If you are experiencing bleeding after dental implants, it is critical to have an evaluation by a periodontist as soon as possible. Early intervention is key. As a periodontist, not only do I place implants, but I also help save implants. I often hear:
“There is bleeding around my implant when I brush. My dentist says ‘Let’s watch it.’ I don’t want to lose my implant. What should I do?”
A couple of things could be going on and they typically are Mucositis and/or Peri-implantitis.
Mucositis is a reversible inflammatory reaction in the soft tissues surrounding an implant. The symptoms are bleeding, redness and swelling around the implant. Common causes of mucositis are excess cement (from having the crown placed), and neglect. In my office, the Perioscope (a tiny fiberoptic camera designed to fit inside the gum crevice) can be used to look for retained cement. Once removed, the inflammation should improve. If the cause of the inflammation is neglect, my hygienist would coach you on your brushing, flossing, and WaterFlossing techniques. She would also likely air polish with a special glycine powder, and give you directions for using an inexpensive bleach solution for home use. She might also use her laser for pocket disinfection. My patients are encouraged to brush, floss, and WaterFloss around their implants daily. The purpose of all of this is to disrupt the bacteria that invade the gum tissue around the implant and detoxify the implant surface with the goal of stopping the disease process.
By treating mucositis early, it can help prevents peri-implantitis.
Peri-implantitis is a destructive inflammatory reaction affecting the soft tissues and the bone around an dental implant. The symptoms of peri-implantitis are similar to mucositis except in addition to bleeding, redness, and swelling, the bone around the implant has been partially destroyed, usually without any pain. There is usually an infection present. A dental professional can detect the bone loss with an x-ray and by checking pocket depths. Frequent causes of peri-implantitis are smoking, diabetes, neglect, previous history of gum disease, excess cement, and excess biting forces. Typically, once the disease process has reached this stage, surgical intervention is necessary. Often I can use my Erbium/ Nd:Yag laser for a minimally-invasive procedure. Sometimes a small incision is made in the tissue so that I can visually inspect the bony defect, and place grafting in the area to encourage the bone to grow back. The goal is to stop the disease process, reverse the bone loss, and save the implant.
If the bone loss and infection are so severe that the implant is loose or hopeless, the implant will need to be removed and the area grafted with material that stimulates your bone to grow. After three months I will recommend we take a 3-D x-ray to see if you have enough bone to place another implant.
Early detection and treatment are important for the future health of your implant. See your dental professional regularly and consider calling my office for a consultation.
Your partner in health,
Kip W. Saunders, DDS, MS