Should the dental hygienist perform scaling procedure around my dental implants?

November 06, 2022

Should the dental hygienist perform scaling procedure around my dental implants?
Tooth implants should be maintained and cleaned with a scale and polish procedure. However, different equipment should be used compared to cleaning natural teeth
Dental scaling of calculus and plaque around tooth implants
Removing tartar deposits around dental implant

The advances in dental implants has led to patients retain the functional efficacy of their oral cavity following the removal or loss of their natural tooth. Dental implants have a screw-like arrangement. They are affixed in the bony region with adequate density. The bone then forms and locks around the implants through biological processes.


How do I clean my tooth implants?


The success of a dental implant procedure depends a lot on how the patient maintains oral hygiene around the dental implant. Patients can brush with either a powered or a manual soft brush in order to keep the implanted tooth free of plaque. Even a floss can be used for cleaning the areas between the implant and the adjacent teeth. Water flossers can also aid in maintaining gingival health. Mouthwashes with chlorhexidine gluconate can help in reducing bacterial load.


Patients with dental implants need to visit the dentist for regular follow-ups. During the follow-up sessions, dentists check the health of the surrounding gingiva, take a radiograph to examine the underlying bone, check the normal bite, stability of the implant and any visible swelling or inflammation.


Do I need dental scaling for my tooth implants?


If needed, a dental hygienist or a dentist may even perform a scaling and polishing procedure. Usually, ultrasonic scalers with a metal tip are used in order to remove the unwanted plaque and calculus. However, for the tooth with implant, a modification is made in terms of the equipment used.


One of the most common conditions associated with inflammation is peri-implantitis. It is characterized by inflammation of the tissues around the implants which may also lead to resorption of the underlying bone which subsequently leads to failure of treatment. Thus, professional scaling procedures need to be done at regular intervals in order to reduce the microbial attack.


Can normal ultrasonic and hand scalers be used around dental implants?


Usually, the plaque and calculus deposits are present at the interface of gums and the natural tooth. In implants, these deposits form at the interface of the underlying abutment and the implant. If metallic instruments are used, then it may lead to roughening of the metallic surface of the implant, create scratch marks on the implant surface, roughen it and may even cause a galvanic reaction due to the metal-metal contact. Usage of these instruments thus creates a surface that welcomes more accumulation of bacteria and plaque. Moreover, titanium pieces may even get dislodged in the surrounding gums and cause inflammation there.


What is the right equipment for scaling around dental implants?


Scaling around implants is done by plastic or resin-based instruments. Some of them are reinforced with graphite or coated with gold that can also be sharpened. Caution is exercised in gold coated instruments which can get abraded, leading to exposure of the underlying metallic alloy. Another alternative incudes covering the conventional metallic scaler tips with plastic.


Medicaments and irrigants which are used for dental implant cleaning


In cases where severe calculus deposits has caused subgingival irrigation, antiseptic medications are used. Peroxide, Listerine or Chlorhexidine are delivered through plastic scaler tips in order to eliminate subgingival microbes. Cannulas with plastic tips can also be used to deliver antiseptics and antimicrobial like Arestin, Atridox, Periochip or Dentomycin. While using such chemicals, it should be taken into consideration that no strong acids are used. This also includes the routinely used sodium fluoride, which should be neutral. Acidic compounds can cause alteration of the structure of titanium, thereby damaging it.


The method used for scaling using resin based scalers is similar to the one that is used with conventional scalers. Based on the tooth surface, the scaler is used in horizontal, vertical or oblique direction with the goal of removing any discoloration, debris, plaque or calculus deposits. Some commonly used scalers for implants are Implacare, Steri-Oss Scaler system, 3i-Implant Innovations, and Implant Cleaning kits.


Can the dental hygienist perform the dental polishing procedure around tooth implants?


Followiing a scaling procedure, the tooth surface needs to be polished. Polishing of the abutment and the prosthesis is done using a rubber cup and a non-abrasive paste. This paste contains oxides that also help in brightening the tooth surface. Abrasive pastes contain fluor or pumice which are contraindicated for implants. Similarly, air polishing is also not recommended. This is because abrasive pastes and air polishing cause degradation of porcelain surfaces of the implants. This leads to pitting and irregularities that leads to accumulation of more plaque and calculus on the implant surface. Airflow polishing can also be used ro remove sub- and supragingival polyps, stains and plaque.


Scaling and polishing can be done around implants, provided that the dental hygienist or the dentist uses the recommended equipment.


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