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 cosmetic dentistry and what treatments does it include?

What is cosmetic dentistry and what treatments does it include?

Cosmetic dentistry is often considered a standalone aspects of dentistry however, it possible for all dentistry to be cosmetic and for everything to look good as well as keep your teeth healthy and in great condition.

What follows is an overview of treatment is normally assigned to the category of cosmetic dentistry, we’ve listed them by dental problem rather than by specific treatment, this allows you to find the best cosmetic solution for you.

How can I straighten crooked teeth?

Straightening crooked teeth can be done with a variety of different treatments depending upon the level of correction required, timeframe and cost.

  1. Dental bonding
    1. Timeframe: immediate, dental bonding can be applied in the dental chair whilst you wait.
    2. Level of correction: usually only suitable for a couple of teeth at a time, mild correctional changes only can be made.
    3. Cost: Low – from £99/tooth
  2. Dental veneers
    1. Timeframe: usually 2 or 3 weeks from start to finish.
    2. Level of correction: dental veneers can treat fairly extensive crooked teeth, but because the teeth are not moved bodily this is still limited.
    3. Cost: medium/high Depending on the number of teeth to be corrected – from £598/tooth
  3. Orthodontics
    1. Timeframe: anywhere from six months to one year
    2. Level of correction: Orthodontics give the highest level of correction and can be achieved with orthodontics as the teeth are moved bodily from their crooked or misaligned position to their new position.
    3. Cost: medium/high. Treatments typically start from £1650

How can I whiten dark teeth?

Whitening dark teeth can also be achieved with a variety of treatments, depending upon the amount of whitening required.

  1. Air abrasion and/or polishing
    1. Regular dental hygiene appointment can remove surface stains of teeth quite quickly, particularly good for smokers stains.
    2. Cost: from £50 per appointment
  2. Teeth whitening
    1. Teeth whitening can whiten teeth to your desired colour, usually in a couple of weeks.
    2. Cost: from £259 per arch (top or bottom)
  3. Dental bonding
    1. Bonding can lighten a single tooth if that tooth has become dark, perhaps due to an underlying problem with the tooth, decay or root canal treatment. This is often only possible if the tooth is set back from the other teeth as the bonding will form a liar over the surface of the tooth.
    2. Cost: Low – from £99/tooth
  4. Dental veneers
    1. Dental veneers can lighten extremely dark teeth which cannot be lightened adequately with teeth whitening.
    2. Cost: from £598/tooth

How can I replace missing teeth?

Missing teeth are unsightly and can affect confidence, they can also be a trap for food which can lead to dental decay. Adjacent teeth can also drift into the gap meaning that, over time, your bite can be affected.

The options to replace missing teeth will depend upon the convenience, cost and number of teeth to be replaced.

  1. Dentures
    1. Convenience: usually the least convenient option as the teeth are not fixed permanently and the dentures can become loose overtime requiring continuous maintenance. Dentures can have a tendency to fracture if not maintained although repair is usually quite simple.
    2. Cost: usually the cheapest option with acrylic dentures starting from £400
    3. Number of teeth: Dentures can be used to replace a single missing tooth right way through to replacing all missing teeth.
  2. Dental implants
    1. Convenience: the treatment can take up to one year to complete but once done, so long as the dental implants are looked after they can be an exceptionally good way to replace missing teeth as they support the teeth either side and can help to prevent further bone loss.
    2. Cost: From £949 per implant to have a dental implant placed and then from £629 per tooth to have the implant restored with a crown. Pricing can be a little complex due to the number of variables.
    3. Number of teeth: It is not always required to have one implant her tooth which need replacing, for example often six teeth could be replaced with two dental implants. Implants can replace anything from a single missing tooth up to a full mouth.
  3. Dental bridges
    1. Convenience: treatment usually takes approximately 2 weeks and once done, so long as the bridge is maintained can last many years.
    2. Cost: from £498 per tooth
    3. Number of teeth: bridges require standing teeth as this is where the new. It will be attached. Therefore in order to have a classic dental bridge (without implants) you need to have existing teeth either side of the gap. To replace a single missing tooth is easy with a dental bridge. In order to replace multiple missing teeth it’s usually only possible to replace three standing teeth in a row, a healthy tooth needs to be at each end of these three teeth. If this is not the case then either a denture or dental implant may be required.

 

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.