What are the symptoms of dental implant infection?

Risk factors for dental implant infection

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The most common causes of implant infection are:

• poor oral hygiene,

• smoking, and

• previous periodontal disease.

Proper implant aftercare is vital. If you do not brush and floss daily, you allow bacteria and fungus to enter and colonize your mouth. These gradually migrate towards the soft and hard tissues surrounding the implant. Infections may lead to a variety of dental implant problems.

Tobacco users have a higher concentration of the enzyme arginase in their saliva. It is argued that it lowers nitric oxide production. This makes saliva more acidic, creating a perfect environment for bacteria to thrive. Smokers are therefore more vulnerable to dental implant infections.

Patients with a history of periodontitis are also at higher risk. It certainly has to be treated before implantation can take place, but gum disease has a tendency to come back. Bone loss is likewise more prominent in such cases, leading to a larger rate of implant failure.

All in all, implant infection is almost always associated with patient-related risk factors. The following are worth noting, but the rate of infection caused by these is very low:

• hypersensitivity to titanium,

• systemic diseases like diabetes,

• excess amount of cement at the time of crown placement, and

• uneven distribution of biting force.

Dental implants infection symptoms

If you observe any of these signs, immediately contact your dentist:

• swelling around the implant,

• changes in the color of the gums,

• bleeding from the implant site,

• a loose implant,

• a fever,

• throbbing in your ear, and

• pain that does not respond to medication.

Harry Lee, DMD, explains: "One of the most significant insights from practice is that this disease is almost always silent at first. Patients do not feel pain, so they ignore the subtle bleeding or swelling—the key early warning signs, much like early gum disease."

"I warn patients that if they notice the gum color changing to a deep red or purple, or if they can feel the implant area weeping or bleeding when they brush, they need to call immediately," he stresses.

Soreness is relatively rare with implant infection, but if it is present, it usually indicates a severe problem. Other causes for concern are similar to those of sinus lift and bone graft infection.

If you experience any of these symptoms, search for emergency dental care near you immediately.

Dental implant infection symptoms also include a deep probing depth of the peri-implant pockets and gradual bone loss in the affected area. Those, however, can only be diagnosed by a professional such as a dentist or periodontist.

Stages of dental implant infection

Tooth implant infection can be described in two stages. The first is called peri-implant mucositis. When left untreated, it can transform into a more serious condition, peri-implantitis.

Both progress similarly to gum disease but may develop more rapidly. This is because the attachment of an implant is less durable than that of a natural tooth. Signs can even occur years after implant placement.

How to treat a dental implant infection

First, an X-ray will be performed to determine whether there is any bone loss. This is followed by periodontal probing. This allows for an accurate diagnosis of the infection stage. Then, the dentist will suggest a treatment plan.

The following are the most popular remedies. Usually, a combination is performed.

Mechanical cleaning

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Shallow mucosal pockets can be cleaned with an ultrasonic device or carbon fiber curettes. This is called sub-mucosal debridement. High-frequency waves allow the dentist to remove contaminated material around the implant.

If the mucosal pockets are 5mm or deeper, your dentist might suggest polishing with a rubber cup and paste, mechanical flossing, or delicate scaling instruments. In such a case, the instruments have to go deeper, and it is important not to roughen the rod's surface.

Mechanical debridement is often conducted in conjunction with locally administered antiseptics. This is done only if the pocket depth is greater than 4mm.

Surgical procedure

Surgical management of implant infection is generally performed when the rod is placed in a non-aesthetic site.

The gums are cut open and flapped back to allow better access to the contaminated area. A mechanical cleaning is performed, often in conjunction with antiseptics. This procedure is sometimes referred to as open-flap debridement.

This option comes with many potential complications. The exposure of porous membranes can lead to further infection, especially during the healing period. It should be performed only if other forms of treatment fail.

Dental implant infection antibiotics

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The dentist will examine the periodontal condition of the remaining teeth. Based on this information, he or she will determine whether to administer antibiotics locally or systemically.

If peri-implantitis is limited to the immediate vicinity of the implant and no other disease is present in the mouth, localized antibiotics might be prescribed. They will be distributed to the affected site for a few days.

If the infection spreads to a larger area of the mouth, antibiotics may be administered systemically. The same happens when the patient is simultaneously suffering from periodontitis.

Antibiotic treatment may have to be repeated within a few weeks or months.

Implant removal

If peri-implant mucositis has progressed to peri-implantitis and significant bone loss has occurred, the implant may need to be removed. This can be done with a surgical instrument called a trephine.

Alternatively, the dentist might decide to allow bone loss to continue until the implant can be extracted with forceps. This decision is made when there is less than 3-4 mm of supporting bone.

Some patients may qualify for reimplantation after bone grafting and several months of healing.