Implant maintenance

5) TOOTHBRUSHES

With the vast number of manual and automatic toothbrush available, patient preferences are the key guides. A soft or extra –soft toothbrush will accomplish plaque and debris removal without traumatizing tissue.
A motorized toothbrush such as the Rotodent may be used with a tapered brush to access the undersurface of connector bars or to aid with interdental cleansing. The sonicare has sonic technology which demonstrates the ability of this toothbrush dental surface similar to implants.
Tufted brushes may also be advantageous in hard –to reach areas of for more site-specific purposes. Tufted brushes are especially useful in posterior lingual regions where a conventional toothbrush might not reach. Heating the plastic handles with hot water of flame may allow the brush to be bent or angled for patient- specific anatomy and needs.

6) FLOSS

Patient instruction for using floss should be aimed at gentle insertion and motion to avoid trauma to tissue. A threader may need to be used to access bridgework or around connector bars. There are also numerous woven flosses with threaders built in to help access and cleanse larger embrasure spaces and under connector bars.
Yarns and loosely woven floss can also be used, but these should not be considered if there is the possibility of fibers being retained on rough surfaces or around restorations. PostCare (john O. Butler Company, USA) is a braided flossing cord. It is more rigid than conventional floss but easy to use in open areas and places where a floss threader may be too flimsy. The braided flossing cord may also remove denser plaque, debris, and calculus that is not too tenacious.
Proxy-Floss (AIT Dental, USA) is an elastomeric material made up of hundreds of semicircular flanges that bend and flex to remove plaque. And debris or to apply chemotherapeutic agents. The elastomeric nature of this product prevents it from collapsing snagging or shredding

7) Many companies manufacture interdental brushes.

It is important that the bristle are plastic or coated with nylon to prevent scratching of the titanium components. Patients should also be instructed to inspect and change the brush when signs of wear are evident. Common brush designs include straight and cone –shaped. Embrasure size and shape should be considered to prevent brush bending and tissue trauma.
Foam tips (Oral-B) can also be used to apply chemotherapeutic agents interdentally and site specifically.
Proxy – Tip (AIT Dental, USA) is an inter proximal brush and stimulator. It has many soft, flexible, semicircular flanges that remove plaque and facilitate application of antibacterial agents. It acts as an interdental brush and rubber tip in one design.