Dental implants have been around for a little while now (+40 years!) but its surprising how few dentists actually tell their patients the best way to maintain them!
The first thing to appreciate is that dental implants are not invincible, and although they will never rot, they can get gum disease. And no any old gum disease, when the bone and gum start to go from around the implants, it happens much more quickly than it would around natural teeth.
This is obviously a very big problem, considering how expensive dental implants are!
The Difference Between Teeth and Implants
In order to understand why gum disease effects dental implants differently, we need to look at how the gum attaches to the implant, compared with natural teeth.
In natural teeth, there are lots of little fibres that attach to the tooth, from the gum. These fibres run is lots of different ways, so some will run around the tooth, some will run from tooth to tooth, some will be from bone to tooth, the end result is a complex mesh of these strong fibres around the tooth.
This means that if there is an area where gum disease is starting, then it can be confined to that area (at least in the early stages).
Dental implants are different, they only have one set of fibres running around them. To add problems, the strength that these fibres attach to the implant is weak!
So in real life, this means that its easier for implants to get gum disease because the gum is more delicate. When gum disease does start, its very difficult to stop (because there is no compartmentalization of fibres and because the implant surface is rough).
Okay… You’re Scaring Me!
So this article isn’t designed to put people off dental implants, or to scare those who have them. I put it together to help you understand something that isn’t well talked about by most dentists.
The good news is that there is a lot that you can do at home to keep your shiney dental implant looking great for many more years!
Until the end of 2015, I used to recommend 3 monthly hygiene sessions to all our implant patients, to help protect from this issue, but I have since changed my advice.
The truth is that if you can effectively clean your implants at home, then you do not need to come in so much for professional cleaning, and these appointments can be used more effectively.
So here are some great ways to maintain your dental implants:
Floss and Super-floss
This is great, and most dentists recommend this. If you do not know what super-floss is, its a special floss designed to get under bridge and some implant work.
The problem with floss and super floss is that most patients are not dedicated enough to do it every day. No matter what you tell your dentist you do, its clear to most dentists that this is not as effective as it can be, possibly because it doesn’t fit with lifestyle or because the technique of the user isn’t right
What about Brushing?
Regular tooth brushing is essential. This will get rid of most harmful bacteria, however its not great at getting below the gum line.
Its easier to do a good clean with an electric toothbrush (I recommend Oral-B, anything above series 2000), but you run the risk of loosening the abutments of the dental implant, which means another trip to the dentist to fix this!
Sometimes people ask me about this. In short, its not recommended, but if you want to read more, you can have a look at my other blog on the subject.
Do Mouthwashes Work?
Actually, many studies have shown that they do!
But be careful, they are not all made the same! Some mouthwashes contain Chlorhexidine (Corsodyl mouthwash contains this). You should use a mouthwash that contains 0.2% Chlorhexidine. Beware that Corsodyl will stain your teeth! There are other brands that do not stain so look for these.
Listerine has also been shown to be better than the average mouthwash. Listerine does not contain any chlorhexidine, but studies have shown it to be better at killing bacteria than placebo mouthwashes.
A Water pick is a device that squirts a thin jet of water, cleaning your teeth. There are many different types available, so you need to be sure to get the right one.
The main thing to look out for is: does it have a dental implant head? and does it have a pulse setting. If the answer to these is ‘yes’ then you should buy it!
One way to make water picks much more effective is to use the 0.2% Chlorhexidine mouthwash instead of water! The water jet will make it go deeper into the gum, for better results.
All these techniques are important, but you may need to be shown exactly how to carry some of these out. A good hygienist will be able to do this for you.
There are a few other things that are not in your direct control that will effect how long your implants last. Lets look at design.
Lets say your teeth on your implants are screwed in, and there is a lot of gum coverage. This design is terrible, because you cannot clean your implants at all, and its only a matter of time until they lose bone. So the skill and knowledge of the dentist who did your treatment is critical – do they think long term!?!
You still need to see your dentist or hygienist for follow up appointments, but they will need to check a whole bunch of other things during these appointments. Next week, I will write another article about this, and the long term changes that need to be monitored, and what your dentist and hygienist should be doing to monitor this.
If you found this useful, please feel free to leave a comment below.