A person with gum disease can receive dental implants, but only if the active infection is first completely treated and stabilized. Dental implants are titanium replacement tooth roots surgically anchored into the jawbone to support an artificial tooth or bridge. This procedure requires a healthy foundation of bone and gum tissue for the implant to successfully integrate and function long-term. An active infection creates an environment hostile to healing and osseointegration, the process where the implant fuses with the jawbone. Therefore, immediate implant placement is not possible when gum disease is present and must be addressed first.
Understanding Gum Disease and Implant Risk
Gum disease manifests in two main stages, each presenting a different level of risk to potential dental implants. The initial stage is gingivitis, characterized by gum inflammation, redness, and bleeding, but without bone loss. Gingivitis is reversible with professional cleaning and improved home care, posing a low threat once treated.
The second, more advanced stage is periodontitis, where the infection has progressed to destroy the underlying bone and connective tissue supporting the teeth. This bone loss is irreversible. Since dental implants rely on a stable, dense jawbone for support, periodontitis significantly compromises the necessary foundation. A history of periodontitis also means a patient is at a higher risk of developing peri-implantitis around the implant itself.
Peri-implantitis is an inflammatory condition affecting the tissues surrounding a dental implant. Caused by the accumulation of bacteria, similar to periodontitis, it leads to deterioration of the bone supporting the implant, potentially causing it to loosen and fail. Patients with a history of gum disease show a higher incidence of this complication, emphasizing the necessity of complete disease control before surgery.
Necessary Pre-Treatment for Eligibility
Achieving full stabilization of the gum disease is required before any implant surgery can be considered. Treatment often begins with scaling and root planing, a deep cleaning procedure that removes plaque and tartar from below the gumline and smooths the tooth root surfaces to encourage gum reattachment. In advanced periodontitis cases, surgical interventions may be necessary to access deeper infection pockets and thoroughly clean the root surfaces.
Following initial treatment, a healing and monitoring phase confirms the infection is under control and gum tissues are stable. A periodontist performs careful assessment, measuring pocket depths and evaluating overall gum health. If significant bone loss has occurred, ancillary procedures like bone grafting may be needed to rebuild a sufficient volume and density of jawbone to securely hold the titanium implant post.
Soft tissue grafting may also restore lost gum tissue, creating a healthier barrier around the future implant site. Patients must demonstrate consistent, excellent oral hygiene during this pre-treatment period, as compliance is essential for clearance. Only after the periodontist confirms the mouth is healthy, stable, and the bone structure is adequate can the patient proceed with implant placement.
Long-Term Maintenance and Success
Patients with a history of periodontitis must understand that their predisposition to gum inflammation remains, making strict long-term care essential for implant success. The bacteria responsible for periodontitis can easily colonize the implant area, rapidly leading to peri-implantitis if vigilance is not maintained. Therefore, the patient must adhere to a heightened hygiene protocol that goes beyond standard brushing and flossing.
This protocol involves using specialized tools like soft-bristle brushes, interdental brushes, and water flossers to clean thoroughly around the implant and under the crown. Regular professional maintenance is equally important. Patients often require cleaning and check-up appointments at more frequent intervals, such as every three to four months, rather than the standard six. During these visits, the professional monitors for early signs of peri-implant mucositis, which is reversible inflammation of the soft tissue around the implant without bone loss.
Neglecting this specialized maintenance increases the risk of inflammation progressing to peri-implantitis, causing significant bone deterioration and ultimately leading to implant failure. While implant survival rates are high for compliant patients, those with a history of gum disease who do not follow a supportive maintenance schedule face a much higher rate of complications and a reduced lifespan for their investment. Ongoing professional care and meticulous home hygiene are the foundations for ensuring the longevity of dental implants.