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If you decide to replace missing or badly damaged teeth, dental implants are the closest match to natural teeth, and can look and function like the real thing. Unfortunately, also like natural teeth, implants can be vulnerable to bacteria and dental disease if they don’t have proper care.

Peri-implantitis or peri-implant disease can develop if bacteria build up around the base of dental implants below the gum. Similar to gum disease, this can lead to inflammation and eventually bone loss if it’s not treated, which can also cause implants to fail.

The risk of developing peri-implantitis can be reduced if you maintain a good oral hygiene routine, avoid smoking and choose an experienced dentist who provides dedicated aftercare. To talk to an accredited dentist in Perth, contact Perth Dental Implant Centre in Kelmscott or East Victoria Park.

What is peri-implant disease?

Peri-implant disease is an inflammatory disease that primarily affects the gum (periodontal) tissue around dental implants, but it may also damage bone tissue in the jaw if it’s allowed to progress. There are two stages of peri-implant disease:

1. Peri-implant mucositis – the early stage of the disease, this can develop when bacteria in the mouth build up around an implant and irritate the soft tissues of the gum. Peri-implant mucositis can usually be reversed if it’s caught early.
2. Peri-implantitis – the advanced stage of peri-implant disease, this may also cause deterioration of the jaw bone supporting the implant, causing it to loosen and eventually need to be replaced. Peri-implantitis may require surgery to treat.

As many as 52% of people with dental implants may develop peri-implant mucositis, with around 18% having more serious peri-implantitis.*

* Rinke S, Nordlohne M, Leha A, Renvert S, Schmalz G, Ziebolz D. Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study. J Periodontal Implant Sci. 2020 May 20;50(3):183-196. doi: 10.5051/jpis.2020.50.3.183. PMID: 32617183; PMCID: PMC7321710.

What are the signs of peri-implant disease?

As peri-implant disease develops inside the gum, it doesn’t always have obvious symptoms, but some possible warning signs to look for include:

• Bleeding gums around an implant, such as when you brush or floss
• Red, tender or swollen gums
• Bad breath or a bad taste in your mouth
• An implant or the attached bridge or denture feels loose

The symptoms of peri-implant disease are similar to those of gum disease (periodontal disease), but peri-implant disease can develop more quickly and it can be more difficult to treat. However, these diseases can usually be prevented and treated at an early stage by following a proper oral hygiene, diet and lifestyle habits and keeping regular visits to your dentist.

If you’re concerned that there might be a problem with your gums or dental implants, contact us today to book an appointment with our Perth dentist.

What causes peri-implantitis?

Peri-implant disease is caused by bacterial plaque that accumulates around dental implants in the gum. You may be at higher risk of developing this condition if:

• you have poor oral hygiene, caused by factors such as improper brushing or flossing, or consuming too much sugar that feeds bacteria in plaque
• you have a history of periodontitis (gum disease), which can make peri-implantitis more likely
• you smoke, as tobacco use can reduce blood flow to the gums and impair healing
• you don’t attend follow-up appointments and regular check-ups with your dentist

An evidence-based overview of peri-implantitis published in 2018 found strong evidence that poor plaque control, a history of chronic gum disease and a lack of regular maintenance care after dental implant surgery were associated with a higher risk of developing peri-implantitis.*

Another study published in 2020 found a significant association between smoking and peri-implantitis risk, while people who had three or more dental implants were found to be at greater risk of developing peri-implant mucositis.**

* Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol. 2018 Jun;89 Suppl 1:S267-S290. doi: 10.1002/JPER.16-0350. PMID: 29926957.

** Rinke S, Nordlohne M, Leha A, Renvert S, Schmalz G, Ziebolz D. Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study. J Periodontal Implant Sci. 2020 May 20;50(3):183-196. doi: 10.5051/jpis.2020.50.3.183. PMID: 32617183; PMCID: PMC7321710.

How is peri-implant disease treated?

If you’re concerned about peri-implant disease, book in to see our dentist as soon as possible. Delaying treatment for peri-implant mucositis at the early stage could lead to it developing and causing implant failure, as well as making retreatment more difficult.

Your dentist’s recommendations for peri-implant disease treatment will depend on how far the disease has progressed and your individual risk factors.

Peri-implant mucositis treatment

In its early stage, peri-implant disease may be effectively treated with a combination of improved daily oral care, following your dentist’s guidance, and professional hygiene treatments provided at a dental clinic to remove plaque and help prevent further inflammation.

Your dentist will recommend a treatment plan with follow-up appointments to confirm whether the situation has improved, or if further treatment may be needed.

Peri-implantitis treatment

If peri-implant mucositis has developed into peri-implantitis, treatment will depend on the severity of bone loss and other symptoms. This may involve a combination of approaches, including:

• Non-surgical therapy, such as antibacterial mouthwashes and gels to reduce bacteria
• Removing cement deposits from around the implant
• Antibiotics to help control the infection
• Bone grafting or gum grafting to regenerate lost tissue
• Surgery to remove irregularities in the bone around the implant or the implant surface

The earlier peri-implant disease is treated, the greater the chance of the treatment being successful.

How can peri-implant disease be prevented?

As with most oral health problems, peri-implantitis can usually be prevented by taking good care of your gums, implant teeth and any natural teeth. Dental implants and bridges require less daily care than dentures, but it’s still important to:

• Brush prosthetic and natural teeth twice a day to reduce plaque build-up
• Floss around teeth and implants daily to remove more plaque and food deposits
• Follow a balanced diet and limit the amount of sugar and starch in food and drink
• Drink plenty of water to rinse and hydrate your mouth
• Avoid smoking and excess alcohol
• Visit the dentist twice a year for comprehensive check-ups and oral hygiene treatments

You can lower your risk of peri-implantitis and other dental implant complications by choosing a reputable dentist who uses the latest techniques, genuine implant components and offers follow-up care and maintenance to improve the chance of any problems being caught early.

Find out more about dental implants in Perth

At Perth Dental Implant Centre, our experienced dentist Dr David Norcross uses the latest techniques and high-quality materials to minimise the risks from implant surgery. We also provide thorough follow-up care and are always happy to answer any questions you have about the dental implant process.

If you’re thinking about dental implants, or want to know more, get in touch with our local Perth clinics today. Call us on 1300 108 133.

References

1. Rinke S, Nordlohne M, Leha A, Renvert S, Schmalz G, Ziebolz D. Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study. J Periodontal Implant Sci. 2020 May 20;50(3):183-196. doi: 10.5051/jpis.2020.50.3.183. PMID: 32617183; PMCID: PMC7321710.
2. Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol. 2018 Jun;89 Suppl 1:S267-S290. doi: 10.1002/JPER.16-0350. PMID: 29926957.