What is peri-implantitis?
Peri-implantitis usually begins when bacteria or food debris becomes lodged around an implant. That accumulation allows plaque to form and harden, which in turn attracts further plaque. It reacts with the soft tissue around the implant, and symptoms such as swelling or bleeding when brushing start to appear.
Left untreated, the gum begins to pull away from the implant and the infection can spread to the bone. Once it reaches the bone, it weakens the connection between the implant and the jaw, and can eventually loosen the implant entirely. In simple terms, it is gum disease affecting an implant rather than a natural tooth.
If you suspect you have it, see your dentist promptly, so it can be properly assessed and a course of action agreed. Treatment can range from antibiotics and thorough hygiene through to surgical cleaning of the implant surface.
Signs to look for
The early signs are easy to dismiss: bleeding when you brush around the implant, gums that look red or puffy, tenderness, or a bad taste that will not shift. Later signs are more serious, including gum recession around the implant, visible threads, discomfort when biting, and in advanced cases movement of the implant itself. Implants do not feel pain in the way a natural tooth does, which is precisely why problems can progress further than you would expect before you notice them.
What causes implant infection?
The most common cause is plaque accumulation, which comes down to how well the implant and the tissue around it are cleaned. Other contributing factors include smoking, a history of gum disease, poorly controlled diabetes, excess cement left behind after the crown was fitted, and a restoration that is difficult to clean around. A previous history of periodontitis is one of the strongest risk factors, which is why we take it seriously in planning.
What happens during treatment?
We start by assessing the extent of the problem, measuring the pocket around the implant and taking an X-ray to see whether bone has been lost and how much. That determines what follows.
Where the infection is confined to the soft tissue, treatment is non-surgical: thorough cleaning of the implant surface, removal of any plaque and calculus, and sometimes a course of antibiotics, followed by a tightened hygiene routine and close monitoring. Where bone loss has occurred, surgical treatment is needed to access and decontaminate the implant surface properly, and in some cases to regenerate lost bone around it. Treatment ranges from around 30 minutes to five hours depending on the case, with recovery of one to 14 days.
Will I need a new implant?
Not necessarily. Caught early, most implants can be saved and kept in function for years. The likelihood of saving it depends on how much bone has been lost and how well the infection responds. Where the implant has lost too much support to be stable, removal and replacement is the honest answer, and we will tell you that rather than treat something that will fail again.
How to prevent implant infection
Prevention is straightforward but it is not optional. Clean around the implant daily, using interdental brushes or implant-specific floss as well as a toothbrush, since the margin where the restoration meets the gum is where the trouble starts. Attend regular hygiene appointments so plaque and calculus are removed professionally, and keep up your routine check-ups so problems are caught while they are still small. If you smoke, stopping makes a measurable difference to implant survival. If you have a history of gum disease, your maintenance schedule matters more than most.
Who is suitable for treatment?
Almost anyone with an infected implant should be assessed, and the sooner the better. What varies is the treatment, not whether you are a candidate for it. The important thing is not to wait: peri-implantitis does not resolve on its own, and the difference between a hygiene-led fix and surgery is often just a matter of months.
