Today’s dental implants are one of the best replacement options for missing natural teeth. Although they are the most stable tooth replacements we have today for missing natural teeth, patients need to understand that dental implant replacement teeth need to be cared for in a very specific way because they are not exactly the same as natural teeth. We explain to our patients that dental implants are a prosthetic, similar to a hip or knee replacement and require specific routine maintenance in order to provide long-lasting function in the harsh environment we call our mouth.
Regular recall visits to your dentist ensures that your dental implant replacement teeth, as well as the surrounding bone and gum tissues, remain healthy. It is definitely not a “set it and forget it” treatment. X-rays are an essential way to keep track of abnormalities that might occur around your dental implant. Your dentist will want to take x-rays every 12 to 18 months to ensure that your jaw bone is healthy around your dental implant. This x-ray protocol is unique to dental implants as the traditional probing you are familiar with around natural teeth cannot tell you 100% what is going on with the bone around a dental implant.
It is important for patients to understand why they need to be vigilant with their oral health care around dental implant replacement teeth. Through dental research, we have learned that the oral cavity and the bacteria that live inside our mouths needs to live in good balance. However, if preventive steps are not taken, bad bacteria can overpower the good bacteria and this creates chronic inflammation which then leads to bone loss and tissue health problems. The bacteria that sticks to things in the mouth is called biofilm. If there is disease forming bad bacteria living in your biofilm that then gets stuck to natural teeth or dental implant replacement teeth, the disruption and removal of this biofilm is imperative to avoid disease. Biofilm removal is most effectively done today with air polishing particles and a treatment known as air abrasion. These very fine particles are sprayed onto the biofilm, blasting the biofilm away. Picking at natural teeth and especially dental implant replacement teeth with traditional dental scalers or rubber wheel cups is not the most effective treatment for biofilm removal any more. Once bad bacteria has been controlled in the mouth, special treatment rinses as well as probiotics may be recommended to keep the mouth healthy long-term in addition to regular recall visits.
Dental implant replacement teeth should be monitored routinely for a disease called peri-implantitis, an infection that affects the bone and gum tissue surrounding a dental implant—It is the direct result of having biofilm disease hanging out around dental implants from poor biofilm management. Peri-implantitis is a disease specific to dental implant replacement teeth. It is the equivalent of periodontal gum disease around natural teeth. Both of these diseases will cause tooth loss.
The bone support around a dental implant is the foundation and the long-term support for health of your implant replacement tooth. If bone is lost and peri-implantitis sets in, this could cause you to lose your implant replacement tooth. Detecting early bone loss around a dental implant gives your dentist an opportunity to perform any early fix needed to keep your implant replacement tooth healthy.
Science confirms that disease causing bacteria doesn’t go away when a bad tooth is removed. So prior to dental implant treatment, patients with periodontal gum disease need to first get that under control. Today, dentists have many more tools than ever before to help determine bacteria presence and bacteria types that lead to other oral health problems. Simple saliva testing can be used to easily determine what kind of bacteria you have in your mouth. These test results will determine how prone you are to biofilm disease long-term, whether on your natural teeth or dental implant replacement teeth. Knowing what the bacteria profile is in your mouth also identifies your risk for other related health diseases like heart disease, high blood pressure, stroke, diabetes, neurologic diseases such as Alzheimer’s and dementia and in the worst case, your potential risk for sudden cardiac death. These diseases of health have been linked in the last decade to several oral bacteria that cause inflammation in our mouths. Having too much of a particular group of 5 high risk bad bacteria leads to mouth inflammation that will promote these other health problems. Ask your dentist about this as it can literally save your life.
Today, we also have access to additional tests that are easily performed in the office before a patient received dental implant treatment. These test results can be obtained while a patient is still in the office and they help to reveal conditions that affect the success of dental implant healing. For example, these tests include measuring for vitamin D deficiency and diabetes.
With science-backed office maintenance procedures and proper home care, dental implant patients can achieve good oral health and improved overall general health, helping to ensure their dental implant replacement teeth last for a long time. The longest dental implant health record we have in our clinic is 23 years, 7 dental implant replacement teeth placed in 2002 and still standing strong. In a January 2025 study published by the Brånemark Clinic in Gothenburg, Sweden, the survival rate of 23 dental implants they placed between 1982-1985 was 96%. The Brånemark Clinic is the place where dental implant treatment first originated so this literature of over 38-40 years now gives clinicians confidence to tell patients that dental implant replacement teeth can last a long time if placed properly and maintained diligently by both the dentist and the patient. “Permanent” is a relative term; how long your brand new car lasts will depend on how it was put together, then how you use it and take care of it. The same for dental implant replacement teeth; if you see an unqualified, inexperienced doctor, chew on inappropriate things and don’t take care of your implant replacement teeth properly as recommended, “permanent” will not be very long.
Looking for an implant dentist? The American Academy of Implant Dentistry provides education and keeps their members updated on the literature and any recent studies concerning implants. As well, there is a good support network in which dentists can work together to support each other. You can go to https://aaid-implant.org/ and find a dentist in your area.
James J Wu, DDS, FRCD(C) is a Clinical Assistant Professor, Department of Oral & Maxillofacial Surgery at Boston University School of Dental Medicine as well as a Clinical Instructor and the Scientific Advisor in Oral Maxillofacial Surgery for the Kois Center for Advancing Dentistry Through Science in Seattle Washington.
He is a member of the AAID and a Diplomate of the American Board of Oral Implantology since 2007. Upon completing the curriculum at the Kois Center, he completed the exam process to become a Mentor and was subsequently invited to be a Clinical Instructor there on a regular basis to mentor future generations of dentists looking to excel in their profession. Dr. Wu can be reached at drjames@mybrandnewsmile.com