Dental implants are an increasingly popular solution for people with missing teeth. According to the American Academy of Implant Dentistry, more than 3 million people in the United States have dental implants. Dental implants improve the lives of these people, but, like any other form of surgery, implant patients sometimes experience side effects. Learn more about a condition called peri-implantitis, and find out what to expect if you need treatment for this disease following implant surgery.

Causes of peri-implantitis

Peri-implantitis is an infectious disease that can affect people with dental implants. The disease infects the gum and bone surrounding an implant and, over time, patients experience bone loss in the affected area. Dentists and doctors don't yet fully understand the condition, and it's not entirely clear whether the infection causes the bone loss, or bone loss makes the surrounding tissue more susceptible to infection.

Dental implant patients won't necessarily know they have the disease. The condition can develop very soon after a new implant, or you may find that the infection occurs several years after your implant. It's important to remember that no procedure is risk-free, and peri-implantitis remains relatively rare.

Risk factors

Some people are more susceptible to the condition the other. You're more at risk of peri-implantitis if:

• You smoke or use tobacco products
• You have a poorly controlled underlying health condition like osteoporosis
• You have a history of periodontitis
• You have a weak immune system
• You don't look after your teeth

Good dental hygiene is critical when you have implants. Without daily brushing and flossing, anyone with an implant could get this type of infection. Some surgical factors can also increase the risk of infection. For example, if the implant is too big or the bone overheats during surgery, this type of infection can occur.

Signs and symptoms

Peri-implantitis is not always symptomatic and you may not feel any pain in the affected area. Brushing may cause a dull ache or tenderness, and your gums will sometimes seem red or slightly purple in color. In more serious cases, you may see bleeding at the gum line, and you may see (or taste) pus coming out of the affected area.

If you suspect you have a problem, you should visit your dentist as soon as possible. He or she will carry out a more thorough examination. As well as looking for signs of bleeding and suppuration (pus), your dentist will probably take X-rays to see if there is any supporting bone loss in your mouth.

Your dentist will also carry out a detailed inspection of the implant. He or she will look for any signs that the implant surgery has caused the problem. For example, you may have signs of faulty restoration work, and your dentist may find residual cement and other foreign material in the affected site. Your dentist will also look for signs of occlusal overload, where the implant cannot cope with the biomechanical forces in your mouth.

Treatment options

The primary aim of any treatment plan is to stop the disease progressing, to make sure the implant remains in place. In some cases, your dentist may refer you to a specialist periodontist for treatment.

First, your dentist will aim to tackle the infection. He or she may try to do this with antimicrobial therapy, which normally involves an antiseptic mouth rinse and prescription antibiotics. In more serious cases, your dentist may decide to undertake mechanical debridement, where he or she will remove small pieces of infected tissue around the affected area. A robust dental hygiene routine during this time is also essential.

For patients that don't respond to this type of treatment, your dentist may consider surgery. The dentist may need to detoxify the implant's surface with special chemical agent. He or she may also use a process called flap management, where the dentist raises a flap of gum tissue to remove any diseased tissue underneath.

If your dentist believes that the implant is causing the issue, he or she may remove or alter the implant to fix any problems. A small adjustment to the way the implant fits could help cut down the risk of further peri-implantitis.

Peri-implantitis is a relatively rare disease that can affect people with dental implants. For more information and advice, talk to your dentist.