While the clinical science of managing peri-implant diseases is progressing, careful monitoring and preventive care of peri-implant tissue health during maintenance is paramount.Implants have become a routine treatment option for missing dentition. The biological complications of restored dental implants and associated supra-structures share similarities with the biofilm infections of natural dentition. Our existing paradigms of periodontal disease treatment can partially be applied to management of peri-implant disease.A critical analysis of the peri-implant disease literature was conducted, anchored by a search on the MEDLINE database (2005 to present) by way of Ovid Medline(®). Search terms peri-implantitis, peri-implant mucositis and peri-implant diseases were utilized. Select references within bibliographies of review articles were sought.The dental team must play a critical role in educating patients to control plaque-biofilm associated with peri-implant tissues and associated restorations. Routine assessments at maintenance appointments allow early treatment intervention to prevent escalation of peri-implant disease. Given the infancy of clinical science surrounding peri-implantitis treatment, further, high-quality evidence based studies are expected.