The floss is thin and the pressure is high enough to easily break any peri-implant soft-tissue seal. Break the contact and then force it into the pocket from both sides and move back and forth. According to his article, “Many dental practices instruct their patients to floss the dental implants the same way they floss natural teeth. Pulec has placed thousands of implants, and he states that there are several causes of peri-implantitis, including traumatic oral self-care. The dean of students at the Toronto College of Dental Hygiene, Boris Pulec, DDS, wrote an interesting article titled, “Tell your patients to stop flossing and your hygienist to stop checking pocketing.” 1 Dr. Second, some say it’s OK to probe, while others say to avoid probing implants. For example, some say to teach patients to floss, while others say to avoid floss. First, there appears to be considerable disagreement among doctors who place implants as to the best cleaning methods. There are two other problems related to preventive care and implant patients. Many of your colleagues have never seen a fixed implant denture in a patient’s mouth. So, you are not at fault for being unsure about the correct protocol. Further, in a temp situation, you never know what you might see. If the doctor does not recommend or provide implant dentistry, obviously the hygienist will lack insight into preventive care for implants. A hygienist typically will become proficient in offering preventive care to patients in the practice where he or she is employed. In between those two extremes is a wide continuum of dental practices that offer many levels of care. I look forward to hearing your professional advice.Īcross the country, there are all kinds of dental practices, from state-of-the-art everything, implant-only practices, to small bread-and-butter practices that focus mainly on restorations and palliative care. Plus, I felt embarrassed about asking the dentist when I am supposed to be knowledgeable (I have nine years of experience as a registered dental hygienist). I don’t feel confident in what I used or what I did to give this patient the best care. What should I do when given an hour for denture wearers? What is the proper way to clean stains, calculus, and plaque from dentures? What are the dos and don’ts with patients like this? My notes from that day are very generic, and I don’t feel confident in the fact that I used coarse polish to polish her dentures. Now I am questioning myself about what I could be legally responsible for if the patient decides to file a complaint. The dentist had her come back in to the office, but he didn’t see anything broken or damaged with her upper denture or anywhere in her mouth. I used coarse polish to polish her upper denture (which I have been doing for years).Īfter the patient left the office, she called back to say that her dentures felt different, something about a “space” that wasn’t there before. I was not given instructions on what to do or not do, so with one hour to spend on this patient, I used regular dental hygiene instruments along with a power scaler to flush out the plaque and blood under her upper denture. She had indicated that she didn’t floss often, and there was a moderate amount of plaque underneath her denture on the upper, in addition to calculus and moderate plaque along the gumline. She is a geriatric patient with poor oral hygiene. ![]() The patient has a permanent fixed-implant full upper denture, as well as crowns and implants on her lower arch. This week I received a call from a dentist’ office where I had temped, and he told me that one of the patients I saw was very upset after I cleaned her teeth. I have been temping full-time for the past six months.
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