‘Prevention is better than cure,’ – this was the key message from Jonathon Schofield at his recent lecture for The South West Hygienists’ and Therapists’ Society, held at The Dental Implant Clinic, Bath.
During his two-hour lecture, Dr Schofield shared his fears about how patients often fail to understand the importance of good implant maintenance, and illustrated the importance of close monitoring of the health of gums post-implant therapy.
He also discussed how his audience of hygienists and dental therapists have a vital role to play, not only in ensuring high standards of oral health at hygiene appointments, but also in making patients more aware of the rigorous cleaning routine required to avoid peri-implantitis.
Jonathon gave practical advice on techniques for use in the surgery and also maintenance tips for patients at home.
Many hygienists are reluctant to use a probe where an implant is present, but Jonathan assured his audience that using conventional probing with lightweight force would be unlikely to damage the peri-implant tissues, but would certainly help determine the health of gingival tissue.
‘Probing is essential for identifying the health of tissues around the implant. If there is a probing depth of more than 3mm, or bleeding on probing, you should administer antiseptic cleansing gel, antibiotics, or, in extreme cases, suggest regenerative surgery.’ he advised.
For maintenance between appointments, Jonathon suggested that patients should be flossing their anterior teeth and cleaning their posterior teeth with an interdental brush to help prevent the build-up of plaque and that ideally patients should be recalled for check-ups anywhere between one and four times a year, depending on their relevant dental history.
Although in general, implant success rates run at around 98%, there is only a 60% success rate in patients with severe peri-implantitis and Jonathon suggested radical action to force patients to commit to a strict cleaning regime, as well after care check-ups, when they sign the consent form for the procedure.
The lecture concluded with a live patient demonstration, where four patients each with a different type of implant restoration were treated with Jonathon using the probing and cleaning techniques he had discussed earlier.
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