Shindang-dong Dental Clinic: Implant and Tooth Problems When Chewing Causes Pain

Shindang-dong Dental Clinic: Implant and Tooth Problems When Chewing Causes Pain

Hello,

This is Dr. Kim Tae-young, chief director of Shindang-dong Dental Clinic / Bareunyoung Dental Clinic, personally explaining treatment cases.

‘My tooth feels loose and hurts every time I chew, so I can't chew.’

We have patients who visit us complaining that their natural teeth or implants are loose and hurt every time they chew.

In mild cases, if the gums around the tooth are swollen due to inflammation, discomfort can be resolved by reducing the gum inflammation through scaling or gum treatment.

In the case of implants, sometimes the screw of the abutment simply loosens, and tightening it can easily resolve the discomfort.

The case I'm introducing today involves pain caused by severe bone loss due to a tooth root fracture or peri-implantitis.

I will explain the subsequent treatment.

‘My tooth has been loose and painful for several weeks, to the point where I can't chew.’

The patient visited us complaining of discomfort in the right premolar area.

The X-ray showed a lesion in the root area.

From the intraoral photo, there appeared to be no problem on the surface,

but the patient complained of pain when touched or chewed.

Looking at the surrounding teeth, multiple tooth fractures due to strong chewing forces were observed, suggesting that tooth mobility and pain were caused by a crack.

‘It hurts every time I chew, but why does it hurt?’

A 3D CT scan revealed severe bone loss around the root, leading to a diagnosis of pain due to mobility.

I explained to the patient that the tooth had reached the end of its life and further treatment was impossible, and suggested immediate implant surgery after extraction.

Since the space where the tooth was located was large, alveolar bone grafting was performed simultaneously with the surgery to maintain the volume of the existing bone.

Tooth Extraction and Implant Surgery

As expected, one root was fractured.

After completely extracting the separated root and thoroughly removing the inflamed tissue from the extraction site, the surgical direction was determined based on CT analysis.

As shown in the photo, alveolar bone grafting was performed simultaneously with the surgery to maintain volume.

The post-operative photo shows how helpful taking a pre-operative CT scan is.

Initial implant stability was good, and if we wait long enough without stimulating the alveolar bone graft performed in the surrounding bone, which was lacking, until proper ossification occurs, good results are expected.

Treatment start: 2022.12.23

Treatment end: 2022.04.04

‘My old implant is loose and hurts so much I can't chew.’

On the X-ray, the white bone called alveolar bone around the implant is not visible,

and the surrounding area appears completely black, indicating that all the surrounding bone has been lost due to peri-implantitis.

‘Why is my implant loose and painful?’

Even with an intraoral photo, no problems are visible on the surface.

However, pressing the surrounding gum revealed pus and blood coming from inside, and the patient complained of looseness and pain.

It was confirmed that not only this area but also other implants the patient had received in the past were already suffering from significant peri-implantitis.

Given that the patient had undergone repeated re-surgeries every few years in the past, it could be inferred that their periodontal condition was not being managed healthily.

Removal of Implant and Inflamed Tissue

The 3D CT scan confirmed that the implant was not receiving support from the surrounding bone.

The implant was easily removed during treatment, and severe contamination had already progressed around the root.

Unfortunately, in this patient's case, their periodontal condition was so poor that immediate implant and alveolar bone grafting surgery was not possible after removal.

After thoroughly removing the surrounding inflamed tissue and performing preliminary periodontal treatment, surgery can be decided upon once the surrounding bone and soft tissues have fully recovered.

Natural teeth or artificial prostheses may require removal due to fracture or inflammation caused by strong chewing forces or periodontitis around the gums.

In the first case, quick action was possible as the symptoms had only recently appeared.

However, in the second case, the periodontal disease had been neglected for too long, and it appears that the completion of treatment will take a considerable amount of time.

Periodontal disease is difficult to detect in its early stages due to subtle symptoms.

Therefore, regular dental visits to prevent and treat periodontal disease are strongly recommended. It is advisable to have regular check-ups even if you do not feel any discomfort.

Today, we looked into the causes of #ShindangdongDentalClinic teeth feeling loose and painful when chewing. I hope your questions have been answered,

and I wish you healthy gums through regular oral examinations.

Thank you^^

Treatment period: 2024.02.28

▼ Related cases you might find helpful

We believe that proper treatment leads to proper results. My ideal dental clinic is one where all patients who visit with worries can leave feeling reassured and confident. – Bareunyoung Dental Clinic

Directions: 2nd floor, JYJ Building, 179 Dongho-ro, Jung-gu. Right in front of Exit 6 of Yaksu Station, towards Yaksu Market. Use Village Bus No. 5 (Yaksu Station), Village Bus No. 12 (Namsan Town, Yaksu Police Station), or bus stops (Yaksu Heights, Shindang Social Welfare Center, Gaon Library, Kumho Tunnel Entrance) from Yuyu Pharmaceutical towards Kumho Station.

This post was written directly by Bareunyoung Dental Clinic for the purpose of providing medical information and hospital advertising (in compliance with Article 56, Paragraph 1 of the Medical Service Act). The photos are of the same patient, but treatment methods and other side effects (pain, inflammation, prosthesis detachment) may vary for each patient.

Frequently Asked Questions

What causes teeth to hurt and feel loose when chewing?

There are various reasons why teeth hurt and feel loose when chewing. In mild cases, it could be gum inflammation or a loose implant screw, but in severe cases, it might be due to a tooth root fracture or severe bone loss from peri-implantitis. Accurate diagnosis is crucial to identify the cause.

How is treatment performed when a tooth root fracture is diagnosed?

When a tooth root fracture is diagnosed, it is usually determined that the tooth has reached the end of its life, and immediate implant surgery is performed after extraction. If the space where the tooth was located is large, alveolar bone grafting may be performed simultaneously with the surgery to maintain the volume of the existing bone.

What causes an implant to feel loose and painful?

The most common cause of a loose and painful implant is bone loss around it due to peri-implantitis. While there may be no visible problems on the surface, pressing the gum around it can cause blood and pus to emerge, accompanied by looseness and pain.

Is immediate re-surgery possible if peri-implantitis is severe?

No, immediate re-surgery may be difficult if peri-implantitis is severe. First, the existing implant must be removed, and periodontal treatment to thoroughly remove the surrounding inflamed tissue must be performed. After the surrounding bone and soft tissues have recovered, the decision regarding surgery can be made.

What efforts are needed to prevent periodontal disease?

Periodontal disease is difficult to detect in its early stages due to subtle symptoms. Therefore, regular dental visits are very important to prevent and treat periodontal disease early, even if you do not feel any discomfort.

How does 3D CT scanning help in dental treatment?

3D CT scanning is very helpful in accurately assessing the extent of bone loss around tooth roots or the condition of the bone around implants. This allows for precise treatment planning, including determining the surgical approach and whether alveolar bone grafting is necessary.