Implants have become increasingly popular. As more people get implants, Peri-implantitis, the silent disease that compromises your implants, is diagnosed more frequently. If you have implants or are thinking of having some implanted, knowing the symptoms and causes could save you from pain.
Peri-implantitis Explained
Red, swollen, and sore gums that bleed may be a sign of periodontal disease. But if you have implants, it is sure to be peri-implantitis. The meaning of peri-implantitis is inflamed soft tissue (gums) around your dental implants. Food and bacteria not removed by brushing or flossing festers below the gum line, causing an infection. The gums become infected, and the soft tissue breaks down.
This is a gradual disease; it doesn’t happen overnight. But if left untreated, it can lead to surgical removal of the implant. In the last several years, peri-implantitis has increased to approximately 20% of patients with implants. If the disease is caught early, it can be reversed.
Following the post-implant instructions and maintaining good oral hygiene can stop the disease before it starts. While poor oral hygiene causes peri-implantitis, there are medical conditions that predispose you to peri-implantitis. These include:
🩸Diabetes: Poor glucose control decreases the circulation needed to help the gums heal and combat disease.
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- 🍽️Excessive Pressure: Eating hard foods requires increased pressure to chew them. This pressure can lead to small cracks in the implant where food and bacteria can hide, causing an infection. It also increases the wear and tear on the implant and the surrounding teeth.
- 📅Missing Follow-up Appointments: Attending the post-implant follow-up is crucial. This allows the dental professional to inspect the implant and surrounding tissue for signs of inflammation and infection. If you have an issue with an implant, these appointments will help catch it early!
- 🦷Poorly Fitting: crowns or dental implants can irritate the gums and cause inflammation at the implant site, creating peri-implantitis.
- ⚒️Poorly Placed Implants: in areas that lack bone support increase the risk of bacterial infection, leading to peri-implantitis.
- 🚬Smoking: Smoking decreases blood flow to your gums, putting you at risk for gum issues and infections. It also increases the buildup of plaque and bacteria in your mouth.
- 🦠Immunosuppression: Patients with Cancer, HIV/AIDS, and other diseases that suppress the immune system have a difficult time combating infection and are prone to severe infections, including peri-implantitis.
Stages and Symptoms of Peri-implantitis
The symptoms of peri-implantitis vary with the stage of the disease. The disease is gradual, and catching it early dictates peri-implantitis treatments.
- ⚠️ Peri-implant Mucositis (Initial stage): is the earliest stage of peri-implantitis. If treated at this stage, peri-implantitis is reversible. No bone is involved, but the gums around the implant are red and swollen. Brushing and flossing can lead to bleeding gums in this stage.
- 🔴 Peri-implantitis Early: develops when the initial stage of peri-implantitis is not treated. The bone surrounding the implant may be less detectable. Dental x-rays may be needed, as it can be difficult to diagnose peri-implantitis solely by examination. As the gums begin to recede, the base of the implant may be seen.
- 💥 Peri-implantitis Moderate: This involves serious bone loss that can be seen with the naked eye and x-rays. The gums recede rapidly, and bone loss is more pronounced. The threads on the implant can be seen along with pus at the implant base. As the implant becomes compromised, it may become unstable.
- 🚨 Peri-implantitis Advanced: This involves serious bone loss that can be seen with the naked eye and x-rays. The gums recede rapidly, and bone loss is more pronounced. The threads on the implant can be seen along with pus at the implant base. As the implant becomes compromised, it may become unstable.
- ❌ Implant Failure: If the implant fails due to inadequate oral care, it must be removed. It can not be replaced until grafting or bone regeneration is done.
Everyone heals at a different pace. While everyone may experience these stages, the severity of them varies from person to person. Catching implantitis in the early stages is essential to keeping the implant.
Treating Peri-implantitis
Peri-implantation treatments are based on the stage of the disease. Early stages can be treated non-surgically, but as the disease progresses, the treatments become more invasive. All treatments are designed to cure the infection and eliminate bone loss.
Non-invasive Treatments include diligent implant cleaning to remove bacterial plaque from the base and outside of the implant. Prescription antibiotics are prescribed, and antimicrobial rinses or gels may be prescribed.
Invasive Treatments
- 🔪Surgery: In the more advanced stages, surgical intervention is necessary. If there is significant bone loss, the gums will be sliced to access the implant. These stages require deeper cleaning to remove bacteria and infection from the implant’s surface and base. If there has been major bone loss, bone grafting will be needed to support the implant.
- 💊Prescription Medications: Treating the infection caused by implant failure generally involves strong antibiotics to heal the surrounding soft tissue. Be sure to take all the pills until they are gone for the best outcome.
- 🔬Laser Therapy: Lasers are used to reduce tissue swelling and minimize bacterial growth. It can be used alone, but is often used in combination with other treatments.
- 🚫Removal of the implant: Implant removal is the last resort in advanced cases of peri-implantitis treatment. The implant is extracted so the area can heal. Bone Regeneration is performed in cases where a new implant is to be placed.
Preventing Peri-implantitis
- 🚫 Peri-implantitis is easily avoided. It starts with following the post-implantation instructions.
- 🪥 Brushing your teeth two to three times daily.
- 🧵 Flossing before bed or when you sense food in between your teeth.
- 🦷 Seeing your dental expert twice a year for cleanings and maintenance.
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