Remember, dentistry is not expensive... Neglect is!

Introduction by Heidi Trautmann

To continue our professional advice series Dr. Oguz Ozan will here speak about Dental Care which in my opinion is not only valid for the implanting process but for all times just as it does not suffice to buy a new robe, you have to keep it in good condition. When you have decided to undergo an implantation you have also taken a decision for improving your life, to regain your joy of life, and to find yourself nice when you look into the mirror and smile.

CARING FOR DENTAL IMPLANTS

By Oğuz OZAN DDS, PhD (Prosthodontist, Dental implantologist)

Near East University Faculty of Dentistry Department of Prosthodontics

Good oral hygiene is very crucial in caring of the dental implant retained restorations. It takes special effort to maximize plaque bacteria removal every day. This means along with regular dental visits, appropriate care like brushing properly, flossing regularly, and cleaning the spaces between the existing teeth with an interdental brush is very important. It is also advised to use antibacterial toothpaste to minimize the bacterial plaque by continuing to kill plaque bacteria after brushing.

Inadequate oral hygiene can lead to the loss of implants. It is very important to perform good oral hygiene and implant care to avoid complications that could result in implant failure since a lot of time and money was spent to have an implant retained restoration. In addition, if one implant is lost there is no guarantee that a new one can be placed again in the same area because if the inflammation around the implant is left untreated, it may result in a bone loss that makes it difficult to find enough bone tissue for a new dental implant in the same area.

One of the prerequisites for an optimal care of dental implants and for oral hygiene and maintenance after the delivery of the prosthesis is to stop habits that are counterproductive, for example smoking. Smoking is one of the greatest risks for implant-related complications. Therefore patients are strongly recommended to try to quit smoking for reducing the risk of complications.

Careful attention to the oral hygiene,  not only during all steps of the dental implant treatment but also after the delivery of the prosthesis is crucially important for the survival of the dental implants. Maximizing plaque removal every day through effective tooth brushing and flossing is also very important. In addition to prevent plaque build-up, antibacterial mouth rinses are also recommended by the dental professionals.

For removing as much plaque bacteria as possible from between teeth and around the implant flossing has to be done. Flossing can be done at any step during the implant process which makes gums healthy and reduces plaque bacteria in the interdental spaces (the gap between teeth or implants). For desired removal of the bacteria plaque from the interdental spaces interdental brushes can be used since a regular toothbrush does not reach into interdental spaces. The unique design of these interdental brushes allows the penetrating of interdental spaces and should regularly be used after using the normal tooth brush.

Check-up appointments are also very important for the maintenance of the implant retained restorations. In these appointments, implants, existing teeth and soft tissues will be checked and new x-rays will be evaluated to ensure long life of the restoration. They are generally at intervals of 6 months but this has to be decided by the dentist. At these appointments, the areas which cannot be cleaned by the patient himself will be checked and professionally cleaned if needed. Professional cleaning of implants is more complex than cleaning existing teeth and may take longer and require special instruments.

Mouthwash instead of brushing and flossing for dental implant patients?

During the healing phase of implant therapy, great care has to be exercised to keep the area clean and with minimal bacterial exposure. For this purpose mouthwash, brushing and flossing have to be performed to obtain the desired oral hygiene. However, mouthwash should not replace brushing and flossing, even the best mouthwash is not a replacement for proper brushing and flossing. The liquid is able to flow through hard to reach surfaces as an extra safety barrier against bacteria as brushing cleans only the cheek, tongue, and biting surfaces of the teeth.  Mouth rinsing is done to prevent tartar and plaque, to freshen the breath, reduce gingivitis, and prevent tooth decay by their different ingredients. Within these ingredients, antimicrobial agents (chlorhexidine) can help reduce plaque, decrease the severity of gingivitis and thereby control bad breath. Fluoride prevents decay by strengthening the tooth enamel. Astringent salts and odor neutralizers can temporarily prevent the formation of bad breath.

Long-term use of a mouth rinse is not recommended without visiting your dentist for advice. For example, salt water is acidic, so it could erode the teeth if you were to use it every day. Additionally, the chlorhexidine mouthwashes have a residual effect, so using it for two weeks and then stopping for 3 months is as good as using it every day.

As a summary, Mouth rinses do serve a lot of purposes, whether to freshen your breath or help fight plaque and gingivitis, but, please keep in mind they should only be used as recommended for the individual situation and should not replace regular brushing and flossing. So do not get lazy with your toothbrush and dental floss!

Note by Heidi Trautmann: Dr. Oğuz OZAN can be contacted at Near East University Nicosia, Faculty of Dentistry, Tel. +90 680 2030 /2640