Critical Information Dental Hygienists Need to Know When Maintaining Dental Implants

More than 5.5 million dental implants have been placed in the United States. Research shows the technique yields a high rate of success and while a boon to esthetic dentistry, the benefits of dental implant therapy reach well beyond good looks.

Replacing a single tooth with an implant, for example, means that adjacent healthy teeth don’t need to be cut down to accommodate a fixed bridge. Patients enjoy similar benefits when implant therapy is used in place of removable dentures. Furthermore, there are few health restrictions associated with this approach to treatment.

However, controlling plaque on dental implant surfaces is vital to the long-term success of implant therapy. Peri-implant mucositis or implant gingivitis is fairly common and is triggered by the same bacteria that cause gingivitis in natural dentition. Dental hygienists are the first line of defense against this complication. The best initial course of action is nonsurgical periodontal therapy with either ultrasonic or hand instrumentation or a combination of both.

Scott Froum, DDS, dedicated to periodontics and implantology in New York and a clinical associate professor in the Department of Periodontology and Implantology at New York University College of Dentistry identified key elements to effective implant maintenance.

Avoid Damage to Implants with Proper Tools

Froum says, “Roughened dental implant surfaces that become exposed can act as plaque traps for bacteria-similar to a roughened root surface of a tooth.” He continues, “When these exposed implants are located in the posterior areas and/or underneath large-span restorations, they can be particularly challenging to properly debride.” It’s essential to note that while the use of systemic antibiotics can help quell the inflammatory response, mechanical debridement is necessary to maintain implant health.

Froum emphasizes that using the right instruments is essential to protecting the implant surface. “When scaling implants, titanium instruments, graphite- or gold-tipped scalers, and/or plastic-tipped ultrasonic inserts or tips should always be used.” He explains, this helps “to prevent scratching” and is important “because a scratched implant surface creates a welcome environment for bacteria.”

Fighting Implant Failure

Maintaining healthy natural tissues around an implant is also vital to successful therapy, and warning flags found in these tissues can signal potential implant failure. Aggressive and chronic periodontitis, for example, can heighten the risk of implant complications. Patients with a history of chronic periodontitis warrant particular scrutiny, since the long-term survival of implants in this population is lower than in patients without a similar history.

Peri-implantitis, which is similar to peri-implant mucositis but includes the loss of peri-implant bone (implant periodontitis), can cause implant failure. You’ll want to be vigilant in detecting early signs, such as bleeding on probing; calculus build-up; suppuration on probing; rolled marginal tissue; changes in color, texture, and movement of the soft tissue; and radiographic evidence of bone loss. Trauma can also threaten implant health.

At Home Implant Care Also Critical

In addition to professional maintenance, much of the long-term success of dental implant therapy hinges on effective self-care. Be sure to have your dental hygienists reinforce the vital nature of effective self-care in controlling the bacterial load, and provide explicit oral hygiene instruction.

For example, offer your patients key tips to strengthen their self-care programs. Determining what areas are hygienically challenging for your patient and demonstrating how to clean these areas are of the utmost importance. To get the most out of self-care practices, have implant patients incorporate antimicrobial dentifrices and mouth rinses, as well as interproximal cleaning devices, into their daily regimens.

While patients may consider implant therapy as the state of the art in dental prosthetics and restorative care, successful outcomes require a commitment on the part of both the clinician and the patient to maintain the implant and surrounding structures.

With an expanding toolbox of oral health technologies to provide optimum care at home and in the office, the prospects are better than ever for patients and clinicians to work together to assure that the benefits of dental implant therapy will last a lifetime.

Your help is critical to ensure patients have lifelong success in caring for and maintaining dental implants. However, if any of your patients show signs of periodontal disease, let them know that new treatment options such as LANAP are available to them. Have them contact our office here or call (904) 731-1324 to set up a consultation.