Simple Dental Implant Tips for the RDH
With dental implants becoming more common in our world, you’ll definitely come across one (or hundreds) in your office each week. Even though they are becoming more common placed within our patient base, that doesn’t mean they are the easiest thing to assess and treat in our clinical chair. And now, with full mouth reconstruction with implants and having full arches full of implants, we as dental hygienists need to feel confident treating and educating this patient population. Here are a few helpful tips to follow as you enter into the implant world.
The neck is a perfect circle, while natural teeth are not. Lucky for us, we can critically think through adaption and angulation when it comes to a different shape. When you come to these implants, make sure you’re adapting differently, and usually more than you would a normal tooth because of the shape.
Different instruments are needed. Implants are made of titanium, which is a softer metal than our stainless steel instruments. Using stainless steel can potentially scratch the implant, which allows more surface area on a once smooth surface and attracts bacteria and biofilm. And we all know, more biofilm is not good news. Let’s keep these implants as smooth as possible, and use implant specific instruments and air powder polishing units to keep them bacteria free.
Stay away from plastic instruments. Research shows that the plastic from these instruments or shielded implant ultrasonic tips is flaking off and staying around the implant, causing irritation in the tissue. It has also shown that some threads from floss has been getting caught around implants, which causes irritation as well. Better keep those very fibrous flosses, the ones that I personally really like for natural teeth, away from implants.
When it doubt, refer it out. Implants can be finicky. Every year, they are changing their designs, materials, how they’re placed, etc. If you’re concerned about a patient’s implant, if the gingiva is inflamed around it, if there’s an open contact between the implant crown and the natural teeth, you’ll want to jump on those before it gets too late. Refer the implant back to whoever placed it to have it assessed, fixed, the crown replaced, whatever is needed to keep it back in health. The last thing we want is us as professions watch an implant get infected or mobile.
Don’t forget to stage and grade each implant. With the “new” AAP classifications, there’s a section that includes periimplantitis , and how to classify each implant to make sure they’re staying in a healthy stage. Make sure you keep your eye out for a new and improved AAP cheat sheet to download and keep in your operatory to help stage and grade not only implant patients, but any patient.
Home care recommendations. One of the most important parts of implant maintenance? Great home care! Of course. Instead of traditional floss, recommend interproximal brushes to help work under the crown and to get around the abutment as much as possible. We like the Tepe Interproximal brushes as they can be custom fit to your patient’s gingiva and implants, and can easily be purchased online.
Do you see implants in your office? Does your dentist place them? What is your protocol when it comes to maintaining dental implants?