Large Calculus Deposits on Dental Implants: How to Manage?

K., a dental hygienist, asks:

The dentist I work for does not have much of an interest in recall of dental implant patients. Once he gets the implants in and does the crowns or overdenture, he basically transfers the care of the patient to me in the hygiene department.

He really pays no attention when I tell him that some of the patients with dental implants have heavy calculus deposits. It is really hard to scale the implants when they have these huge deposits. I have been in the practice a long time and I know many of the patients well. Those that have calculus before, have calculus after the implants are installed. Some are chronic mouth breathers and others have the same awful oral hygiene habits that they did before they got the implants. I have two questions. What is the best way to scale off these large calculus deposits without damaging the implants? Is there anything else I can do to reduce the deposition of calculus on the implants?

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10 thoughts on “Large Calculus Deposits on Dental Implants: How to Manage?

  1. Use carbon inserts for ultrasonic scalers designed especially for implants.

    There are some hand instruments designed for implant scaling with special tips. Ask Hu-Friedy/Salvin.

    Your dentist probably knows that some patients won’t change their habits and won’t acquire new good habits either. Some patients are frustrating to deal with. They probably got the implant done because their friend had one. Implants are a commitment. The practice would have been better off if those patients were not selected for implants. Now that they are in the practice you have no option but to scale them periodically and see whether better sense prevails some day and they improve.

    Till that time remember your dentist and his errant patients in your prayers!

  2. I would say exactly that.Although we spend lots of time with patients in their training and teaching them, some just dont learn. Also if the restorations are screwed in , they can easyly be unscrewed and completely cleaned outside the mouth and then re installed(that is what we do)

  3. incorporate waterpik into your practice – compliance increases compared to other methods; I love it, give it to all my patients

  4. I have an ultrassonic insert especially for implants. It comes with disposable plastic blue inserts. I believe we bought it from Dentsply. It works great for the big calculus. As for prevention, the best method in my experience is using a Sonicare toothbrush. It is amazing especially for these patients. I gave some of my patient a complimentary Sonicare after Implant treatment. I also recommended it for Implant overdenture patients. I realize that not all patients are good with their home care but I do not see how does this make them not good candidates for just implants. They may not be good candidates for any dentistry. Implants are not different. Reality is Reality. Very few patients floss regularly, does this mean you are not going to crown their teeth. My concern about my implant patient’s home care is mainly during the treatment phase, which is critical. Most of implant patients improve their hygiene during the treatment phase and most of them relapse to their old habits after treatment is completed. Your best shot is giving them or have them buy a Sonicare “Compend Contin Educ Dent. 2002 Jul;23(7 Suppl 1):11-4.” I am not a fan of waterpik except for patients with completed fixed implant restorations “Hybrid”.

  5. The Rotadent rotary toothbrush is a good tool for implant patients. I used the Rotadent Soft Tissue Management in my practice for years and found this device to be very effective. My patients loved them!

  6. Tell the patients to find out what Sjogren’s Syndrome is, and figure out how to treat it themselves. Because they won’t find a doctor smart enough to diagnose it for them. And that includes dentists.

  7. I never do an implant before the patient is clearly informed to what i am performing in his mouth. when i decide to threat an implant program in his mouth he must proove that his dental hygiene is at the toptop.

    at that moment i dont have any problem with dentntal or iplant calculus with this patient. it’s all

  8. The calculus must be removed! I dont have a lot of confidence in most of the products on the market that are used for dental implant instrumentation. This includes curettes and ultrasonic tips. There have been many times I have used my regular cavitron tip to remove the calculus from an implant. Just be sure to detune or decrease the power on the cavitron and instrument the implant with the side of the insert and not the tip. Use light pressure only. I guess I justify doing this by knowing that the calculus must be removed and nothing on the market, being sold for implants, is very effective.

  9. I have practised for over 25 yrs and the best way to scale around an implant is with the Wingrove Titanium Scalers from PDT they have 3 styles with great blade design which will adapt to any implant need you have. They can be resharpened using s dedicated stone

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