Dentistry focuses on diagnosing, preventing, and treating conditions of the teeth, gums, and oral structures, supporting oral health and overall well-being.

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Oral Hygiene Tips

Keeping dental implants healthy over time means caring for the gums and tissues around them. While the implant itself doesn’t decay, the surrounding area can get inflamed, similar to gum disease. Cleaning around implants is different from cleaning natural teeth, so we focus on removing harmful bacteria to protect the bone and gums.

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Mechanical Biofilm Disruption

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Dental implants and their restorations can have shapes that make cleaning tricky. Special tools like interdental brushes with coated wires help clean these areas without scratching the implant. Water flossers are also helpful for cleaning under full-mouth implants, as they remove debris and reduce inflammation without harming the gums.

Chemical Adjuncts and Surface Integrity

Chemical rinses can help support brushing and flossing, but they must be safe for implants. Avoid acidic fluoride products, as they can damage the implant surface. Use neutral fluoride or chlorhexidine rinses for short-term inflammation control. The aim is to lower harmful bacteria while keeping the mouth’s natural balance.

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Professional Maintenance and Debridement

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Professional care is the cornerstone of prevention. During maintenance visits, clinicians use instruments made of carbon fiber, plastic, or titanium to clean the implant surfaces. Traditional stainless steel scalers are contraindicated as they can damage the implant surface, creating a niche for bacteria. In cases of early peri-implantitis, glycine powder air polishing is utilized. This technology uses kinetic energy to remove biofilm from the rough implant surface without removing the implant itself, effectively detoxifying the root and allowing soft tissue reattachment.

The Systemic Link and Longevity

Caring for dental implants helps protect your overall health, not just your teeth. Ongoing infection around implants can worsen heart disease and diabetes. Good oral hygiene is essential for long-term health and to make sure your implants last.

Biochemical markers of peri-implant health vs. disease

  • Levels of Matrix Metalloproteinase-8 (MMP-8) in sulcular fluid indicate collagenase activity and tissue breakdown.
  • The presence of polymorphonuclear leukocytes (PMNs) indicates active defense against bacterial invasion.
  • Concentration of pro-inflammatory cytokines IL-1beta and TNF-alpha correlates with the severity of inflammation.
  • The balance of the RANKL/OPG ratio is a critical determinant of bone stability versus resorption.
  • Absence of bleeding on probing (BOP) is the primary clinical indicator of peri-implant health and stability.
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Comparative objectives: Natural Teeth vs. Implants Maintenance

  • Probe orientation requires light force and specific angulation for implants due to anatomical differences.
  • Resistance to probing is less in peri-implant mucosa, allowing the probe to penetrate deeper than in natural teeth.
  • The biological seal around implants relies on hemidesmosomal attachment, whereas teeth have Sharpey’s fibers.
  • Vascular supply to implants is reduced due to the absence of a periodontal ligament and collateral circulation.
  • Response to plaque is marked by a faster progression of inflammation in implants due to tissue structure.

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FREQUENTLY ASKED QUESTIONS

How do I clean underneath a fixed hybrid denture?

Cleaning under a fixed hybrid denture, often used in All-on-4 cases, requires a water flosser and specialized floss threaders (Superfloss). You must thread the floss between the appliance and the gum to clean the underside where it rests on the tissue. An interdental brush can also be used to clean around the metal cylinders.

Yes, you can use a regular soft-bristled toothbrush, but an electric toothbrush is generally recommended. It is more efficient at removing plaque. Avoid stiff bristles, as they can cause gum recession and scratch the prosthetic materials.

This condition is called peri-implantitis. It causes inflammation and bone loss around the implant. If caught early (mucositis), it can be reversed with improved cleaning. If bone loss has occurred, professional treatment, such as deep cleaning, laser therapy, or surgery, may be needed to save the implant.

Absolutely. Even with full implants, you need regular check-ups to monitor gum health, implant stability, and the condition of the prosthetic teeth. The dentist also checks for oral cancer and ensures your bite remains balanced.

Metal tools that are harder than titanium can scratch the implant surface. These microscopic scratches create rough areas where bacteria can easily hide and multiply, increasing the risk of infection. Always use tools recommended by your dentist, which are usually coated or made of softer materials.

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