High Quality Dental Implants Vietnam

WHAT ARE DENTAL IMPLANTS?

Dental Implants are artificial tooth roots used to restore a tooth or teeth, which help to prevent jaw bone loss. An dental implant procedure is considered as a form of prosthetic (artificial replacement) dentistry as well as cosmetic dentistry.

People who have lost teeth might be more afraid to smile or talk. Besides, biting irregularities caused by tooth loss can also have a negative impact on eating habits, causing issues such as malnutrition.

Dental Implants will therefore replace the missing tooth roots and provide the strength and stability for chewing, biting and eating habits. Additionally, Dental Implants also stimulate and maintain jaw bone, which prevent bone loss and thus maintaining the person’s facial features.

Source: YourDentistryGuide

DENTAL IMPLANTS IN VIETNAM

Dental Center in Ho Chi Minh City, Vietnam offers international quality Dental Implants at remarkably lower cost than Western countries and a majority of Eastern nations. A price comparison chart for Implant replacement with crowns is shown below:

Are you looking for cheap and good quality dental implants abroad? What are you waiting for? Contact Dr Hung & Associates Dental Center in Ho Chi Minh City, Vietnam now at (+84-8)39257526 for your quote, flight & accommodation booking as well as airport pickup. All are free of charge.
For more information on Booking Procedure, please click here

SOLUTIONS FOR TOOTH/TEETH LOSS

1. Single Missing Teeth

When a single tooth is missing, the two most common treatment options are:

- A traditional tooth-supported bridge (3-unit bridge)

- An implant-supported crown

   2.  Multiple Missing Teeth

When multiple teeth are missing or failing, treatment options may include:

- An implant-supported bridge

- A multiple tooth supported fixed bridge

- A removable partial denture

   3.  All Missing Teeth

With the high technology of Implant placement, we provide you the most efficient and saving solution for people lose all teeth.

- All-on-4

- All-on-6

- Removable denture on 2 implants                                                             

    4. Bone Graft & Sinus Lift

DENTAL IMPLANT PROCEDURE

The implant procedures include 2 steps as follows:

 Step 1: Implant Placement, which includes :

- Examination and creating treatment plan - Surgery

 Step 2: Prosthesis (Crown on Implant), which includes 2 steps:

- Healing cap- Abutment and Crown on implant

For more details on Dental Implant Procedure, please click here

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High Quality Cosmetic Dentistry Vietnam

WHAT IS COSMETIC DENTISTRY?

While traditional (general) dentistry deals with oral hygiene as well as preventing, diagnosing and treating oral diseases, cosmetic dentistry focuses on improving the appearance of the person’s teeth, mouth and smile. In other words, restorative or general dentistry addresses necessary dental treatment, while cosmetic dentistry considers the aesthetic factors for an elective treatment.

Cosmetic dentistry might also involve restorative impacts. For instance, dental fillings are a common solution for tooth decay. In the past, most dental fillings were primarily made of gold, amalgam or other materials that appear as dark spots on the teeth.

Nowadays, dental fillings are also categorized as cosmetic dentistry, as they are now made up of porcelain or composite materials that match teeth color better, and therefore would maintain the natural look of your teeth and smile. Many people have had their old fillings replaced with the newer, better-colored fillings to improve the oral appearance.

COSMETIC DENTISTRY IN VIETNAM

Dental Treatment Abroad provides unique cosmetic dentistry services in Ho Chi Minh City, Vietnam with high quality at a much cheaper cost than other countries. This is not because the quality is not good but the labor cost is lower.

Price Comparison Chart

Average Cost	In Vietnam	In other Western countries
Teeth Whitening	$170 to $200	$450 to $650
Porcelain Veneers	$325 to $375	$925 to $2,500
Composite Veneers	$310 to $320	$250 to $1,500
Dental Bridges	$150 to $300 per tooth	$700 to $1,500 per tooth

For more information on prices, please click here

Are you looking for cheap and good quality cosmetic dentistry abroad? What are you waiting for? Contact Dr Hung & Associates Dental Center in Ho Chi Minh City, Vietnam now at (+84-8)39257526 for your quote, flight & accommodation booking as well as airport pickup. All are free of charge.

For more information on Booking Procedure, please click here

COSMETIC DENTISTRY TREATMENTS IN VIETNAM

• Teeth Whitening: is the process of removing stains from the teeth to brighten the appearance of your teeth. Three standard methods of teeth whitening are teeth polishing, teeth bleaching, and micro abrasion.

• Laminate Veneer: is a thin layer of porcelain that is bonded to the tooth’s surface to protect a damaged tooth (such as stained or darkened tooth, broken and chipped tooth, diastema, foreshortened tooth) or to improve its esthetics. They enable the dentist to change the appearance, size, color, spacing, and to a minor extent, the positioning of teeth.

• Porcelain Veneer: contains Zirconia frame inside & thin layer porcelain outside for more stronger & beautiful of front teeth which are worn teeth, big broken teeth, deviation teeth,…Porcelain veneer procedure need grinding the natural teeth more than laminate veneer.In some cases it needs to do root canal treatment before doing porcelain veneer.

• Crowns & Bridges: replace lost or damaged teeth to restore that natural look for your smile.
• Inlays/Onlays: can be made of porcelain, gold, or composite resin. These pieces are bonded to the damaged area of the tooth. An inlay, which is similar to a filling, is used inside the cusp tips of the tooth. An onlay is a more substantial reconstruction, similar to the inlay but extending out over one or more of the cusps of the tooth.

• Composite Bonding: is an alternative to veneers and can be used as a restorative procedure for teeth that are chipped, cracked, discolored and misarranged.

Sourse: YourDentistryGuide

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High Quality General Dentistry Vietnam

WHAT IS GENERAL DENTISTRY?

General Dentistry involves preventation, diagnosis and treatment of a variety of conditions, disorders and diseases related to the teeth, gums or maxillofacial (associated with the jaw and face) region of the body. In other words, general dentistry is related to the general maintanance of oral hygiene and tooth health.

Dentistry is preventive. According to the American Dental Association, you should visit your dentists at least once every six months to ensure proper oral hygiene and functionality. Regular chekups and oral health maintainance can prevent the development of dental problems that might lead to costly treatment. If you remain vigilant and visit your dentist regularly, you can enjoy exceptional dental health.

GENERAL DENTAL WORK IN VIETNAM

The cost of general dental treatment at our Dental Center in Ho Chi Minh City, Vietnam is relatively lower than most other countries, including those in the Asia region, whilst still maintain high international dental standards.

Are you looking for cheap and good quality dental implants abroad? What are you waiting for? Contact Dr Hung & Associates Dental Center in Ho Chi Minh City, Vietnam now at (+84-8)39257526 for your quote, flight & accommodation booking as well as airport pickup. All are free of charge.

For more information on Booking Procedure, please click here

Below is a list of the general dental works available at Dental Center Vietnam:

• Root Canal Treatment: is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges.
• Composite Filling: Once cavity is detected it should be treated immediately. Filling a tooth before having toothache is better for you, because having pain means the cavity has grown and might have affected the root, in which case the treatment will be more complicated and you might need to have a root canal.
• Wisdom Tooth Extraction: Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. Wisdom teeth also can be impacted — they are enclosed within the soft tissue and/or the jawbone or partially break through or erupt through the gum.
• Teeth Night Guard: can prevent you from teeth grinding at night, which might lead to dental problems such as constant headache or sore jaw.
• Gummy Smile Treatment: is not too complicated, and has become very popular in cosmetic dentistry in recent years. Statistics have shown that 15-20% of Asian people have gummy smile, and hundreds of thousands of cases have been resolved.
• Laser-assisted Treatments For Gingivitis And Periodontitis

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Oral Health – A Window To Your Overall Health

Your oral health is more important than you might realize. Get the facts about how the health of your mouth, teeth and gums can affect your general health. 

Did you know that your oral health can offer clues about your overall health — or that problems in your mouth can affect the rest of your body? Understand the intimate connection between oral health and overall health and what you can do to protect yourself.

What’s the connection between oral health and overall health? Like many areas of the body, your mouth is teeming with bacteria — most of them harmless. Normally the body’s natural defenses and good oral health care, such as daily brushing and flossing, can keep these bacteria under control. However, without proper oral hygiene, bacteria can reach levels that might lead to oral infections, such as tooth decay and gum disease. 

In addition, certain medications — such as decongestants, antihistamines, painkillers and diuretics — can reduce saliva flow. Saliva washes away food and neutralizes acids produced by bacteria in the mouth, helping to protect you from microbial invasion or overgrowth that might lead to disease. 

Studies also suggest that oral bacteria and the inflammation associated with periodontitis — a severe form of gum disease — might play a role in some diseases. In addition, certain diseases, such as diabetes and HIV/AIDS, can lower the body’s resistance to infection, making oral health problems more severe. 

What conditions may be linked to oral health? 

Your oral health might affect, be affected by, or contribute to various diseases and conditions, including: 

• Endocarditis. Endocarditis is an infection of the inner lining of your heart (endocardium). Endocarditis typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart. 

• Cardiovascular disease. Some research suggests that heart disease, clogged arteries and stroke might be linked to the inflammation and infections that oral bacteria can cause. 

• Pregnancy and birth. Periodontitis has been linked to premature birth and low birth weight. 

• Diabetes. Diabetes reduces the body’s resistance to infection — putting the gums at risk. Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels. 

• HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS. 

• Osteoporosis. Osteoporosis — which causes bones to become weak and brittle — might be linked with periodontal bone loss and tooth loss. 

• Alzheimer’s disease. Tooth loss before age 35 might be a risk factor for Alzheimer’s disease. 

• Other conditions. Other conditions that might be linked to oral health include Sjogren’s syndrome — an immune system disorder that causes dry mouth — and eating disorders. Because of these potential links, be sure to tell your dentist if you’re taking any medications or have had any changes in your overall health — especially if you’ve had any recent illnesses or you have a chronic condition, such as diabetes. 

How can I protect my oral health? 

To protect your oral health, practice good oral hygiene every day. 

For example: 

• Brush your teeth at least twice a day. 

• Floss daily. 

• Eat a healthy diet and limit between-meal snacks. 

• Replace your toothbrush every three to four months or sooner if bristles are frayed. 

• Schedule regular dental checkups. Also, contact your dentist as soon as an oral health problem arises. Remember, taking care of your oral health is an investment in your overall health. 

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How To Take Care Of Your Teeth Everyday

What is good oral hygiene? 

A person with good oral hygiene habits will have clean teeth without a bad smell. This means:

• Your teeth does not have food remained.

• The gum is pink and healthy – not damaged or bleeds when brushing or using dental floss.

• If your gum is damaged whilst using dental floss or brushing, or if you have a bad breath, please visit the dentist immediately to have your teeth taken care of.

• Dentists will explain in details how to take care of your teeth, remove the tartar and whiten your teeth, in order to help you to have a beautiful smile with healthy teeth.

How to have good oral hygiene? 

• Brush your teeth carefully twice a day and use dental floss daily.

• Have a balanced diet and avoid junk food between meals.

• Use dental products that contain flour, including toothpaste.

• Use mouthwash liquid that contains flour.

 Brush your teeth correctly 

Tilt the brush at a 45° angle against the gumline and sweep or roll the brush away from the gumline.

Gently brush the outside, inside and chewing surface of each tooth using short back-and-forth strokes.

Gently brush your tongue to remove bacteria and freshen breath.

Use dental floss correctly 

Cut off a section of floss about 45cm (18 inches) long. Wind it around the middle fingers of each hand.

Grip the floss with your thumb and forefinger of each hand so that the floss between your hands is about 2.5-5cm (1-2 inches) long. Pull it tight so you can insert the floss in a gap between two teeth.

Gently guide the floss up and down against the sides of the teeth and under the gumline. When the floss reaches the gumline, curve it into a C-shape against the tooth until you feel resistance.

Hold the floss against the tooth and gently scrape the side over it, away from the gum. This will help you to floss under the gumline without causing any damage.

Repeat this process for the next gap, along the side of the next tooth.

Make sure you floss between every single tooth. Working to a pattern round the whole of your mouth makes it less likely that you’ll miss out any teeth.

• Remember to floss the side of the teeth at the back of your mouth.

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Good Habits For Dental Care

Your diet, including the type of food and the frequency that you use them, plays a key role in creating and maintaining your dental health. Sweets have long been known for its impact on teeth, but there are other types of food that can bring a negative effect as well. Lots of food and drinks, especially those contain high levels of sugar, will speed up the process of causing tooth decay. 

Taking care of your teeth and gum 

Cleaning your teeth regularly is very important. Brush your teeth twice a day and use dental floss or other cleaning tools daily to maintain good oral hygiene. Once the tartar has been formed, they might lead to dental problems and gum bleeding.

You should have regular dental visit to have overall dental health check and clean your teeth properly.

Diet and dental health 

Being on diet can reduce the risk of having tooth decay. Drinking products such as soda, juice can create an environment that might lead to tooth decay. Paying attention to the amount of sugar in your diet will also help to protect your teeth. Most types of food contain sugar, including fruit and vegetable, which can potentially lead to tooth decay. You can eliminate this risk by reducing the amount of sugar consumed daily. Otherwise, you should eat sugar-containing products during the main meals rather than afterwards. This is because the amount of saliva produced during main meals is higher, which will have to reduce the amount of acids inside the mouth and remove tiny particles between teeth. Chewing gum is also effective in increasing the amount of saliva produced and also the amount of calcium and phosphate which will enhance your teeth. Chewing sugar-free gum 20 minutes after your meal would prevent tooth decay.

Balanced diet 

A balanced diet is very important in maintaining your overall dental health. The United States Department of Agriculture (USDA) has encouraged us to choose food from the following main categories:

• Vegetable, especially those with a dark green or yellowish orange color

• Food made from grains such as brown bread, porridge, etc

• Dairy products such as low-fat yogurt/cheese, etc

• Different types of beans and meat such as chicken, fish or beef

• Vegetable or fish oil

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How To Brush Your Teeth Correctly?

What Is the Right Way to Brush? 

Proper brushing takes at least two minutes — that’s right, 120 seconds! Most adults do not come close to brushing that long. To get a feel for the time involved, try using a stopwatch. To properly brush your teeth, use short, gentle strokes, paying extra attention to the gumline, hard-to-reach back teeth and areas around fillings, crowns or other restoration.

Concentrate on thoroughly cleaning each section as follows:

• Clean the outer surfaces of your upper teeth, then your lower teeth

• Clean the inner surfaces of your upper teeth, then your lower teeth

• Clean the chewing surfaces

• For fresher breath, be sure to brush your tongue, too

What Type of Toothbrush Should I Use? 

Most dental professionals agree that a soft-bristled brush is best for removing plaque and debris from your teeth. Small-headed brushes are also preferable, since they can better reach all areas of the mouth, including hard-to-reach back teeth. For many, a powered toothbrush is a good alternative. It can do a better job of cleaning teeth, particularly for those who have difficulty brushing or who have limited manual dexterity.

How Often Should I Replace My Toothbrush? 

You should replace your toothbrush when it begins to show wear, or every three months, whichever comes first. It is also very important to change toothbrushes after you’ve had a cold, since the bristles can collect germs that can lead to reinfection.

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Chewing Gum

There is no scientific evidence about the impact of chewing gum to your teeth and jaw. However, if you ever feel that your teeth are “tired” or in pain, or there are signs of TJM (Temporomandibular joint dysfunction), then you should stop chewing gum. 

Chewing gum can also be useful as it stimulates the production of saliva. Saliva is an important part of dental health, containing antibacterial and natural antibodies. Saliva also helps neutralize and reduce the impact of acids in causing tooth decay.

However, the sugar in chewing gum also contains sugar which leads to increased concentration of sugar in the mouth. For that reason, scientists have researched and replaced the sugar in chewing gum with xylitol – a sweet compound that can reduce the amount of bacteria causing tooth decay.

Overall, it is not necessary that you need to stop chewing gum regularly, but choose the suitable type and don’t forget to listen to your body.

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Dental Care For Pregnant Women

Pregnant women has dental problems more easily than others 

A- Reasons There are 2 main reasons behind this:

1. Changes in hormones can make the gum inflamed easily. The common symptoms are swollen and bleeding gum.

2. Changes in diet – pregnant women usually have nausea and changes in eating habits, which can potentially lead to tooth decay.

B- Why protect your teeth during pregnancy

Dental diseases if left untreated will weaken your teeth and might eventually lead to tooth loss. According to a medical research in America, pregnant women’s gum diseases can lead to the production of prostaglandins which stimulates labor. Severe infected cases which require medicine might also have an impact on the fetus.

C- Dental care during pregnancy

Women need to take care of dental diseases prior to pregnancy. During pregnancy, women need to be supplied with all necessary nutrients, avoid high-sugar products and eat vegetable and food.

Pregnant women need to have good oral hygiene to prevent tooth decay or gingivitis. Regular dental visit is necessary so that all essential dental work can be done. This should be done between fourth and seventh month of the pregnancy. Pregnant women should only use drugs under doctors’ advice.

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In-House Dental Lab

Most dental offices send all their laboratory work to outside labs, some even outside of the country, but here at Dr Hung & Associates Dental Center we have an in-house dental lab that fabricates all of our crowns on site. The dentists and laboratory technicians work together to achieve the best results from single crown restoration to full mouth reconstructions.

Our Dental Lab Technicians

Our dental lab technicians has years of experience working with dentists and over 10 years of experience in total. The lab has been developed through modern lab equipments and annual training program.

CAD/CAM SYSTEM

In our laboratory, we use CAD/CAM technology and Exocad & DentalWings software suite provides a solution for the design and manufacture of high quality dental restorations in 3D; faster, easily and more accurately when compared with conventional manual techniques.

CAD (COMPUTER-AIDED DESIGN)

CAD is the use of computer technology for design and design restorations. At Dr.Hung & Associates Dental Center, we use Exocad and Dental Wing software to make better designs.

CAM (COMPUTER-AIDED MANUFACTURING)

CAM : uses subtractive process (CNC milling) to produce  dental prostheses such as crowns,veneers, inlay/onlay, dental implant restorations,… 

At Dr.Hung & Associates Dental Center we use Silamill 5 milling machine from Germany to manufacture and NexxZr Zirconia Dics from USA (FDA approves) as material to provide the best quality results.

Advantages Of In-House Dental Laboratory

• Close quality control by the dentist who does the dental treatment.
• Fast and efficient for international patients having limited timeframe for the treatment.
• Instant correction and adjustment (If necessary) during your dental treatment.
• Selecting our own laboratory material to provide the best results.
• 

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What Is An Implant?

Dental Implant is a technique to implant a titanium “root” into the jawbone to replace missing tooth and then to place crown on that root. Implant is a good solution to help you restore loss tooth or teeth.

The crowns will be made to mirror the shape and size of your natural tooth. It will give you a comfortable feeling and recover 90% of your chewing ability.
Dental implant can be used to support crown bridge or denture.

ADVANTAGES OF DENTAL IMPLANT:

• Prevent bone loss
• Restore, maintain and improve bite alignment
• Preserve the facial structure
• Improve speech
• Maitain chewing muscles and facial expression muscles
• Increase the success of dentures
• Reduce the size of the dentures
• Improve stability and retention of the removable denture
• Increase durability of dentures
• Do not affect the adjacent teeth
• Improve comfort and self-esteem.

Dr. Do Dinh Hung and his team at Dr. Hung & Associates Dental Center are leading experts in implant field in Ho Chi Minh City.

Dr. Hung & Associates Dental Center particular success in “All on 4” technique of Nobel Biocare for edentulous clients.

The clinic also has the latest detailed equipment including CT Cone- beam i-CATVision™ made in USA, therefore it is a reliable place for you to get your wish of having a beautiful smile.

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Implant Home Care

Good oral hygiene must take place before, during, and after placement of dental implants to ensure the health of the implant. Patients are concerned about what kind of maintenance their implants will require. Do they brush and floss their implants like regular teeth? Does food get underneath the fixed implant bridge or prosthesis? Patients look to their hygienists to address these concerns and help them with an individualized home-care routine.

The tissue surrounding the implant should appear pink, firm, and keratinized with no signs of infection. The peri-implant soft tissues (permucosal seal) that separates the connective tissues surrounding the implant from the outside environment should be keratinized tissue (see Figure 1). The absence of keratinized tissue has been documented to be more susceptible to pathogenic bacteria thus leaving the implant vulnerable to peri-implant disease.1 The success of the implant depends directly on the health of this seal, and the hygienist’s goal is to educate the client on how to obtain keratinized tissue and maintain a healthy permucosal seal.

Figure 1: Keratinized tissue surrounding the implant. Courtesy of Dr. Robert Horowitz

This reinforces the point that home-care must begin immediately and, if possible, before the implant is placed to maintain a healthy field and for optimal healing.
Once the implant is exposed to the environment, loaded (occlusal forces) and restored (see Figures 2a, 3b) a salivary pellicle is formed followed by bacteria with the formation of biofilm.2,3 The elimination of 85% of plaque/biofilm on a daily basis is critical to the overall health of the implant.4

Hygienists can prepare clients by providing home-care recommendations based on the individual treatment case. This begins with post-surgical home-care guidelines to ensure the clients feels comfortable and confident until they return for routine implant maintenance.3 (see Table 1). Always verify recommended guidelines with the implant surgeon’s recommendations.

Figures 2a, b: Placement of an implant. Courtesy of Keystone Dental 

Knowledge of the implant titanium surface is necessary to fully understand what oral hygiene recommendations and products to present to clients. After 1990, a definite switch from smooth titanium alloy surface to a rougher implant surface transpired, which has proven to accelerate osseointegration. The addition of surface coatings to create roughness with plasma spraying, grit blasting, and etching has also proven to raise the bone-to-implant contact and accelerate osseointegration.5-7

To help the cliemt protect their implant(s), their investment, clients need to be aware of the following key points on choosing safe home-care products. First the product (for example, toothpaste or gel) needs to be low-abrasive to not scratch the surface of any exposed surfaces of the implant (exposed threads, for example). Avoid dentifrice with stannous fluoride, sodium fluoride (APF >3.0), baking soda, stain removers, and smoker’s toothpaste.

Figures 3a, b, c: Interproximal brushes. Courtesy of Hager Worldwide

What toothbrushes and interdental products are best to use with implants?

Several studies have been conducted regarding what type of toothbrush is most effective for implants. The results show no significant difference between sonic, electric, or manual tooth brushes. The main focus needs to be on adaptation to the prosthesis and the customer’s dexterity. Instruct the client to brush the implant(s) twice daily to remove bacterial plaque with a low-abrasive dentifrice. A soft toothbrush should be used; options include a manual brush, electric, or sonic brush (examples include Oral-B Triumph, Sonicare, and Waterpik Sensonic Plus), Sulcabrush, or end-tuft brush.

Figures 4a, b: Examples of implant floss. Courtesy of Hager Worldwide and Sunstar

Americas

Nylon coated interdental brushes/ proxabrushes are also an excellent alternative to clean especially tight and hard-to-reach areas around implants and prosthesis. Nylon only interdental brushes (no metal wire) are necessary to prevent scratching the implant or prosthesis. The interproximal brushes such as I-Prox P or I-Prox Plus work extremely well and can be dipped in non-alcohol antimicrobial rinse or gel. It is extremely important to brush under, around, and in the peri-implant crevice circumferentially (see Figures 3a-c).
Floss

There are many types of floss in the market, and generally it is highly recommended to use unwaxed tape or implant-specific floss in order to protect the tissue surrounding the implant. Alternatively for a bar-retained prostheses, full fixed retained prostheses, or wider interproximal spaces, a floss threader or a specialized floss that has a built-in threader is necessary (see Figures 4a, b).

Figure 5a: Insert floss on mesial and distal. Courtesy of Dr. Peter Fritz

To floss the implant, use dental tape and insert the floss in contacts on both sides of the implant. Wrap in a circle and crisscross in front, switch hands, and move in a shoe-shine motion into the peri-implant crevice, which is highly susceptible to inflammation/peri-implant disease due to biofilm1 (see Figures 5a, b).

In addition, antimicrobial mouth rinses may be recommended, especially if inflammation is present or if the client has dexterity problems, and difficult-to-reach areas. If the client is prone to inflammation, the use of an antimicrobial rinse, in conjunction with a rubber tip stimulator, may be recommended to inactivate bacteria substantive.12

Figure 5b: Crisscross floss and move in shoe-shine manner. Courtesy of Dr. Peter Fritz

Oral irrigators/Water Flossers

It is highly recommended for clients to use oral irrigators for the reduction of plaque/biofilm, inflammation, and hard-to-reach emergence profiles around implants 13,14 (see Figure 6a). Instruct the client to use a non-metal tip one to two times daily, and, if inflammation is present, add a diluted non-alcohol anti-microbial rinse (chlorine dioxide or chlorhexidine gluconate).
Studies using oral irrigators with implants for oral hygiene reveal that Waterpik Water Flosser is the only oral irrigator to date to be proven safe and effective with dental implants.15,16 A study was conducted to compare rinsing with 0.12% CHX to using a Waterpik oral irrigator with 0.06% CHX. The irrigation group using the soft rubber tip (PikPocket Tip, see Figure 6b) at lower pressure was 87% more effective in reducing bleeding and three times more effective in reducing gingivitis than the rinsing group.15

Another study of oral irrigation and floss revealed that the Waterpik Water Flosser with the standard tip with three bristle filaments (Plaque Seeker Tip, see opening page) used at medium pressure around implants was 81% more effective in bleeding reduction compared to 33% using floss.16 These specialized tips are very effective for implants and to deliver anti-microbial rinse around difficult-to-reach prostheses (All-on-4, full-fixed prosthesis, for example) in a prevention of peri-implant disease.

Figures 6a, b, c: From left to right, Waterpik Ultra Water Flosser, Waterpik PikPocket Tip, and Waterpik Traveler 

Water Flosser

Water irrigation in conjunction with diluted non-antimicrobial rinse has proven to be extremely helpful for full-fixed and removable prostheses to remove daily biofilm and prevent inflammation if used on a daily basis. Waterpik makes a compact Traveler Water Flosser unit, which is my personal favorite to recommend ensuring clients to continue their home-care routine at home and away (see Figure 6c).
Stimulators

Stimulators are coming back into vogue with implants and regenerative procedures. Remember healthy keratinized tissue is the key to a healthy permucosal seal surrounding the implant. Stimulators are the ticket to achieve this, particularly in full-fixed, supra-structure implants, as well as implants that retain over-dentures (bar-retained implants). Examples of stimulators are rubber tip stimulators producted by multiple manufacturers and Soft Picks by Sunstar Americas (see Figures 7a, b).

Figures 7a, b: Examples of stimulators. Courtesy of Dr. John Remien & Sunstar

Americas

Instruct the client to place the tip of the rubber-tip stimulator so it lays flat against the gum tissue, not poking in the tissue, with pressure roll to massage and stimulate the tissue. The tissue will blanch or change to a lighter color when the correct pressure is applied.

A generalized home-care routine for implants is listed in Table 2 to be modified to individualize the clients home-care routine.

Note that a specific denture cleaner may be recommended for the overdenture. Plaque and bacteria can also accumulate on the inside of the overdenture, causing wear to the attachments and oral–systemic health complications for the client. Educate the client on how to do a visual check for attachments (O-rings, locator caps, and clips) and the importance of these attachments for retention. If attachments are worn or missing they will need to be replaced. O-rings and locator caps should be replaced once a year and clips as needed.17

Hygiene tip: Note the color and attachment type (O-ring, locator or clip) and record in the patient’s chart (see figure 8).

Figure 8: Note the color and attachment. Courtesy of Salvin Dental Specialties

Post-surgical implant placement home-care guidelines

• Drink only clear liquids; a soft diet is recommended for the first few days.
• Take all prescribed antibiotics to prevent infection.
• Take prescribed pain medication as needed for pain.
• Use an extra-soft toothbrush twice daily to clean pre-existing teeth or other implants, being careful to avoid the surgical incision area. If client uses an ultrasonic or electric toothbrush, wait one to two weeks.
• Clean between teeth once a day throughout the entire mouth except at the surgical site.
• Avoid wearing the temporary prosthesis provided or denture to let the gum tissue heal (if the implant was not immediately loaded).
• If recommended, use saltwater rinses or non-alcohol antimicrobial mouth rinse two times daily.

Implant Home-Care Guidelines

• Brush twice daily with low-abrasive dentifrice.
• Floss with dental tape (mesial/distal and facial/lingual) in shoe shine motion or use a water flosser one to two times daily.
• If recommended, use interdental brush, rubber tip, soft picks, and/or water irrigation unit one to two times daily.
• If inflammation present use non- alcohol anti-microbial rinse and/or add to water irrigation unit in 1:10 dilution.

Removable Prosthesis Guidelines

• Remove the prosthesis (overdenture) daily to soak in specific cleaner for recommended time only.
• Do a visual check of O-rings, locator caps, and clips. Alert dental professional if worn or missing, to be replaced.
• Remove the prosthesis from the cleaner and brush the underside with denture brush, being careful not to damage the attachments.
• Rinse off the prosthesis thoroughly with water and/or non-alcohol antimicrobial rinse.
• Rinse mouth with antimicrobial for 30 to 60 seconds and re-insert the overdenture into place.

Guidelines for care of your mouth after dental implant treatment:

• Take care to only have cold drinks and do not eat until the local anaesthetic has worn off. Avoid hot drinks or hot food for the first day and do not vigorously ‘swill’ liquid over the area. Try not to disturb the area with your tongue or fingers. Avoid undertake strenuous exercise for the first 48 hours (running / gym).
• Some swelling is normal and is usually worse in the mornings after lying flat all night. This will start to reduce after 48 hours. There may be some bruising on the skin which will also clear after a few days. Swelling can be reduced with ice packs (or a bag of frozen peas) wrapped in a towel. Hold on the cheek area for a maximum of 10 minutes at a time with 20 minutes break before applying again. After 24 hours gentle heat is more beneficial. Sleeping on 2-3 pillows may also help.
• Pain should not be a problem. Although you will be sore for a few days this can usually be easily managed with simple analgesics (pain killers) which you should take regularly for 2 days at the normal maximum stated dose. Take your first dose before the local anaesthetic has worn off. If pain seems to get worse after the first couple of days, rather than getting better, you should contact The Implant Centre.
• If you have a denture that covers the surgical area please wear it as little as possible for the first day to protect the underlying implants or graft. If the denture doesn’t seem to fit properly after your surgery then you must come back to have it adjusted. A badly-fitting denture can damage a healing implant.
• Any stitches will be dissolvable but often remain for around 2-3 weeks. If they are uncomfortable or annoying you may contact us to remove them after at least 1 week.
• Some bleeding following surgery is completely normal. If this persists apply pressure with a dampened gauze or clean handkerchief for 30 minutes.
• If you have been given antibiotics to take after your surgery then please complete the course.
• If you experience increasing pain or swelling after 2-3 days you should contact us for a review.

Cleaning – Successful implant surgery depends on keeping the mouth as clean as possible

• Please start to use the chlorhexidine mouthwash that you will be given, on the evening of surgery and continue for 1 week. You should hold half a cap-full over the surgical site for 1 minute, twice a day for 7 days. This will keep the healing site clean even if you are not able to clean it with a toothbrush.
• You should also start cleaning your other teeth with your toothbrush as normal on the evening of surgery. Avoid brushing the surgical site for the first few days, but then start to carefully clean this area as well when tenderness permits.
• Try to keep food away from the surgical area for as long as possible. Rinse following eating to keep the area as clean as possible.
• You are advised not to smoke until the wound has healed as this severely limits healing in the mouth.

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