Even though the dental implant has become the new gold standard solution for tooth loss, it can still be possible for issues to arise, sometimes years after the implant was first placed. Peri-implant disease is a primary example of such a problem. Dental implants are increasingly becoming more popular as the treatment for partial or complete tooth loss with a 95% success rate. When properly placed, dental implants increase the level of predictability and can be utilized in a range of restorations.
Peri-implant disease has two distinct manifestations, either peri-implant mucositis or peri-implantitis. Both diseases are initially recognized by an inflammation in the gums around the implant caused by bacterial buildup. Peri-implant mucositis remains in the soft tissue surrounding the dental implant and does not infect any supporting bone. Peri-implantitis is more serious, infecting both the soft tissue and the surrounding bone which is supporting the implant. Without proper professional treatment, peri-implant mucositis can easily progress into peri-implantitis and might result in bone loss supporting the implant, causing the implant to now fail.
What are Dental Implants?
An astonishing innovative development to replace a missing tooth, a dental implant consists of three basic parts, a small titanium artificial root surgically placed in your jawbone, an abutment or extension added to reach the surface, and the custom artificial crown attached to the top. An extremely successful and popular option, the benefits of dental implants include:
- Will provide you a normal, healthy bite and the ability to chew.
- With the artificial root, it will not slip or come loose, like traditional dentures.
- Looks and feels like a natural tooth and will never develop a cavity.
- The artificial root also provides natural stimulation to the jawbone necessary to maintain mass, integrity, and density.
Dental implants are still susceptible to plaque buildup. Bacterial plaque buildup on your implant will cause peri-implantitis. Peri-implantitis is the ensuing inflammation around the implant, resulting in deterioration in the gums and in the jawbone supporting the dental implant.
Studies have suggested that about 40 percent or more of five-year-old implants can be vulnerable to peri-implantitis. If you do not have it treated the infection can result in the loss of your implant.
Including a Preventative Strategy in the Planning Stage
When planning an implant for a restoration, it is beneficial to consider the possibility of peri-implant disease. Placing the implant in the correct location, and in good healthy bone increases the chances of a successful long-term outcome. In some cases, it can be useful to use a custom abutment extension to help establish the proper reach to the gum surface, which will make it easier for you to maintain proper oral hygiene. When placing a cement-retained restoration, additional care needs to be taken to find and remove any residual cement from the crown and abutment.
How to Properly Care for Your Dental Implant
The primary benefit of taking consistent care of your implant is that it will last for decades, and to avoid the risk of peri-implantitis. To prevent any implant plaque buildup, your oral hygiene routine should include:
- Continue to brush twice a day and floss.
- Adding a water flosser or interdental brush.
- See your dentist every six months to monitor the health of your gums and jawbone.
- Consider giving up smoking, as this increases your risk of implant failure.
If you have experienced periodontal disease or diabetes, your risk is higher of developing peri-implantitis.
Minimizing Your Risk of Developing Peri-Implant Disease
Based on your personal risk factors for developing peri-implant disease, proper daily maintenance is important for the long-term success of your dental implants. Your medical and dental history will help your dentist determine the necessary preventative maintenance schedule. Your history will include the date of your implant placement, the manufacturer, and the specific type and design. Your records will also include the crown restoration, when it was placed, and whether a screw or cement-retained method was chosen. If you have suffered from periodontitis you might benefit from a shorter maintenance schedule. One of the difficulties with peri-implant disease is that it is most often not painful. You might have no warning that your implant has become infected until more significant symptoms arise.
The Signs and Symptoms of Peri-Implant Diseases
Peri-implantitis will not appear the same for everyone. It is strongly suggested that you continue with your regular dental checkups so your dentist can monitor your implant.
As a baseline, it should be established that healthy peri-implant tissue will not be inflamed, swollen, bleeding, producing pus, or red in appearance.
From your viewpoint, you just might notice a slight loosening or even a wobbling of your implant. This symptom is evidence that you have a more advanced stage of peri-implantitis, because now the implant integration into your jawbone is being compromised. You might also notice some bleeding while you are brushing your teeth. You may also see some swelling around the implant, and you have annoying bad breath or a constant foul taste in your mouth.
From a clinical standpoint, peri-implantitis involves both the inflammation of soft tissue and damage to your jawbone, which is recognized with an x-ray and when tissue probing causes bleeding, which is common for soft tissue inflammation. On some rare occasions you could have bone loss without any signs or symptoms of soft tissue inflammation. If there is no evidence of bone loss, then the diagnosis is peri-mucositis disease.
Other symptoms might include discomfort, pain, and gingival hyperplasia. Pain is a rare and infrequent symptom and is usually associated with a more acute infection.
Your At Home Oral Hygiene Education
You should be instructed and educated on proper oral care and advised of the accelerated risks if you choose to neglect your oral hygiene. If you have been negligent with your oral hygiene, you might not be a viable candidate for dental implant treatment. Correct oral hygiene instructions will be provided, including a demonstration of the proper cleaning techniques and correct brushing methods. A consistent collaboration with regular professional cleanings every six months will allow your dental office to monitor your oral health as well as that of your dental implant.