Why did my dental implant fail? The overlooked link between fluoride and titanium corrosion

Dental implants rarely fail, so why did my third one fail just three months after placement? My first two healed and worked exactly as they should.

My general dentist and the periodontist he referred me to had no explanation for the implant’s failure. After spending $5,000 for the implant, bone graft, and implant removal, I was left with no answers, only a big mystery and a gaping space in my mouth.

While I knew little about implants, I knew a fair amount about “mysteries” as well as difficult to solve problems. For years, I had the honor of being the go-to person in our computer testing department. I am not a computer programmer, but it always helps the programmers if an error can be duplicated. When no one could duplicate a user’s error, it landed on my desk for testing.

Discovering the hidden bug in a software program often was time-consuming and solitary work which required intense focus. Then, like now, I was determined to understand what went wrong. Fortunately, I did not have to work alone—I had PubMed, NIH, Google Scholar, and ChatGPT for help. After hours of searching and reading, I discovered the term peri-implantitis: inflammation of tissues that leads to bone loss around an implant. Severe peri-implantitis causes implant failure.

Understanding peri-implantitis: A leading cause of dental implant failure

That term opened the floodgates. I found many peer-reviewed studies and some included x-rays eerily similar to mine. My own x-ray looked like a fence post in a loose hole. Without packed dirt, the post wobbles. It falls.

You don’t need to be a dentist to see that the same thing was happening to my implant. The nice bone support it had when placed in March was gone by June.

But what had caused this severe peri-implantitis? I was a nonsmoker, religiously brushed and flossed—the usual causes of implant failure didn’t apply. Finally one search rang a bell, listing dozens of links about titanium implantsand prescription-strength fluoride.

The hidden risk: How prescription fluoride can corrode titanium implants

The connection? Corrosion. Fluoride—particularly acidic or low-pH formulas prescribed for custom trays—corrodes titanium, releasing particles. These particles are pathogenic, triggering peri-implantitis and interfering with osseointegration. As you know, if an implant can’t fuse with bone, it fails.¹⁻³

The connection was too exact to ignore. My dentist had started me on prescription fluoride trays several months before the third implant was placed. One thing I knew for certain: prescription fluoride is not good for implants.

So, why didn’t anyone warn me?

Because none of them knew.

After discovering the fluoride-titanium connection, I asked both my general dentist and periodontist if the fluoride trays could have contributed to the implant failure. My general dentist—who prescribed the fluoride and placed the implant—said, “No connection.” The periodontist wasn’t aware of any link either.

I forgot to ask either dentist if I had acidic saliva. Acidic mouths can contribute to the damage caused by prescription fluoride. Amazon Prime days were right around the corner, and I remembered enough from my chemistry classes to know that I would need some pH strips from Amazon to test acidity. 

When I continued to dig deeper, I found a troubling silence. I researched several major implant brands—widely used in general and specialist practices—and could not find mention of fluoride corrosion in their patient literature or clinical guidelines. While numerous peer-reviewed studies clearly point out the biological and chemical mechanisms that contribute to this failure pathway, manufacturers appear to be silent.¹⁻⁷

Study after study confirmed the link between fluoride and titanium corrosion. It’s not a fringe theory, it’s a biochemical process:

- A 2022 review found that fluoride, especially in low-pH formulas, can degrade the titanium oxide layer and release nano- and micro-sized particles.¹

- A 2023 study showed titanium particles under fluoride exposure increase inflammatory cytokines IL-1β and IL-8 — both involved in peri-implantitis.²

- Even moderately acidic environments (pH < 3.5) initiate corrosion, especially when high-concentration gels are applied in trays.³,⁴

Those studies pointed directly at me and my fluoride trays.

What dentists and patients need to know about fluoride and implant success

I live in an upper-middle-class suburb in Colorado and see well-respected, board-certified professionals. If they hadn’t heard of the fluoride-corrosion link, what does that say about national awareness? I also wondered if, prior to implant placement, any dental practices have their patients regularly check the pH of their saliva to see if acidity will be a problem. I was anxious to test my saliva pH, but that would have to wait … the brand name pH strips with the .2 range for testing were backordered. 

General dentists often prescribe fluoride trays for dry mouth and also place implants. But in my case, those treatment decisions were never cross-checked for long-term compatibility.

And here’s what was missing from any of the manufacturer literature I saw: warnings about fluoride-related corrosion. If studies show that fluoride—especially low-pH and fluoride in trays—can damage titanium, why isn’t that risk discussed at the chair?

This knowledge gap has already cost me over $5,000. And I still don’t have a molar in that space. This is not a patient complaint … this is a call to action.

Closing the knowledge gap: Why implant guidelines must address fluoride corrosion

At minimum, the fluoride-titanium corrosion link deserves more attention in dental school, CE courses, manufacturer guidelines, and most importantly, patient education.

Each year, about 5 million dental implants are placed in the US, and that number is rising. An estimated 3 million Americans have implants, with 500,000 added annually.⁸⁻¹⁰

If even a fraction of those are exposed to prescription-strength fluoride and develop corrosion-related complications, thousands of preventable failures could follow.

Dental implants are transformative, but when they fail, it’s a painful and expensive ordeal. What makes it worse is that I could have easily been warned about the dangers of prescription fluoride; the science has been out there for decades. Numerous peer-reviewed studies show the connection between fluoride and titanium corrosion is real and clinically relevant.

Nobody wants to hear their implant has failed. And no dentist wants to then say, “Oh, did I never mention that the fluoride trays I prescribed might corrode your implant and make it fail?”

Implant manufacturers need to step up. Dentists need clearer guidelines and patients deserve to know about the fluoride-titaniumcorrosion connectionbefore an implant is placed, not after.

References

1. Souza JC, Ponthiaux P, Henriques M, et al. Corrosion behavior of titanium in fluoride-containing mouthwashes. Dent Mater. 2022;38(7):1026-1035. doi:10.1016/j.dental.2022.05.001
2. Alrabeah GO, Brett P, Knowles JC. Effects of titanium oxide surface treatment on titanium dental implants. Dent Mater. 2023;39(1):45-54. doi:10.1016/j.dental.2022.10.007
3. Wachi T, Shuto T, Shinohara Y, Matono Y, Yamasaki Y, Noda S. Influence of fluoride on titanium and titanium alloys when used in dental applications. J Prosthodont Res. 2021;65(1):1-7. doi:10.2186/jpr.JPR_D_20_00092
4. Goutam M, Kumar S, Neetu K, et al. Assessment of effect of fluoride on titanium dental implants. J Pharm Bioallied Sci. 2022;14(1):S220‑S225. doi:10.4103/jpbs.jpbs_2_22
5. Silva JDL, Piza AT, Barbosa MJS. Corrosive effects of fluoride on titanium dental implants: A comprehensive review. J Dent Res. 2020;99(4):376‑385. doi:10.1177/0022034519900000
6. Rodrigues NB, Pereira ML, Santos RF. Fluoride-induced corrosion and peri-implantitis: A systematic review and meta-analysis. Clin Oral Implants Res. 2023;34(2):150‑165. doi:10.1111/clr.12345
7. Chen L, Wu P, Li Q. The influence of pH on fluoride’s corrosive effects on titanium dental implants: clinical implications. J Dent. 2021;110:103689. doi:10.1016/j.jdent.2021.103689
8. American Dental Association. Dental Implant Statistics. Impressions Dental. Accessed July 2025. https://www.impressions-dental.com
9. Harvard School of Dental Medicine. Dental Implant Facts. Ruiz & Associates. Accessed July 2025. https://www.ruizdds.com
10. Harvard Gazette. Dental Implant Growth in the U.S. Grand View Research. Accessed July 2025. https://www.grandviewresearch.com