How gums (professionally known as gingiva) affect your dental implants is a very broad & diverse topic, but is extremely important.  Without healthy gums, the chances of dental implants failing is significantly increased. Dental implants have a very high success rate, but if their health is not maintained, dental implants will fail over time, and you may not even be aware of the ongoing situation.


The most intuitive aspect of how your gums interact with dental implants is cleanliness.  Just like natural teeth, if you don’t have good oral hygiene (brushing, flossing, etc.), you are putting the dental implants at risk of failing.  The plaque that builds up on the implants can cause the gums to become irritated, red, puffy, and bleed. In turn, bacteria buildup increases, and the toxins created by the bacteria will erode the gums and underlying bone.  The bone will then deteriorate, and melt away from the implant. The more the bone loss, the more damaged the dental implant / bone interface becomes, and eventually you may lose the implant. You may have no feeling or sensation in your mouth as this process starts or continues.


Another arena of gums and dental implants includes the type of gum tissue present.  Basically, there are two types of gum tissue: keratinized (thick, non-mobile gum tissue) and non-keratinized (also known as mucosa), which is thin and mobile.


This quality of gum tissue around dental implants (also known as “biotype”) is extremely important.  Thick, non-mobile gum tissue is absolutely preferred over thin, mobile gingiva around dental implants.  It is more resistant to abrasion from eating, toothbrushing, and general activity. The more mobile the gum tissue, the more susceptible the dental implant becomes to failure since the gum may erode from noxious stimuli.  As the gum recedes, the bone will follow, and a negative pathway of bone loss around your dental implant ensues, putting your dental implant at risk of failing.


All too often I need to speak to new dental implant patients about the quality of gum tissue described above (biotype).  It is not unusual for patients to be interviewing multiple dentists to determine who they want to provide their dental implant care.  If they have already visited one or two other offices and then come to me, they are skeptical when they hear me speaking about this topic if it applies to them.  I understand this skepticism, but it is a very important and critical area that should not be overlooked. They are entitled to know about this often overlooked topic, because more often than not it will affect the health of their implant over time.  I have had to remove many implants that failed due to this problem.


It is important to know that the quality of gum tissue can be addressed / corrected around dental implants, but ideally you would want to address it before the dental implants are placed.  Gum grafting procedures are usually the best way to improve the situation.


A person’s health is another important component for the success of dental implants with respect to the gums.  Systemic diseases such as diabetes and heart disease directly affect the gingiva. Medications can affect both the gums and bone, such as Calcium Channel Blockers (ie: Dilantin), SSRIs (Lexapro, Proazc, Zoloft), bisphosphonates (Fosamax, Boniva, Actonel, Zometa), and Proton Pump Inhibitors (ie: Prilosec, Previcid).




About the author:  Dr. Ira Goldberg has been performing implant procedures for 23 years.  He is a Diplomate of the American Board of Oral Implantology / Implant Dentistry, a Diplomate of the International Congress of Oral Implantologists, and a Fellow of the American Academy of Implant Dentistry.  He performs all phases of implant dentistry at his office in Succasunna, NJ. He lectures to dentists in the field of implantology. For a free consultation, including a free 3-D scan (if necessary), please call his office at (973) 328-1225 or visit his website at  Dr. Goldberg is a general dentist, and also a Fellow of the Academy of General Dentistry.

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