Dental implants are an excellent solution for replacing missing teeth and restoring your smile. However, just like natural teeth, implants require proper oral hygiene to keep them clean, prevent infection, and ensure their longevity. Plaque is a thin, sticky film of bacteria that adheres to tooth and implant surfaces. If plaque is allowed to accumulate, it can lead to inflammation, infection, and bone loss around the implant. Fortunately, with the right tools and techniques, keeping implants plaque-free is very achievable.
What is Dental Plaque?
Plaque is a colorless biofilm that constantly forms on teeth and dental work like implants, bridges, crowns, and veneers. It is made up of bacteria, food debris, saliva, and mucus. As plaque accumulates, the bacteria within it metabolize carbohydrates and produce acid that can start deteriorating tooth enamel and irritate gums. If left untreated, plaque can turn into tartar or calculus – a hard deposit that can only be removed by a dental professional.
On natural teeth, plaque tends to accumulate along the gumline and in cracks, fissures, and interdental spaces. The same goes for dental implants, where plaque gathers around the implant-abutment connection, implant shoulders, and between neighboring implants. Even small amounts of plaque on implants can trigger inflammation, bleeding, and infection of surrounding tissues and bone.
Why is Plaque Harmful to Dental Implants?
Dental implants fuse to the jawbone through a biological process called osseointegration. For successful osseointegration and longevity of implants, the bone and tissues around them must remain healthy and free of infection. However, bacterial plaque produces inflammatory compounds that cause gum swelling, redness and bleeding – a condition known as peri-implant mucositis.
If left untreated, peri-implant mucositis can advance into a more serious form of infection called peri-implantitis. This leads to loss of supporting bone around the implant. Unlike gingivitis which is reversible, bone loss due to peri-implantitis is usually permanent. It makes the implant unstable and can eventually lead to its failure.
Additionally, the acidic byproducts in plaque erode the protective titanium oxide layer on implant surfaces. This exposes the metal underneath to corrosion and further bacterial colonization, jeopardizing osseointegration.
Therefore, adequate plaque removal is critical for protecting the tissues and bone surrounding implants, preventing infection and technical complications, and ensuring the long-term survival of implant restorations.
How Often Should I Clean Plaque Off My Implants?
Most dental professionals recommend cleaning implants at least twice daily – after breakfast and before bedtime. However, some patients who are more susceptible to plaque buildup may need to clean their implants more frequently – after each meal and snack.
The goal should be to remove plaque before it has a chance to accumulate and cause harm. When choosing implant cleaning frequency, consider factors like:
- Amount of saliva flow – Low saliva means less self-cleansing.
- Diet – Frequent snacking adds to plaque buildup.
- Dexterity and motivation to clean implants.
- Types of implant restoration like bridges which are harder to clean.
- History of periodontal disease which increases infection risk.
Your dentist and hygienist can guide you on the optimal cleaning schedule for your unique situation. Be diligent, as prevention is much easier than dealing with implant infections after they develop.
Steps for Effective Plaque Removal from Implants
Here is a step-by-step procedure to thoroughly clean plaque off your implants:
- Use antimicrobial rinses – Rinse your mouth with an antimicrobial mouthwash before brushing. This helps loosen plaque and reduces the microbial load.
- Brush with a soft or extra-soft bristled toothbrush – Use gentle, massaging motions to clean implant surfaces without damaging them. Electric toothbrushes are ideal but manual ones work too if used properly.
- Choose non-abrasive toothpaste – Avoid whitening pastes as they are too abrasive for implant surfaces. Use a paste for sensitive teeth.
- Brush along the gumline – Use gentle vibrational motions to remove plaque from implant shoulders where it likes to collect.
- Tilt brush to clean all implant surfaces – Hold brush at 45° angle and use precise motions to access smooth, hard-to-reach implant sides.
- Brush your tongue – This removes bacterial buildup and freshens breath.
- Rinse out residual toothpaste – Use an antimicrobial rinse again to wash out any remaining debris.
- Use interdental cleaners – Floss or interdental brushes to remove plaque from between implant crowns or bridges.
- Rinse with water – Rinsing washes away dislodged plaque and keeps implant areas clean.
Always be gentle while brushing implants. Let the brush bristles do the work rather than applying excessive pressure. Consult your hygienist if you are unsure about optimal brushing techniques around implants.
Which Oral Hygiene Tools Work Best for Implant Cleaning?
Specialized tools help clean implant surfaces more effectively. Some recommended options include:
Soft-Bristled Toothbrushes
Use a brush with ultra-soft or extra-soft bristles, such as a surgical toothbrush. The softer bristles are non-abrasive and contour nicely along the implant-abutment interface.
Electric Toothbrushes
Sonic or ultrasonic electric brushes provide an easy, efficient cleaning. Their high-frequency vibrations help dislodge plaque without damage. Choose a model with a pressure sensor and adjustable intensity.
Specialty Implant Brushes
These have uniquely tapered bristles to clean under and around implant abutments, crowns, and bridges. Popular options are the Curaprox Perio brush and Philips Sonicare AirFloss.
Plastic Proxies or Implant Aid Brushes
These allow accessing smooth implant sides to brush plaque away. They have long angled handles with either regular bristles or specialty rubber polishers on the ends.
Interdental Brushes
Also called proxa-brushes, they have a tapered wire core and bristles. These help remove plaque from tight spaces between implants, below the gumline and around prosthetic connectors.
Dental Floss
Slide floss carefully between implants to dislodge plaque. Special threaders can be used to get floss through implant bridges.
Oral Irrigators
These counter-top water devices use pressurized pulses for plaque removal below the gumline and between teeth. Ensure tip sterilization to prevent redistributing bacteria.
Specialty Oral Rinses
Antimicrobial and antiseptic rinses aid mechanical cleaning by killing bacteria and preventing plaque formation when used daily.
Always use implant brushes as directed to avoid tissue damage. The goal is plaque removal, not vigorous scrubbing. Schedule professional implant cleanings every 3-6 months too.
Tips for Optimizing Implant Brushing
Here are some tips for getting the most plaque removal from your daily implant cleaning routine:
- Soak brushes in mouthwash to sanitize them.
- Replace your toothbrush every 2-3 months or sooner if bristles appear frayed.
- Brush before eating to clear debris dislodged by food.
- Brush again after eating sugary or acidic foods to limit plaque attack.
- If brushing after meals isn’t possible, at least rinse thoroughly with water.
- Brush your tongue to keep implant areas bacteria-free.
- Take your time – don’t rush the cleaning process.
- Use a mirror to check sides and surfaces of implants.
- Get professional cleanings every 3-6 months to remove hardened calculus.
Are Special Toothpastes Better for Implant Brushing?
Regular toothpastes may be too abrasive for implant surfaces. Some choices gentler on implants include:
Sensitivity Toothpastes
Formulated for people with sensitive teeth and gums, these contain minimal abrasives. Options like Sensodyne Rapid Relief are suitable.
Tartar Control Pastes
Oral-B, Crest and Colgate make toothpastes that fight tartar buildup without being too abrasive. Using these minimizes calculus formation around implants.
Fluoride Toothpastes
Fluoride strengthens dental work by remineralizing surfaces. It’s best to use a fluoride paste twice daily for added implant protection.
Antimicrobial Pastes
Containing ingredients like triclosan, these reduce biofilm formation and gingivitis risks. But triclosan safety is controversial, so check with your dentist first.
Baking Soda Pastes
These help neutralize plaque acids and have mild abrasion for stain removal. Options like Arm & Hammer Advanced White are suitable for occasional use.
Whitening toothpastes and tartar control pastes with pyrophosphate should be avoided as they are too abrasive for implants. The best solution is to ask your dentist to recommend the ideal toothpaste for your situation.
Why Seek Professional Implant Cleanings?
While maintaining implant hygiene at home is important, professional cleanings are still needed every 3-6 months. Here’s why:
- Removes hardened calculus – Tartar around implants can only be removed by specialized dental instruments.
- Accesses difficult areas – Hygienists can better clean under bridges, around prosthetic connectors, and behind implants.
- Regular evaluation – Dentists examine implants for problems like looseness, inflammation, and peri-implantitis.
- Polishing – Removes stains and creates a smooth surface less prone to plaque adhesion.
- Irrigation – Flushing below gumlines provides added antibacterial benefits.
- Oral cancer screening – Checking for signs of oral cancer is an important aspect of regular visits.
- Motivation – Seeing the dental team reminds people to keep up daily implant care.
Do not skip your routine professional cleanings. Report any implant sensitivity, swelling, or discomfort you notice so it can be addressed promptly.
What Does a Professional Implant Cleaning Involve?
A professional dental cleaning tailored to implants will likely include:
- Reviewing medical/dental history – The hygienist notes any changes to medications, health conditions, symptoms, habits.
- Extra-soft polishing – Implant surfaces are gently cleaned and polished to remove biofilm and stains.
- Scaling – Manual scalers or ultrasonic devices remove calculus above and below the gumline.
- Plaque staining – Disclosing solution reveals any plaque left after cleaning to be removed.
- Flushing – Antimicrobial and oxygenating solutions flush out bacteria.
- Curettage – Inflammation is reduced by scraping beneath the gums.
- Oral cancer screening – Visually examining and palpating oral tissues.
More frequent cleanings or periodontal therapy may be advised for those prone to heavy plaque and calculus buildup. Alert your hygienist to any implant sensitivity during cleanings.
Post-Cleaning Care for Your Implants
Follow your dentist’s post-cleaning instructions to avoid complications and support healing. Typically, this includes:
- Rinsing with antimicrobial mouthwash 2-3 times a day.
- Brushing twice daily with a soft toothbrush.
- Avoiding hard, sticky, crunchy foods that could dislodge healing gum flaps.
- Taking any prescribed antibiotics or antiviral medication.
- Using topical medicated ointments on inflamed gums.
- Returning promptly if you have heavy bleeding, severe pain, fever, or other issues.
The tissues around implants may be sensitive for several days after a thorough professional cleaning. Proper oral hygiene, medication use, and diet will hasten recovery.
When to Seek Emergency Dental Care
In rare cases, an implant cleaning can lead to complications warranting urgent dental attention. Seek emergency care if you have:
- Moderate to severe pain that medication cannot control.
- Significant swelling inside or outside the mouth.
- Bleeding that does not stop within 2-3 hours of cleaning.
- Numbness or tingling in the lips, face, tongue, or throat.
- Difficulty swallowing, speaking, or opening your mouth.
- Fever above 100°F.
These could indicate a bone or tissue infection, nerve injury, or hematoma that needs immediate treatment. Emergency extraction may be needed if the implant becomes loose, mobile, or unsalvageable.
Preventing Implant Complications
You can avoid many implant problems by staying diligent with your oral hygiene and getting regular dental checkups and cleanings. Additionally, be sure to:
- Not skip your daily implant cleaning even when you’re busy or traveling.
- Avoid smoking, chewing tobacco use, and excessive alcohol.
- Control existing medical conditions like diabetes that increase infection risks.
- Discuss any medications that cause dry mouth with your dentist.
- Get gum disease treated promptly to limit bacterial seeding of implants.
- Use night guards if you grind teeth to prevent implant damage.
- Replace worn toothbrush heads regularly for optimal plaque removal.
Your implants can last many years when well cared for. But poor hygiene accelerates failure risks. Stay vigilant and get professional help early at the first sign of any implant problems.
Conclusion
Dental implants require conscientious oral hygiene to stay plaque-free and avoid detrimental complications. Daily brushing and flossing using specialized implant tools is essential, along with professional cleanings every 3-6 months. With proper diligent care, your implants can remain healthy, clean, and functioning at optimal levels for decades.
