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(904) 656-1117 · JacksonvilleDentalSpecialists.com · December 2025
Peri-Implant Mucositis: What Every Restorative Dentist Should Know A CLINICAL UPDATE BY DR. RAFAEL PEREIRA, DDS, MS
Dental implants remain one of the most predictable treatment solutions in modern Dentistry, but as their use continues to rise, so does the incidence of biologic complications. Among these, peri-implant mucositis stands as the most common and the most important to detect early. Although reversible, mucositis is also the final warning sign before a site progresses into peri-implantitis, where bone destruction becomes significantly harder to manage. In my recent publication earlier this year in the International Journal of Dentistry (Treatment Strategies for Peri-Implant Mucositis: The Final Stop for Preventing Peri-Implantitis), my co-authors and I reviewed the current evidence on the etiology, diagnosis, and treatment of peri-implant mucositis, and proposed a practical clinical decision pathway to help dentists intervene early. What Is Peri-Implant Mucositis? Clinically, peri-implant mucositis can be understood as the implant equivalent of gingivitis. It presents with redness and swelling of the peri-implant soft tissues, profuse bleeding and/or suppuration on probing and increased probing depths due to inflammation but without bone loss. The peri-implant mucosa provides the first protective seal against microbial invasion. When biofilm accumulates, this seal becomes inflamed, triggering a cascade similar to periodontal disease but within tissue that lacks the structural defenses found around teeth. The good news is peri-implant mucositis is reversible if treated promptly. However, the challenge is it progresses more slowly than gingivitis, and patients often miss early symptoms. Why Are We Seeing So Much Of It? Studies consistently report high prevalence rates (up to 80%) of implant patients experience mucositis at some point. Several systemic and local risk indicators contribute to this trend, including but not limited to poor oral hygiene, inadequate keratinized tissue, prosthetic designs that hinder access, smoking,
diabetes (especially if poorly controlled), excess cement as well as irregular maintenance intervals. As clinicians, we have an opportunity to intervene early, guide patients toward supportive therapy, and reduce long-term complications. What Are The Evidence-Based Treatment Ttrategies? The central objective in managing peri-implant mucositis is simple: Disrupt and remove biofilm. The current evidence overwhelmingly supports nonsurgical mechanical debridement as the gold standard. Both clinicians and patients have multiple tools available, from professional debridement to daily plaque control routines. Effective mechanical options include titanium, carbon fiber, or PEEK-coated curettes, specialized ultrasonic tips and glycine or erythritol air polishing. Whether performed with or without adjuncts, mechanical debridement consistently reduces bleeding and inflammation. What About Adjunctive Therapies? The literature remains mixed, but across systematic reviews, the consensus is clear: If you must choose one intervention, choose mechanical therapy. • Chlorhexidine: useful for patient irrigation, less so for professional sulcus irrigation • Photodynamic therapy (PDT): shows promise, but results vary due to lack of standardization • Probiotics and microbiome-based therapies: clinically helpful in some scenarios but not yet reliable as a primary treatment. • Ozone therapy: demonstrates antimicrobial and regenerative potential, though more studies are needed • Local antibiotics: not routinely recommended What Is The Decision Pathway? A good clinical decision-making workflow to implement: 1. Confirm diagnosis: visible inflammation + bleeding on probing + no bone loss.
2. Evaluate prosthesis design: remove excess cement and correct contours if needed.
3. Perform nonsurgical mechanical debridement.
4. Provide customized home-care recommendations.
5. Reevaluate in four weeks.
6. If resolved, enter supportive maintenance every 3–6 months.
7. If not resolved, repeat therapy or reassess biomechanical/prosthetic triggers.
This simplified and structured plan ensures early interception and minimizes the risk of progression to peri-implantitis. What Is The Long-Term Strategy? The progression from peri-implant mucositis to peri-implantitis is not inevitable, but it becomes significantly more likely without proper recall intervals. Literature shows that patients without supportive implant therapy are more than four times more likely to develop peri-implantitis. Therefore, every implant patient should receive routine professional biofilm removal with individualized risk-based recall intervals (every 3–6 months), reinforcement of home care techniques and additional regular evaluation of prosthesis design. Helping patients understand the “why” behind their implant maintenance can dramatically improve compliance. Final Thoughts Although peri-implant mucositis is considered treatable, it continues to be underestimated in daily practice. When clinicians prioritize early diagnosis, timely intervention, and a structured maintenance protocol, we can safeguard long-term implant health and significantly reduce the risk of biologic complications. —Dr. Rafael Pereira
JacksonvilleDentalSpecialists.com · 1
A LOOK BACK AT THIS YEAR’S MOLAR CUP TOURNAMENT
This year’s Molar Cup Tournament was another unforgettable day of golf, camaraderie, and celebration for the dental community. Hosted by Jacksonville Dental Specialists & Advanced Dental Seminars, the event once again delivered the perfect blend of relaxation, friendly rivalry, and top-tier hospitality set on the stunning Players Stadium Course. The morning began as players checked in their clubs and picked up their golf carts before heading out for a warm-up. A grab-n-go breakfast and fresh coffee set the tone for the day, giving everyone the energy they needed to loosen their swing and enjoy the crisp morning air. With cart fees, green fees, forecaddies, forecaddie gratuities, and practice balls all included, participants could focus entirely on enjoying the experience. Once on the course, players were treated to one of the day’s biggest perks: an open bar golf cart service available across all 18 holes. Whether they were celebrating a great drive or laughing off a challenging shot, golfers enjoyed beverages delivered right to the fairway. Mid-round, participants grabbed a delicious lunch from the ULTRA Turn (Halfway House), delivered via golf cart directly to the green, keeping everyone fueled and refreshed for the back nine.
The friendly competition intensified hole by hole as golfers vied for this year’s specialty awards: Closest to the Pin (Hole 5), Longest Drive (Hole 7), and Closest to the Water (Hole 6). Of course, the ultimate prize, the title of Molar Cup Champion, remained the highlight of the day, with teams giving their all for a chance to claim the trophy and bragging rights for the year. The tournament was wrapped up with a lively awards luncheon buffet, complete with a complimentary open bar. Players gathered to celebrate the day’s achievements, share stories from the course, and cheer on the award recipients. The atmosphere was filled with laughter, camaraderie, and the sense of community that made the Molar Cup such a special tradition. This year’s tournament once again proved why the Molar Cup has become a favorite annual event. From start to finish, it was a day of great golf, great company, and great memories — and everyone is already looking forward to doing it all again next year.
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Why Updated ADA Codes Matter in 2026
WHAT DENTISTS NEED TO KNOW
Every year, the American Dental Association (ADA) releases updates to the CDT code set — the foundational language that dental practices use to accurately report procedures, communicate with insurers, and maintain compliance. These codes aren’t just administrative tools; they directly affect clinical documentation, reimbursement, and the legal accuracy of patient records. For 2026, the ADA has introduced 31 new codes, 14 revised codes, and nine editorial revisions, making this a significant update in recent years. Staying current is essential, not only to ensure proper billing and maximize reimbursement, but also to maintain accurate clinical reporting that aligns with modern standards of care. One example that illustrates why these updates matter is the major revision to D0180: Comprehensive Periodontal Evaluation. In the 2025 version, this code focused mainly on dental-related factors such as periodontal symptoms and risk factors like smoking or diabetes. However, the 2026 update completely reframes the criteria, emphasizing systemic medical conditions and social risk factors as integral to determining when D0180 is medically necessary. In fact, entire sections of the older description have been removed. The new language requires an in-depth, medically oriented evaluation including full-mouth charting, oral cancer screening, medical history review, and assessment of systemic conditions such as heart disease, diabetes, dementia, and high-risk
pregnancy. This shift means that reporting D0180 without documented medical correlation could now be considered inaccurate — and insurers are expected to follow these stricter guidelines. This is only one example. New codes, such as those created out of necessity for more efficient refabrication of dentures (e.g., D5877 and D5878), were added specifically to reduce unnecessary patient visits and streamline documentation. Many other changes likewise reflect real clinical challenges and emerging diagnostic needs. For dental practices, using outdated codes can lead to denied claims, compliance risks, and missed opportunities to correctly document the care provided. The 2026 CDT update ensures that your coding reflects current clinical standards, medical- dental integration, and evolving insurer expectations.
To purchase the updated 2026 CDT book, simply scan the QR code, which will take you directly to the official ordering page.
Grow Your Practice With Cherry Finance
As specialists in Full Arch Dentistry, we at Jacksonville Dental Specialists understand that life-changing treatment often requires significant financial commitment. But we believe cost should never stand between a patient and the healthy, confident smile they deserve. That commitment to accessibility is what led us to partner with Cherry Financing, and why we encourage our colleagues to consider integrating this powerful tool into their own practices to help close more comprehensive, high-value cases. Cherry is a leading point-of-sale financing solution designed to make healthcare payments simple, transparent, and manageable. Whether a patient needs a single implant or a full arch restoration, Cherry allows them to split their investment into predictable monthly payments. By giving patients immediate purchasing power with the ability to pay over time, Cherry removes one of the biggest obstacles to treatment acceptance: the burden of a large upfront cost. For practices that offer major procedures like Full Arch Dentistry, financing can be the difference between a hesitant “maybe” and a confident “yes.” Offering Cherry transforms a $25,000-plus treatment plan into an accessible monthly commitment, significantly boosting case acceptance. More accepted cases translate directly into
higher production and revenue, all while your practice receives the full treatment amount upfront (minus a small fee) within a few business days. This eliminates receivable risk and supports healthy cash flow. Cherry also stands out among third-party financing options for its patient-friendly approach. Its soft credit check allows patients to pre-qualify without impacting their credit score, contributing to some of the highest approval rates in the industry. For qualifying patients, Cherry provides true 0% APR plans, not deferred interest promotions that can lead to retroactive charges. Patients appreciate the honest, transparent terms, flexible payment lengths of up to 60 months, and clear monthly breakdown of costs. With a quick, 60-second application and instant decisions, patients can begin treatment the same day they apply. At Jacksonville Dental Specialists, we’ve seen firsthand how Cherry expands patient access and accelerates practice growth, especially for full arch and other high-value procedures. We encourage you to explore Cherry Financing as a strategic addition to your financial offerings, helping more patients achieve the oral health and confidence they deserve.
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JacksonvilleDentalSpecialists.com · 3
PRST STD US POSTAGE PAID BOISE, ID PERMIT 411
11512 Lake Mead Ave. #532 Jacksonville, FL 32256
INSIDE Strategies to Stop Progression of Peri-Implant Mucositis
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Fun and Friendship at Molar Cup Tournament
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ADA Codes Have Been Updated
Cherry Finance Can Help With High-Cost Procedures
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Partner With Dr. Pereira Today!
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