A dental implant replaces a missing tooth root, typically made of titanium, surgically placed into the jawbone. It provides a stable foundation for a crown, bridge, or denture, mimicking natural teeth. While largely successful, dental implants can become infected. These infections are a serious complication that can impact long-term success.
How Infections Develop
Dental implant infections stem from bacterial colonization, leading to inflammatory conditions known as peri-implant mucositis and peri-implantitis. Peri-implant mucositis involves inflammation of the soft tissues surrounding the implant, similar to gingivitis around a natural tooth. If left unaddressed, this inflammation can progress to peri-implantitis, characterized by inflammation and progressive bone loss around the implant.
Several factors increase the risk of these infections. Poor oral hygiene is a contributor, allowing plaque and bacteria to accumulate around the implant and initiate inflammation. Smoking also elevates this risk due to its effects on blood flow and the immune system, hindering the body’s ability to fight bacteria.
Underlying health conditions, such as uncontrolled diabetes, can compromise healing and immune response, making individuals more susceptible to infection. A history of gum disease (periodontitis) around natural teeth also predisposes individuals to peri-implantitis. Complications during or after surgical placement, such as inadequate sterile technique, improper implant positioning, or issues with the restoration, can create environments where bacteria thrive.
Recognizing an Infection
Identifying an infection early is important for successful management and preserving the dental implant. Patients might notice pain or discomfort around the implant site, which can range from mild to severe. Swelling or redness of the gums surrounding the implant is another common indicator, often accompanied by tenderness.
Bleeding when brushing or flossing around the implant signals gum inflammation. In more advanced stages, pus discharge from the gum line near the implant may be visible, often causing a bad taste or persistent bad breath.
While early signs like redness and swelling may indicate peri-implant mucositis, progression to peri-implantitis can manifest as increased pocket depth around the implant or a loose implant. Any of these symptoms warrant prompt professional evaluation, as an untreated infection can lead to further complications, including implant failure.
Addressing an Infection
Addressing a dental implant infection begins with a thorough diagnostic process by a dental professional. This typically involves a clinical examination, where the dentist will check for signs of inflammation and measure probing depths around the implant. X-rays are also taken to assess the condition of the bone surrounding the implant and to detect any bone loss.
Treatment approaches vary based on the severity and stage of the infection. Non-surgical methods are often employed for earlier stages, focusing on removing plaque and calculus through professional cleaning and debridement. Localized antimicrobial therapy, such as medicated mouth rinses or gels, may also be prescribed to help control bacterial growth. In some cases, oral antibiotics might be necessary to combat more severe infections.
If the infection has progressed and caused significant bone loss, surgical intervention may be required. This can involve flap surgery to access the infected area for deeper cleaning and decontamination of the implant surface. Procedures like bone grafting might be performed to regenerate lost bone support around the implant, aiming to stabilize it. In severe situations where the infection is extensive and the implant cannot be saved, removal of the infected implant may be the only course of action to protect the surrounding bone and soft tissues. The primary goal of any treatment is to eliminate the infection, preserve the implant if feasible, and prevent further deterioration of the supporting bone structure.
Preventing Future Issues
Preventing dental implant infections is important for their long-term success and involves consistent care. Daily oral hygiene is essential, requiring thorough brushing, flossing, and the use of interdental brushes for cleaning around implants. This routine helps remove plaque and food debris, minimizing bacterial accumulation.
Regular dental check-ups and professional cleanings, typically every six months, are also important. These visits allow the dental team to monitor implant health, identify early signs of inflammation, and perform specialized cleanings. Avoiding smoking reduces the risk of infection, as smoking impairs healing and increases susceptibility to bacterial overgrowth. Managing systemic conditions like diabetes effectively also supports oral health and reduces infection risk. Promptly addressing any signs of gum inflammation can prevent them from escalating into more serious implant infections.