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    5 things hygienists need to know about dental implants

    Being comfortable cleaning and treating dental implants is key.

    Dental hygiene school is no joke. Students spend countless hours understanding tooth morphology, calculus detection and removal around said morphology. The understanding of healing and recreating a healthy attachment level, knowing what health looks like and what to do when disease has taken hold of a person’s mouth is coached into the minds of students to the point they may even chant it in their sleep.

    However, if we look at what we know of natural teeth versus dental implants, not every hygienist will feel as comfortable in his or her knowledge base. Every week there is a new Facebook post about dental implants. We are all comfortable with seeing patients who have natural teeth in their mouths, but not all hygienists are comfortable with handling dental implants. Now that dental implant placement is growing and becoming a part of everyday dentistry, it is time we ALL get comfortable with dental implants. Sticking your head in the sand like you don’t see it or just pretending it is like a natural tooth isn’t going to cut it.

    Here are five things to consider the next time you see a dental implant.

    1. To probe or not to probe

    It is confusing as to why, in 2017, probing dental implants is still a controversial topic with little consistency in the proper protocol. Let’s be clear, evidence-based dentistry supports proper probing technique as a way to monitor the health of dental implants. 1-4 Probing around dental implants not only gives you quantitative information like the depth of the sulcus, but it also allows for qualitative information like tissue health and gingival consistency. 1Keeping in mind that a 5 mm probing depth doesn’t necessarily mean that we need to shove the patient out of the chair and refer him or her out because there are signs of disease. Implant probing depths can range depending on how they were placed.1It is important to have a baseline probing depth after the implant has been restored so there is always something to compare the current measurements to. With that said, hygienists must keep in mind that 5 mm measurements around implants might not mean disease activity, but these are areas that could harbor higher levels of anaerobic bacteria, so timely professional maintenance and at-home care will be important! 1

    Trending research: New discovery could reduce the dental implant failure rate

    “Yeah, but, my doctor says not to probe around the implant because we can break that seal and cause trauma.”  So, let’s talk about that! 

    There is no arguing that the attachment around an implant is different, with only a few types of fibers creating more of a rubber band effect around the implant and never attaching to the implant itself. This is a more fragile environment compared to a natural tooth and does require a more gentle probing technique. 4 This, however, does not negate the need to probe around dental implants. Studies clearly show that with gentle insertion of the probe, metal or plastic, does not damage the mucosal attachment. 2 In the case of inflammation around a dental implant, the chance that the probe will penetrate the attachment level has shown to be higher. The argument then is that this is in the presence of inflammation, and NOT probing could miss these signs of inflammation, creating a higher chance of progressing and far more problems than any trauma from probing. Not to mention, if a probe is inserted too forcefully, it can heal. Hygienists were taught how to properly probe around natural teeth; we are smart enough to figure this out too!

    At the end of the day, not probing is supervised neglect 3. We have to monitor implants properly and probing is a part of that assessment process. 

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    Michelle Strange
    Michelle Strange, MSDH, has been a clinician in dentistry since 2000 and currently is a practicing hygienist, surgical assistant, ...


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