Dental implants are designed to look, feel and function like natural teeth, but they still require careful long-term care. Just like natural teeth, implants can be affected by inflammation and infection in the surrounding tissues. When this occurs, it may be a sign of dental implant gum disease, including a condition known as peri-implantitis.
At Pure Periodontics in the City of London, Dr Neesha Patel and the specialist team regularly assess patients with concerns about their gums and dental implants. As Clinical Director and a former Consultant Periodontist at King’s College Hospital, London, Dr Patel takes a specialist approach to diagnosing problems around implants and identifying the most appropriate treatment for each patient.
Understanding the warning signs of implant-related gum disease is important because early intervention can make a significant difference to the health and stability of an implant.
WHAT IS DENTAL IMPLANT GUM DISEASE?
Dental implant gum disease refers to inflammation or infection affecting the tissues around a dental implant.
There are two main conditions to be aware of:
Peri-implant mucositis is inflammation of the soft tissues around an implant without evidence of supporting bone loss. It can often be managed successfully when identified and treated early.
Peri-implantitis is a more advanced inflammatory condition where there is inflammation around the implant alongside progressive loss of the bone supporting it. If left untreated, peri-implantitis can compromise the stability of the implant.
While an implant itself cannot develop tooth decay, the tissues supporting it can develop disease. This is why maintaining healthy gums and regular professional monitoring remain important long after implant treatment has been completed.
WHAT ARE THE WARNING SIGNS OF IMPLANT GUM DISEASE?
One of the challenges with peri-implant disease is that it does not always cause obvious symptoms in its early stages.
Patients should arrange an assessment if they notice:
- Redness or swelling around an implant
- Bleeding when brushing or cleaning around the implant
- Tender or sensitive gums
- Pus or discharge around the implant
- Persistent bad breath or an unpleasant taste
- Gum recession around the implant
- Changes in the appearance of the gum around an implant
- Pain or discomfort around the implant
- An implant crown that feels loose or different
- Changes in the way the implant or crown feels when biting
Bleeding around an implant should not simply be dismissed as something that happens because the area is difficult to clean. It can be an early sign of inflammation and warrants professional assessment.
WHAT CAUSES PERI-IMPLANTITIS?
There is rarely one single cause of peri-implantitis. Several factors can contribute to inflammation around dental implants.
Plaque accumulation is one of the key factors. Bacteria can build up around an implant just as they can around natural teeth. If plaque is not effectively removed, inflammation can develop in the surrounding tissues.
A previous history of periodontitis can also be relevant. Patients who have experienced gum disease may have an increased susceptibility to inflammatory conditions around implants, making long-term periodontal maintenance particularly important.
Other factors may include smoking, difficulty maintaining adequate oral hygiene, certain systemic health conditions, implant positioning and the design or fit of the restoration.
Importantly, an implant that is not causing pain can still have an underlying problem. Clinical examination and, where appropriate, radiographs are needed to determine what is happening beneath the gum.
HOW IS IMPLANT GUM DISEASE DIAGNOSED?
Diagnosing peri-implant disease involves more than simply looking at the implant.
A periodontist will assess the condition of the gum tissue around the implant, look for signs of inflammation and bleeding, and assess the depth of the tissues around the implant. The implant and surrounding structures may also be evaluated using dental radiographs to identify changes in the supporting bone.
The history of the implant is also important. When was it placed? Has the patient previously had periodontal disease? Has there been any previous inflammation around the implant? Has the implant crown or restoration changed?
At Pure Periodontics, this detailed assessment helps build a complete picture rather than treating a single symptom in isolation.
HOW IS PERI-IMPLANTITIS TREATED?
Treatment depends on the severity of the disease, the amount of supporting bone that has been affected and the individual circumstances of the patient.
In early cases, treatment may focus on controlling inflammation and improving plaque control around the implant. Professional periodontal and implant cleaning can be an important part of this process, alongside personalised advice on how the patient can effectively clean around the implant at home.
Where there is more established peri-implantitis, treatment may need to be more involved. Depending on the individual case, this can include non-surgical periodontal treatment or surgical treatment to access and clean the affected implant surface and address defects in the surrounding bone.
In selected cases, regenerative periodontal procedures may also be considered where the pattern of bone loss makes this appropriate.
There is no single treatment that is suitable for every failing implant. A specialist assessment is therefore an important first step.
CAN A FAILING DENTAL IMPLANT BE SAVED?
In some cases, an implant affected by peri-implantitis can be successfully treated and maintained. However, the possibility of saving an implant depends on several factors, including the extent and pattern of bone loss, the condition of the surrounding tissues and the stability of the implant itself.
Where an implant has become significantly loose because of advanced bone loss, removal may sometimes be necessary.
This is why early assessment matters. Treating inflammation before substantial supporting bone has been lost can provide more options for managing the condition.
CAN PERI-IMPLANTITIS BE PREVENTED?
Good long-term implant care begins before the implant is even placed.
Patients considering dental implants should have their overall gum health assessed, particularly if they have a history of periodontitis. Existing gum disease should be appropriately managed before implant treatment wherever possible.
Following implant placement, excellent daily plaque control and regular professional maintenance are important. Patients should also attend recommended reviews so that any changes around the implant can be identified early.
An implant may be an artificial tooth, but it is surrounded by living gum and bone. Those tissues still need specialist attention and long-term care.
WHEN SHOULD SOMEONE SEE A PERIODONTIST ABOUT AN IMPLANT?
Any new bleeding, swelling, discomfort or change around a dental implant is worth investigating, particularly if symptoms persist.
A periodontist specialises in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and implants. For patients with complex periodontal or implant problems, specialist assessment can help determine exactly what is happening and which treatment options may be appropriate.
At Pure Periodontics in the City of London, Dr Neesha Patel and the team provide specialist periodontal and implant care with a focus on detailed diagnosis, personalised treatment planning and long-term oral health.
If there are concerns about bleeding, inflammation, gum recession or changes around a dental implant, an assessment with a periodontist can help identify the problem before it progresses further.