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flossDental hygiene is just as important for the implant patient as it is for the patient with all natural teeth. The gum tissue around a dental implant is different than around a natural tooth. The natural tooth has a stronger tooth-to-gum connection than the dental implant. Dental hygiene visits will be scheduled for every three months in the first year following surgery, then every three to six months depending upon the remaining teeth or what our office recommends.

Our office has specific instruments that our hygienists use to clean and maintain dental implant restorations. Every few years some of the teeth that are screwed onto the implants will need to be removed for additional cleaning. Cleaning and maintenance fees are separate from the dental implant surgical and restorative fees.

In our commitment to you, we are continuously staying abreast of the latest scientific research and technology available. Please don’t hesitate to come to us with your questions and concerns.

Below are some basic home care oral hygiene instructions that will meet most patients’ needs on a daily basis. There are many oral hygiene aids on the market and your hygienist/dentist can work with you to individually customize a home care for your individual needs.

 

Please click on any of the following questions/topics:

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Standard Daily Home Care

Your daily home care is imperative to maintaining a healthy smile. Below are the home care steps for oral health:

  • Brush your teeth at least twice daily (in the morning and the evening) with an ADA-accepted toothpaste that contains fluoride. Each brushing session should last 2-3 minutes while focusing the bristles of the brush at a 45-degree angle toward the gums. Make sure to brush all sections of your mouth, including the inside of the teeth. The most often missed spot is the inside of the lower teeth. Please see your dental hygienist if you have any questions about proper brushing techniques.
  • Floss at least once daily. An alternative to flossing is proper use of a Waterpik once daily. Ask your dental hygienist to demonstrate how to use a Waterpik and/or how to floss properly.
  • Rinse with Listerine two to three times daily. Our office supports the use of Listerine (or the generic form of Listerine) because it is the currently the only non-prescription mouth rinse with long-term scientific research to back its efficacy.
  • Limit between-meal snacks or drinks containing sugar. The bacteria in our mouths feed off of what we eat; however, most oral bacteria can only hold onto the food source for 20 minutes. You can eliminate the source of fuel for the bacteria by cleaning the mouth after eating or drinking, thus slowing down the destructive ability of the bacteria.

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What can I expect at my first dental cleaning appointment at the Forte Dental Implant Center?

Your first hygiene appointment is composed of an extensive periodontal and dental exam, which includes:

  • Review of your medical history and medications
  • Checking vitals
  • Full-mouth set of radiographs (usually 18 to 20 individual radiographs)
  • Charting all of your existing and needed dental restorations
  • Full-mouth periodontal probing
  • Evaluation of temporal mandibular joint
  • Oral cancer screening, including a visual and palpitating exam along with the use of the Identafi oral cancer examination light
  • Comprehensive exam and diagnosis by our doctors
  • Patient education

If time allows at your first appointment, you will also have your dental cleaning and fluoride treatment, however, due to the extensive nature of the above procedures and/or your individual periodontal condition, some patients may need a second appointment for their dental cleaning and fluoride treatment.

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What are sealants?

Sealants are a non-intrusive plastic material that is applied in the dental office by your hygienist or dentist to the chewing surface of molars and pre-molars. The sealant is placed inside the pits and fissures of the tooth to prevent decay from occurring. These pits and fissures in the tooth can be difficult or impossible to thoroughly clean daily at home as the bristles on your brush are too big to reach into them. The sealant creates a protective barrier from toxins and bacteria that cause decay.

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Gum Disease

It is estimated that 80% of adults in the U.S. suffer from some form of gum disease. This is not a discriminating disease, and people of all ethnic, cultural, educational and financial statuses can be afflicted with the disease. The disease ranges from mild inflammation of the gums to advanced destruction of the bone and tissues surrounding the tooth. If left untreated, it can ultimately result in the loss of teeth.

Your oral healthcare professionals will make treatment recommendations based on your periodontal condition. Some of the non-surgical treatment options may include a scaling and root planning, also known as a “deep cleaning,” more frequent dental cleaning visits, and/or the use of locally placed antibiotics.

For more information on periodontal disease, visit American Academy of Periodontology.

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What is a deep cleaning?

Scaling and Root Planning (SRP), commonly referred to as a “deep cleaning” is a non-surgical treatment of periodontal disease when gingival pockets are 3mm and deeper. An SRP is considered the first line of treatment in dealing with periodontal disease. Plaque, tartar, and biofilm are mechanically removed from the pocket and tooth surface using hand scalers and/or ultrasonic instrumentation. This is commonly called a deep cleaning as the cleaning takes place deep within the gingival pockets. A local anesthetic may be administered to reduce any discomfort during the procedure.

Depending on how many quadrants need the SRP, the patient will return for multiple visits, usually having half of the mouth cleaned at one session and the other half at the second session. By mechanically removing the irritants in the pockets, the infection is being directly addressed and a smooth surface is provided, making it more difficult for plaque and bacteria to adhere and cause further damage. The patient will return for a follow-up appointment 4 to 6 weeks after the SRP to reevaluate the tissues and periodontal condition.

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Why do I need a deep cleaning/SRP?

A “regular dental cleaning” is actually called a prophylaxis. This preventive treatment allows the hygienist to remove hard and soft debris from the teeth and surrounding soft tissues, around the gum line, and mildly under the gums but not more than 3mm below the gums. A prophylaxis and an SRP are not the same thing.

While good home care is essential in maintaining a healthy oral state, home care is not enough to reverse your active infection and requires professional treatment of scaling and root planning (SRP). If you have been diagnosed with needing scaling and root planning, then a regular prophylaxis cleaning is not sufficient for you. Prophylaxis by definition is a preventative procedure performed on healthy gum tissue and bone levels, whereas a scaling and root planning is directly addressing a disease process/infection that is active in your mouth.

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Home care instructions following a deep cleaning (SRP)

Following a deep cleaning (SRP) you might experience little to no discomfort or you may feel tender and show some bruising. If you received anesthetic for your procedure, be careful not to bite your tongue or cheek while numb and don’t drink/eat hot foods that could potentially burn you. You may wish to eat softer foods for the first day or two.

Warm saltwater rinses are recommended to aid in soft tissue healing. An anti-inflammatory, over-the-counter pain medication such as ibuprofen may be taken, as long as you do not have any allergies or contraindications with these types of medications (consult your physician).

You may experience an increased sensitivity to cold and hot temperatures in your mouth. As your tissue heals, it will shrink and tighten around your teeth. Due to this healthy shrinkage, root exposure may occur.

Brushing, flossing or Waterpik use, and rinsing with Listerine and/or Peridex should be conducted daily as instructed by your oral health care professional or as listed under basic home care instructions.

Do not bleach your teeth following an SRP. Your teeth and gums need time to heal first.

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Why do I need fluoride treatments?

The importance of fluoride for optimum dental health should not be underestimated. Think of your teeth as having pores like your skin. These pores leave the tooth susceptible to staining and decay. Fluoride helps to reduce the pore size on the enamel and root surface of the tooth. It also strengthens the tooth through a calcification process.

The Centers For Disease Control and Prevention posted an article on the importance of fluoride that is informative. Our doctors will often recommend prescription-strength fluoride toothpaste to patients that are at particularly high risk.

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Will antibiotics help with my gum/periodontal infection?

Diligent home care combined with routine professional dental cleanings and healthy/low-sugar nutrition provides the foundation for a healthy mouth. As with any infection, our bodies and immune systems sometimes need a stronger weapon to fight an active infection. By placing an antibiotic directly into the pocket of the infected gum, we can maintain a higher concentration of the medication exactly where it’s needed. Arestin is a 1mg powdered dosage of minocycline hydrochloride microspheres, an antibiotic that is a derivative of Tetracycline. By placing this antibiotic locally, it is able to remain active in the gingival pocket for up to 21 days, fighting against the aggressive gram-negative bacteria in the pocket that destroys periodontal ligaments, tissues and bone.

Home care instruction after Arestin has been placed:

  • Don’t touch the area of application
  • Wait 12 hours before brushing
  • Wait 3 days prior to flossing the application area
  • Wait 4-5 days prior to using a Waterpik at the application site
  • Avoid hard, crunchy, or sticky foods for 1 week

For additional information, please visit the Arestin website.

 

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Do you screen for oral cancer?

Our practice continually looks for the latest advances in order to ensure that we are providing the optimum level of oral health care to our patients. We are concerned about oral cancer and look for it in every patient. A clinical visual exam and manual palpating of oral tissues are conducted, and our doctors will also conduct an examination of the oral mucosa using the Indentafi light.

One American dies every hour from oral cancer. Late detection is the primary cause in both the incidence and mortality rates of oral cancer continue to increase. As with most cancers, age is the primary risk factor for oral cancer. Tobacco and alcohol use are other major predisposing risk factors, but more than 25% of oral cancer victims have no such lifestyle risk factors. HPV, a common STD has been known to cause cervical cancer in women for many years. It is now known that the same strains of HPV that cause cervical cancer in women are causing oral cancer in both men and women.

Oral cancer risk by patient profile is as follows:

  • Increased Risk: patients ages 18-39 sexually active patients (HPV can cause both oral and cervical cancer)
  • High Risk: patients age 40 and older; tobacco users (any age, any type within 10 years)
  • Highest Risk: patients age 40 and older with lifestyle risk factors (tobacco, alcohol use); previous history of oral cancer

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What is Identafi 3000 Ultra?

The Identafi 3000 Ultra is an adjunctive tool in conducting an oral cancer examination. Using three different wavelengths of light, the Identafi 3000 allows the trained clinician to more accurately see mucosal abnormalities such as premalignant dysplasia and oral cancer using a combined system of fluorescence and reflectance.

This enhanced examination is recognized by the American Dental Association Code Revision Committee as CDT 2007/2008 procedure code D0431; however, this exam may not be covered on your insurance plan. At Forte Dental Implant Center, we feel every patient should have a thorough oral cancer screening at least once per year. Because of our strong belief in the importance of this exam, we offer the oral cancer screening with Identafi 3000 Ultra as a complimentary part of our routine exam at your hygiene appointment.

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Recommendations for an infant’s oral health care

It is important to begin caring for your infant’s oral health immediately, even prior to the eruption of teeth. After feeding (bottle or breast), gently and quickly wipe the surfaces of the inside of the mouth, especially the ridges where teeth will come in. You may use a damp washcloth, paper towel, or gauze to do this. This will cleanse the oral cavity and get your infant used to your hands being in their mouth, which will be vital when the teeth begin to come in.

Never put your child to bed with milk or juice in their bottle. There are sugars in these products that will feed the oral bacteria and cause ramped decay, known as baby bottle decay. Once your baby is old enough, they can go to bed with water in the bottle or sippy cup. Oral bacteria feeds off of what we eat; however, the bacteria can only store the food source for 20 minutes. With this in mind, it is best to limit the sweets and sugar-containing drinks to mealtime only and not allow your child to sip from a bottle or sippy cup constantly throughout the day.

When your child is young and is at risk for swallowing toothpaste, use non-fluorinated toothpaste made for children. As the child matures learns not to swallow the toothpaste (usually age 2 or 3), it is good to move to a toothpaste with fluoride. You will need to brush your child’s teeth for them. As they mature, you will still need to monitor your child as they brush and help them along. There are disclosing tablets available to use as an educational tool for you and your child to pinpoint areas that are not being brushed well.

Remember that the bacteria from one person’s mouth can transfer to another. It is best to wash pacifiers and such in the sink when possible rather than in your mouth for the safety of your baby. As adults we can have more aggressive forms of bacteria to which we don’t want to expose our children.

If you have children or are expecting, please feel free to consult with us about the oral health of you and your child.

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