When teeth need to be replaced, dental implants are a wonderful option for many people. Just like natural teeth, however, there is no guarantee a person’s dental implant(s) will last a lifetime. Although they may look bionic in pictures, a dental implant still needs careful monitoring and regular care. True, they cannot decay like natural teeth – but they are subject to the same complications of gum disease and bone loss.

There are two categories of peri-implant complications: Peri-Implant Mucositis and Peri-Implantitis.

Peri-Implant Mucositis: This condition is similar to gingivitis around a natural tooth and does not include loss of attachment (bone or gum tissue) and is hopefully reversible at this stage. Peri-Implant Mucositis is a reversible inflammatory reaction in the soft tissues surrounding a functioning implant. Treating this condition as soon as possible will prevent peri-implantitis!

Peri-Implantitis: This is a condition similar to periodontitis with loss of supporting structures (gum and/or bone) around a natural tooth. Peri-Implantitis is a destructive inflammatory reaction affecting the soft (gingiva) and hard (bone).

Checking for implant health

Upon routine examination, Dr. Britten, your general dentist or dental hygienist will evaluate your implant for plaque or tartar build up around the implant, as well as gum tissue color, texture and type of gum tissue supporting the implant (attached to bone or unattached).

Next, probing measurements will be taken around the implant. Dr. Britten, the dentist or hygienist will use light pressure and a plastic probe. The tissues surrounding dental implants have a weaker attachment, bleed easier, and may be a bit more sensitive to probing. Heavy bleeding, pus, and increased probing measurements will require attention.
We will check both the implant body and its restorative parts, such as the implant abutment or crown for any loose parts. If the restorative parts are loose they can likely be repaired by your restorative dentist or implant specialist, Dr. Todd Britten. If the implant body itself is mobile, it’s an immediate failure and will require removal. Dr. Britten, or your dentist will also check your bite to make sure that the implant is not being hit with excessive pressure, as this could cause the bone surrounding the implant to weaken and the implant body to become loose.

Radiographs, or x-rays, should be taken at different times during the surgical and restorative phase of implant placement. Routine, annual “checkup” x-rays should be taken of the implant to compare to the original ones taken to carefully evaluate bone levels.

The dental hygiene visit includes removal of all soft and hard deposits on the implants, just as on the teeth themselves. Our hygienists often use instruments designed exclusively for implant care. We will then discuss the best daily oral hygiene care plan for your mouth and your dental implant(s). Listen closely to these oral hygiene instructions and customized daily oral hygiene strategies. Just like with natural teeth, biofilm or plaque must be removed skillfully every day because it can cause both infection and inflammation around a dental implant.

Studies show rinsing with Listerine (diluted with water if strong alcohol content is an issue) has its benefits because of its great antibacterial properties. Other great oral hygiene aids for implant care include a power toothbrush (love Sonicare by Phillips), Proxysoft Bridge and Implant Floss (www.proxysoft.com), double-bend end tufted brush for lingual of lower hybrids (Tepe brand). A Waterpik may also be used, but with careful instruction from your dental professional.

Our periodontist, Dr. Todd Britten, will determine a maintenance schedule that is appropriate for you. It is very common for patients with implants to be seen every 3 to 4 months for those with less-than-ideal oral health, advancing age, or systemic conditions.

When complications arise

Peri-Implant mucositis can be treated with non-surgical therapy and daily disease control (effective oral hygiene). This condition should be carefully reevaluated and reassessed. If the issue cannot be resolved in six months, it is advisable to see an implant specialist.

If Peri-Implantitis is diagnosed, non-surgical therapy is typically ineffective. At this stage, it is adviseable to see an implant specialist to see if there is a restorative issue that can be addressed, or if surgical (traditional or laser LAPIP therapy) or implant removal is needed.

Regular dental hygiene care and examination is just as important to dental implant health as it is to natural teeth. If you have any questions regarding the health of your dental implant, contact us today at 727-586-2681 or visit our website at www.brittenperio.com.