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Information for Dentists - Implant Care for Hygienists

Implant Care for Hygienists: Implants can suffer the same disease processes as teeth, so it is vital to perform an effective examination and provide effective supportive periodontal care.

Examine the whole of the oral cavity. Observe the condition of any natural teeth - record any signs of periodontal disease. Look for areas of plaque and inflammation, performing at least a BPE, proceeding to a full six-point pocket chart if there is a score of 4 in any sextant or if there is any doubt as to whether the patient's periodontal condition is worsening. Ask the patient whether they are aware of any problems such as pain or bleeding.

Always probe the implants as well as the teeth. You can use either plastic or metal periodontal probes, but be aware of the differences in probing around teeth or implants.

Note any areas of plaque,(disclose if necessary) pocketing, bleeding, suppuration or mobility. (Ref to CIST). Check the patient's oral hygiene procedures. Make sure the patient is using appropriate interdental cleaning aids. Reinforce the importance of daily self performed home care. We recommend an electric toothbrush and various interdental cleaning aids such as "TePe" brushes and "Superfloss".

For scaling, use either titanium or gold tipped scalers. Never use stainless steel instruments, as these can scratch any polished implant or abutment surfaces and encourage further plaque accumulation. Scale the implant as you would a natural tooth but with the implant scalers. Remove any hard or soft deposits. An ultrasonic scaler can be used as long as it has the implant tip.

If there is bone loss from the rough surface of the implant, it does not matter what you use to clean it - it is already rough! However, you should still avoid scratching any smooth surfaces. Follow with polishing, using a rubber cup and fine prohpy paste. Course grade pastes and abrasive air polishing units are not recommended. In areas of bleeding or suppuration, irrigate with Corsodyl mouthwash subgingivally. Continue to monitor these areas - refer to a Specialist Periodontist if necessary, according to the guidelines to be found on the BSP website.

Decide on an appropriate recall interval for each individual patient. Generally implant patients are seen on a 3 - 4 monthly recall basis. There is ample evidence to suggest that patients who lost teeth due to periodontal disease are more likely to lose teeth (REF)


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