Dental Implant Care Beyond the Chair

Even implant patients who are diligent about keeping maintenance appointments may run into trouble with peri-implant disease if they don’t practice good daily oral hygiene at home. Successful implant home care depends on educating patients about how infection risks for implants are different than for natural teeth and encouraging them to develop an effective routine for plaque removal that they can practice two or three times a day.

This can be challenging, as a lifetime of poor oral hygiene may be a factor in the patient’s need for implants in the first place. Tailor suggestions as much as possible to the patient’s implant type and individual lifestyle, including aspects like motivation and dexterity. In-office demonstration of the proper use of unfamiliar tools – such as electric toothbrushes, water flossers, interproximal brushes and rubber tip stimulators – can help.

Patients also should be cautioned against using anything that may scratch the implant (such as metal or plastic picks and abrasive toothpaste) or leave particles in the sulcus (such as certain types of floss).

Implant maintenance: do’s and don’ts

9 things to do at every visit

  • Assess gingiva for signs of inflammation (redness, swelling, fistulas)
  • Document plaque index
  • Measure probing depth
  • Assess bleeding on probing
  • Note presence of suppuration, if any
  • Evaluate soft-tissue margins for recession and implant exposure
  • Assess implant mobility
  • Evaluate occlusion for potential overload or contact issues
  • Palpate/percussion test for signs of pain
  • Take radiographs to monitor bone level*

*At recommended intervals depending on evidence or progression of bone loss.

7 things to do at home

  • Perform oral hygiene routine two or three times daily
  • Brush for two full minutes at a time
  • Use soft-bristled toothbrush
  • Use water flosser, nylon interproximal brush, or floss that does not shred or leave particles behind
  • Use low- or non-abrasive toothpaste (toothpaste that does not contain stain removers)
  • Use a rubber tip stimulator
  • Wear a night guard (as recommended by dentist)

10 risk factors for implant failure

  • Smoking
  • Radiotherapy
  • Poorly controlled diabetes
  • Osteoporosis
  • Biomechanical overload
  • Infection/inflammation
  • Bruxism
  • Periodontal disease
  • Poor oral hygiene
  • Poor clinical assessment, treatment planning or prosthetic design

Sources:

Fody A, Marsh L. Importance of implant maintenance. Dimensions of Dental Hygiene. April 28, 2020.

Hatfi eld S. Implant maintenance: An overview. Today’s RDH. February 8, 2021.

Obrotka MA. Dental implant care basics: Single-tooth replacement. Dentistry IQ. February 15, 2017.

Strange M. 5 things hygienists need to know about dental implants. Dental Products Report. June 2, 2017.

Wingrove S. Focus on implant home care. RDH. September 11, 2013.

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This blog post originally appeared in pages 46-47 of the October issue of OnTarget.