Can I have dental implants if I have gum disease?

Doctor's Answers 2

Dental implants can also be affected by gum disease (peri-implant mucositis or peri-implantitis), similar to how natural teeth can develop gingivitis (reversible inflammation of the gums) or periodontitis (inflammation of the gums and loss of supporting bone).

Should you have been successfully treated for periodontitis AND successfully maintained for a period of time (to demonstrate stability), then you can consider dental implants.

Past periodontitis results in reduced bone volume in the edentulous site (where a tooth has been lost) and this may be even more pronounced if a denture has been worn for a long time. Implants require sufficient bone for short and long term stability, so bone grafting may be required.

If the soft tissues around the implant are not thick and firmly attached, movement of the surrounding soft tissues can cause plaque entrapment around the implant. This is usually the first step on the road to developing a peri-implant infection. Soft tissue grafting is needed for the long term health of the implant.

After the implant has been placed and restored (with a crown), you MUST commit to lifelong professional periodontal maintenance of both teeth and implants. If you fail to do so, it can result in implant loss and costly revision surgery (if sufficient bone is available). Yearly x-rays of the implants and bone are essential tools for monitoring implant stability.

Smoking and diabetes increase the risk for more severe gum disease (around teeth AND implants). Quitting smoking and having good diabetic control are part of overall oral health maintenance.

Not yet. Gum disease, or periodontal disease, is the irreversible loss of the bone and gums supporting your teeth. Therefore, ideally, your periodontal condition needs to be healthy (e.g. no bleeding while brushing, no plaque and tartar deposit, no gum recession), and to keep the gums healthy, you also need to understand your role in maintaining your oral hygiene. There are several ways to have healthy gums:

  1. Floss at least once a day
  2. Brush twice a day
  3. Have your teeth cleaned at the dentist once every 6 months
  4. Quit smoking
  5. Use fluoride toothpaste

Active periodontal disease needs to be managed and controlled. If not, it would lead to an infection developing around the implant and/or delayed healing, which in turn will cause implant failure.

Severe periodontal disease leads to permanent gum recession and bone loss. An implant requires sufficient healthy bone to integrate with. If there is too much loss of bone, there may not be enough to hold an implant, in which case an additional procedure - bone graft - may be required.

It is a must to ensure that oral hygiene is of a high standard before, during and after treatment, as the long-term success of implants depends on good plaque control.

However, not to worry, since periodontal disease is both preventable and treatable if appropriate action is taken. Before proceeding with implant treatment, please check for these early signs of gum disease

  • Bleeding Gums
  • Inflamed Gums
  • Receding gums
  • Gaps between teeth and gums
  • Constant bad breath and a bad taste in your mouth
  • Sensitivity of tooth or around the gums

If you experience any of these symptoms, it is recommended to see a dentist straight away. They will be able to examine whether or not you have gum disease and how advanced it is. The earlier it is caught, the easier it can be treated with less serious consequences.

Similar Questions

Why do different dentists disagree on whether I should have a root canal treatment or an extraction and dental implant?

Dentists choose treatment plans based on many different factors. Some of these factors have nothing to do with clinical data. As a patient, your dentist should go through the different treatment options with you so that you understand the treatment itself, and the long term maintenance required with that selection. Keeping the tooth by performing root canal treatment and a crown may mean that the tooth may still crack further and require extraction at a later date.

Photo of Dr Jaclyn Toh

Answered By

Dr Jaclyn Toh

Dentist

Should I get dental implants or braces for a front lower teeth gap due to removing baby teeth in my adulthood?

Losing a baby tooth later in life always presents as a dilemma for patients. Certainly a missing front tooth affects our confidence as it is in a visible region. This is often a multidisciplinary problem and best assessed by an orthodontist who work closely with a restorative dentist.

Photo of Dr Enrica Sham

Answered By

Dr Enrica Sham

Orthodontist

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