Peri-implant health, peri-implant mucositis, and peri-implantitis are distinct entities and present with distinct clinical and microbiologic findings. Ongoing appropriate implant maintenance and examination as well as early identification of peri-implant disease and treatment of reversible inflammation in peri-implant mucositis with nonsurgical therapy is critical for optimal outcomes of implant therapy. In cases where implants demonstrate peri-implantitis, adjunctive laser therapy may allow for enhanced debridement of the peri-implant defects. Further, selecting appropriate lasers for the treatment to be rendered and standardized protocols may aid in augmenting peri-implant treatment results. To facilitate diagnosis and treatment of peri-implant diseases, a decision matrix was formulated to allow for identification and treatment for ailing/failing implants. More studies are needed to quantify best treatment options in the varying clinical scenarios seen in practice.