[Health Column] Peri-implantitis: Can It Occur Even Without Pain? Early Signs and Management

 

 

There is something I hear most often from people who have finished implant treatment.
"Since they are artificial teeth now, you don't have to worry about cavities, right?", "Aren't implants something you use for a lifetime once they are placed?"

 

It is true that implants do not get cavities. However, Ultimately, it is my gums and jawbone that hold the implant in place. Just as gum disease can occur in natural teeth, inflammation can develop around implants, and this Peri-implantitis It is called [this].

 

Today, I will explain in order what peri-implantitis is, why it is difficult to detect, and what you need to check and manage to use your implants for a long time.

 

1️⃣ What is peri-implantitis?

 

Inflammation around implants is divided into two stages depending on the degree of progression.

 

The first step is Peri-implant mucositis As a result, there is no effect on the alveolar bone, and inflammation occurs only in the gums surrounding the implant. The Korean Academy of Periodontology explains that plaque and tartar attached to the surfaces of implants and prosthetics are the main causes.

 

If the inflammation spreads down to the gum bone and the bone surrounding the implant begins to dissolve, Peri-implantitis It becomes like this. You can think of it as similar to gum inflammation (gingivitis) progressing to periodontitis (gum disease) in natural teeth.

 

 

division	Peri-implant mucositis	Peri-implantitis
Area of ​​inflammation	Only in the gums surrounding the implant	Up to the gums and alveolar bone
Gum bone loss	doesn't exist	Present (bone has descended compared to the previous X-ray)
Representative symptoms	Bleeding or gum swelling during brushing or examination	Bleeding, pus, receding gums, and loosening in severe cases
possibility of recovery	It can be restored if plaque is managed properly again.	Treatment is needed to stop the progression

 

It is not a rare disease either. In a comprehensive analysis of various studies, peri-implantitis is based on patient standards Around 20% It has been reported to appear in (Derks and Tomasi 21.7% in 2015, Diaz et al. 19.5% in 2022). About 1 in 5 people with implants may experience this. It means...

 

2️⃣ Why is peri-implantitis harder to detect than in natural teeth?

 

Between the natural teeth and the gum bone periodontal ligament There is a thin tissue called [name], so if a problem arises, it sends signals of sensitivity, pain, and discomfort when chewing. However, Implants do not have nerves or periodontal ligaments. Therefore, even if inflammation occurs, it is difficult to feel pain, and it is easy to miss the timing for treatment.

 

The speed of progression must also be monitored. An international consensus report (World Workshop on the Classification of Periodontal Diseases) jointly compiled by the American and European Academies of Periodontology in 2017 states that peri-implantitis is more than periodontitis of natural teeth. Rapid, irregular, and increasingly accelerating patterns It explains that it proceeds as follows.

 

 

 

Shaking is often a signal that appears only after the situation has already progressed quite a bit. Before that, It is important to check at the bleeding and swelling stages. do.

 

3️⃣ Who needs to be more careful?

 

Peri-implantitis can occur in anyone, but there are known cases where the risk is higher. The risk factors assessed as having strong evidence in the same international consensus report are as follows:

 

📌 If you have suffered from severe periodontitis (gum disease) in the past
📌 In cases where plaque is not properly managed and regular care is not received

 

Since the cause of needing implants was often gum disease, there are more people than expected who fall under the first category. If you lost a tooth due to weak gums, it is safe to assume that the gums around the implant may also weaken for the same reason.

 

It is difficult to definitively conclude that smoking and diabetes are definite risk factors due to inconsistent research results. However, since they can have a negative impact on overall gum health, it is advisable to manage them together.

 

 

 

4️⃣ How is peri-implantitis treated?

 

Treatment How far the inflammation has progressed It depends on

 

🔹 Peri-implant mucositis stage
Recovery is possible by thoroughly removing plaque and tartar around the implant and correcting home care practices. An international consensus report also explains that mucositis can be cured if plaque management is properly restored. The best reason to discover this at this stage no see.

 

🔹 Peri-implantitis stage
Treatment is required to clean the contaminated implant surface inside the gums. The Korean Academy of Periodontology explains that because implant surfaces are more difficult to treat than natural teeth, lasers, chemotherapy, and ultrasonic devices are used in combination. It is also important to use instruments that do not scratch the implant surface.

 

🔹 If it does not subside with non-surgical treatment or the bone loss is deep
We consider surgical treatment that involves opening the gums and directly cleaning the infected area. Depending on the condition, reconstructive treatment to reinforce the lost bone and gums may also be performed.

 

📌 This is a scene of a typical gum (periodontal) cleaning treatment.

 

However, if bone loss has already progressed too extensively and the implant is loose, it may be necessary to remove the implant, undergo a recovery period, and then formulate a new plan. Which treatment is appropriate... A decision will be made after accurately confirming the current condition through a gum examination and X-ray. do.

 

5️⃣ How should I care for my implants to make them last a long time?

 

Implants What happens after planting is more important than the day of planting. Even if the surgery is successful, the lifespan of the implant is determined by how well the gums and bone are maintained afterward.

 

Brushing alone is often insufficient at home. This is because the toothbrush does not reach the boundary where the implant prosthesis meets the gums, nor the spaces between adjacent teeth. Using interdental brushes or dental floss together This is good. Since the appropriate tool varies depending on the shape of the prosthesis, I recommend checking with a dentist to determine which size interdental brush is suitable.

 

Regular dental checkups are also essential. Since peri-implantitis is determined by how much the gum bone has receded compared to the previous examination, Recording the condition immediately after treatment and comparing it regularly This is important for early detection. The interval for checkups varies depending on the condition of your gums and risk factors, so please consult with your medical team to determine it.

 

 

I hope you view regular checkups not as a time to find problems, but as a time to confirm that you are being well cared for. You've managed it well so far. It is also a good checkup to leave after hearing that. 😊

 

 

💬 Frequently Asked Questions (FAQ)

 

Q1. Can dental implants get cavities?

A1. Since implants are made of artificial materials, they do not develop cavities. However, inflammation can occur in the gums and alveolar bone that support the implant. If you neglect care simply because you do not have to worry about cavities, you may end up discovering gum problems late, so caution is required.

 

Q2. If it doesn't hurt, isn't it okay?

A2. Since implants lack nerves and periodontal ligaments, they often cause little to no pain even if inflammation is present. Instead of focusing on pain, you should monitor for changes such as bleeding during brushing, gum swelling, and bad breath. It is recommended to undergo regular checkups to monitor the condition of your gums and bone, even if you have no symptoms.

 

Q3. Can I receive checkups or treatment for implants placed at a different dental clinic?

A3. Yes, even if you are not at the dental clinic where the implant was placed, you can check the condition around the implant through a gum examination and X-ray. However, since the available treatment may vary depending on the type of implant and the prosthetic structure, knowing your previous treatment records or implant details will be helpful for the diagnosis.

 

Q4. If peri-implantitis develops, do I have to have the implant removed?

A4. In most cases, this is not the case. If it is at the mucositis stage, recovery is possible through cleaning and management, and even in the case of peri-inflammatory disease, the goal is to halt progression through non-surgical or surgical treatment depending on the extent of the disease. However, if there is significant bone loss causing the implant to loosen, removal may need to be considered, so it is important to detect it at an early stage.

 

Q5. I had dental implants due to gum disease. Do I need to be more careful?

A5. That is correct. There is evidence that individuals who have suffered from severe periodontitis in the past have a higher risk of peri-implantitis. It is recommended to care for both the gums of your remaining natural teeth and your implants, and to undergo regular checkups consistently.

 

🎯 Wrapping up

 

While implants do not develop cavities, they are not free from gum disease. Peri-implantitis often progresses painlessly, and once it begins, it can advance faster than periodontitis in natural teeth.

 

Fortunately, if detected at the mucositis stage where inflammation is limited to the gums, it can be cured with proper management. Not ignoring small signs such as bleeding or swollen gums while brushing, and regularly checking the condition even if it doesn't hurt. This is the most certain prevention.

 

However, the condition of the gums surrounding the implant and the necessary treatment may vary from person to person. If you experience changes such as bleeding or swelling, please undergo gum examinations and imaging tests to accurately assess your current condition and consult with medical professionals to determine the course of care.

 

The journey with dental implants begins after they are placed. I believe the key to making your implants last a long time is to look beyond just the teeth to the gums, and to ensure proper care rather than stopping at treatment. 🦷

 

 

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