Peri implantitis Symptoms Causes Diagnosis Treatment

If you plan to replace missing teeth because you are struggling to bite or chew food, feeling self-conscious, or you are tired of your traditional dentures and you would like a more reliable restoration, dental implants have become the best long-term, natural-looking solution, with many health benefits.

Peri-implant disease is a condition that can develop affecting the tissue around a dental implant. Just like any natural tooth, bacteria can and will also build up at the base of the implant. Over time, the bacteria will irritate and infect the soft tissue, resulting in swelling and inflammation, damaging the soft tissue, and then even causing deterioration of the jawbone.

With a proven success rate of around 95 percent, dental implants have now become the new gold standard as reliable restorations for one or more missing teeth, according to the American College of Prosthodontists. No different than your natural teeth, implants require proper daily oral hygiene to ensure their extended life expectancy. Issues such as peri-implantitis, an infection around your implant, can develop without your proper daily care.

The Reasons for Getting a Dental Implant

If you have had the misfortune of either having a tooth extracted or losing it unexpectedly, it is in your best interest to fill the gap as soon as possible. The neighboring teeth will drift into that space affecting your alignment and bite. If the gap is visible, it will have an impact on your smile as well.

With the incredible success of implants, they are now an innovative addition to different versions of dental bridges and a variety of denture options. The artificial root does wonders in maintaining the integrity of the jawbone with constant pressure stimulation.

The Dental Implant Procedure

The implant procedure starts with your dentist numbing the immediate soft tissue with a local anesthetic. Once this step is completed a small incision is made in the gum. This now allows access to the jawbone. The next step is a tiny hole is made into the jawbone. The dentist will then place a titanium screw or post into that hole. The surgical site will be sutured closed. The implant now needs a few months to bond, fuse, or integrate to the jawbone. After it is confirmed that the post is stable and secure, the site is opened back up, and an abutment or extension is put on the post to reach the surface and finally a permanent artificial crown is affixed to the abutment. Or several implants might be used to anchor a dental bridge or a denture-like appliance.

Peri-implant disease is an inflammatory condition which develops and will affect the soft and hard gum tissue around your dental implant due to the buildup of plaque. The accumulation is the direct result of poor daily hygiene. Like your natural teeth, bacteria can accumulate on the base of the implant, right below your gum line. If not addressed over time, the bacteria will damage both the soft gum tissue and then progress into the jawbone compromising the integration and causing the implant to fail.

Peri Implantitis Symptoms and Diagnosis

Peri-implant diseases are classified into one of two categories.

  • Peri-implant mucositis- This stage is the inflammation around the soft tissues of the dental implant, with no evidence of bone loss. Peri-implant mucositis, if not reversed, is often a precursor to peri-implantitis. Peri-implant mucositis has been proven to be successfully treated and is reversible if caught early.
  • Peri-implantitis- Gum inflammation is again evident around the soft tissue and now there is also deterioration in the jawbone supporting the dental implant. Peri-implantitis usually requires surgical treatment.

Signs of peri-implant disease are much like symptoms of gum disease, tender or red gums around the implant, or bleeding when you are brushing. No different than your natural teeth, your implant needs regular tooth brushing and flossing and consistent check-ups with your dentist. Other risks factors influencing the development of peri-implant disease are previous periodontal disease, neglect and poor plaque control, diabetes, and smoking. It is beneficial to routinely monitor each and every dental implant as part of your comprehensive periodontal evaluation.

Signs most often identified by you:

  • Bleeding during brushing.
  • A consistent foul taste in your mouth.
  • Swelling around your implant.
  • Bothersome bad breath.
  • A loose or wobbly implant.
  • Discomfort or pain.

Symptoms most often identified by your dentist:

  • Bleeding and even the possible discharge of pus with soft tissue probing.
  • The color changes from a healthy pink to redness.
  • Swelling and inflammation.
  • Pocket formation or gum recession.
  • Hyperplasia.
  • X-ray confirmation of bone mass loss around implant.

The terrific upside to a dental implant is it functions much like a natural tooth. The downside is that they are also capable of plaque buildup, just like a natural tooth. With simple proper daily oral health, your dental implant can last a lifetime.


It can become challenging to treat peri-implantitis. Depending on the nature and extent of your disease, treatment can vary significantly, from a non-surgical approach to control the infection and detoxify the implant surface, to a surgical procedure to regenerate bone that has been lost.

Each treatment will have advantages and disadvantages. Some treatments may be more effective when combined.

  • Mechanical Removal- Dental tools can remove most bacterial plaque and restore tissue. These tools might include titanium brushes and air-abrasive and ultrasonic devices.
  • Antibiotics- Antibiotics will work on moderate levels of infections.
  • Laser Therapy- Your dentist might choose to use laser therapy to eliminate the bacteria.
  • Surgery- This is the most effective way to successfully treat peri-implantitis. The oral surgery may involve pulling back the soft tissue to create flaps to remove the plaque. Another could include bone regeneration, which may introduce bone grafts.


Cumulative interceptive supportive therapy, which is a protocol of therapeutic measures, provides your dentist the guidance to decide which approach would be best to treat your peri-implantitis, depending on whether there is dental plaque, the condition of the tissue, bleeding on soft tissue probing, and the evidence of bone loss with an x-ray.


After your treatment, you can expect necessary follow-up appointments. This will allow your dentist to monitor your healing progress and make sure the implant is stable again. The new gold standard for teeth replacement, dental implants allow you to live your life just as with your natural teeth.

Protect Dental Implants from Peri-Implantitis