The implant was meant to last. The gum around it has started to talk back.

Peri-implantitis is inflammation around a dental implant that has progressed to involve loss of the supporting bone. Its earlier, reversible stage — inflammation of the gum tissue around the implant without bone loss — is called peri-implant mucositis.

Both are driven by bacterial biofilm accumulating on the implant surface, often combined with risk factors like smoking, uncontrolled diabetes, or excessive bite forces on the implant. The distinction between mucositis and peri-implantitis matters because the management approach and the prognosis differ. The earlier we catch and address inflammation, the more we can do about it.

The early signs are often subtle: gum around the implant that bleeds when you brush or floss, mild swelling or redness, occasional tenderness, or a change in how the gum looks compared with your other teeth.

As things progress you might notice a small amount of pus, persistent bad taste, deepening of the gum pocket around the implant, or — in late stages — the implant feeling different to bite on. Many cases are first picked up on a routine X-ray before there are noticeable symptoms. A clinical examination and a small targeted X-ray are how we confirm what's happening underneath.

An implant surface is engineered to encourage bone to grow into it — that same texture makes it very hard to clean once bacterial biofilm has colonised it.

Traditional metal instruments scratch titanium. Plastic instruments are limited by their geometry. Ultrasonic tips struggle to follow the threads of the implant. The Er:YAG wavelength is effective at removing soft tissue and biofilm from titanium without harming the surface. The Nd:YAG wavelength then penetrates further to disinfect the surrounding tissues. Used together, the combination is one of the most studied approaches to implant surface decontamination in the peer-reviewed literature.

The goal of treatment is to halt the disease process, settle the inflammation, and give the surrounding tissues the best chance of stabilising at their current level.

The outcome depends on how much bone has already been lost, the location of the implant, your general health, smoking status, control of any underlying conditions like diabetes, and how consistently you can maintain the area afterwards. Lost bone does not reliably regenerate. We will give you an honest, individualised read on what we think is achievable at your assessment, and we will not over-promise. Where the case is too advanced for a predictable outcome, we will say so.

We use local anaesthetic where useful to keep you comfortable throughout the appointment. Most patients describe the laser-assisted approach as gentler than the alternative — open-flap mechanical debridement — because the inflamed tissues can often be addressed without scalpel surgery in early-to-moderate cases.

Some tenderness for a day or two afterwards is normal and is usually well-managed with simple analgesics. We'll give you clear written aftercare guidance, including what to look out for and when to call us.

Plan for at least an initial assessment visit, one to two treatment visits depending on the severity of the case, and a structured series of review appointments — typically at three, six and twelve months.

Peri-implant disease is a chronic condition that requires ongoing maintenance, not a one-off fix. After the first year of structured reviews, we move you onto an individualised long-term supportive maintenance schedule. We will set out the full plan for you in writing after the assessment so you know exactly what to expect.

Sometimes the most honest assessment is that an implant has lost too much supporting bone — or is mobile — and trying to treat it would only delay an outcome that is going to happen anyway. In that case we will say so plainly.

We'll talk you through what removal would involve, the healing period that follows, and whether replacement is realistic — either with a new implant after a period of healing and any necessary grafting, or with an alternative restoration such as a bridge or partial denture. The decision is always yours, and we will support whichever path you choose.

Ongoing professional maintenance is the single most important factor. We typically recommend a structured peri-implant cleaning visit every three to four months in the first year after treatment, then individualised based on how the area is responding.

Daily home care around the implant is the other half — we'll teach you the technique and the products that work for your specific implant. Controlling risk factors like smoking, uncontrolled diabetes and excessive grinding, along with addressing any bite forces falling on the implant, are also part of a complete plan. Most recurrent peri-implant disease comes down to maintenance falling away, so the plan we build with you is one you can actually follow.

Not at all. We manage peri-implant disease around implants placed at any practice — including older systems, implants placed elsewhere in Australia, and implants placed overseas.

We will ask for any records or imaging you can provide, but if you don't have them, we'll take new baseline records as part of the assessment. There is no judgement and no preference for our own work — what matters is helping you keep the implant you've got.

Yes — laser-assisted peri-implantitis management is offered across all three Magical Smiles clinics: Caroline Springs, Bacchus Marsh and Point Cook.

Our team helps coordinate the appointment, the records transfer if relevant, and the long-term review schedule afterwards. The same dentist will usually see you across the treatment and review visits, for continuity.