Our dental hygienists always use special instruments to clean around dental implants. Why does cleaning dental implants differ from cleaning natural teeth? Cleaning around implants differs from maintenance of natural teeth. Each attaches to surrounding bone and gums in a very different way. Also, the materials from which implants are made are very different from natural teeth.
Dental implants replace the root parts of the teeth. Artificial crowns, bridgework or removable dentures — tooth replacements that make up the visible (crown) parts of teeth — are attached to the implants. In between the implant and the crown of a tooth there is 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 “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 (connecting) tissue composed of tough fibers 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, the abutment and lower part of the crown attach to the gum via a specialized structure . 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 pocket 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 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. 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 (“peri” – around; implant “itis” – inflammation), which can result in loss of the attachment described above. Unlike inflammation around teeth, this reaction can be quite catastrophic both in rate and amount, quickly leading to a well- or dish-shaped loss of bone around an affected implant. Bone loss can rapidly progress to loss of the implant.
The dental hygienist has an important role to play in keeping dental implants infection-free. Visiting your dental hygienist every 3 months is imperitive to maintaining the health of your implants. Your hygienist is trained in how to clean around the implant body and also to look for problems that can be fixed more easily with early intervention.
People often think dental implants are a forever solution. However, the most common reason for failure is infection. Poor hygiene or patients not coming in regularly for their teeth cleaning appointments usually results in implant complications or failure. Plaque buildup along the gumline of a natural tooth or dental implant body can lead to gum loss. Gum loss or recession can happen to either, with plaque and tartar buildup along the edge of the implant.
If any part of the implant body (root replacement portion) itself becomes visible, this may mean there is infection that has resulted in gum and/or bone loss. The implant surface becomes exposed following loss of its fusion to the bone. Implant surfaces are generally microscopically “roughened” to increase surface area for bone attachment. But this surface roughness makes implants difficult if not impossible to clean and disinfect. Additionally, some implants are screw-shaped and their threads just add to the cleaning dilemma.
Despite these special cleaning challenges, implants are highly successful. In fact, studies indicate long-term success rates well over 95%. However, the prevention of peri-implant disease is fundamental to implant health, maintenance and function. Cleaning implants and their related components is an important part of success.
Of course, we recommend people who have Dental Implants to include the following in their daily routine.
-Water-Pik use in moring and evening
-Flossing around implants in a shoe shine motion
-Rinse for 1 minute with OraCare Mouthrinse and DO NOT rinse with water or eat or drink afterwards!
Be well!
