Peri-implantitis: Causes, Signs, Treatment and Prevention of Inflammation in the Gum and Bone
Peri-implantitis is a condition in which the gum and jawbone surrounding an implant become inflamed. The Korea Disease Control and Prevention Agency (KDCA, 질병관리청) cites bad lifestyle habits such as smoking and poor oral hygiene as causes, and warns that the implant does not loosen even when the jawbone is severely destroyed, so the time for treatment is easily missed. In Korea, treatment and surgery for peri-implant disease arising 3 months after the prosthesis is placed are handled as National Health Insurance covered items regardless of age.
Key facts
| Definition | Inflammation of the gum and jawbone surrounding an implant (source: KDCA National Health Information Portal) |
|---|---|
| Main causes | Bad lifestyle habits such as smoking, and poor oral hygiene (source: KDCA National Health Information Portal) |
| Why it is found late | The implant often does not loosen even when the jawbone is severely destroyed (source: KDCA National Health Information Portal) |
| Health insurance | Treatment and surgery for peri-implant disease 3 months after the prosthesis are covered (including implants placed as non-covered, regardless of age) (source: National Health Insurance Service (NHIS, 국민건강보험공단) dental implant Q&A) |
| Check-ups for prevention | Regular check-ups every 3-6 months after treatment ends (source: KDCA National Health Information Portal) |
What kind of disease is peri-implantitis?
Bacterial film that builds up around an implant causes inflammation in the gum, and when this inflammation progresses downward, the jawbone holding the implant dissolves. The KDCA describes inflammation of the gum and jawbone surrounding an implant as peri-implantitis.
It looks similar to gum disease around natural teeth, but an implant has no tissue surrounding the root as a natural tooth does, so when inflammation spreads toward the bone it is harder to deal with. If a lot of bone is lost, the implant may have to be removed and placed again.
In the early stage, when the inflammation stays only in the gum, there is a good chance of reversing it with cleaning and care. That is why finding it at the stage before bone loss is the key to treatment.
What signs does peri-implantitis show?
In the early stage, the gum around the implant becomes red and swollen, or bleeds when brushing or using an interdental brush. As it progresses, pus may come out when the gum is pressed, there may be bad breath, and the gum may recede so the implant screw part shows.
The most important thing to note is that pain and looseness appear late. The KDCA explains that the implant does not loosen even when the jawbone is severely destroyed, so the time for treatment is easily missed. If you put off check-ups because it does not hurt, it will be found later.
- Redness and swelling of the gum around the implant
- Bleeding when brushing or using an interdental brush
- Pus coming out when the gum is pressed, bad breath
- The gum recedes and the metal part shows
Why does peri-implantitis occur?
The biggest cause is the bacterial film left around the implant. Around an implant the spaces between teeth are wide, so there are areas a toothbrush alone cannot clean, and plaque and calculus build up there.
The KDCA cites bad lifestyle habits including smoking, and poor oral hygiene, as the main causes. Smoking is also directly linked to implant failure, and poorly controlled diabetes slows recovery from gum inflammation.
People who previously lost teeth to gum disease should also take care of the gums of their remaining teeth. Repeated excessive force on the implant, such as from teeth grinding or clenching, is also checked at check-ups.
How are peri-implantitis treatment and insurance handled in Korea?
Treatment depends on the degree of inflammation. In the early stage, the bacterial film and calculus on the implant surface and under the gum are removed, and the home cleaning method is corrected. If bone has been lost, surgery that opens the gum and cleans the surface, or regenerative treatment, is considered, and if recovery is difficult, the implant is removed.
The National Health Insurance Service says that if treatment or surgery is done for periodontal disease around an implant after 3 months have passed since the prosthesis was placed, it is calculated under the corresponding covered item. The same standard applies, regardless of age, to implants placed in the past as non-covered. On the other hand, treatments related to prosthetic restoration, such as the cost of making a new prosthesis, are non-covered.
How is peri-implantitis prevented?
Every day, in addition to brushing, clean around the implant with floss and interdental brushes. The KDCA explains that because the spaces between teeth are wide around an implant, using such tools is essential.
Even after treatment ends, get a check-up every 3-6 months to check the gum condition and bone height, and receive a professional cleaning if needed. For smokers, quitting is the most reliable prevention. If you see blood or pus from the gum, get seen without waiting for the next check-up.
- After brushing, clean both sides of the implant with interdental brushes and floss
- Quit smoking if you smoke; manage blood sugar if you have diabetes
- Check-ups and professional cleaning every 3-6 months
- Discuss teeth-grinding or clenching habits with the dentist
Common myths and facts
Myth: If the implant is not loose, it is not peri-implantitis.
The KDCA explains that the implant often does not loosen even when the jawbone is severely destroyed. Looseness is a late sign.
Myth: Insurance for peri-implantitis treatment applies only to insured implants for people 65 and over.
Treatment and surgery for peri-implant disease 3 months after the prosthesis are handled as covered items regardless of age, including for implants placed as non-covered.
Frequently asked questions
If the gum around the implant bleeds, is it peri-implantitis?
Bleeding can be an early sign of inflammation in the gum around the implant, and if it continues for several days, more care is needed. Whether the inflammation is only in the gum or has progressed to the bone is confirmed by measuring gum depth and taking radiographs, so see a dentist.
Does peri-implantitis heal completely?
In the early stage, when inflammation stays in the gum, recovery is possible with cleaning and care. Bone that has already dissolved does not come back by itself, so the goal becomes stopping progression, and surgery or regenerative treatment is considered if needed. After treatment, check-ups are scheduled at tighter intervals to watch for recurrence.
Might the implant have to be removed because of peri-implantitis?
If a lot of bone has dissolved and can no longer support the implant, removal is considered. Whether it can be placed again afterwards is judged from the amount of remaining bone and the gum condition. If bone is lacking, it is supplemented with a bone graft, or other methods such as a bridge or dentures are compared.
What does peri-implantitis treatment cost?
Treatment and surgery for peri-implant disease 3 months after the prosthesis are billed under the covered item that fits the disease, so the copay is calculated at the ordinary treatment standard. Some parts may not be covered, such as materials used in regenerative treatment or remaking the prosthesis, so check item by item before treatment.
Can an implant placed at another dental clinic be treated too?
Yes. However, parts and tools may differ depending on the fixture product, so it helps to bring any records or product information from the clinic that placed it. When it was placed and the check-up records received since then also help in judging how far the inflammation has progressed.
Related topics
- Dental implants
- Implant care and lifespan
- Gum Disease Treatment
- Smoking and Gum Disease
- Diabetes and Gum Disease
- Gum Maintenance Interval