Man in a dentist chair looks at his new implant in a hand mirror

Dental implants are an excellent replacement option for tooth loss for multiple reasons. Many people, including dentists, prefer implants to other tooth replacement options due to greater longevity and enhanced aesthetics.

Despite this, dental implants are not always the best option. Even though cavities cannot occur on the implants due to the materials used to create them, there’s a risk of developing gum disease around these artificial teeth. If this happens, most likely, the implant will need to be removed or replaced, drastically reducing its lifespan.

Peri-Implant Disease

When the periodontal disease develops around dental implants, it is referred to as peri-implant disease. A complication of dental implants, peri-implant disease, is an inflammatory issue that adversely impacts the gum tissue around the implant. Similar to the development of periodontal disease in natural teeth, it is caused by bacteria build-up at the base of the dental implant, which then causes inflammation. 

If left undiagnosed, the inflammation progresses, damaging the hard and soft gum tissue around the implant. This results in impairment of the dental implant's aesthetics, function, and longevity.

Types of Implant Gum Disease

Gum diseases affecting dental implants can be split into two categories: 

  • Peri-implant mucositis- In this condition, only the soft tissue surrounding the implant becomes inflamed. There’s no sign of bone loss, but the soft tissue inflammation can progress to peri-implantitis if not treated early.
  • Peri-implantitis- Extensive inflammation around the implant that destroys both soft and hard tissue around the implant. The bone structure supporting the implant is lost, and surgery is the definitive treatment. 

Like most periodontal diseases, the peri-implant disease is usually painless. For this reason, the condition might remain unnoticed for an extended period if you don’t visit your dentist regularly. 

Symptoms of Peri-implant Disease

The signs and symptoms of peri-implant inflammation are similar to gum disease. If you have dental implants, here are some signs indicating you might be experiencing this condition:

  • Red and sore gums, especially around the implant
  • Gum swelling around the implant
  • Bleeding issues when brushing
  • Bad breath and taste in your mouth
  • Gum recession with or without pus around the implant

Typically, the implant metal threads should not be visible. Exposure of the implant threads and loosening of the implant indicates dental disease, and you should seek help from a dentist immediately. 

Causes of Peri-implant Disease

The mouth harbors thousands of bacteria. Some are beneficial, while the majority are harmful. These bacteria can colonize different parts of the implant, especially the base, and will multiply if conditions are favorable.

Factors that favor the growth and multiplication of bacteria causing peri-implant disease include:

  • Poor oral hygiene, including inadequate plaque control
  • Medical conditions such as poorly controlled diabetes
  • Previous periodontal disease
  • Failure to comply with implant cleaning requirements
  • Improper implant fixation technique. For instance, the dentist may have left residual cement on the implant's surface during crown cementation. 

Treatments for Implant Gum Disease

The treatment usually depends on the severity of the condition. The initial phases of peri-implant mucositis can only be successfully reversed through implant decontamination. This involves the removal of the debris below the gum line, thereby preventing the progression of gingival inflammation. More recently, dentists have been using, laser technology which has been shown to be effective in decontaminating implant surfaces.

Although implant decontamination can be used in treating peri-implantitis, the success rate is relatively low. When you develop peri-implantitis, your dentist might recommend bone or gum grafting around the dental implants.

Bone grafting helps restore lost bone structure around the implant and sometimes might require removal of the implant, crown, or abutment. Gum grafting is indicated in events of considerable gum recession.

Prevention of Peri-implant Disease

With good oral care, you can prevent the development of peri-implant diseases. Some prevention tactics you can use to prevent disease include:

  • Regular brushing and flossing according to the American Dental Association guidelines
  • Regular visits to your dentist, at least twice per year
  • Cessation of smoking
  • Adequate management of medical conditions like diabetes