Oral hygiene instructions
- Oral hygiene instructions are one of the most important, yet often overlooked, steps in aftercare
- A properly designed fixed prosthesis is essential to facilitate adequate access for oral hygiene by the patient
- Plaque retention will predispose to mucosal inflammation and pathology as well as unpleasant oral odors
Treatment planning and hygiene considerations
All tissue surfaces, prosthesis surfaces and implant surfaces should be accessible by oral hygiene aids like toothbrushes, interdental brushes and dental floss or dental tape. It is paramount that, during treatment planning, implant location and prosthesis design take place with the final oral hygiene outcome in mind. To this end, all intra-oral prosthesis surfaces should be smooth and highly polished to counteract plaque retention.
Oral hygiene instructions - patient
Every visit should have oral hygiene instruction incorporated, and the instruction should potentially need review. This is especially important for fixed prosthesis. Oral hygiene instruction should be pursued until the patient can demonstrate independent competence accessing all pertinent intra-oral areas using the appropriate oral hygiene aid. Although most patients can clean well with a regular toothbrush and dental floss, special brush forms are available to clean around implant-supported restorations. There seems no difference in outcome between powered and manual toothbrushes.
Removable prostheses should be removed every night by the patient and kept in a humid atmosphere or soaked in water or denture cleanser. Abutments and prosthetic superstructures retaining removable prostheses should be brushed scrupulously to be kept plaque-free and ensure optimal mucosal health. Inflamed mucosal tissues may result from inadequate plaque removal.
To also make the caretakers familiar with the recommended hygiene measures, the dentist/dental hygienist should consider to associate caretakers to the instructions for aftercare for (elderly) dependent patients.