Implants · patient case question
Which hygiene instruction is NOT appropriate for this fully edentulous, implant-restored patient?
Patient case: Implant Maintenance Problems
demo: 57-year-old female
chief: “The gums around my implants bleed and food gets stuck underneath.”
history: Edentulous maxilla restored with an implant-supported fixed prosthesis 3 years ago. Former smoker.
meds: None
findings: Bleeding on probing and erythema of the peri-implant mucosa at three sites. Radiographs show no bone loss beyond the initial remodeling. The intaglio of the prosthesis is concave, with food packing at the tissue interface.
Show answer and explanation
Correct answer: A. Daily fluoride mouth rinses
- A. Correct — this is the exception. Fluoride prevents caries in natural tooth structure. In a fully edentulous patient with titanium implants there is no enamel or dentin to protect, so fluoride rinses serve no purpose.
- B. Interdental brushes are a mainstay of peri-implant hygiene.
- C. Water irrigation is effective at the tissue-prosthesis interface where brushes cannot reach.
- D. Floss threaders and superfloss are standard for cleaning beneath a fixed implant prosthesis.
Note: There is a further nuance: high-concentration acidulated fluoride can corrode titanium surfaces, giving a second reason to avoid it around implants.