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Gum Problem Around Dental Implant

A gum problem around and implant can be the beginning of the end for the implant.

Gum On Implants VS. Teeth

Because dental implants are not teeth they behave differently than natural teeth.  Dental implants need extra thick gums.  They also need as much gum as possible around them.  This may be more important than the bone foundation!

In this video I described 2 types of gum tissue that we all have.  There is a proportion of “good gum” that is attached and strong, versus loose gum that is found closer to our lips.

Symptoms Of Gum Problems Around Implants

If you are experiencing redness, receding gumline, tenderness, pain, bleeding, pockets, inflammation around your implant there is likely a gum problem.  These are the common symptoms of a gum problem around dental implants. Of course brushing it very well will help but if the gum is not healthy it likely needs to be surgically corrected.  

Gum grafting can correct some of the problems.

This video is really important so take a few minutes to watch it!

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry
Burbank, California

Video transcription:

Hello, I’m Dr. Ramsey Amin. The topic today is gum problem. I have a gum problem around my dental implant. That’s something we see a lot of, and we’ll begin to see more of over time, not because dental implants are bad, but sometimes they’re not treatment planned appropriately, and sometimes, genetically, our gums are little thin. So, we might have enough bone, and that’s oftentimes the focus, bone, bone, bone. You don’t have enough bone, but the reality is it’s the gum that provides the life and longevity to dental implants, so let’s get into this topic a little deeper. If you’re having a gun problem with your implant, it’s probably red. It probably hurts. It probably bleeds. It probably is inflamed and just looks a little funny or just kind of tender when you brush. Those are things that aren’t normal.

There’s two types of gums to have around our mouth. I’ll kind of show you my own teeth here. We have the light pink gum that’s right near the surface of our teeth, and that’s really durable. It’s kind of like the surface of our… the skin of our hand or palm. It’s very dense. You can beat it up, and it can take a lot. The other type of skin is the one under our lip, really low, like down in here, this pink stuff with all the veins in it, and it moves around a lot. That gum is more like the skin around our eyelid. It’s very, very tender and very thin. So, we have two types of gum in our mouth, that thick, attached, keratinized gingiva we call it. That’s the thick stuff. Then, we have the thin, mobile gum tissue that allows our lip to move and to make these motions. I know I kind of look funny doing this, but I want to get the point across.

Really, if your implant doesn’t have enough of this good gum around it… Of course, it has to have bone, but if it has this good gum around it, it can often make up for not enough bone around an implant and really hold it stable over time. So, a gum problem can be remedied by a gum graft if it’s done soon enough. Sometimes I do them before the implant. I actually add gum through some way. I can borrow gum from the inside and transfer it to the outside, or I can rotate some of the fat from our cheek and bring that in.

Or, sometimes it’s done before the implant. Sometimes it’s done during the implant. Sometimes we have to do it after the implant, although we’d like to do it before as much as possible so that we don’t have a problem. The sooner it gets done, the better. Once you begin to lose bone around the implant, the success of a gum graft, bringing back that good skin, is less successful, and that skin or that gum comes from the roof of our mouth over here, usually on the side, on the upper right, our left side, or right behind our wisdom teeth on the upper. It’s called a tuberosity. It’s got a lot of dense gum, like this hand skin.

So, that could be transplanted, basically placed underneath there, stitched in place. It’s a very delicate and precise procedure, especially around an implant done with very, very fine suturing we call microsurgical. Some of these I call oral plastic surgery procedures, and they will help bring back maybe a tooth that looks too long, or it doesn’t have the gum on either side. Not all teeth are correctable this way. Sometimes I wish that we could correct all of them. In fact, I see 35% of what I do our revisions and redo procedures, so I’m kind of sometimes the last guy people see when there’s really a big problem. Obviously, if we can do it right the first time, but some people genetically just have very thin gum. They don’t have any of that good skin. They just has really nothing at all, and they’re maybe not a great dental implant candidate, or at least they need to go through more procedures to get a good, solid, long-lasting result.

Sure, anybody can put an implant in, and anybody can make the teeth, or do an All on 4, or whatever, but longevity to these procedures. I have cases that are 20 years old at this point, and I’m proud of them, and it’s because they’ve undergone a really good treatment plan, really good execution as well. If you have a gum problem, the bottom line is treat it early. Probably have a gum graft using your own gum as opposed to a synthetic or cadaver type of gum. It’s called AlloDerm.

Those are other options, not quite as good. They’re better for teeth. Gum grafting around teeth is much easier, does not require as much technical expertise. Gum grafting around implants is definitely a very specialized methods, and techniques, and tunneling. We don’t always open the gum. We just make a tunnel and put it through in that direction. So, again, give some consideration to that. If you’re having a gum problem, treat it early. Feel free to ask them questions on this post over here, and I’ll try to get to them as soon as I can, but certainly get yourself taken care of.

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About Ramsey Amin, DDS

Dr. Ramsey Amin has extensive experience in surgical and restorative implant dentistry. As one of only less than 400 Diplomates of the American Board of Oral Implantology/ Implant Dentistry (ABOI/ID) he is considered an expert, and board-certified in dental implants. He is a former instructor at the UCLA School of Dentistry.