Implant care and maintenance

Daily care at home

The AAP states that implant teeth are cared for with the same daily brushing and flossing recommended for natural teeth.¹ The ACP states that conscientious home care and regular professional cleanings are essential to lasting implant success.² The FDA advises following the dentist's oral hygiene instructions and attending regular appointments.³

How often to see the dentist

A 2016 meta-analysis by Monje and colleagues studied maintenance therapy and peri-implant disease.⁴

• Implants under maintenance therapy had fewer failure events than implants without it.⁴
• The interval between maintenance visits influenced peri-implantitis.⁴
• The authors suggested a minimum recall interval of 5 to 6 months, tailored to each patient's risk.⁴
• Disease can still occur with maintenance, so patient and implant factors need ongoing review.⁴

What a maintenance program includes

The European Federation of Periodontology's S3 guideline (2023) recommends a structured supportive care program once implants are in function, including periodic assessment of the tissue around the implants.⁵ The 2017 World Workshop recommends baseline x-ray and probing measurements when the restoration is completed.⁶

Signs to report

The AAP lists red or tender gums around the implant and bleeding when brushing as signs of peri-implant disease.⁷ Early mucositis may be reversed with treatment.⁷

Parts that need service

Implant crowns and bridges have parts that can loosen or chip over time.⁸ Screw loosening occurred in 8.8 percent of single implant crowns over 5 years.⁸ For fixed full-arch bridges, chipping of the veneering material was the most common technical event.⁹

Questions to ask

• How often maintenance visits are scheduled, and who provides them.
• Which cleaning aids suit the bridge or denture design.
• Whether a full-arch bridge is removed for professional cleaning, and how often.

General information about dental implants. Treatment decisions are made with a licensed dentist.

Sources

1. American Academy of Periodontology: Full Mouth Dental Implants. perio.org
2. American College of Prosthodontists (GoToAPro): Dental Implants FAQ. gotoapro.org
3. U.S. FDA: Dental Implants, What You Should Know. fda.gov
4. Monje A et al. Impact of maintenance therapy for the prevention of peri-implant diseases: systematic review and meta-analysis. J Dent Res 2016. pubmed.ncbi.nlm.nih.gov
5. Herrera D et al. Prevention and treatment of peri-implant diseases: EFP S3 level clinical practice guideline. J Clin Periodontol 2023. pubmed.ncbi.nlm.nih.gov
6. Berglundh T et al. Peri-implant diseases and conditions: consensus report, 2017 World Workshop. J Periodontol 2018. pubmed.ncbi.nlm.nih.gov
7. American Academy of Periodontology: Peri-Implant Diseases. perio.org
8. Jung RE et al. Survival and complications of single crowns on implants: systematic review. Clin Oral Implants Res 2012. pubmed.ncbi.nlm.nih.gov
9. Papaspyridakos P et al. Complications with fixed implant rehabilitations for edentulous patients. Int J Oral Maxillofac Implants 2012. pubmed.ncbi.nlm.nih.gov