Periodontal disease and dental implant failure

Periodontal disease and dental implant failurePeriodontal disease and dental implant failure

One of the concerns with anyone that has dental implants is, how successful will they be? This is clearly a question which needs answering, working on the assumption that a dental implant has been placed into a sufficient amount of bone then the biggest reason that an implant files is lack of post-placement care.

A dental implant integrates entirely with the body and needs to be looked after much the same as a natural tooth.

How do dental implants fail

Typical reasons for failure of dental implants include:

  • Poor surgical decisions. This can involve placement of implants in insufficient quality or quantity of bone & poor design of the final restoration.
  • Abusing your oral environment. Studies show that smoking can inhibit healing, smoking restricts blood vessels which can mean that the implant placement doesn’t heal as well. Alcohol has also been shown to increase risk of post operative complications, including general infections and wound complications.
  • Dental decay. If you already have tooth decay on other teeth when you may be more susceptible to developing gingivitis and/or periodontitis around the implant area.
  • Overloading the dental implant. If you have a poor/heavy bite and/or grind heavily you may overload the dental implant and support structures. Extreme contact sports can also affect the success rate.
  • Overall poor oral hygiene. Implant failure is also exacerbated by bad oral health, implants succeed much better in a healthy environment.

Risk factors of periodontal disease and peri-implantitis

Risk factors for periodontal disease include:

  • Age – Indicators are that 70% of people over the age of 65 have periodontitis.
  • Smoking – Smoking affects your body’s ability to heal and alter is the bacteria levels in your mouth.
  • Genetics – Some people are just more prone to developing periodontal disease and peri-implantitis
  • Stress – Stress can lead to a general reduction in overall body health meaning your ability to heal is reduced. Stress can also mean you grind your teeth more.
  • Bruxism – Teeth grinding
  • Poor diet – A poor diet can also affect your body’s ability to heal itself leaving you more inclined to gum disease which then leads onto periodontal disease

The early warning signs

One of the earliest warning signs of periodontal or periimplant disease is gum disease or gingivitis. Periodontal and periimplant disease are the progression of gum disease which hasn’t been treated. Gum disease is an infection of the gum whereas periodontal or periimplant disease are an infection of the surrounding support structures around either the tooth or the implant.

Therefore the early warning signs include:

  • Puffy or red gums around the tooth or implant
  • Bleeding upon mild brushing around the gum or implant
  • Persistent bad breath.
  • Gums that are receding making the teeth look along.

Whether the signs appear around a natural tooth dental implant it’s important that the early warning signs are treated. If you end up with periodontal disease you can end up with tooth loss… Tooth replacement can then be quite expensive! The same can be said if you have gum disease around a dental implant, ultimately this could lead to failure of the implant and bone loss.

If the dental implants fails is it worth getting another?

Complete failure and loss of the dental implant happens in less than 3% of cases so it is fortunately quite rare. You should always have a discussion with your dentist about the reason the implant failed, if the reason can be clearly identified and resolved i.e. smoking, poor oral hygiene, teeth grinding etc then yes, it is probably worth having another dental implant.

If the reason for the implant failure persists then it may be wise to look for alternative ways to replace the missing tooth/teeth.

Is it possible to completely cure peri-implantitis?

Research published in 1994 using techniques modified from the periodontal arena have shown that the best way to treat peri-implant problems is to

“…arrest the progression of disease and to achieve a maintainable site for the patient’s implant”

The study goes on to say that

“Bone regeneration is possible in selected peri-implant bony defects when appropriate surgical techniques are used, implant surface preparation is achieved, and the cause is eradicated.”

It therefore is possible to treat periodontal disease and dental implant failure with skilful dental and surgical techniques.

Dr Lage has a special interest in Implant Dentistry, Mercury free Dentistry, Root Canal Treatments (Endodontics), and Cosmetic Dentistry (crowns, bridges, veneers, teeth whitening).

He is very calm and very good with children and nervous patients.

Jose speaks English, Portuguese and Spanish and is trying to improve his Italian and French.

What is the best type of dental filling?

What is the best type of dental filling?

As with many things in dentistry and in life the real answer to this question is, it depends. The best type of dental filling depends upon:

  1. The clinical situation.
  2. Your views about the different materials.
  3. Your budget.

In some instances your dentist will prefer to design a dental filling to protect any remaining tooth structure. If this is the case they may turn of filling into what is known as an overlay. An overlay covers any remaining tooth cusps and can protect them from the bite.

Very often this type of dental filling/overlay is made out of porcelain.

Because porcelain is made by a dental technician they can be more expensive than other types of dental filling.

Gold fillings can also be made, once again these are made by a dental technician so have increased cost which added to the cost of the gold can make them quite an expensive alternative.

Composite resin can also be used. These type of composite fillings Are what are known as white fillings. Tooth colored composite fillings are also often used if you want old amalgam fillings replaced. 

Amalgam fillings are not used as much as they used to be. This type of filling material is often associated with mercury poisoning and general health problems. For this reason amalgam fillings are often replaced. There is much written about the science behind amalgam filling replacement, However even the American Dental Association still recommend the use of amalgam.

Glass ionomer can also be used as a white filling, this type of filling material will release fluoride slowly.

Common questions asked about dental fillings.

What is the difference between root canal and teeth filling?

Very simply a dental filling is only in the enamel and dentine of your tooth. The dentist will remove any decayed area and replace it with the dental filling. Root canal is when the nerve of the tooth is removed, this is a much more involved procedure and is often done by a specialist known as and endodontic.

Is it possible to develop a cavity under a filling?

Yes. Good oral health is key to preventing this although fillings, inlays or onlays can leak over the years allowing bacteria and therefore decay to take hold. Unfortunately there is often nothing that can be done about this and the filling simply needs to be replaced. You may find you have the early warning signs of this if you have sudden onset of tooth sensitivity in an area where you have a dental filling.

Can you eat with a temporary filling?

Yes. We do however recommend sticking to food which is not too sticky or chewy. If the temporary filling is towards the front of your mouth then you may also want to avoid food which can sustain for example curry, red wine or lots of tea. The composite material does have a tendency to stain.

How long does it take a dental filling to harden?

Most tooth colored fillings are cured using a high-intensity light in the dental practice, this ensures they have a primary hardening immediately. They do however continue to harden for a little while after although the bulk of this is done within 10 min.

What do fillings on front teeth look like?

A good filling on a front teeth will not look like a filling at all! A good dental filling will blend in so that you don’t even know it exists. This of course will only happen with a tooth coloured filling.

Is a dental filling a very painful process?

No. You will always have a local anaesthetic to numb the area. Also it is recommended that you ask your dentist for a topical anaesthetic first. A topical anaesthetic gel, applied on the end of a little cotton will bud will numb your gum, will numb the area prior to having a dental injection. This means that you can have the injection with no sensation or feeling at all. This should ensure that the whole dental filling procedure is relatively pain-free.

You may experience some mild discomfort as the truth numbness wears off, particularly around where the dental injection was given. This however should be mild discomfort at worst and will clear up after a couple of days

Can a permanent tooth filling stay for a lifetime?

Yes it is possible for tooth filling to last a lifetime however it is not usual. composite fillings tend to last 7 to 10 years whilst metal fillings tend to last 8 to 10 years although they can last up to 20 years. The most common reason that are filling needs to be replaced is due to decay which has managed to creep in around the edge of the filling where it meets the tooth. This can happen with any type of filling regardless of the material.

Are Composite Resin fillings better than Amalgam fillings?

Composite fillings don’t last quite as long as amalgam fillings generally however they are more aesthetic, more biocompatible and for this reason generally more accepted by patients.

Mercury Fillings

With a mercury filling in place

Mercury Filling After

After the mercury filling has been removed and replaced with a composite filling

Do amalgam fillings leak mercury

Amalgam fillings do not generally leak mercury once they are fitted. The critical times for mercury to escape from a filling is whilst the filling is being placed or especially during removal. This is why dental practice which specialises in amalgam filling removal will always use specialist equipment to ensure that any free mercury vapour is extracted away with a dedicated protocol for Mercury replacement.

Dr Lage has a special interest in Implant Dentistry, Mercury free Dentistry, Root Canal Treatments (Endodontics), and Cosmetic Dentistry (crowns, bridges, veneers, teeth whitening).

He is very calm and very good with children and nervous patients.

Jose speaks English, Portuguese and Spanish and is trying to improve his Italian and French.

How to find a good dentist

Finding a new dentist in Croydon can be a daunting and difficult experience, follow our top tips for finding the best dentist near you.

Questions to ask a new dentist

Relaxing at the dentistAre you focused on whole-body health?

A dentist that focuses on the entire body is far more likely to ensure that your dental health is looked after in the same holistic manner.

No one wants a dentist that simply pulls out a single tooth and takes no time to consider the implications on the other teeth or indeed the whole body.

With the use of amalgam now being clearly understood to have a detrimental effect on the body finding a dentist that is amalgam free could be important to you.

Are you a member of a professional organisation? If so which one?

Professional organisations such as Denplan or  Society for the Advancement of Anaesthesia in Dentistry (SAAD) can help to demonstrate that your dentist is keen to learn, develop and stay up-to-date with the most modern dental techniques. Who wants to go to a dentist that hasn’t been out of the dental practice for years and is still stuck in the 1970s?

Do you have recommendations from friends & family?

Asking a dentist to see recommendations from happy patients, their friends and family is one of the best ways to know if your dentist is a good one. If the dentist you have chosen cannot show these recommendations it might be the time to ask why!

Questions to ask once you have been to the dentist

Once you actually get to visit your new dentist it’s good to review the treatment and process, here’s what we recommend you think about.

Was everything explained to me in a manner that I found acceptable?

When you initially went the dentist did you complete your medical history and questionnaire form in a confidential manner and what it all explained to you. Did the dentist communicate with you in a way that you found relaxing and calming?

Was the dentist wearing magnification equipment?

When working in your mouth a dentist should really be using some form of magnification, in order to be able to see the finest details in your mouth and spot the earliest signs of gum disease and dental decay magnification loupes are a vital accessory.

Was I comfortable?

Were you made to feel comfortable in the dental chair? Did they ask if you were warm enough? Were you offered head and neck rests? Did you get to choose the music you listen to or were you even asked?

Relax at the dentist

All of these things can help you relax and feel calm and whilst not crucial to the dentistry itself can help you feel more comfortable.

Did the reception team welcome me to the practice?

When you initially arrived did the reception team look up from the work they were doing and welcome you? If they were on the phone did they politely asked the person on the phone to wait one moment whilst they spoke to you? Or were you completely ignored for some considerable time?

Was the treatment explained prior to going ahead?

Every good dentist should explain treatment beforehand, many times you should also be given a full treatment plan explaining what will happen with associated costs… Did you receive this?

Personality traits to watch out for in a good dentist

A good communicator

Being able to communicate with you is a vital trait of a good dentist, a dentist that can speak to you in words that you can understand and in a way that makes things simple and easy to follow and comprehend.

a person that is easy to talk to

If you have found a good dentist and wish to stay with them in the long-term you may find that sometimes treatment can be uncomfortable. You may also be anxious or nervous about a particular treatment, so having a dentist that is easy to talk to and approach about your concerns can help set your mind at rest.

trustworthiness

If someone says they are going to do something it’s good to know that they are going to do it. A dentist that you can trust to do what they say and keep to the timings they promise will also help to keep any anxieties at bay.

someone that focuses on detail

Teeth are rather small and tiny and are a little detail in our body… You will therefore want a dentist that focuses on this tiny detail. Sometimes when people explain things they go into extreme detail, this is actually a good trait for a dentist to have and it will be worthwhile looking out for this.

artistic and creative

If you have to have some natural tooth structure removed due to disease or decay you want to have a dentist that has a creative and artistic side in order to rebuild that tooth in a natural and holistic way. Even looking out for then natural creativity and artistic flair with paintings on the wall could be a good way to understand if your dentist is artistic.
excited about what they do

Yes, it is possible for people to get excited about teeth! If your dentist talks in an excited manner about helping you maintain your dental health then you may just found the best dentist!

Image source: freedigitalphotos.net

Dr Lage has a special interest in Implant Dentistry, Mercury free Dentistry, Root Canal Treatments (Endodontics), and Cosmetic Dentistry (crowns, bridges, veneers, teeth whitening).

He is very calm and very good with children and nervous patients.

Jose speaks English, Portuguese and Spanish and is trying to improve his Italian and French.