Now that dental implants have become more common, two new disease conditions have been diagnosed and named; peri-implantitis and mucositis. Mucositis, which is the milder condition, which may or may not precede peri-implantitis, though both are inflammatory disorders. Research studies suggest that almost a third of patients who have dental implants may be affected by one or both conditions. While mucositis is treatable, left untreated it may lead to peri-implantitis, a disorder in which bacterial infection threatens the gradual loss of the jaw bone supporting the dental implant, threatening the implant's stability.
While the reason some patients are troubled by one or both of these conditions after undergoing dental implantation are not fully understood, there are risk factors known to make certain patients more vulnerable. These risk factors include:
- Family history of periodontal disease
- Thin gums
- Diabetes or osteoporosis
- Poor immune system
- Teeth grinding
- Inadequate dental hygiene
- Infrequent dental checkups after implantation
Smoking has been found to have a strong adverse effect on healing from dental implant surgery and is closely associated with increased infection rates. Also, there appears to be a correlation between the recent use of dental cement, rather than hardware, in securing implants, and the risk of infection. This may be because this dental cement may escape and become lodged in the gums, resulting in irritation and possible bacterial invasion.
The first signs of mucositis are mild, but it is crucial that patients pay attention to the disease process at this stage when it can be more easily treated. Once the periodontal disease has progressed to peri-implantitis, it is much more dangerous to the patients oral integrity and much more difficult to treat.
Symptoms of mucositis include:
- Red, swollen gums that bleed easily
- Local swelling
- Bad breath or bad taste in the mouth
- Loosening of the implant, or of bridge or dentures
Because these symptoms are relatively mild and may go unnoticed, and because peri-implantitis (bone loss) is painless, patients may be unaware that they have these conditions. This is the reason that regular follow-up dental appointments after implantations are imperative. Since sometimes symptoms of mucositis and peri-implantitis do not become evident for months, or even years, following the surgery, ongoing dental care is very important.
Treatment of Peri-Implantitis and Mucositis
While most dental implants are designed to last a lifetime, and 95 percent have been shown to last for at least 5 years, prophylactic care is essential in keeping peri-implantitis and mucositis at bay. Treatment actually begins as prevention. Patients are instructed on methods of excellent oral hygiene and advised to stop smoking before any implantation procedure takes place since this will give the surgery a much better chance of success. Whether dental hardware or dental cement is used during the implantation process, an effort will be made to fill in all gaps that bacteria might infiltrate during or after surgery.
Peri-implantitis is a frequent cause of dental implant failure. The earlier the condition is detected, the better the chances that treatment will be effective. Once detected, peri-implantitis is treated with a professional cleaning of the implant surface to remove any and all bacterial deposits. Additionally, patients are usually instructed to use an antibacterial mouthwash or gel, and are sometimes prescribed an oral antibiotic as well.
In situations where the peri-implantitis has progressed, it may be necessary for the dentist to perform a surgical procedure in order to gain better access for cleaning. In cases in which the disease process cannot be controlled, the implant may have to be removed.