Oral Hygiene after Implant Placement 

Although Mrs. Lin has successful immediate implant placement, her oral hygiene around the implant is a big concern for the dentist.  There is plaque (a thin membrane containing germs) attached to the top of the implant (Fig.1 ^) and the side (Fig.2 ^).  The doctor worries the most about the plaque on the side of the implant, i.e., next to the gums.  Fig.3 is a diagrammatic picture of cross section through an implant (I), the gums (G) and bone (B).  There is always a small gap between the implant and the gums, but big enough for tinny tiny germs to get in.

Fig.3 and 4 are taken right after professional cleaning.  The implant and gums look much better.  In fact, implant patients should clean the junction between the implant and the gums well on daily basis (Fig.6: left handed side).   The toothbrush should be angled at 45 degrees at the junction, all around the implant (360 degrees).  Do you want to see examples of good oral hygiene after implant placement (1,2)?

If oral hygiene remains bad for a while, the plaque (Fig.6 P, purple area) accumulates over the exposed portion of the implant.  The gums are turning red and inflamed (right handed side of Fig.6).   The germs travel into the space between the gums and the implant and even deeper, causing the bone to be separate from the implant.  The latter may become loose.

Therefore, we should keep the implant clean to prevent infection after placement.  Besides, take preventive antibiotic after surgery.

Xin Wei, DDS, PhD, MS 1st edition 09/11/2012, last revision 09/28/2012