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The most common pathogens associated with dental implant failure due to peri-implantitis include:
Porphyromonas gingivalis (Pg)
Fusobacterium nucleatum (sub spp. nucleatum and animalis)
Treponema denticola (Td)
Tannerella forsythia (Tf)
Prevotella intermedia (Pi)
Pseudomonas aeruginosa is considered an opportunistic pathogen associated with peri-implantitis, particularly when present as a part of the bacterial biofilm around a dental implant arising from the above bacterial species.

Fungal organisms like Candida albicans, and herpes family viruses, including cytomegalovirus and Epstein-Barr virus also have significant influence

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Ardila CM, Ramón-Morales OM, Ramón-Morales CA. Opportunistic pathogens are associated with deteriorated clinical parameters in peri-implant disease. Oral Dis. 2020 Sep;26(6):1284-1291. doi: 10.1111/odi.13342. Epub 2020 Apr 16. PMID: 32248598.

Săndulescu M, Sîrbu VD, Popovici IA. Bacterial species associated with peri-implant disease – a literature review. Germs. 2023 Dec 31;13(4):352-361. doi: 10.18683/germs.2023.1405. PMID: 38361546; PMCID: PMC10866163.

Aggravated Clinical Manifestations of Peri-implant Disease are Associated with Opportunistic Bacteria Ardila et al., Oral Disease Reports, Sept. 2020

Leonhardt A, Renvert S, Dahlén G. Microbial findings at failing implants. Clin Oral Implants Res. 1999;10(5):339-345. doi:10.1034/j.1600-0501.1999.100501.x

Schwarz F, Becker K, Rahn S, Hegewald A, Pfeffer K, Henrich B. Real-time PCR analysis of fungal organisms and bacterial species at peri-implantitis sites. Int J Implant Dent. 2015;1(1):9. doi:10.1186/s40729-015-0010-6

Albertini M, López-Cerero L, O’Sullivan MG, et al. Assessment of periodontal and opportunistic flora in patients with peri-implantitis. Clin Oral Implants Res. 2015;26(8):937-941. doi:10.1111/clr.12387

Jankovic S, Aleksic Z, Dimitrijevic B, Lekovic V, Camargo P, Kenney B. Prevalence of human cytomegalovirus and Epstein-Barr virus in subgingival plaque at peri-implantitis, mucositis and healthy sites. A pilot study. Int J Oral Maxillofac Surg. 2011;40(3):271-276. doi:10.1016/j.ijom.2010.11.004

Roca-Millan E, Domínguez-Mínger J, Schemel-Suárez M, Estrugo-Devesa A, Marí-Roig A, López-López J. Epstein-Barr virus and peri-implantitis: a systematic review and meta-analysis. Viruses. 2021;13(2):250. doi:10.3390/v13020250

Probing and bleeding on probing offer limited insights into microbial activity. Saliva testing identifies the presence and quantity of specific pathogens at the molecular level, often before clinical signs emerge helping to guide earlier, more targeted intervention.

Our SimplyTest Oral Health panels detect key bacteria such as P.gingivalis, T. denticola, F. nucleatum, and other orange and red complex species. The panels also identify Candida albicans, herpes viruses, and pathogens associated with peri-implantitis and systemic disease.

Results are accessible via the secure SimplyTest provider portal dashboard.

Periodontal disease (gum disease) is a chronic inflammatory condition caused by a polymicrobial infection in the tissues that support the teeth. It begins as gingivitis, a reversible inflammation of the gums, and can progress to periodontitis, where the infection damages the bone and connective tissue, potentially leading to tooth loss.

The disease is primarily triggered by pathogenic bacteria in dental plaque biofilms. These bacteria elicit an immune response that leads to chronic inflammation and tissue destruction. Left untreated, periodontal disease not only compromises oral health but has also been linked to a wide range of systemic conditions such as cardiovascular disease, diabetes, rheumatoid arthritis, respiratory disease, and Alzheimer’s disease.

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Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. (2017). Impact of the global burden of periodontal diseases on health, nutrition, and wellbeing of mankind: A call for global action. Journal of Clinical Periodontology, 44(5), 456–462. https://doi.org/10.1111/jcpe.12732

Hajishengallis G. (2014). Immunomicrobial pathogenesis of periodontitis: Keystones, pathobionts, and the host response. Trends in Immunology, 35(1), 3–11. https://doi.org/10.1016/j.it.2013.09.001

CDC – Centers for Disease Control and Prevention. (2023). Periodontal Disease.
https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html

Kinane DF, Stathopoulou PG, Papapanou PN. (2017). Periodontal diseases. Nature Reviews Disease Primers, 3, 17038. https://doi.org/10.1038/nrdp.2017.38

Routine Screening

• All sexually active women under age 25 should be tested once a year.

• Women over 25 with risk factors such as new/multiple partners should also be tested annually.

• Pregnant women should be tested at their first prenatal visit; if at continued risk, retest in the third trimester.

• Men who have sex with men (MSM) should be tested at least once a year at exposed sites (urethra, rectum, throat), and every 3–6 months if at higher risk.

• Routine screening in heterosexual men without risk factors is generally not recommended, except in high-prevalence settings.

Re‑testing After a Positive Result

• Anyone who tests positive for chlamydia should be retested approximately 3 months after treatment to detect possible reinfection.

• If a 3-month follow-up isn’t possible, retest at the next healthcare visit within 12 months.

• A test of cure (4 weeks after treatment) is not routinely recommended for nonpregnant individuals except in pregnant persons, persistent symptoms, or suspected treatment failure.

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https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm

https://www.cdc.gov/std/treatment-guidelines/screening-recommendations.

Many sexually transmitted infections (STIs) can infect the oral cavity and throat, including chlamydia, gonorrhea, syphilis, herpes (HSV), and HPV. These infections are often asymptomatic but can still be transmitted to others and may contribute to long-term complications if left untreated.

Standard STI screening often focuses only on genital sites, which means oral infections are commonly missed. Testing the oral cavity separately, especially in individuals who engage in oral sex, provides a more accurate picture of infection status and helps guide proper treatment.

Routine Screening

• Sexually active women under age 25 and women 25+ with risk factors (e.g., new/multiple partners) should be screened annually.

• Pregnant women under 25, or older with risk factors should be tested at their first prenatal visit, and again in the third trimester if still at risk.

• Men who have sex with men (MSM) should be tested at exposed sites (urethra, rectum, throat) at least once a year, with those at higher risk tested every 3–6 months.

• Screening heterosexual men without risk factors is generally not recommended, but may be appropriate in high-prevalence settings.

Re‑testing After a Positive Result

• Anyone with a gonorrhea diagnosis should be re-tested approximately 3 months after treatment to check for possible reinfection.

• Test of cure is not recommended for most urogenital or rectal infections, but is recommended 7–14 days post-treatment in cases of pharyngeal gonorrhea.

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https://www.cdc.gov/std/treatment-guidelines/screening-recommendations.htm

https://www.cdc.gov/std/treatment-guidelines/gonorrhea.htm