Very receding gums around two implants - is it infection?

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Olesja

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I have two implants on +5 and +6, one done four years old and the other two years ago.
I'm now experiencing very receding gums between the two implants, and it seems it is developing above the implants. I have no bleeding or swelling.
My hygienist keeps on telling me it's only a cosmetic issue, but I can almost feel that there is a difference in the bone compared to the upper right side.
So my question is, is it likely that it's only cosmetic or is it instead a growing infection?
I clench and grind very much at night, mostly on my left side. Which can also be seen clearly on my nightguard, where there is clear "bitemarks".
Can it be due to my clenching?
I'm really careful with my mouth hygiene.
 
Gordon

Gordon

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What does your dentist think? This needs investigating by a dentist not a hygienist.
 
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Olesja

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I have just booked an apointment at my dentist, to get his view on it.
 
Gordon

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Good. Hope it all goes well for you.
 
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Olesja

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My dentist looked at it and took x-ray, and said that he's still comfortable with the bone structure. And the pockets around the implant is within normal.
I'm just still a bit nervous as to why the gum is receding then, is that normal when it comes to implants?
That gum can be receding, but the implant is still healthy?
 
Gordon

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PM Lincoln on here, he knows a lot more about implants than I do.
 
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Olesja

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@drhirst I hope you are the correct person to tag.
Can you perhaps help with my question above?
 
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Olesja

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Yes, is it possible for you to see anything from this?
 

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drhirst

drhirst

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OK, the area of interest is a little out of focus on both the photos so I cannot see well. Having said that, when two implants are placed next to each other the litte triangle of gum that normally sits between them (called the papilla), can receed without there being a problem. This is because although implants look and feel like teeth, they do not interact with the jaw bone in the same way that real teeth do.
If your dentist has reviewed them and is happy with the appearance of the bone on the x-ray, and the health of the gum around them, then hopefully they are OK. I would recommend being meticulous with your cleaning in this area and wearing your nightguard religioulsy. The wear pattern visible on your canine in the photos indicates you do grind or clench at night.
 
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Olesja

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Thanks for your answer!
I have tried to take another photo.
I do wear my nightguard each and every night, no exeptions. Even often during the day, leaving my husband very amused :)
 

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drhirst

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Ok, that is a lot better, nothing difinately untoward there if the x-ray, clinical examination was also ok
 
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Olesja

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Thanks for reply :) according to my dentist the x-ray showed ok bone structure. He said if it was incisors he would do something about the gum for cosmetic reasons.
But I’m still very concerned, since I can feel the gum has strunk. I can feel a “hole” in the area.
Maybe a stupid question, but can the jaw bone decrease without it can be seen on x-ray?
I have asked my general practice doctor for a 3D scan, would that show if something was really wrong with surrounding bone?
 
drhirst

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Actually, that is a good question, the answer is yes because the image ifs 2D not 3D and bone could recede on the cheek or tongue side without showing up on a regular 2D x-ray. However, the bone is often so thin on the cheek side it is difficult to see on a 3D xray as the implant causes distortion of the image, so I am not sure how helpful the 3D scan will be.
 
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So it might actually be some sort of bone decrease I can feel.
It seems as if my dentist takes the conservative wait-and-see approach.
I know it is difficult to give an answer, but if nothing is done for now, and it is bone decreasing, will it then at all be possible to save the implants?
 
drhirst

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Maybe maybe not, it may just be a normal amount of bone loss, or remodeling as it is called when it is to be expected, associated with the loss of the tooth that necessitated the second implant. It may not be a problem at all.
 
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Olesja

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Firstly Happy New Year.
And thanks for replying, I really appreciate it.
What if the gum continues to recede? More than it has already done?
What confuses me is that I have no bleeding at all. Neither any swelling.
 
drhirst

drhirst

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It will need to be monitored, if it continues to receed then you have a problem! However, it may be stable so only time will tell. Keeping my fingers crossed for you.
 
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