An Implant Crown That Is Loose or Fell Off: Three Different Problems, and What to Do About Each

Practice clinician: Gerald M. Marlin, DMD, MSD, prosthodontist, Elite Prosthetic Dentistry, Friendship Heights, Washington, DC. Last updated October 30, 2026.

A loose or lost implant crown is not one problem but three, and they are treated very differently. It may be the crown that has come loose from its abutment, which is a nuisance. It may be the screw holding the abutment or crown to the implant that has loosened, which is a repair. Or it may be the implant itself that moves, which is a different matter and needs prompt evaluation. This page explains how to tell them apart, what to do and not do in the meantime, the signs that indicate infection around an implant, and what the visit involves.

In the Next Hour

1. Keep every part. The crown, and any small screw that came with it. Implant screws are specific to the system and are not interchangeable. Rinse, dry, container, not tissue.
2. Do not force anything back on. Not the crown, not the screw. Pressing a cemented crown back can seat it wrongly; pressing on a loose screw can damage it; pressing on a loose implant can make it worse.
3. Do not use any adhesive. Glue in the connection between an implant and its crown can ruin the components.
4. Avoid chewing on that side. If the crown is still in the mouth but loose, be careful not to swallow or inhale it; remove it gently if it is about to come out on its own, and keep it.
5. Look and note. Is there a metal post standing where the crown was? Does the gum around it look swollen or red? Is there a bad taste? Does the post itself move when you touch it lightly with a clean finger? The clinician will ask.
6. Call the office. During hours, (202) 244-2101; patients are triaged by urgency and same-day visits are arranged when the schedule allows. After hours, follow the voicemail prompts.

When to Go to the Emergency Room Instead

A loose implant crown is not an emergency room situation on its own. Go to the emergency room, or call 911, for facial swelling that is spreading, fever with swelling, uncontrolled bleeding, difficulty swallowing or breathing, or if a crown has been inhaled with any breathing or chest symptoms. Tell the office afterward.

What Can Wait Until Office Hours

A crown that has come off cleanly, leaving a firm post or a clean implant opening, with no pain or swelling, can wait until office hours with the parts kept safe and the area kept clean. A crown that is loose but still in place should be seen within days; do not keep chewing on it. An implant that itself moves, or an implant with swelling, pus, a bad taste or increasing pain around it, should be seen promptly, and the same day where the schedule allows.

The Three Problems

The crown has come loose from the abutment. A cemented implant crown is held to its abutment by cement, and cement can let go after years, leaving the abutment, a metal or ceramic post, standing in the gum. This is the least serious of the three. The crown is cleaned, the abutment is checked, and the crown is recemented, or, where it has come loose repeatedly, remade as a screw-retained crown.

The screw has loosened. Implant crowns and abutments are held to the implant by a small screw torqued to a precise value. Screws loosen under bite forces, especially where the bite loads the crown unevenly or the patient grinds. The crown may rotate or rock, or come off with the screw. The screw is removed, inspected, replaced if worn, and retightened to the correct torque, and the bite is checked so it does not loosen again. A screw that has loosened more than once is a sign of a bite or design problem rather than a screw problem.

The implant itself moves. This is different. An implant that is integrated with the bone does not move at all. If the whole unit, abutment and all, moves in the gum, or if there is swelling, pus, a bad taste or deepening pockets around the implant, the implant may have lost its bone support or may never have integrated. This needs prompt evaluation, X-rays, and a conversation about whether the implant can be treated or should be removed and the site rebuilt. Our pages on a loose dental implant and failed implant integration go into detail.

Signs of Infection Around an Implant

Red, swollen or tender gum around the implant; bleeding when brushing it; pus or a bad taste at the gum line; a pocket that a probe sinks into; bone loss visible on an X-ray; and in later stages, movement. The gum can be inflamed without bone loss, which is treatable, or bone can be lost around the implant, which is treated more seriously and is better caught early. Any of these signs is a reason for an evaluation even if the crown is firmly in place.

What the Visit Involves

The implant, the components and the surrounding gum and bone are examined and X-rayed. The X-ray shows whether the crown has separated from the abutment, whether a screw has backed out, and whether the bone around the implant is intact. The components are removed as needed, inspected, cleaned and reassembled to the correct torque, or the crown is recemented; worn or damaged components are replaced with the correct parts for the system. The bite is checked and adjusted where it has been loading the crown unevenly. Where the implant itself has moved or lost bone, the findings are explained and the options are set out, which may include treatment of the tissue around the implant, or removal and rebuilding of the site before a new implant. Where a crown has to be remade, the practice’s on-site laboratory makes it.

Why It Happened

• Cement fatigue over years on a cemented crown.
• Screw loosening under uneven bite forces or grinding, or because the screw was not torqued correctly or has worn.
• A bite that overloads the implant, often because other teeth have worn down or been lost and the implant crown has become a high spot.
• Component wear or fracture, more common in older systems and in implants that have carried a heavy load for many years.
• Loss of bone around the implant from inflammation, which loosens the implant itself.

What an Emergency Often Reveals

An implant crown that loosens is frequently the implant that has been working hardest, and the reason it has been working hardest is usually elsewhere in the mouth: worn teeth, missing teeth, a bite that has shifted. The visit corrects the component; the follow-up examines the bite and the other implants and restorations of the same age. Patients with several older implants will find our guide on older implant crowns and bites relevant, and signs your dental work is wearing out is a quick self-check.

How Elite Prosthetic Dentistry Handles a Loose Implant Crown

Call the office; patients are triaged by urgency and same-day visits are arranged when the schedule allows. The visit distinguishes a component problem from an implant problem, corrects the component with the correct parts, and checks the bite that loosened it. Dr. Gerald M. Marlin has placed more than 3,900 implants and holds 9 U.S. patents in dental implant restoration methodology; the practice restores implants from many systems and can usually identify an unfamiliar one from the X-ray. The on-site laboratory, operating since 1985, remakes crowns without an outside laboratory in the chain. Where the implant itself has failed, the practice evaluates the site and plans the rebuilding and replacement in one office.

When Another Setting Fits Better

A patient whose implant was placed and restored recently by another office should contact that office first; it has the component records and the responsibility for the work. A patient who can reach the surgeon who placed a moving implant should call them. The emergency room is the right place for the signs listed above. The practice sees patients who cannot reach the original office, and patients whose implants are old enough that the original office no longer exists.

Documented Cases

• Restoring multiple old dental implants that had fractured or failed.
• Older implant crowns redesigned for a better bite and natural appearance.
• Rejuvenating severely worn-down implant overdentures.
• Both arches rebuilt after advanced periodontal disease, where bone loss had reached the point of replacing the teeth.

Related Reading

• Restorative dental emergencies: all situations
• Loose dental implant
• Failed implant integration
• Implant crowns
• Why do some dental implants last longer than others?

Call the Office

During office hours, call (202) 244-2101 and describe what came loose, whether a post is visible, and whether anything moves. After hours, follow the voicemail prompts for urgent care instructions. For a planned evaluation of older implants, or of an implant crown that has loosened more than once, request an appointment or call (202) 244-2101.