and neck areas
  • Food lodging between the implant and the adjacent teeth
  • The unsatisfactory surface of the implant
  • Implant overload
  • Traumatic bite

Two or more years after the procedure

The causes of pain at this stage are:

  • Peri-implantitis
  • Heavy Continuous Smoking
  • overloading of implant
  • Cancer

 FAQ

Can an implant get infected?

Yes, any gum disease can infect the implant by decreasing the bone level and exposing a rough surface of the implant for the bacterial environment.

Why dental implant pain when chewing?

Patients with dental implants initially feel pressure pain while chewing food because it is in the healing phase. Pressure pain and discomfort during chewing go away within a week.

Is amoxicillin good for dental implant pain?

No, amoxicillin can’t be used for pain. It is an antibiotic used to treat a bacterial infection, not pain.

What is the recommended implant pain relief?

Take ibuprofen (400-600mg) every 6 hours. Avoid taking ibuprofen if you are already taking a prescribed pain killer. Consult with your doctor.

What is the difference between dental nerve pain vs Implant pain?

Dental nerve pain is caused due to nerve damage during the procedure and when the implant puts pressure against the nerve. Whereas, implant pain is caused due to infection.

Why do I get dental implant pain when reclining?

During recline, the blood supply increases towards the head and causes more pressure towards the gums resulting in implant pain. Keep your head level above the extremities (legs).

What causes implant pain tooth sensitivity to cold and hot drinks and food?

Gums pocketing surrounding implant and adjacent tooth decay cause sensitivity to hot and cold stimuli.

Why do implant pain during biting hard food?

High occlusal points, ill-fitted or bigger size of a crown over implant cause pain during biting hard food.

Why does implant pain come and go?

Pain comes and goes due to gum recession, food impaction, and sensitivity.

What is the cause of jaw pain after implant?

Patients with a history of TMJ related problems are likely to feel jaw pain after a dental implant.

What is the cause of dental implant pain while running?

Blood supply increases towards the implant during running and if there’s an infection then a person is likely to feel pain.

How long pain will last after a tooth implant?

Normally pain subsides within 3-4 days. Depending on the complexity of the surgery, the pain can last for 7-10 days.

What causes throbbing pain after dental implants?

A throbbing pain is caused due to poor blood supply, damaged surrounding tissues of implant, and implant infection.

What causes ear pain after dental implants?

Apical pathological infection or apical bone loss can cause referred pain from the site of infection to the ear.

If you want a 100% naturally functional and aesthetically pleasing permanent solution for your missing teeth then the implant is the best option for you. In conclusion, dental implant pain is easily manageable and with the right guidance, anyone can enjoy their natural-looking implant for more than 25 years.

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