An implant crown cannot decay, but the gum and bone holding the implant can still become diseased, and plaque is what sets that off. So home care for an implant looks a lot like care for a natural tooth, with a few changes in tools and a closer eye on the gumline. What you need depends mostly on the type of implant work: a single crown, or a bridge sitting on implants.
Gum problems around implants are common
When plaque sits around an implant, the gum next to it can become inflamed. This is called peri-implant mucositis, and like gingivitis around a natural tooth it can usually be reversed with better cleaning. If it carries on, it can progress to peri-implantitis, where the bone supporting the implant starts to be lost. A systematic review by Derks and Tomasi (Journal of Clinical Periodontology, 2015) estimated that, across the studies it pooled, about 43% of people with implants had mucositis and about 22% had peri-implantitis, although the figures varied widely between studies.
Early problems are easy to miss because they are often painless. Bleeding when you clean around the implant, swelling, a bad taste or gum that seems to be shrinking back are all worth reporting. Our article on signs of dental implant problems describes what to look for.
A single implant crown: clean it like a tooth, with softer tools
Brush twice a day with a soft toothbrush, angling the bristles towards the gumline where the crown meets the gum. Manual or electric both work. Choose a regular fluoride toothpaste rather than a gritty whitening or charcoal paste, which can slowly dull the surface of the crown and leave it easier for plaque to cling to.
Once a day, clean the sides of the implant where it meets the neighbouring teeth. Floss works for many people. Interdental brushes are often easier, and for implants the usual advice is to choose ones with a plastic or nylon-coated wire, because a bare metal wire may scratch the metal parts of the implant. Your dentist or oral health therapist (OHT) can show you the right size for each gap.
An implant bridge: the space underneath matters most
When several teeth are joined in a bridge on two or more implants, there is a space under the bridge where food and plaque collect and a toothbrush cannot reach. Bridge floss (floss with a stiff end and a spongy section) or a floss threader can be passed under the bridge and drawn back and forth along each implant. Interdental brushes can be angled in from the side.
Many people with bridges find a water flosser easier to use every day. In a small 30-day trial (Magnuson and colleagues, Compendium of Continuing Education in Dentistry, 2013), bleeding around implants fell at about 82% of implants in the water flosser group, compared with about 33% in the string floss group. That is a small study of 40 implants, and one author worked for a water flosser maker, but it suggests a water flosser can be a useful addition, set to a low or medium pressure. If your whole upper or lower arch is restored on implants, our guide to cleaning a full-arch implant bridge at home goes into more detail.
What to leave out
- Hard-bristled toothbrushes, which can irritate the gum around the implant.
- Gritty whitening or charcoal toothpastes.
- Bare metal picks or interdental brushes with uncoated wire.
- Toothpicks forced into the gum, which can damage the seal of gum around the implant.
Professional care fills the gaps
Even good home care leaves some plaque behind, particularly just under the gum. At a maintenance visit your dentist or OHT removes it with instruments suited to implant surfaces, checks the gum around the implant for bleeding or deeper pockets and takes an X-ray when needed to check the bone level. How often you need these visits depends on your gum health, your history and the type of implant work you have, so your dentist will suggest an interval that suits you.
A history of gum disease raises the risk of problems around implants, so regular care matters even more in that situation. Our article on dental implants and gum disease explains why. For background on how an implant becomes anchored in the jaw, see how implants bond with bone, and if you have noticed your implant crown looking duller over time, read whether dental implants stain or discolour.
Questions about implant cleaning
Do I need special toothpaste for an implant?
No. A regular, non-gritty fluoride toothpaste is fine. Fluoride does not protect the implant itself, but it protects your natural teeth next to it.
Is a water flosser enough on its own?
It works best as an addition to brushing and floss or interdental brushes, not a replacement. Your dentist or OHT can suggest the combination that suits your mouth.
Should an implant bleed when I clean it?
Healthy gum around an implant should not usually bleed. If it bleeds regularly, book a check so the cause can be found early.
Keeping your implant healthy for the long term
If you have an implant or are thinking about one, our team at Lumi Dental can show you a cleaning routine suited to your implant and check it at regular visits. Visit our dental implants page, learn about full-arch implants at Lumi, or see our current deals for a free implant consult.
This article is general information and does not replace an individual dental assessment.
