If you have recently lost a tooth or extracted a tooth, you might be looking forward to placing a dental implant immediately to replace your missing tooth. Your excitement and enthusiasm is normal.
However, while looking for dental implant providers, you might have found out from your dentist that you are unable to do so because of active gum disease. Your dentist then advises periodontal treatment and a waiting period of at least 3 months before reviewing whether you are suitable for dental implants.
In disbelief and even mild irritation, you might have approached another dental clinic hoping that they will give you an answer you are looking to hear.
When visiting the second clinic, you are also told that it is not advisable to place implants when having gum disease. This dentist might have also told you that you might require bone grafting in addition to your gum disease treatment. This irritates you further because it means additional cost and a longer waiting period before you get your tooth replaced!
You scour and approach other dental clinics hoping that one will accept you and restore your teeth at the fastest speed. For some patients, their implants journey starts with marked resignation at knowing that they will require a longer duration to receive a new tooth.
Everyday, I meet patients who look forward to restoring their teeth immediately but are unable to do so because of poor gum and bone health. If you somehow find yourself in a similar predicament, this article has been written to help you understand why patience is going to be your best virtue when it comes to placing dental implants.
What is Gum Disease?
Gum disease is otherwise known as periodontal disease. Unlike most diseases that have more overtly obvious symptoms, gum disease can be a silent killer (literally). It is also often the most overlooked disease until it is too late.
Advanced gum disease (periodontitis) is not treatable but can be managed.
Some of the symptoms of gum disease include:
- Bleeding gums
- Red gums
- Inflamed gums
- Receding gums
- Persistent bad breath
- Loose and shaky teeth
- Lingering bad taste in the mouth
Placing an implant with gum disease present can be similar to placing a plant in spongy and sandy soil. The plant is unable to properly take root and establish a firm base. This can lead to infection that can lead to implant failure.
What Causes Gum Disease?
Contrary to popular belief, gum disease can be caused by a variety of reasons, some of which cannot be controlled by a patient.
I often see patients who are shocked when they find out about their gum disease prognosis as they brush, floss and even rinse their mouth with mouthwash every day. Many even pay regular visits to a dentist for dental maintenance.
Gum disease is not just because of poor oral hygiene. That is just one of the many factors.
The following are some of the most common causes of gum disease:
- Bad oral hygiene
- Poor oral hygiene habits (e.g. smoking, vaping)
- Dry mouth (xerostomia)
- Genetics
- Chronic health conditions (e.g. diabetes)
- Certain medications that have to be taken long-term
- Hormonal changes
If you have found out that you have gum disease because of any of the aforementioned reasons, there is no need to be disheartened. It is possible to treat gum disease in the early stages or manage it in the more advanced stages.
Early stages of gum disease act as a warning flag for you. Early diagnosis and treatment are the key ways of preventing your gum disease from advancing. It can also help you retain more teeth so that you avoid extensive use of dentures or dental implants.
How Can I Treat Gum Disease?
You can treat gum disease effectively with a combination of different home and professional techniques, depending on how severe your gum disease is.
For early-stage gum disease, it is still possible to use the following techniques:
- Scaling and polishing with a preferred dentist near you
- Brushing and flossing at least twice a day with fluoridated toothpaste
- Rinsing with an antiseptic mouthwash
- Quitting smoking (if you are a smoker)
- Having a healthy and balanced diet
- Doing saltwater rinses to help get rid of bacteria
If your gum disease has advanced, you might require further professional assistance:
- Scaling and root planning to remove plaque and tartar (calculus) from above and below your gum line
- Medications like antibiotics to control bacterial infection
- Flap surgery to reduce gum pocket depth
- Bone or tissue graft to restore lost tissue.
Pay a visit to your preferred dentist if you suspect that you are having gum disease. Early intervention can prevent costlier dental treatments like extensive dental implants. It can also prevent prolonging the duration of your dental implant treatment, should you require tooth replacement.
What is the Impact of Gum Disease on Dental Implants?
Gum disease has a direct and destructive effect on dental implants because both natural teeth and implants rely on healthy gums and bone for support.
When gum disease is active, the gums are inflamed and infected. The bone that anchors teeth (or dental implants) also begins to deteriorate. This creates a hostile environment for any implant to heal and integrate.
Here are the main impacts gum disease can have on implants:
- Poor Osseointegration (Implant Not “Taking Root”)
- For an implant to succeed, it must fuse with the surrounding jawbone through a process called osseointegration. Gum disease disrupts this healing process, leaving the implant unstable.
- The outcome can be early implant loosening or outright failure within months of placement.
- For an implant to succeed, it must fuse with the surrounding jawbone through a process called osseointegration. Gum disease disrupts this healing process, leaving the implant unstable.
- Increased Risk of Peri-implantitis
- Peri-implantitis is essentially gum disease around an implant. It causes inflammation, infection, bone loss, and eventual implant failure.
- Patients with untreated gum disease are at significantly higher risk of developing peri-implantitis.
- Peri-implantitis is essentially gum disease around an implant. It causes inflammation, infection, bone loss, and eventual implant failure.
- Bone Loss and Implant Instability
- Gum disease gradually destroys the jawbone. Without sufficient bone density and volume, an implant lacks the foundation it needs to remain secure.
- Even if an implant is placed, ongoing bone loss can cause it to loosen or fall out over time.
- Gum disease gradually destroys the jawbone. Without sufficient bone density and volume, an implant lacks the foundation it needs to remain secure.
- Shortened Implant Lifespan
- Gum disease undermines the long-term success rate of implants. Instead of lasting 10–20 years (or longer), implants in diseased tissue may fail prematurely, sometimes within the first year.
- Gum disease undermines the long-term success rate of implants. Instead of lasting 10–20 years (or longer), implants in diseased tissue may fail prematurely, sometimes within the first year.
- Higher Cost and Complexity of Treatment
- Ignoring gum disease before implant surgery often leads to additional corrective procedures later (e.g. bone grafts, flap surgeries, or even implant removal and replacement). This can triple the cost compared to treating gum disease first.
- Ignoring gum disease before implant surgery often leads to additional corrective procedures later (e.g. bone grafts, flap surgeries, or even implant removal and replacement). This can triple the cost compared to treating gum disease first.
Placing implants when gum disease is present is not just risky! It is often setting yourself up for disappointment. Treating gum disease first creates a healthy environment where implants can integrate successfully and last for years, protecting your investment and your smile.
Can gum disease affect my dental implants?
Yes, if you are looking for treatment longevity, gum disease reduces the longevity of your dental implants. It can cause your dental implants to fail and drop out.
The thing is, it is not impossible to place an implant while you have gum disease. If your dentist has advised against doing so, they are not trying to be difficult, they are just trying to protect your investment.
How Do I Become a Suitable Candidate for Dental Implants?
You can become a suitable candidate for dental implants if you have good oral hygiene and health, strive to head to your dentist every 6 months for dental maintenance, do not have any pre-existing gum and dental conditions and have sufficient bone density in your jaw to support the implant.
Dental implants might be cheaper with Medisave subsidies, but they are still a long-term investment that can become a hassle to repeat.
Here are the key factors that can improve your suitability for dental implants:
- Healthy Gums
- Your gums should be free from active gum disease (gingivitis or periodontitis).
- If gum disease is present, it must be treated and stabilised first, otherwise the infection can spread to the implant and cause failure.
- Your gums should be free from active gum disease (gingivitis or periodontitis).
- Sufficient Bone Density
- Implants need solid bone to anchor into. If you have had bone loss from gum disease, missing teeth, or other factors, your dentist may recommend a bone graft to rebuild support before implant placement.
- Implants need solid bone to anchor into. If you have had bone loss from gum disease, missing teeth, or other factors, your dentist may recommend a bone graft to rebuild support before implant placement.
- Good Oral Hygiene Habits
- Brushing twice a day, flossing daily, and attending regular dental check-ups are essential.
- Patients who commit to maintaining oral hygiene greatly increase the success rate of their implants.
- Brushing twice a day, flossing daily, and attending regular dental check-ups are essential.
- Stable Overall Health
- Conditions such as uncontrolled diabetes, heavy smoking, or certain medications can affect healing and implant success.
- Having your general health well-managed improves your chances of long-term implant survival.
- Conditions such as uncontrolled diabetes, heavy smoking, or certain medications can affect healing and implant success.
- Non-Smoker (or Willing to Quit)
- Smoking restricts blood flow and slows healing, making implant failure more likely.
- Many dentists strongly advise patients to quit before starting implant treatment.
- Smoking restricts blood flow and slows healing, making implant failure more likely.
- Commitment to Long-Term Care
- Dental implants are not a one-time procedure. They require ongoing care.
- Regular professional cleanings, reviews every 6 months, and proper home care are non-negotiables if you want your implants to last.
- Dental implants are not a one-time procedure. They require ongoing care.
You can certainly place dental implants even with active gum disease but risk having almost immediate dental implant failure.
While it is technically possible to place a dental implant when gum disease is present, doing so is like building a house on unstable ground.
Gum disease destroys the very foundation, your gums and bone, that implants rely on for long-term success. Placing an implant without addressing active gum infection dramatically raises the risk of infection, bone loss, and near-immediate implant failure.
This is why most responsible dentists will recommend treating gum disease first, sometimes along with procedures like bone grafting, before considering implant placement. Although this process may feel frustrating, costly, and time-consuming, it is designed to protect your long-term oral health and ensure that your implant investment does not go to waste.
The best path forward is patience: Resolve gum disease early, restore gum and bone health, and then move ahead with implants.
By following this route, you significantly improve your chances of enjoying strong, healthy, and lasting dental implants, rather than rushing into a quick fix that may fail before it even has a chance to succeed.
