Care of the oral cavity and dentures after implantation; Tips, tricks and cleaning

If you have a temporary adaptive prosthesis installed and if you have not yet gone through its replacement, then you will need to change the design to a permanent one in the near future. Your doctor will tell you about this need at your next preventive examination or during comprehensive hygiene. Some of the symptoms that we have reflected in this leaflet will also tell you that it is time to change the prosthesis.

The recommendations indicated in the leaflet are relevant only for those patients who have passed the adaptation period, i.e. only after complete implantation! For those who have just had implants installed or only a few weeks/months have passed since the operation, there are completely different recommendations, which can be found here.

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Why you need to take care of your mouth after surgery

Why and how to care for installed implants? Let's sort it out in order. The installation of implants always occurs through surgery. The tissues (gums, bone) will be injured in any case - and they need to recover as quickly as possible so that the patient can return to their normal life. But, as we know, there are many bacteria living in the mouth - and hundreds of millions of them are harmful. After implantation, local immunity “throws” all its energy into healing the damaged area, so it has fewer free resources to contain the attack of pathogens. Therefore, it is important to provide the oral cavity with proper care, which is expressed in hygiene procedures, proper nutrition, etc.

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Who is at risk

There is a group of patients who must very carefully follow medical recommendations in the postoperative period. Among them:

Patients with diabetes mellitus - the disease is one of the common causes of rejection. Drugs with a healing effect and to improve metabolism are indicated.
Allergy sufferers should definitely take antihistamines.
Drug, alcohol or nicotine addicts - there is a high risk of developing rejection. You need to visit the dentist often, eat foods enriched with vitamins and beneficial microelements.
People with weakened immune systems require constant medical monitoring of their health. Until complete engraftment, you should take medications to strengthen the immune system and anti-inflammatory drugs.
HIV-positive - patients with this diagnosis, along with careful care of implants, are prescribed medications to increase the protective properties of the oral cavity.

What is useful for oral hygiene: a complete list of products

Products and tools for oral care after implant installation can be purchased independently at a pharmacy/store or at the clinic where the implantation will be performed. Some dentists even provide such kits to their patients without charging a separate fee. Below is a list of what may be useful at first:

solutions for mouth baths and rinses: antibacterial, antiseptic agents - for example, Miramistin, Chlorhexidine. You can use infusions and decoctions of herbs prepared at home - chamomile, sage, etc.,
a clean glass for solutions and water,
new toothbrush (for example, Curaprox brand): the bristles should be soft, after a few months you can try to switch to a “medium” one, but with the permission of your doctor,
toothpaste: without abrasive particles and aggressive whitening agents,
irrigator (we will tell you more about it later),
dental floss - only labeled “super-floss” and only with the permission of the dentist, because, as a rule, dental floss is prohibited after implantation.

Do I need to use dental floss?

Floss is a very effective additional means for cleaning the oral cavity, which is used to treat hard-to-reach areas. Complete care of implants is ensured by the use of so-called superflosses.

First, you need to apply a small amount of paste to the floss, then place it between your teeth and remove any remaining food. To remove plaque, a floss is passed through the inside of the tooth, forming a “P” symbol. The lower part of the denture in the area adjacent to the gum must be cleaned by introducing a thread through the lingual part of the adjacent element of the dentition.

Care immediately after implant installation (first 3-5 days)

How to care for dental implants immediately after they are installed? This means the earliest rehabilitation period at home - the evening after surgery, as well as the next 2-3 days. Maximum 7 days, because Everyone's gums heal differently. This period can be called the most important and most difficult stage of oral care after installation of implants. After all, here you will have to not only give up too hard foods and follow a new diet, but also radically change your approach to hygiene procedures. By the way, you shouldn’t skip them - it’s better to strictly follow the doctor’s recommendations, which will help prevent bacteria from penetrating into the gums and into the bed of the installed implant.

On a note! In general, there is no need to take care of the implants themselves. After all, they are made of the strongest materials and cannot “get sick” with caries, for example. But it is imperative to take care of your gums, sutures, and oral tissues in general.

Immediately after dental implantation, you should not use a toothbrush for about 2-3 days. After all, the mucous membrane is very vulnerable, and the sutures can be damaged. Instead, oral baths are recommended - and active rinsing should be avoided. Both pharmacy solutions and infusions made at home are suitable for baths. Moreover, only the implant surgeon prescribes the drugs.

Key nutritional features

During the first 3 days:

chew only with the teeth located on the opposite side;
Avoid alcoholic drinks and coffee, which can cause bleeding (ethanol can react with medications used during surgery, which often leads to allergies).

During the first 14 days and until complete healing:

increase the chewing load very slowly and incrementally;
Avoid very cold, hot or spicy foods;
include foods with a lot of calcium in your diet, which will speed up the restoration of bone tissue;
Eliminate rough and tough foods, such as nuts and seeds, from your diet.

Care after gums have healed (after 5-7 days)

The second stage of care occurs after the gums have almost healed from the installation of dental implants. Here, hygiene procedures are also mandatory, but there is one feature - they can be carried out less carefully. After reducing inflammation and swelling of the tissues, you should gradually begin to use toothbrushes, but only soft ones, so as not to damage the gum tissue and sutures. In addition, it is worth paying special attention to the interdental spaces, where bacteria and food residues usually accumulate - i.e. Clean thoroughly between crowns. To do this, be sure to use a toothbrush after every meal or at least rinse your mouth with plain water or mouthwash.

Important! The toothbrush must be new. Even if a good brush was purchased a few days before implantation and the patient used it, it will definitely need to be replaced with a new one. Because the old one already has germs.

Oral irrigators can begin to be used 2-3 weeks after implant placement. First you need to set the minimum jet pressure, and increase it every 1-2 weeks - if this does not cause discomfort. The irrigator can be used even after every meal, because... it perfectly washes the spaces between teeth, crowns, between the base of the denture and the gum - where pieces of food often linger and bacterial plaque settles. This device also massages the gums with a stream of water, keeping them toned.

Cleaning process using a brush

The gums and the implant are treated. You can use a classic or electric soft toothbrush. To clean the space between teeth, special brushes with a narrow and thin nozzle are used, which effectively remove plaque and food particles from hard-to-reach areas.

The movements should be circular, and the plaque should be removed from the bottom up. To treat the inner surface of the teeth, sweeping movements are performed. The place where the implant contacts the gum deserves special attention.

Care after implantation (3-4 months after implantation)

And finally, the third stage of oral care is after complete implantation and installation of dentures. This stage should be highlighted separately for those patients who underwent classical two-stage implantation with delayed prosthetics - i.e. The permanent prosthesis was installed on implants after 3-6 months. For patients after one-stage implantation - when the prosthesis is placed on the implants immediately or 3-7 days after the operation, the third stage seems to merge with the second. However, everyone still needs to remember the following rules of oral care to avoid possible complications:

Using a toothbrush and toothpaste: It is important to clean both natural and artificial teeth daily, morning and evening. In the morning - from plaque accumulated overnight, because at night saliva is less active and bacteria multiply much faster. Brushing your teeth in the evening removes germs and food debris that have accumulated during the day. It is recommended to use a soft or medium-hard toothbrush so as not to damage the material of artificial teeth,
mouth rinsing: after eating, as well as after brushing your teeth with a toothbrush, it is important to rinse with plain water or using special antiseptic solutions. A good auxiliary tool would be an irrigator,
regular dental examinations: do not forget about visits to the dentist, who, if necessary, will be able to timely detect inflammation of the gums or bone tissue around the implant and thereby prevent unpleasant consequences - peri-implantitis or rejection.

Read on the topic: what is peri-implantitis and can it be cured without removing the implant?

Implantation and smoking

It is mandatory to quit smoking in the first 3-4 days after surgery to install implants (or before removing sutures, if they were applied). After the osseointegration process is completed, smoking is allowed, but you need to remember that the tars and carcinogens contained in cigarettes lead to increased accumulation of plaque, burns of the mucous membrane, and disruption of metabolic processes between the cells of all periodontal tissues. As a result, the risk of developing inflammatory processes and implant rejection increases. There is also a change in shade and rapid wear of the denture.

Therefore, we recommend giving up this bad habit completely. If this does not work, then you need to at least minimize the number of cigarettes consumed per day or switch to electronic analogues with a reduced content of harmful substances.

After smoking, be sure to perform oral hygiene - brush your teeth with toothpaste and a brush, rinse your mouth with mouthwash. This is a mandatory procedure that will minimize harmful effects.

If you smoke, then a complex of oral hygiene with a dental hygienist, together with a preventive examination of the condition of periodontal tissues, implants and dentures after complete implantation, must be completed more often than usual - at least 2 times. Talk to your hygienist about how best to enhance your hygiene.

Features of denture care

What are the features of care after crowns, bridges or dentures (removable or fixed) are installed on implants? Some patients believe that if they have been given artificial teeth, then there is no need to care for such structures, because they are not alive. Or you can gnaw something very hard with such teeth, and everything will be fine. Both of these opinions are wrong, and below we will tell you why.

you need to try to clean the denture from all sides: not only the external, but also the internal part adjacent to the gums needs to be cleaned - after all, food debris very often accumulates between the gums and dentures. This is how plaque forms and an unpleasant odor appears. Fixed dentures are cleaned with a brush or irrigator. And for conditionally removable ones, one more point is added - approximately 1-2 times a month you should remove them from your mouth and soak them in special solutions (they are sold in pharmacies),
the tops of the implants located above the gum require regular cleaning (especially in the case of fixing removable structures): for this you can use a toothbrush marked “implants”, toothpaste, irrigator,
After cleansing, you must rinse your mouth with plain water to remove all the plaque that has been removed.

On average, the service life of classic removable dentures is 3-5 years. However, dental technicians who create artificial teeth admit that with careful care, dentures fixed on implants will last at least 10-15 years. And ceramic-composite structures or those made of zirconium dioxide – from 20 years and longer. It is also necessary to undergo regular examinations by a dentist in order to prevent damage to dentures - professional cleaning[1] of structures, adjustments, and repair of minor damage.

Hygiene products

In a good dental clinic, the doctor must consult the patient about the use of certain products to care for implants. Which ones can be used, which ones cannot be used, which ones are best used for the prevention of dental diseases.

Toothbrushes

Artificial teeth can be cleaned with regular or electric brushes. However, in the second case, the bristles should be extremely soft, since hard bristles can easily damage the mucous membranes of the mouth. It is better to opt for interproximal models, which are equipped with narrow nozzles that make it easy to clean the interdental space. You can also use brushes of different sizes.

Dentures are processed in the same way as living teeth:

circular movements on the gums;
along the crowns from the front - from bottom to top;
on the back wall of the dentures there are sweeping movements.

If there are protruding parts, they also need to be thoroughly cleaned.

Irrigator

The use of irrigators is possible only after complete implantation and installation of permanent crowns. A jet of water supplied under high pressure perfectly washes away food particles, plaque, and cleans the micropores of the material.

You should choose soft or standard cleaning. To properly clean the coronal part, the jet is directed under the base of the prosthesis. The device has a shower mode that allows you to massage your gums. Massage has a beneficial effect on the condition of soft tissues, improving metabolic processes, blood supply, and regeneration.

Instead of plain water, you can use mouth rinses, infusions, decoctions of medicinal plants or antiseptics. This is especially true when dental diseases, gum disease, and bad breath occur. To prevent caries on natural teeth, solutions containing calcium and fluoride are used.

Dental floss

Otherwise, the device is called floss. If toothpicks can easily damage the gums, then dental floss is not dangerous in terms of injury to soft tissues. The device allows you to remove food debris from hard-to-reach places.

The thread is very easy to use. It is placed in the gap between the crowns, encircled them and with movements back and forth, unnecessary elements are removed. To make the floss softer, it is first coated with toothpaste.

Cleaners

A very convenient device for removing plaque from the surface and inside of dentures. They are cylindrical, curved, cone-shaped. To clean artificial crowns, it is better to choose the first model, since the bristles are the same length.

When to visit the dentist according to plan

After implantation, the doctor must give the patient a reminder, which lists the dates (exact and approximate) of all subsequent appointments. Depending on the indications, some patients will need to attend appointments more often, others less frequently. An approximate schedule of visits looks like this: 2-4 days after implantation, 14 days, a month and a half, three months, six months after installation of implants. You will then need to visit your dentist every 12 months.

“After implantation, I went to the dentist several times for examination. In the first days, I remember, there was an appointment where a prosthesis was installed. Then I went to adjust the prosthesis a little. After another couple of months, it was necessary to take another control photo and professional hygiene; the doctor also removed the prosthesis and cleaned it. It’s better to take proper care of your new teeth right away, I think, so that there are no problems later.”

Anastasia Vladimirovna, review from gidpozubam.ru

Using an irrigator

This device removes food debris and plaque from hard-to-reach areas, while massaging the gums and optimizing blood flow, which promotes faster healing of soft tissues. To achieve maximum results from its use, a variety of medicinal and antiseptic agents are used.

An irrigator is very important when caring for fixed bridge systems that are based on implants. Directing a jet of liquid into the spaces between the elements of the dentition promotes proper cleaning of the area where the denture comes into contact with the gum. The procedure is carried out 2 times a day for 3-5 minutes.

When you need urgent help from a dentist

the stitches on the gums have come apart,
swelling does not subside 4-5 days after surgery or appears again after normalization of the condition,
the pain does not decrease after 3-4 days: you can contact the dentist earlier if the pain is unbearable,
tissue numbness lasts longer than 7 days in a row,
the gums are very inflamed, pus or an unpleasant odor appears,
very high temperature (above 39 degrees), or its increase after normalization,
it hurts to close your jaws (even very carefully),
the prosthesis wobbles and shifts.

Precautions for people with bad habits

After installing implants, you should give up such bad habits - chewing a pencil, pen, biting off threads with your teeth. Otherwise, you can damage the dentures, disrupt the fixation of the implants, and cause infection in the gums. Dentists also strongly recommend stopping smoking, since tobacco smoke contains toxins and harmful substances. Even 1 cigarette smoked immediately after implantation reduces the ability of tissues to recover by 30%. And rejection in smokers occurs much more often - in 7% of cases, in non-smokers - in 1-3% of cases.

Life style

In most cases, there are no significant restrictions, but you need to remember the following recommendations:

avoid serious overheating and hypothermia;
give up alcoholic beverages and smoking, especially during the first time after installation of the implant;
avoid physical activity, especially during the first 24 hours after surgery;
gently cough, sneeze and blow your nose;
sleep on your back or the other side, slightly raising your head in order to ensure proper blood flow;
do not fly during the first hours due to the likelihood of complications caused by the use of anesthesia during the operation;
It is forbidden to drink with a straw when performing a sinus lift;
visit your doctor in accordance with your individual examination schedule.

What is prohibited when you have dentures on implants?

use electric toothbrushes: vibrations can lead to disruption of the connection between the abutment and the crown and the intraosseous part of the implant. But not all loose structures can be “tightened” again. Since screws are not always used for fixation, there is also special cement - if it breaks, you will have to make a new crown,
Eating too hot or cold food: ceramic crowns expand under hot water and contract under cold water. Therefore, try not to alternate these products (for example, drink ice cream with hot tea), this can lead to chipping of the crown coating. Also, sudden temperature fluctuations can prolong the healing time of gums,
use regular dental floss: floss can damage the gums around the implant. They are not as sensitive as with living teeth, and you will not be as aware when you need to stop brushing due to lack of pain. Subsequently, through inflammation of the gums, bacteria can enter the tissue around the implant and lead to its rejection,
professional teeth cleaning must be carried out with caution: be sure to warn your hygienist that you have implants installed, since in this case the hygienic procedure is carried out more carefully,
eat foods that are too hard: crowns may break and implants may move if you bite off threads with your teeth, chew pencils, or crack open nuts.

Following simple recommendations and rules will make wearing dental implants (which last for decades) very comfortable and significantly extend the life of the dentures on them. With careful care, implants will not bother you for the rest of your life.

[1] Botticelli A.-T. Taking on experience. Guide to professional oral hygiene, 2013.

Author: Zhilenko E. A. (Thank you for your help in writing the article and the information provided)

Implantation and alcohol

Remember that the effects of alcohol are very harmful to the entire body. Therefore, we insist that the consumption of drinks that contain even a negligible amount of alcohol must be limited and kept to a minimum.

While intoxicated, you may perform inappropriate actions. For example, getting into a fight, which will lead not only to damage to the prostheses, but also to displacement of the installed implants,
hygiene is difficult or impossible - when a person is heavily intoxicated, he cannot control his actions. If you carry out hygiene in this state, you can damage the gums around the implants, which can lead to the development of inflammation and subsequent rejection of the structures,
appetite increases - you can damage the implants by eating prohibited, too hard food,
your immunity will stop working at full strength,
alcohol has a negative effect on the mucous membranes, especially if they are inflamed (you may not know about the presence of a problem if you have not had a preventive examination with a doctor for a long time),
you forget that you need to visit a doctor: such situations arise in cases where the patient drinks alcoholic beverages for a long period of time,
you may lose your warranty.

Drinking alcohol should not become an obstacle to living a full life and maintaining the results of expensive treatment!