- Maintenance of the natural teeth with daily hygiene is critical to oral and systemic health.
- Teeth adjacent to implant supported restorations must be maintained with diligent oral hygiene.
- There are a variety of tools available for the patient to perform routing hygiene that will insure the longevity of the natural teeth for a lifetime.
Maintenance of the natural teeth is essential for both optimum oral health and the overall systemic health. There is increasing evidence that the loss of the permanent dentition has such a deleterious effect that there are increased risk of cardiovascular disease, diabetes, hypertension and loss of cognitive function (insert Felton comorbities). There is also evidence that the loss of teeth has enormous psychosocial affect and reduces the overall quality of life (QOL) of a patient. This loss oral health quality of life (OHQOL) directly impacts the individual and the family. There is documentation that the absence of teeth prevents individuals from seeking meaningful employment.
The absence of even one tooth in a critical esthetic area will affect the patients self esteem. Thus implant restorations restore much more than a tooth. The patient must be constantly attentive to daily hygiene of their natural dentition, and surrounding soft and hard tissues. Therefore a daily regimen of brushing and flossing is essential. Additionally a patient may wish to utilize an oral rinse containing fluoride to help prevent future decay. If the patient has has multiple implant restorations, whether connected or as individual teeth it may be wise to place them on the CAMBRA protocol. Some patients due to their natural oral flora, or compromised hygiene ability, reduced salivary flow, or other factors may have altered pH which will make them more prone to decay. This should be discussed with their oral health care provider.
There are additional tools that can be employed from manual interdental brushes to rotary mechanical brushes to assist in keeping the hard and soft tissues in optimum health. On would also be wise to carefully control the ingestion of refined sugars that add to acid production in the oral cavity that can cause enamel dissolution.
On the professional level patients should have their teeth and dental restorations cleaned by a professional dental hygienist on a biannual basis. This will allow the monitoring of the soft and hard tissue around all the teeth and any restorations. It is advisable to also have annual radiographs to detect any inter-proximal decay that may occur between teeth or teeth and implants and asses the bone level around the implant supported restorations.