Clean and Maintain Dental Implants
Depending on the type of dental implants you have, you will clean them at home, either by brushing them just as you would your natural teeth, or by removing any removable pieces and soaking them outside of the mouth. Cleaning dental implants at home is an important step in preventing peri-implantitis, an infection that can lead to loss of the implants. In addition to cleaning dental implants rigorously and routinely at home, your dental hygienist will use specialized tools to clean your dental implants during periodic professional cleanings. Cleaning around dental implants requires tools and techniques that differ from those used to clean the natural teeth. Because dental implants attach to the bone and surrounding tissue very differently from natural teeth, and because they are made from materials that vary significantly from natural teeth, they have specific needs.
Dental implants are designed to serve as replacement roots for natural teeth that have fallen out or been removed. Dental restorations, which can include crowns, bridges, or dentures, are affixed to the tops of the implants, which are surgically placed into the alveolar bone in the jaw. Most of the time, there is a small connecting piece, called an abutment, that attaches the dental restoration to the implant. In order to function successfully, the dental implant must fuse with the alveolar bone, a process that occurs as the implant heals and is called osseointegration. The material used to make dental implants contributes to osseointegration; because of the importance of this process, materials must be biocompatible and predisposed to fuse with the bone. Above the bone, the abutment connects with the gum tissue and is supported there by connective tissues that are made of collagen. These collagen fibers hold the gum tissue securely to the surface of the implant. Just atop the implant and abutment, the crown attaches to the gum tissue with the epithelial attachment, a specialized type of tissue that occurs naturally in the periodontium and suctions the cells of the gum tissue to the smooth surface of the dental crown. This is considerably different from the mechanism that holds a natural tooth in the mouth. With natural teeth, a periodontal ligament inserts into the bone and the root of the tooth and holds the tooth into the mouth. The periodontal ligament also provides the blood supply that nourishes the tooth and maintains its vitality, helping it resist infection. Obviously, a ligament can’t insert into a dental implant, and it therefore lacks this blood supply and vitality, leaving it susceptible to infection.
When the tissues surrounding the dental implant are healthy, the implant itself is better supported and less prone to infection. Bacterial plaque accumulates on dental crowns just like it does on natural teeth, and daily home hygiene can remove the majority of this potentially destructive biofilm. During professional cleanings, dental hygienists will choose their cleaning tools based on the type of debris that may be present on the crowns and at the gumline, the location of this debris, the type of tissue where it is located, and the durability of the debris. The selected tools must be designed to limit possible damage to the crown, abutment, and implant, as the smooth surface of these elements is a valuable part of their ability to reject bacteria. Metal instruments that are harmless on natural teeth can scratch these highly polished surfaces, so dental hygienists will often choose scalers and curettes that are made of resin or plastic. Dental hygienists may also choose ultrasonic instruments with nylon or plastic tips; these clean the teeth with high-frequency vibrations, which can be particularly effective when there is an excessive amount of debris. Hygienists may also use a greater level of water irrigation, or they may introduce antibacterial solutions to help clean the area. If the implant itself is visible, this may indicate infection, and the exposed implant area will be cleaned with soft brushes before any restoration or other treatment. Dental implants have a long-term success rate of more than 95%, and diligent home hygiene, combined with the professional methods dental hygienists use, help ensure their continued success.