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This is the start of a blog series on dental implants, where we'll share knowledge from over 50 years of clinical experience. We're here to help new and less-experienced dentists avoid the pitfalls that can come with this demanding procedure.A patient does not walk in the dental office because they want to buy an implant. They expect to look and eat better, without experiencing pain or discomfort, for the rest of their life. If the patient is dissatisfied with any of his or her wants, the treatment has failed the patient.According to dental literature, dental implant success is defined by a combination of factors:· Aesthetics: The final restoration should look natural and blend seamlessly with the patient's other teeth and facial features. A successful implant contributes to a pleasing smile and a restored facial profile.· Functionality: The implant must be able to withstand the forces of chewing and provide adequate support for the final dental prosthesis (e.g., a crown, bridge, or denture). The patient should be able to chew comfortably without pain or discomfort.· Absence of Pathology: There should be no signs of infection, pain, nerve damage, or persistent inflammation (peri-implantitis) around the implant site. The gums and tissues around the implant should be healthy.· Patient Satisfaction: The patient must be satisfied with the outcome of the treatment. This includes their comfort, the appearance of the implant, and their ability to function normally, which ultimately improves their quality of life. From the standpoint of the dentist, dental implant "failure" is defined by failure of the bone to initially fuse with the implant, or loss of that attachment afterwards, leading to mobility of the implant and its removal. Persistent pain or severe discomfort, infection, bleeding or pus discharge, swelling, inflammation, or redness of the gums around the implant, loose implant, or visible bone loss on a dental X-ray or other severe symptoms may also necessitate implant removal.In essence, a dental implant is considered successful not just if it stays in the jaw, but if it remains healthy, functional, and aesthetically pleasing for the long term, fulfilling the patient's needs and expectations.The dental literature repeatedly states that in 19 out of 20 patients (or 95 - 98%), will experience "success" with their dental implant for at least five years (the 5-year success rate).Based upon the definitions defined by both the dentist and the patient, almost all dental implants start to fail the moment an implant is inserted into the bone. In reality, an implant begins a battle against failure from the moment the patient walks into a dental office for an assessment. There are many reasons why an implant should fail; and probably fail, sooner than expected. This is not difficult to understand once you are aware of certain facts.The short and long-term success of dental implant treatment hinges on proper patient assessment, knowledgeable treatment planning, atraumatic surgical placement of the implant and comprehensive follow-up by the dental provider. More than 1 in 4 dental implants (&gt;25%) fail in unrecognized, medically compromised patients.The long-term success of dental implant treatment is also dependent upon proper brushing and flossing to prevent plaque and tartar to build up, the main cause of peri-implant disease. 1 out of 5 smokers will need to have second operation for its removal within the first five years. Heavy alcohol consumption significantly increases the risk of complications and implant failure, especially during the crucial recovery period. These causes are all patient related.But “them’s the facts folks”, that you don’t hear about. I often wonder if an unaware patient would choose dental implants as an option if they realized the odds, the pain, discomfort and ongoing cost, only to face a second operation for the implant’s removal.I look forward to hearing from all of you. My next blog will be about the seven major causes of implant failure ... And don’t forget to pass this on to anyone interested in dental implants.Thank you, Dr. Harold Bergman, DDS, Dipl.OS&amp;A, MScD(Path)

WHAT IS IMPLANT SUCCESS?

As I alluded in my previous blog, “What Is Implant Success “, an implant begins a battle against failure from the moment the patient walks into a dental office for their initial consultation. The short and long-term success of dental implant treatment hinges on proper knowledge and experience by the dental provider of:1. Medical or dental problem or medications, 2. Bone and Soft tissue Physiology, 3. Prosthetic Choices, 4. Treatment Planning, 5. Mechanical Principles, 6. Advanced Surgical principles, 7. Poor Home Hygiene by the patient. Should the treatment provider not be totally aware of the risks involved with the patient’s medical, dental problems or medications, the battle is already lost. More than one in four implants (&gt;25%) fail in unrecognized, medically compromised, patients. I will cover this subject in greater detail in my next blog.For an implant to be successful; it must first integrate with the bone without an intervening soft tissue layer, a process called (Osseointegration during the initial four to six months after placement, but not all bone is the same; and bone constantly undergoes remodeling where old or damaged bone tissue is removed and new bone tissue is formed. It is critical that the treatment provider understand Bone and Soft tissue physiology; another upcoming blog.If all you own is a hammer, then everything looks like a nail. There are numerous Prosthetic Choices supported by several implants; not everything is attached by a nail.Without a basic understanding of Medical or Dental Problems or Medications, Bone and Soft tissue Physiology, adequate radiographs and awareness of the various Prosthetic Choices, the treatment provider cannot accurately provide a workable Treatment Plan for the patient. Even doing nothing is a treatment choice.Understanding rudimentary Mechanical Principles allows the treatment provider to design a patient friendly, long-lasting, aesthetically acceptable, functioning prosthesis for the patient; another upcoming blogThe simple removal of a tooth does not qualify the treatment provider to remove wisdom teeth atraumatically, let alone place an implant. If the person removing a wisdom tooth or placing an implant who not does not understand how to handle the complications, are putting the patient in serious jeopardy. There are a number of atraumatic Advanced Surgical Principles which must be known and used to reduce unnecessary postoperative problems for the Poor Home hygiene by patient.Finally, the patient must be aware of their responsibilities. A dental implant has little chance of success if the patient chooses to smoke, vape, drink heavily and or not provide adequate home care for their implants.It’s not enough just to have “Dental Implants” painted on your dental office front door. Your regulatory bodies, your patients and their lawyers are now demanding more.I look forward to hearing from all of you. Each of the 7 Major Causes of Dental Implant Failure will be covered more deeply in upcoming blogs ... And don’t forget to pass this on to anyone interested in dental implants.Thank you, Dr. Harold Bergman, DDS, Dipl.OS&amp;A, MScD(Path)

Top 7 Major Causes of Dental Implant Failure

VANCOUVER, BC – July 29, 2025 – In a significant leap forward for dental implant patients and implant dentists, Dr. Harold Bergman today announced the official launch of PREP™ (Patient Risk Evaluation Platform), a groundbreaking mobile application designed to empower implant dentists with detailed insights into how a patient's systemic medical health impacts the success and longevity of dental implants.For too long, the intricate relationship between a patient's overall health and the prognosis of dental implants has presented a complex challenge for both patients and practitioners. While fundamental medical history collection is standard, a comprehensive, evidence-based tool for evaluating these specific interdependencies has been lacking. PREP™ addresses this critical need by providing a sophisticated, user-friendly platform that translates complex medical data into actionable insights for implant treatment planning."The success of a dental implant goes far beyond the surgical chair; it's deeply rooted in the patient's systemic health," says Dr. Bergman. "With PREP™, we're giving implant dentists an unprecedented tool to proactively identify, understand, and mitigate medical risks. This means more predictable outcomes, fewer complications, and ultimately, enhanced patient safety and satisfaction."Key Features and Benefits of PREP™ Include:· Comprehensive Medical Risk Profiling: PREP™ systematically collects and analyzes a wide array of patient medical conditions, medications, and lifestyle factors.· Evidence-Based Correlations: The app provides detailed, evidence-based explanations of how specific medical issues (e.g., diabetes, osteoporosis, autoimmune diseases, cardiovascular conditions, certain medications like bisphosphonates or SSRIs) can influence osseointegration, infection risk, healing, and long-term implant stability.· Actionable Insights &amp; Recommendations: PREP™ goes beyond simply identifying risks, offering practical guidance and considerations for treatment modifications, referral needs, or enhanced post-operative protocols based on the patient's unique health profile.· Intuitive Interface: Designed with the busy dental professional in mind, PREP™ features a clear, intuitive interface for efficient data entry and easy comprehension of complex medical correlations.· Enhanced Patient Communication: The app can assist dentists in explaining the medical implications of implant treatment to patients, fostering greater understanding and informed consent.· Data Security &amp; Compliance: Dr. Bergman prioritizes patient data privacy and security, ensuring PREP™ adheres to recent proficiency requirements in unified, regulatory body, professional guidelines and standards for implant dentistry."In an era where dental implant procedures are expensive and increasingly common, often involving patients with complex medical histories, a tool like PREP™ is no longer a luxury but a necessity," adds Dr. Bergman. "We believe PREP™ will empower implant dentists to make more informed decisions, leading to higher success rates and better overall patient care."PREP™ will soon be available for download through direct subscription at simplersolutions.ca. Free trials for patients and dentists are available.About Dr. Bergman Dr Harold Bergman, DDS, Dipl.Oral Surgery &amp; Anaesthesia, MScD(Pathology) has over 66 years experience in the placement and restoration of dental implants and bone grafting procedures. He introduced several “limited exposure” surgical techniques designed to make implant surgery easier, quicker and less traumatic for the patientAn internationally recognized lecturer for over 45 years, Dr. Bergman has been active in training thousands of dentists, veterinary dentists and denturists in the placement and restoration of implants. As part of the educational process, he authored over 100 scientific and technical publications; and aims to shape the future of dentistry. Contact: Dr Harold Bergman, haroldbergman1@gmail.com, 604 220 0414.High-resolution images of the PREP™ app interface and logos are available upon request. Interviews with Dr Bergman are also available.

PREP™ App Revolutionizes Dental Implant Planning by Integrating Comprehensive Medical Risk Assessment

Dental implant screw, placement procedure

The landscape of implant dentistry in British Columbia just changed significantly, and if you haven't already, it's time to take note. As of June 30, 2025, our regulatory body, the British Columbia College of Oral Health Professionals (BCCOHP), has implemented unified professional guidelines and standards for dental implant dentistry. Given the complexity and associated risks of our work, this is a move that, for lack of a better term, is "tightening the screws" on all of us. Him himThese new guidelines are comprehensive. They're no longer just general suggestions; they are the new standard of care. They provide detailed requirements that we must meet in key areas:· Education and Training: We are now required to demonstrate competency in implant dentistry, backed by specific post-graduate training, continuing education, and proven experience in both surgical and prosthetic phases.· Patient Assessment and Selection: A thorough medical history review is more critical than ever. This means meticulously documenting systemic conditions, medications, smoking habits—anything that can influence osseointegration and healing. Our risk assessment must be rigorous, factoring in the patient's overall health and local factors.· Treatment Planning &amp; Informed Consent: This is where we need to be flawless. We are now held to a higher standard for obtaining truly informed consent. This means comprehensive discussions—not just a signature—about risks, benefits, alternatives, prognosis, and potential complications specific to the implant treatment we're proposing.· Documentation and Accountability: Meticulous, detailed, and accurate documentation is no longer a suggestion; it’s a requirement. From the initial consultation and consent to every surgical note, prosthetic detail, and ongoing maintenance, we will be held accountable for our records.Many of us rely on our all-in-one practice management systems, but let's be honest—they often fall short when it comes to the comprehensive level of detail these new regulations demand. They might track some medical info, but they don’t appear to be as robust as we now need.Fortunately, there are tools emerging to help. I've found an inexpensive app, "PREP," that specifically addresses these new regulations, which appears to be a necessary supplement to our current software.The public today is more informed than ever. They are doing their research and expect their providers to be experienced, competent, and knowledgeable about the services we're offering. The BCCOHP is responding to this by upgrading our professional standards. Thisisn't just a BC thing either; dental regulatory bodies everywhere are moving in a similar direction.To avoid disciplinary actions and litigation from dissatisfied patients, the message is clear: We must be proactive. Let's all be checking our local dental regulatory body websites for the most current and official versions of their Professional Standards and any relevant Practice Standards or Guidance documents. Our due diligence now will prevent significant headaches and professional risk down the road.Dr. Harold Bergman, DDS, Dipl.OS&amp;A, MScD(Pathology)

Tightening the screws on implant providers

While your dental provider is responsible for expert planning and placement, the long-term survival of your dental implants is significantly in your hands. After the first year of an implant's life, the 2% to 3% failure rate over the next five years is often attributed to inadequate patient dental hygiene and follow-up care.Just like natural teeth, implants are susceptible to the effects of plaque and bacteria. In fact, most people over 50 lose their natural teeth to periodontal (gum) disease, which is caused by this bacterial accumulation. A similar condition, known as peri-implantitis, can develop around dental implants. This inflammatory condition affects the soft tissues and bone surrounding the implant, leading to progressive bone loss and, eventually, implant failure. Patients who have a history of gum disease are at a higher risk of developing peri-implantitis.The success of your implant depends on:osseointegration—the process of your jawbone fusing directly to the implant surface. This process unfolds in stages over many months.Initial Healing (First 6 months): This is the most critical period, where the implant integrates with the bone. Your overall health, medical conditions, and hygiene habits heavily influence this phase.Bone Remodeling (6 to 18 months): During this time, the initial weak bone is replaced by stronger, denser bone. However, this new bone is still vulnerable. Habits like teeth grinding (bruxism) or biting on hard foods too soon can overload the implant, leading to bone loss.It is your treatment provider's duty to educate and inform you on how to provide proper and diligent home care. However, it is your responsibility to follow through. The longevity of your investment in dental implants depends on you keeping the implant system scrupulously clean. Dental implants usually fail due to a combination of shortcomings on the part of both the treatment provider and the patient.

Your Role in Dental Implant Success: Home Care is Crucial

Have you ever wondered why dental implants, foreign objects placed into your jawbone through one of the most bacteria-laden parts of your body, even work in the first place? The answer isn't necessarily the superior design of the implant itself, but rather the unique and remarkable environment of the human mouth.&nbsp;The oral cavity is teeming with a diverse array of bacteria, fungi, viruses, and protozoa, making it one of the "dirtiest" areas of the body. If we were to drill a hole in your arm and insert a titanium screw, leaving it exposed to the air and your own saliva, a severe infection would likely set in within hours, potentially leading to amputation4. Yet, this is precisely what happens in your mouth when an implant is placed, and the outcome is vastly different.&nbsp;The secret to this success lies in the mouth's incredible capacity for healing and resistance to infection. Several factors contribute to this unique environment:Rapid Healing: The oral mucosa heals much faster than skin, with minor cuts healing in days and more significant wounds in about 10 days, compared to the 6-8 weeks skin often needs. This healing also results in minimal scarring.Rich Blood Supply: The jawbone and surrounding tissues have a rich blood supply that delivers a rapid response of immune cells, antibodies, and nutrients directly to the surgical site.Protective Saliva: Saliva is a powerhouse of protection. It contains antimicrobial enzymes and immunoglobulins that control bacterial growth, growth factors that stimulate tissue repair, and maintains a neutral pH that is optimal for healing. It also keeps tissues moist, preventing cracking that could impede healing.Primed Immune System: Constant exposure to pathogens may lead to a more "primed" local immune system in the gums and underlying bone, making them less susceptible to infection compared to bones elsewhere in the body.So, while the titanium or zirconium materials of implants are durable enough to outlast a human lifetime, their initial success is a testament to the biological marvel that is your mouth. It's a prime example of how "you can do things in the oral cavity you cannot do anywhere else on the body".

Simpler Solutions

EDUCATION

WHAT IS IMPLANT SUCCESS?

Top 7 Major Causes of Dental Implant Failure

PREP™ App Revolutionizes Dental Implant Planning by Integ...

Tightening the screws on implant providers

Your Role in Dental Implant Success: Home Care is Crucial

The Surprising Success of Dental Implants: A Story of the...