When a patient has lost a tooth or several teeth, implants are a popular and reliable choice for restoring their smile. They’re an excellent dental restoration option, especially if you neither want to remove good tooth structure to make room for bridges nor wear oft-uncomfortable dentures. We’ve widely used dental implants at our Hospital Excel center, achieving superb results every time.
Nonetheless, dental implants are not perfect and a few issues can cause them to fail. Aside from heavy smoking, gum disease is one such common issue we’d like to explore today.
Gum Disease Defined
Also known as periodontal disease or periodontitis, gum disease is a rampant and serious infection of the gums. The culprit is bacteria-laden plaque that sticks to and accumulates around the lining of the gums. This bacterial infection and buildup are known for the inflammation and weakening of the gum tissue.
Gum disease advances in three distinguishable phases: gingivitis, periodontitis, and advanced periodontitis.
Gingivitis – An initial stage of gum disease, gingivitis is marked by the inflammation of the gums. That’s most frequently due to a bacterial infection. If left untreated, gingivitis will become a more serious gum infection called periodontitis, which counts towards most tooth loss in adults, according to the American Dental Association.
Periodontitis – Occurring if gingivitis is left untreated, periodontitis is a severe gum infection. The culprit is a buildup of bacterial plaque on the gums and teeth. The bacterial infection will damage your teeth and bones as it advances, but proper oral hygiene and prompt treatment can curb its progression.
Advanced periodontitis – This is the worst-case scenario of gum disease. In advanced periodontitis, the connective tissue that anchors your teeth will begin to destruct. The bones, gums, and other tooth-support tissue will also deteriorate. Well-known advanced disease symptoms – foul oral taste, tooth loss, foul breath, and severe pain when eating.
Gum disease will eventually result in tooth loss, especially in middle-aged and older adults. The worst part is that it has been heavily linked with an increased risk of chronic diseases. If left untreated, it can elevate the risk of developing cardiovascular disease, stroke, and heart attack. Oftentimes, gum disease complicates chronic conditions like certain cancers and diabetes.
Symptoms of Gum Disease
Every day, millions of people wrestle with gum disease due to bacterial plaque. The disease shows up in various ways and may not present the same symptoms for two people:
Tender, swollen, or reddish gums
Gums bleeding when brushing or flossing your teeth
Pus between your teeth and gums
Pain when chewing
Partial dentures that no longer fit
Foul-smelling breath that doesn’t go away after you brush your teeth
You might show no symptoms of gum disease at all, particularly through the first two phases. Early detection and treatment can make all the difference. It’s crucial to see your dentist at least twice yearly for thorough, professional cleanings and check-ups.
Healthy Gums are required for Dental Implant Success
Each day, tens of thousands of people undergo dental implant surgery to replace missing teeth. A trained oral and maxillofacial surgeon or dentist will surgically insert the implants into the jawbone. Dental implants can look, function, and feel similar to your existing teeth, providing a long-term replacement solution for missing teeth. Besides, unlike traditional dentures and fixed bridgeworks, implants won’t cause bone jawbone loss or impact adjacent healthy teeth.
If properly placed and keenly cared for, dental implants can last for years, if not a lifetime. That’s because they are crafted from aviation-grade titanium alloy that integrates with the bone in your jaw. There’s no way to circumvent osseointegration – the process in the implant fuses with the jawbone, and it can take several months after the implantation. However, osseointegration is crucial – it’s the reason that dental implants are far more retentive, stable, and longer-lasting than dentures and fixed bridges.
Osseointegration requires healthy gums. The success of this first phase of dental implant surgery is crucial for the success of the entire procedure. If the implants don’t integrate with the bone, they will fall and slip out of the jaw, just like the missing teeth did.
As far as gum disease goes, dental implants may fail to fuse and take root for a couple of big reasons. For one, the underlying bone matter must be thick and wide enough for the implants to anchor the fake teeth. If the disease has progressed to advanced periodontitis, the jawbone is likely to have deteriorated and the implants won’t have enough base support.
More crucially, like a natural tooth, an implant requires healthy gums to envelope the lower crown and the root. Unfortunately, a flared gum disease is known for continually eating away at the gum tissue and there won’t be enough to surround the base of the fake tooth.
People with Gum Disease Are Not Ruled Out of Getting Dental Implants
Fortunately, dental implants are not ruled out for people with any stage of gum disease. Once they get proper treatment, they are almost always eligible for the implant. Patients with mild to moderate gum disease may only need to keep the disease under control. This may necessitate deep, frequent dental cleanings and following a strict oral hygiene regimen. Your dentist will likely recommend quitting habits that can impede gum disease healing – drinking alcohol, chewing, tobacco, or smoking.
Once the disease is gone, you may be referred by your dentist to an oral and maxillofacial surgeon to examine if the gums and bones are ready for implants. If your gum disease has advanced, your oral surgeon will likely decide that gum or bone grafting is required before dental implant placement.
In bone grafting, your dentist or oral surgeon will use a donor bone (either from someone else or other parts of your body like the tibia, jaw or hip) to rebuild the bone structure afresh. As for gum grafting, your surgeon will take tissue from the roof of your mouth to repair parts of the gum that have been eroded by the disease.
Gum Disease and New Implants
If you have recently received dental implants, you should go above and beyond to prevent gum disease. Any stage of the disease can cause insurmountable damage to the implants. If left untreated, they hold the potential to cause implant failure – especially in the early months of recovery.
As mentioned, the implants have to fuse with the bone in your jaw, a process that can take several months after the procedure. Only once osseointegration has completed that the implants will be strongly rooted to support crowns, dentures, or bridges. Even if gum disease doesn’t result in complete implant failure, it can prolong the healing, delay treatment, and rack up costs.
Gum Disease and Well-Established Implants
You are not completely safe from gum disease even if it occurs long after the dental implant surgery. Dental implants are not susceptible to decay and cavities but are still vulnerable to the effects of gum disease. Periodontal disease doesn’t infect the implants in and of themselves. However, they can erode the gum tissue, other natural teeth, and the jawbone. More specifically, infection of the gum tissue can compromise the stability, fit, and overall integrity of dental implants.
How to Treat and Prevent Gum Disease
Most gum disease treatments aim to get rid of the bacterial deposits and plaque on your gums and teeth.
Rigorous Oral Hygiene Regimen
Your dentist will draw an oral hygiene plan to help you eradicate gum disease. Some of the widely-acknowledged tactics are regular flossing at least once daily, brushing twice a day, and using other oral hygiene items like mouthwash.
Professional Dental Cleanings
During a deep dental cleaning, your dentist will get rid of tartar and plaque build, focusing mainly on the roots and teeth. Root planing and scaling may be required for rough spots, followed by polishing and treating your teeth with fluoride.
A Course of Antibiotics
In most severe cases, your dentist may prescribe a course of antibiotics to help curb persistent infection of the gums. This is particularly the case if the infections don’t respond to professional cleanings.
Check-ups are a vital part of following up on the healing, especially if you already have your dental implants placed. The first follow-up appointment should come up after two or three weeks. Subsequent follow-ups will come at 3 to 6-month intervals.
Your dentist may refer you to an oral surgeon if your gums continue to become inflamed and infected. This is especially true if the inflammation is focused on sites that flossing and brushing don’t reach. The most recommended procedure is flap surgery which helps remove deep-seated plaque and bacterial deposits under your gums.