How implant surgery can help both you and your patients

When identifying implant candidates and creating the long-term goals for successful implant therapy, the dentist and hygienist must work seamlessly to understand the clinical reasons that a patient may need or choose implant therapy, including the psychological needs or trauma that accompany. Many patients who benefit from implant therapy are those who have lost their teeth from periodontal disease or trauma.

With proper education, preparation and perspective you can become a true co-therapist in your practice. With that in mind, I want to present three reasons why implant therapy could be important for your patients, followed by a discussion of how to give your patients the best advice and care. These ideas are meant to either spark your interest in implant therapy, or keep the lifelong learning habit that is a must for successful implant case selection and maintenance. Here are the reasons you should consider implant therapy:

1. Anodontia (genetically missing teeth):

Imagine the remorse of parents who must tell their small children they will never have natural teeth. The FDA has approved mini implants for use in the developing jaws of children, enabling them to wear dentures until a final treatment plan can be executed. For these children, implants boost self-esteem and bring hope for a more natural entry into social settings, let alone the ability to eat properly and grow strong.

2. Teeth lost to disease:

When all teeth are lost, the jawbone be­gins to resorb, and over time can lead to life threatening spontaneous fractures, especially in the mandible. Implant therapy can create and maintain jawbone health and function. Many geriatric patients living with ill-fitting dentures often purposely limit their social engage­ments out of embarrassment over their in­ability to speak or chew comfortably. Do you believe this situation can impact their self-esteem and lead to loneliness and despair?

3. Trauma:

Psychological trauma either through illness or accident robs us of our sense of identity, and spawns fear and pain, both physical and emotional. Not only does the patient suffer through the healing phase of an accident or illness, but the emotional effects can also overwhelm families and friends. Implants help to rebuild lives.

Solution? Foster professional and at-home understanding:

Developing expectations and clearly presenting the importance of continued, structured maintenance after the case is complete must begin at case presentation. The success of implant therapy rests with the patient fully understanding the need for at-home and in-office care.

Aids to use at home:

Power Brushes:

Electric and sonic brushes have been proven safe for use around implant restorations. Electric brushes such as “Rotadent” or “Oral-B” can be recommended.

My preference for sonic brushes is the “Sonicare” brush by Philips. Why? The sonic technology has a vast library of research supporting the efficacy and safety for use around dental implant restorations. The sonic ability of the Sonicare has been given the classification of a “medicament placement device,” meaning that the toothpaste, gel fluoride or any needed medication is pushed 3 mm past the end of the brush. This function allows for increased interdental cleaning.

Oral Irrigators:

Water Flosser by WaterPik, Profloss 4190 Waterflosser and the Air Floss by Philips are three top choices for at-home irrigation.

Manual Interdental Aids:

Whatever interdental aid you choose, the most important aspect is that all parts of the bristles are rubber, plastic or covered with plastic. Examples are TEPE brushes, Super Floss and GUM brand Soft Picks.

There are many other aids for use around dental implants. Remember to ask your manufacturer representative for research papers on any brush you choose.

Hazards:

Peri-mucositis:

• Main symptom is inflammation without evidence of bone loss
• Caused by insufficient oral hygiene and/or poor prosthetic design or occlusion
• Most often caused by loose abutment which enables bacterial infiltration and can lead to peri-implantitis
• Peri-implantitis:
• Gingival expression may mimic a periodontal abscess, suppuration and BOP may occur
• Can cause rapid bone loss
• Treatment involves infection control and possible modification of exposed implant surface; resective or regenerative procedures may also be indicated.
• Recognized by radiographic or clinical evidence of bone loss

The practice of implant dentistry is growing faster than any other specialty dentistry. Don’t be left behind! The potential for patient satisfaction and your professional fulfillment will be enormous as you embrace this topical “Gold standard of care”.