Plaque

Dental plaque is a sticky biofilm of bacteria that forms continuously on all surfaces in the mouth — teeth, implants, crowns, and gum tissue. It is the primary cause of both tooth decay and gum disease, and in the context of implants, the primary cause of peri-implantitis.

Plaque and implants

Plaque bacteria produce inflammatory toxins that trigger an immune response in the surrounding gum tissue. Around natural teeth, this causes gingivitis and periodontitis. Around implants, the same process causes peri-mucositis (reversible gum inflammation) and, if untreated, peri-implantitis (irreversible bone loss).

Why implants may be more susceptible

The junction between an implant crown and gum tissue is different from a natural tooth-gum junction. There is no junctional epithelium of the same structure, and the soft tissue seal around an implant is somewhat more vulnerable to bacterial penetration than around a natural tooth.

Control

Plaque is controlled by twice-daily brushing, daily use of interdental brushes or floss, and regular professional cleaning. Around implants, water flossers are particularly useful for cleaning under the crown at the gum margin where standard floss can be difficult to manipulate.