Dental Implant Maintenance Part 2

By Alexander Germanis

Everything worth keeping over a long period of time requires some form of upkeep. Cars need regular oil changes, a home occasionally needs a new roof, and even relationships have need of communicative maintenance. Our teeth are, of course, no different. If we want them to last, we need to take care of them.

Artificial teeth, such as dental implants, are no exception to this rule. As mentioned in the last article in this series, dental implants are now the treatment of choice for dentists and patients alike when it comes to replacing lost teeth. A common misconception with the implants is once they are in place, they can be more or less ignored. After all, they will not succumb to cavities because they are made of porcelain; their roots will not rot because they are made of titanium.

Dentists like Emil Verban, Jr., DDS, want to stress there is no such thing as a maintenance-free tooth — natural or artificial. “There is a maintenance associated for the implant,” he insists. “They have to be inspected and cleaned around the neck of the implant to prevent any accumulation of bacteria.”

That bacteria, Dr. Verban goes on to explain, can result in a condition called peri-implantitis. Having arisen since the advent of dental implants, peri-implantitis is a growing problem. “It can develop as an inflammation and infection around the neck of the implant, which can cause loss of bone around the implant and can eventually cause it to fail.”

Just like with a screw imbedded in the strongest wood, that seemingly immoveable bond can be broken if the wood rots or is weakened by termites. Only preventative maintenance can stave off that potential deterioration.

The preventative maintenance is no more complicated than that which one already does for one’s natural teeth. “On a daily basis for patients at home, they need to control the bacteria in the mouth accumulating on the surface of the crown over the implant,” Dr. Verban says. “That can be done by brushing and using inter-dental cleaning devices such as floss or special little brushes that can clean around the neck of the implant.”

The Waterpik, a dental cleaning device that has been around since decades before dental implants, is also a good cleaning device when used in conjunction with those other cleaning methods. “When we’re restoring missing teeth and some bone has been lost, sometimes there are food impaction problems that need to be addressed,” Dr. Verban adds. “Sometimes the only way to keep things cleaned out is with the use of a Waterpik.”

As for dental check-ups, the dental hygienist uses a slightly different set of instruments when cleaning the implants. As preferable as implants are as replacements, the porcelain is still not as strong a material as what nature originally provides. “Hygienists use special graphite scalers to prevent scratching,” Dr. Verban says. “You don’t want to use the same type of stainless steel scalers used on normal teeth on the surface of a porcelain tooth.”

Not only has technology advanced for tooth replacement, it has done so for the tools used for cleaning. Scalers using ultra-sonic vibrations can now do the job once done only by steel. Equipped with special tips, the ultra-sonic scaler can also work around implants.

This is beneficial as some of the other newer cleaning methods, such as the micro-etcher — also known as the intraoral sandblaster — can be detrimental to the newer porcelains used today, the doctor says. “You could use it all around natural teeth, but it’s usually contraindicated around crowns, because you will abrade the surface of the porcelain.”

Simply put, no advances in dentistry will replace the factor of human responsibility. “Although implants are great for the replacement of teeth,” Dr. Verban states simply, “that doesn’t eliminate the need for maintenance.”

To learn more about the advantages of dental implants, read “Treatment of Choice, Part 3” in next month’s issue of Healthy Cells.