Implants and Gum Disease
Implants (metal titanium rods) have fast become the option of choice when faced with conditions involving missing teeth. They provide a suitable fixed solution where you can have teeth that do not have to be taken out like dentures.
However like teeth, implants too can be affected with gum disease. And they too can be lost and have the bone deteriorate around them. When this happens often too much damage will have occurred for repeat treatment in this region.
There are namely two conditions that can affect Implants:
This is infection of the soft tissues surrounding an implant.
This is infection of the bone support surrounding an implant. Once the gum is infected there becomes a greater risk of bone involvement too. Statistics claim that 30% of failures of Implants are because of gum disease of the supporting tissues that hold implants in the jaw. It is being termed the “New Dental Epidemic”.
Once there is infection around an Implant it seems to progress faster than when it is around teeth. For this reason it is imperative to have a sound Post-Implant Treatment Prevention Program designed that is unique to the particular case.
One aspect we look at early on in the diagnosis process is the particular risk factors associated with problematic Implant treatment. We aim to eliminate these and make the patient aware of these during the assessment process.
Implant Periodontal Risk Factors
There are certain aspects that tend to exacerbate if not deteriorate the condition of implants. These risk factors need to be addressed prior to commencement of any implant restorative work.
Some of these risk factors include:
- Poor oral hygiene. This then goes on to form a bacterial biofilm which attracts further infection. This in turn causes inflammation around the teeth and implants.
- The patients dental and medical history and social habits can have a negative impact upon the outcome of implant treatment especially related to periodontics. For example there are numerous studies that show that smoking habits inhibits the healing process and so further deteriorates the implant.
- Systemic diseases and medications. This needs to be carefully evaluated prior to any implant treatment. Those that form contra-indications can include psychiatric instability, recent heart attack or stroke, severe immunosuppression, uncontrolled bleeding, current malignancy therapy, high dose radiation, drug abuse-alcoholism, pregnancy, diabetes that is severely uncontrolled and renal failure. Some medications have an effect on bone metabolism and so this needs to be looked at carefully prior to implant treatment.
- Previous periodontitis and infection can have an effect on the current condition. This may occur even if no teeth are present but the patient had periodontal disease in past. This can affect prognosis.
- There should be no mobility of implant gum margin. It can happen when the fold of tissue (frenum) that holds the lips in place pull on the gums. There is increased failure associated with this condition and it should be assessed early on in during the examination process.
- It is important to assess the active or period of time infection has been present so that we can integrate certain preventative protocols.
As you can imagine implant failure with respect to gum disease can be a multifactorial situation. For this reason it is better to prevent any such occurrence from happening in the first place.
Our unique diagnosis and treatment planning protocols ensure that the treatments are based upon a sound foundation and any risk factors are clearly identified much early on in the process.
Post-Implant Treatment Prevention Program
The cause for gum disease surrounding implants is much the same as for teeth. However, once infected the disease tends to spread faster with implants. For this reason it is imperative that a Post-Treatment Prevention Program is considered at the treatment planning stage. We like to work closely with the referring dentist to ensure this occurs.
For more information on causes of gum disease.
There are 3 stages to ensuring a healthy implant system within the mouth:
1. Pre-Assessment. Before any implant treatment is considered we need to eliminate any risk factors and make sure the conditions for treatment are conducive for success.
2. Create a Prevention Program based upon the specific needs of the patient’s condition. This home regime and the professional maintenance plan needs to be practical and achievable.
3. Regular reviews are necessary post implant treatment to ensure no deterioration is occurring. This can easily be done by the dentist and/or the periodontist. We can commence with Maintenance Therapy as part of this plan.
We can create personalized programs based upon the unique needs of the specific case. For more information see Personalised Periodontal Post Treatment Programs.