Dental implants are a great alternative to bridges and dentures. They provide a more stable chewing surface than dentures and are cosmetically virtually indistinguishable from natural teeth—in fact, even better in some cases! However, the care of implants differs from the care of natural teeth in some important ways.
Each natural tooth sits in a bony socket within the jawbone. It is attached by the periodontal ligament, which penetrates both the root of the tooth and the bone (or the gum tissue, above the bone) with tiny fibers. Blood vessels supply the tooth and surrounding tissue. A dental implant, by contrast, consists of a titanium peg inserted into the jawbone which over time fuses to the surrounding bone tissue. A connector called an abutment attaches the crown (the artificial tooth) to the titanium peg. Much as it does with a natural tooth, the surrounding gum tissue attaches to the polished surface of the abutment with microscopic suction cups.
Careful cleaning of dental implants is so important because implants lack the infection-fighting capabilities of natural teeth. The blood vessels that supply a natural tooth bring antibodies and white blood cells in addition to oxygen and nourishment; without those blood vessels, an implant is much more susceptible to infection. Plaque—the film of bacteria that accumulates on teeth—is responsible for gum disease. But plaque can produce infection and inflammation of the gum tissue frighteningly fast in a dental implant. Infected gum tissue tends to pull away from the abutment, and if the infection progresses to the underlying bone, the socket can be eroded, leading to loss of the entire implant.
A dental hygienist typically cleans an implant using tools made of plastic. You’re probably accustomed to the metal tools used on natural teeth, but dental implants are made of material that is softer than teeth. The surfaces of the abutment and the crown must remain highly polished. Scratches—even microscopic ones—impede the ability of the gum tissue to adhere and provide a home for bacteria.
Another cleaning technique for dental implants uses ultrasonic tools, which employ high-frequency sound (vibrations) to remove contaminants. These are normally only used when large amounts of debris must be removed. Often the hygienist will use an antibacterial rinse to accompany the ultrasonic cleaning.
If the implant body (the titanium peg itself) has become partially exposed, this is a cause for concern, as it means some of the bone of the socket has eroded. It also presents a challenge for cleaning, because the surface of the peg is either threaded (like a screw) or roughened to help bone fuse to the metal. This rough surface provides plenty of hiding places for bacteria, so brushes are the tool of choice for cleaning any exposed implant bodies.
Dental implants have a very high success rate exceeding 95%, and they are preferable in many ways to dentures and bridges. However, it is vital that implants be kept clean with a rigorous dental hygiene regime. Just as with your natural teeth, this means brushing twice daily with a soft-bristle toothbrush and a low-abrasive toothpaste and flossing to ensure all sides of the implant are clean.
Your dentist may also recommend an antibacterial mouth rinse. Depending on the amount of space between the implants and the surrounding teeth, interdental brushes may also be helpful in cleaning between teeth. In addition to daily home care, twice-yearly cleanings by a dentist are critical to ensure that the implants do not become subject to infection. With proper care, your implants will provide many years of good service.