Patients with new dental implants may be able to detect signs of trouble early enough to help prevent complications that can damage gums and bone, a British study suggests.
When researchers asked 75 people who received dental implants in the past year if they had complications such as bleeding, pus or loose replacement-tooth “roots,” they expected clinicians to routinely catch problems that the patients missed.
But that didn’t happen.
Because the mouth is a very sensitive part of the body, it’s not surprising that patients and clinicians had a similar opinion about post-implant oral health, said Bruno Chrcanovic, a researcher in odontology at Malmo University in Sweden who wasn’t involved in the study.
That doesn’t mean patients are forever in the clear, however, or that all problems can be easily detected without regular dental checkups, he said.
“Some patients have the feeling that they understand the problem and can properly deal with it by themselves,” Chrcanovic said by email. “It is not always true.”
About 3 million people in the U.S. have dental implants, and another 500,000 implants are placed each year, according to the American Academy of Implant Dentistry.
Implants are artificial tooth roots – typically titanium posts - inserted into the bone of the jaw to replace missing teeth. An implant with an attached crown, functions like a normal tooth and can help preserve the jaw structure and prevent bone loss, unlike bridgework or dentures.
While generally safe, dental implant procedures, like any surgery, are not risk-free. Patients can develop damage to blood vessels, nerves, sinuses or other teeth. They can also get a serious condition known as peri-implantitis, a bacterial infection that can lead to inflammation around the post and bone loss.
The study, co-authored by Dr. Simon Wright of the Implant Centers of Excellence in the U.K., tested a hypothesis that patients can’t perceive the difference between successful and unsuccessful implants. Wright didn’t respond to emails seeking comment.
Patients who received implants from one of two dentists at the practice within the previous one to 11 months were asked to complete questionnaires and have an exam to see if their responses lined up with what clinicians saw in their mouth.
The patients ranged in age from 23 to 92 years old, and none of them was treated as part of the National Health Service, the U.K.’s publicly funded health system.
Researchers focused on five areas of post-implant health: aesthetics, loose restorations, bleeding or pus, fractured implants and what’s known as occlusion, when the upper and lower teeth collide when the mouth is closed.
On all five of these variables, there wasn’t a significant difference of opinion between the patients and the dentists, according to the results published in the British Dental Journal.
Patients perceived fractures in 5.3 percent of restorations, whereas dentists detected fractures in 1.4 percent.
For loose restorations, patients thought this of 14.7 percent of implants, while dentists found 13.3 percent of restorations to be loose.
With occlusion, patients reported this 1.3 percent of the time, but dentists found it during 5.3 percent of exams.
Patients may have been fairly accurate in assessing their own oral health because they were educated on the potential risks before implant surgery and then taught proper implant care after the procedure, the researchers note. The study is also too small to draw conclusions about a broader patient population.
Patients who aren’t well educated may struggle to spot complications and also be less likely to continue with routine checkups, said Dr. Frank Strietzel, an oral health researcher at Charity Medical University Berlin.
“If the patient will not follow the advice of the dentist, there is a risk of undetected inflammation around the implants,” Strietzel, who wasn’t involved in the study, said by email. “A dental implant is a foreign body like a prosthesis, which requires regular observation.”