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Contributing Expert: Training Patients on Cleaning their Implant Restorations

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Dental Care

Dental Care

Joseph J. Massad, DDS
Practicing Dentist and International Speaker


In the early years of placing implants, patients were not given a specific protocol on optimal methods of cleaning their implant restorations. Over the past 2 decades, we have found a high prevalence of periomucositis in a significant number of patients. If patients are not informed of the vital importance of cleaning their implant restorations, problems will likely develop. There are documented reports which suggest peri-implantitis is now a factor of implant disease and potential susceptibility for failure has become a concern. Generally other contributing factors complicate this premise, however, clinicians are professionally and ethically bound to closely evaluate implant candidates and discuss the need to have meticulous hygiene of any recommended implant procedure prior to accepting treatment. There have been several published articles supporting this rationale. Patients are generally informed to make routine hygiene appointments in which the dentist and/or hygienist cleans the patient’s teeth along with their implant restorations. However, patients are not always compliant and do not make their routine three to six-month recall appointments consistently, thereby allowing additional formation of debris to accumulate around the implants between appointments. Even though we have had a significant amount of success with our implant patients, we in the United States are becoming more and more sophisticated in providing fixed implant restorations, which become even more difficult for patients to maintain due to the cosmetically designed prosthesis which many times create areas difficult to gain hygienic access.

Due to technology innovations of oscillating-rotating power brushes, we now have the tools to help prevent conditions leading to problems associated with poor implant hygiene. With the advent of the Oral-B® Professional Care SmartSeries 5000 power brush, there are numerous brushing heads that can negotiate difficult areas around and under many implant supported restorations. The Professional Care SmartSeries 5000 brush also has a number of features to enhance the cleaning experience for patients. These include an excessive pressure sensor light on the handle to alert the patient they are applying too much pressure which may be harmful to both tissues and tooth structures avoiding gingival abrasion or increase cervical tooth wear. Other features include variable modes for pulsation speeds allowing both the sensitive and healthy patients to alter both brushing time and mode settings. The most novel features are the variety of brush head designs. I have chosen three main designs to accommodate most if not all implant prosthetic design scenarios.

An instructional video provided online or by request is provided to the dental professional to instruct their patients a recognized hygiene protocol which demonstrates each implant restoration type and how it is utilized for optimal cleaning. The individual brushing heads are also identified as to which head will negotiate the particular implant configuration for the patient. A short video on hygiene of implants can also be found on my website under the subheading “Dental Economics Tip of the Day” (click on February in the video window).

The Professional Care SmartSeries power brush is an excellent tool for patients to protect their restorative investments. We inform our patients that once they have implants, it then becomes their responsibility to maintain their hygiene. It is the responsibility of the dental professional to inform and encourage their patients on how to maintain their implant restorations. The easy instructions give each patient the ability to choose the particular brushing head and the particular mode which best suits their situation. I believe this is an authentic and honest approach we can offer our patients.

Taking all this into consideration, the patient has very little excuse on not maintaining their teeth between appointments.

I encourage all dental professionals to consider informing their patients about an implant hygiene protocol to improve the over health of their teeth and body.



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