Clenching Teeth: Can I Get Dental Implants?

Christine asks:

I believe I am a candidate for dental implants, but I am clenching my teeth at night, i.e. bruxism. I do have a bite guard for sleeping. What do you advise for my situation? Can someone with bruxism get implants?

Answered by: Dr. David R. Edenbaum

Marlton, NJ

Hi Christine,

Bruxism can be a problem when restoring (placing crowns, bridges, etc) dental implants, but usually not an insurmountable problem. Natural teeth are held into bone with billions of tiny fibers called the periodontal ligament (PDL). Implants on the other hand are ankylosed, or essentially fused to the bone of the jaw. While teeth are usually lost through dental decay or periodontal disease, when an implant fails after crowns have been placed, the most common cause for failure is overload. The periodontal ligament allows natural teeth some degree of movement within the bone of the jaw while implants are quite rigid. This rigidity results in all of the biting forces being transmitted to the implant and its components.

In a patient who is constantly grinding and clenching their teeth, it is possible to have difficulties with dental implants. These difficulties may be related to breakage of crowns or the screws that retain them to actual failure of the implants over time. The degree of clenching and grinding should be apparent to the dentist planning your case based on the mobility of the remaining natural teeth as well as the wear on the surfaces of these teeth.

Before placing dental implants in any patient a careful analysis of the occlusion (the way the teeth and jaws come together) is a standard part of the treatment planning process. So, the short answer is that a patient who is a 'bruxer' can be candidate for implants under the right circumstances.