Dental Implant Maintenance

Dental Implants are not just “replacement” for natural

teeth. It is believed that dental implant is an
“investment”!

Patients are often in a dilemma about the maintenance of

their implants.
Do they brush and floss their implants like natural teeth?
Does food get underneath the Implant Bridge or
prosthesis?

Patients look to their dentist for these concerns. We at

Dr.Sachdeva’s Dental Clinic address these concerns and
help our patients with an individualized home-care
routine!
Difference between Dental Implant and Natural Teeth

• Dental Implants replace the root part of the teeth. In

between the Implant and the crown of a tooth there is
often a connector known as an Abutment.

• The success of the whole system is based on the

implant's attachment to bone. Titanium, the metal of
which implants are made, is uniquely osteophilic —
literally “bone-loving.” It fuses to bone in a process called
osseointegration (“osseo” – bone; “integration” – fusion
or joining).
• Above the bone where the integration process ends, the
abutment comes in contact with the gum tissue where it
is supported by a connective (i.e. “connecting”) tissue
composed of fibers made of a tough material called
collagen.

• The fibers run beneath the surface parallel to the

implant ending at the top of the bone. They hold the
gum tissues against the implant surface

• At the very top of the implant assembly, the abutment

and lower part of the crown attach to the gum via a
specialized structure known as an epithelial attachment.
• The cells actually attach to the highly polished metal or
ceramic, of which the implants are made, by means of
microscopic suction pads.

• By contrast, a Tooth root is attached to the bony socket

that surrounds it — by a Periodontal Ligament . The
ligament is composed of tiny fibers that insert into the
bone on one side and into the tooth root on the other.
Above the bone, the fibers attach from the tooth into the
gum tissue.

• An Implant has no such attachment. Since the whole

periodontal ligament has a greater blood vessel supply
through which it can bring cells and nutrients, it is more
readily able to resist and fight against infection.
 Infection Is the Enemy

• Cleaning Implant-supported tooth replacements is just as

important as cleaning natural teeth, as both depend on
healthy surrounding tissues for support.

• Bacterial biofilm (plaque) collects on implant crowns just

as it does on natural teeth, and must be removed on a
daily basis at home. Without daily biofilm removal,
infection can develop known as Peri-Implantitis.
• Which can result in loss of the attachment tissues. Unlike
inflammation around teeth, this reaction can be quite
catastrophic both in rate and amount, quickly leading to
loss of bone around an affected implant. Bone loss can
rapidly progress to loss of the implant.
 Implant Home-Care Guidelines

• Brush twice daily with a low abrasive dentifrice.

• Floss with dental floss in shoe shine motion.

• If recommended, use interdental brush, rubber tip, soft

picks.

• Water irrigation systems once or twice daily

• If inflammation present, use of non-alcohol anti-

microbial rinse.
 Removable Prosthesis Guidelines

• Remove the prosthesis (over denture)daily to soak in the

specific cleaner for recommended time

• Remove the prosthesis from the cleaner and brush the

underside with denture brush, being careful with the
attachments.

• Rinse off the prosthesis thoroughly with water and/or

non-alcohol antimicrobial rinse

• Rinse mouth with antimicrobial for 30-60 seconds and

then reinsert over-denture.
• The Dentists in North Delhi have an important role to
play in keeping dental implants infection-free, and there
are many factors to be considered in selecting the right
instruments for a professional cleaning.

• They include: the nature of the debris, meaning whether

soft (foods) or hard (calculus or tartar, calcified material);
the location of the deposits; the type of surface on which
they accumulate; and the stubbornness with which they
adhere.
 The Right Tools For The Job

• At Dr.Sachdeva’s Dental Clinic in Ashok Vihar, we select

instruments for cleaning that do not damage the crown,
abutment, or the implant itself.

• Maintaining the highly polished, smooth surface of the

abutment and crown are critical. If they are scratched
they can attract and harbor bacteria.

• That's why the instruments used, called scalers and

curettes, are most often made of plastics and resins.
• Natural teeth don't scratch in the same way, and
therefore metal instruments can be used to clean them.

• A number of power (ultrasonic) instruments have nylon

or plastic sheaths or tips to minimize implant damage.
They clean by using high-frequency vibration, which may
be necessary if large quantities of debris have
accumulated.

• They are used on a low power setting with a lot of water

irrigation, and sometimes antibacterial solutions, to
clean and flush material.
 Home care recommendations for implant care

Toothbrushes: There is no significant difference

between electric or manual brushes when it comes to
implant care. The main focus needs to be on adaptation
to the prosthesis and patient’s dexterity.

• Patient is instructed to brush twice using a soft tooth

brush with a low abrasive dentifrice.
• Nylon coated interdental brushes /proxabrushes are also
an excellent alternative to clean the tight and hard –to-
reach areas. Nylon only interdental brushes prevent
scratching the implant or prosthesis.
• Dentifrice and mouthwash: A low abrasive/non
abrasive formula to the exposed implant is
recommended. It should also contain antimicrobial
ingredients.

• Floss: There are many types of floss in the market, and

generally it is highly recommended to use unwaxed floss
or implant specific floss.
Be sure to select a type that doesn’t shred or leave
particles behind, as it may contribute to implantitis.
• Oral irrigators/water flosser: It is highly
recommended for patients to use oral irrigators for the
reduction of plaque/biofilm, inflammation, and hard to
reach areas around the implant.
Patient is instructed to use a nonmetal tip one to two
times daily, and, if inflammation is present, add a diluted
non-alcohol antimicrobial rinse (chlorhexidine gluconate)
 Water irrigation in conjunction with diluted non-
antimicrobial rinse has proven to be extremely helpful for
full-fixed and removable prostheses to remove daily
biofilm and prevent inflammation if used on a daily basis.

• Protective appliances: Occlusal guards, if

recommended, will decrease the occlusal load on the
implant during night time grinding or clenching.
• Not recommended: Plastic or metal “picks” seen over-
the-counter that mimic professional instruments should
be avoided. Metal instrument can scratch the implant
surface, creating areas for bacteria to colonize.

What Happens When Implants are not Taken care

of?

Implants can develop problems without consistent daily

care. The earliest sign of a problem begins with the
observation of bleeding. This is known as mucositis.
 The current scientific evidence suggests that this may be
successfully treated and is reversible if caught early.
Unfortunately if it progresses to bone loss, also known as
peri-implantitis, the bone loss is not reversible.
If peri-implantitis is not treated it can lead to advanced
bone loss and the removal of the implant.
 Conclusion

Despite these cleaning challenges, implants are highly

successful. However, the prevention of peri implant
disease is fundamental to implant health, maintenance
and function. And cleaning implants and their related
components is an important part of success!
For more information, you can book an appointment at

Dr Sachdeva's Dental Aesthetic And Implant Institute,

I 101, Ashok Vihar Phase 1, Delhi- 110052

Contact us at

Phone : +919818894041,01142464041

Our Websites:

www.sachdevadentalcare.com
www.dentalclinicindelhi.com
www.dentalimplantindia.co.in
www.dentalcoursesdelhi.com
www.facialaestheticsdelhi.com
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