You feel great about your new smile, thanks to dental implants! And you may also be feeling relief as the problems with your former teeth fade into the past.

But that doesn’t mean you can drop your guard on periodontal (gum) disease. Even though implants are impervious to decay, the natural tissues supporting them are vulnerable to periodontal (gum) disease. If they become diseased, your implants could lose their bone support and eventually fail.

And that failure could happen quickly. That’s because, as life-like as they are, implants don’t have one important advantage of real teeth: an attachment to a connective tissue called the periodontal ligament. This tough but elastic ligament lies between the teeth and the bone, attaching to both with tiny extending fibers and holding the teeth in place.

And that’s not all: Because the periodontal ligament contains an abundance of blood vessels, it can supply antibodies to help fight infection. The body’s defenses may not be able to stop disease, but they can certainly inhibit its progress.

Implants can’t benefit from this infection-fighting mechanism. So, when an infection arises in the gums surrounding an implant, it can spread rapidly through a form of gum disease known as peri-implantitis (literally “inflammation around an implant”). If we don’t stop it with prompt treatment, you could lose bone support from your implant and eventually lose it, sometimes in quick fashion.

That’s why you should clean your implants everyday like you do the rest of your teeth with brushing and flossing. You should also visit us regularly for dental cleanings. A dental cleaning involving implants is similar to one with natural teeth, except the hygienist won’t use metal instruments on the implants—this could create tiny scratches on their surface. Instead, they’ll use nylon or plastic instruments or ultrasonic equipment to clean them.

You should also make a dental appointment as soon as you notice swollen, reddened or bleeding gums. If you have gum disease, we can stop the infection through treatment and restore your gums to health. This can be a long and involved process, but it’s necessary to preserve your implants.

It’s true that implants can change your life. If you want to enjoy that change for a long time, take care of your implants and the natural tissues that support them.

If you would like more information on caring for dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Maintenance.”

Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.

That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.

That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.

When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.

If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.

Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.

To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants After Previous Tooth Loss.”