Dental Implants Can Get Gum And Bone Disease!

Yes They Can! I will review the types of disease and what can be done to stop it. This is basically the same disease as occurs around teeth except the gums are more prone to bleeding and the bone is less prone to significant bone loss compared to teeth.

Gum disease around dental implants is called Mucositis and has: 1) Bleeding with periodontal probing(BOP) , tenderness or pain  2) Swelling and  Redness of the gum tissue, 3) and Periodontal Probing Depth of 5mm or less. Probing a healthy tooth shows 3mm or less depth and healthy tissue around an implant can be 4mm or deeper (Abrahamssom, 2006) . We find peri-implant probing is essential to catching disease early. This inflammation in front is NOT HEALTHY!

A dental implant, requires more attention on your part to clean thoroughly. If there is mucositis the dentist that cemented the crown, bridge, bar or teeth on the implants, or the surgeon checks for the fit of the prosthesis and most importantly checks for residual cement, which is difficult to remove yet common. According to Linkevicius et al, 2011, all cemented implant crowns have residual cement, that rarely shows on an x-ray. Removal of the cement resolves most mucositis.

Peri-implantitis: is Mucositis with Pus or Bone Loss. Both Periodontitis & Peri-implantitis have similar micro flora (types of bacteria). Bone loss of .9 -1.6mm  in the first year after implant placement and .02-.15mm bone loss in the following years is considered normal for an implant.

Preventing Mucositis and Peri-implantitis: More time/attention cleaning around dental implants is necessary. Effective power brushing and flossing give the best results in prevention of gum and bone disease. Ask your dental hygienist and/or dental implant surgeon: Do my gums bleed? How are the gum depths healthy? Is there any sign of bone loss? Show your hygienist how you brush and floss, and get coaching as small differences in technique make big differences in results. I recommend that patients have professional cleanings and evaluation each 3-4 months the first year and this follow-up is adjusted accordingly after that. Professional cleaning around dental implants takes more skill, time, local anesthetic and/or special instruments (ultrasonic, titanium, graphite or plastic scalers) as well as time spend to coach you on your cleaning technique, so fees for implant maintenance may be higher than for tooth maintenance.

Treating Peri-implantitis: If you and your hygienist have been unable to stop the infection, surgery is sometimes needed to improve the situation. Again the sooner the problem is caught and corrected the more effective the result. So the 3 key areas to ask your implant care providers about are: 1) bleeding or pus on probing, 2) periodontal probing depth and 3) bone loss.  This disease progresses if not treated effectively so Keep asking questions!

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