Dental implant time bomb alert

CATHY Gunnell was thrilled when she had dental implants fitted at the age of 52. Since childhood, she'd endured crooked teeth, gum disease and abscesses, one of which forced her to have a tooth removed. So when a local London clinic charged her £13000 to replace four diseased teeth with gleaming white porcelain ones, fixed in place with metal pegs, she was more than happy to pay.

That was in 2002, and for 12 years she had no problems.

But three months ago, she felt a lump on her lower right jaw near one implant.

"There was no pain, but I got it checked out by my local dentist," says Mrs Gunnell, now 64.

The lump was caused by inflammation that cleared up after antibiotics. But an X-ray showed the bone supporting the implant was receding.

To her shock, Mrs Gunnell's dentist diagnosed her with a little-known disease that is now emerging as a serious complication of dental implants: It is called peri-implantitis, and has been described as a "time bomb" by a leading dental surgeon.

Peri-implantitis is an inflammatory disease marked by bacterial infection and the gradual loss of the jaw bone supporting the implant. It's not yet clear whether the infection causes the bone to recede, or the bone loss exposes the area to bacteria. Dentists are uncertain how to treat it. "I was shocked," says Mrs Gunnell. "I'd never heard of the disease."

Ten years ago, professionals said the condition didn't exist.

But now it is on the rise, as increasing numbers of people have replacement porcelain crowns with titanium roots. Half-a-million adults in Britain have at least one dental implant, according to the latest Adult Dental Health Survey.

Studies have suggested that one third of patients will be infected. "We're sitting on a time bomb," says Dr Stephen Jacobs, a past president of the Association of Dental Implantology and well-respected implant surgeon.

"We are going to be seeing more and more cases."

Peri-implantitis is always preceded by a milder disease, called peri-implant mucositis, which is common and treatable. Early warning signs are red, swollen gums and bleeding when probed. If undetected and untreated, it might become peri-implantitis.

Because bone loss is painless, many people don't realise they have the condition.

So scrupulous oral hygiene and regular follow-up appointments after an implant are essential, says Dr Jacobs, who runs a Glasgow clinic. – Ruth Wood © The Daily Telegraph