Dental implants offer a durable option for replacing missing teeth, providing functional and aesthetic benefits. Periodontal disease, or gum disease, is a widespread oral condition caused by bacterial infection affecting gums and supporting bone. A common question is whether individuals with a history or presence of periodontal disease can still receive them. Understanding this relationship is important for anyone considering tooth replacement.
How Periodontal Disease Affects Dental Implants
Periodontal disease concerns dental implant success due to bacteria. The same bacteria causing periodontitis around natural teeth can lead to peri-implantitis, inflammation. This begins as peri-implant mucositis, inflammation of soft tissues around the implant. If untreated, peri-implant mucositis can progress to peri-implantitis, causing progressive bone loss around the implant.
Peri-implantitis compromises implant stability and viability by eroding bone. Healthy bone and gum tissue are necessary for osseointegration, where the implant fuses with bone. Active bacterial infection and inflammation can impede this fusion or, if already integrated, break down the bone-implant connection. Therefore, a stable, healthy oral environment is necessary for successful implant integration and minimize peri-implantitis risk.
Treating Periodontal Disease Before Implant Placement
Before dental implants can be considered, active periodontal disease must be controlled. Initial treatment involves non-surgical approaches to eliminate infection and inflammation. This often includes scaling and root planing, a deep cleaning removing plaque and tartar below the gum line and smoothing root surfaces. Local antibiotics may also be administered to target specific bacteria.
Sometimes, surgical interventions may be necessary to address deeper infection or regenerate lost gum and bone. These treatments aim to establish a stable, healthy oral environment free from inflammation and bacterial load. This foundation reduces harmful bacteria transfer to the implant site and allows optimal healing and integration. A period of healing and monitoring, often several months, follows treatment to confirm disease stability.
Assessing Candidacy for Dental Implants
Even after successful periodontal treatment, a comprehensive evaluation determines suitability for implants. This assessment extends beyond gum health and includes analysis of jawbone quantity and quality. Previous periodontal disease may have caused bone loss, which could make implant placement challenging, sometimes requiring bone grafting for adequate volume.
Systemic health also plays a role in candidacy. Uncontrolled diabetes can impair healing and increase infection risk, while smoking can compromise blood flow and hinder osseointegration. A patient’s medical history, including medications affecting bone metabolism or healing, is reviewed. Commitment to diligent oral hygiene and regular follow-up appointments is assessed, as these are necessary for long-term implant success.
Long-Term Care and Implant Success
For individuals with a history of periodontal disease, maintaining implants requires diligent long-term care. Diligent daily oral hygiene, including brushing and flossing around implants, prevents plaque and bacteria. This home care helps avoid gum disease recurrence and peri-implantitis development.
Regular dental check-ups and professional cleanings are important for monitoring and maintenance. These appointments allow the dental team to assess gum and bone health around implants, detect early inflammation or infection, and provide specialized cleaning. Early intervention is necessary if issues arise, as prompt treatment of peri-implant mucositis can prevent progression to peri-implantitis. Adhering to these maintenance protocols contributes to long-term implant success and stability, especially for those predisposed to gum disease.
—
Citations:
Dental implants and periodontal disease – PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC8974104/.
Periodontal disease and dental implants – PubMed. https://pubmed.ncbi.nlm.nih.gov/22900760/.