Are you treating patients with dental implants the same way you treat natural teeth — and could that approach be putting those implants at risk?
Dr. Jon Suzuki is a Professor of Microbiology and Immunology in the School of Medicine and Professor of Periodontology and Oral Implantology in the School of Dentistry at Temple University, where he also serves as Chairman and Program Director of the Department of Periodontology and Oral Implantology and Associate Dean for Graduate Education. A former Dean at the University of Pittsburgh and CEO of the University faculty practice plan, Dr. Suzuki holds a D.D.S. from Loyola University of Chicago, a Ph.D. in Microbiology from the Illinois Institute of Technology, an N.I.H. Fellowship in Immunology from the University of Washington, a Clinical Certificate in Periodontics from the University of Maryland, and an MBA from the Katz Graduate School of Business. He is a Diplomate of the American Board of Periodontology, a Diplomate and Board Examiner of the International Congress of Oral Implantology, a Boarded Specialist Microbiologist, a Fellow of the American and International College of Dentists, former Chairman of the FDA Dental Products Panel, and former Chairman of the ADA Council on Scientific Affairs, with over 150 published papers, chapters, and symposia and a textbook in Medical Technology.
In this episode, Dr. Suzuki joins Dr. Phil Klein to deliver a comprehensive, evidence-based framework for managing peri-implant health in the general dental practice. The conversation spans the biological reasons implant disease progresses faster than periodontal disease around natural teeth, the emerging concern of titanium corrosion and its potential systemic implications, and the practical protocols hygienists should follow at every implant maintenance visit. With 5 million implants placed annually in the United States, this discussion is immediately relevant to nearly every dental professional seeing patients today.
Episode Highlights:
- Because dental implants lack a periodontal ligament, they have no PDL-associated vascularity, diminished local immune response, and only an epithelial soft tissue collar rather than a full gingival fiber complex. These anatomical differences mean peri-implant disease can progress significantly faster than periodontitis around natural teeth, making early detection and intervention critical to implant survival.
- Probing depths of three to five millimeters are considered within normal limits around implants due to the nature of soft tissue adhesion, but pockets deepening to five to six millimeters, combined with erythema and bleeding on probing, represent clear red flags for peri-implant mucositis or early peri-implantitis. Hygienists should use a plastic or resin probe rather than a stainless steel probe during implant assessment to avoid scratching the titanium surface.
- Titanium corrosion from dental implants is an emerging area of clinical concern supported by parallel literature in orthopedics and obstetrics-gynecology. Corrosion risk increases once implant threads become exposed to the oral environment — accelerated by pH changes from plaque, dietary factors, and occlusal loading — and the potential for systemic distribution of corrosion byproducts warrants continued research and clinical vigilance.
- Approximately 80 to 85 percent of patients do not floss consistently, and implant patients are no exception. Power brushes, interproximal irrigating devices, and antimicrobial mouth rinses used selectively — particularly for two to three weeks following a surgical or maintenance appointment — represent practical, compliance-friendly strategies for reducing peri-implant biofilm in the home care setting.
- Smoking lowers sulcular oxygen tension, promotes pathogenic anaerobic bacteria, suppresses neutrophil response, reduces salivary flow, and diminishes secretory immunoglobulin A — all of which increase peri-implantitis risk. While smoking is not an absolute contraindication for implant placement, dental offices should offer a tiered cessation approach including community counseling, nicotine-containing lozenges and gums, nicotine patches, and — with significant caution given documented psychiatric adverse effects — prescription cessation medications.
Perfect for: general dentists and restorative dentists managing implant patients, dental hygienists performing implant maintenance, periodontists, implant surgeons, and dental residents seeking evidence-based protocols for peri-implant disease prevention and early intervention.
If you place, restore, or maintain implants — or if you have patients who do — this episode gives you a clinical framework you can apply at your very next appointment.
