How to Clean Your All On 4 Plus® Dental Implants

Although All-On-4 Plus® bridges are fixed in place, they still require ongoing daily care to help keep the surrounding gums and implants healthy. Food particles and bacteria can collect around the bridge and beneath the prosthesis, particularly in areas that a regular toothbrush cannot easily reach.

Most patients are advised to brush at least twice a day using a standard toothbrush and toothpaste. Brushing should include all visible tooth surfaces, the gum line and the areas around the implants. It should be noted that thorough cleaning cannot damage the prosthesis or the implants. Patients who still have some natural teeth may also be advised to use a soft-bristle toothbrush. Electric toothbrushes are not recommended for All-On-4 Plus® bridges, as intense vibrations can affect the internal micro-screws over time.

Additional cleaning tools are often recommended to help clean underneath the bridge and between implant areas. These may include specialised floss ( x-floss), interdental brushes, or water flossers ( DO NOT use a water flosser if you have had zygoma implants). Professional hygiene appointments are also important for monitoring implant health and cleaning areas that may be difficult to maintain at home. Good daily hygiene and regular maintenance help reduce the risk of inflammation, infection and peri-implantitis over time.

How you clean your teeth after surgery is important as your mouth is currently in a healing phase. You should follow the following instructions:

- Brush twice a day with a standard toothbrush and toothpaste ( no charcoal toothpastes) (DO NOT USE AN ELECTRIC TOOTHBRUSH). Brushing should include all surfaces of the teeth, aswell as the gums and around the implants, it may be slightly uncomfortable at first but persist with it- make sure to be soft at first.

NOTE: Bleeding may be a sign of inflammation and should subside with effective hygiene.

- Floss under the bridge using X-Floss alongside one of these methods ( tee-pee brushes, mouth rinse, waterpik) at least once a day.

NOTE: A waterpik SHOULD NOT be used on your top teeth if you have had Zygoma Implants. If you had Zygoma implants on the top and standard implants on the bottom, you can use a waterpik on your bottom teeth.

3 Week Review

You will return to your clinic for a check-up 3 weeks after your surgery. During this appointment we will assess how your mouth and implants are looking- any swelling, bruising or discomfort after surgery should be gone by this point. During this appointment we will:

- Show you how to clean your implants
- Explain how to use your cleaning tools ( X-Floss, waterpik etc)
- Ensure that the implants and surrounding gums are healing appropriately
- Make any adjustments needed ( if you feel that something is off or uncomfortable)

4 Month Review

You will return to the clinic 4 months after your surgery for your final check-up. At this stage, the process of osseointegration ( integration of the implants into the jawbone) would be complete and the implants should be fulled healed. During this appointment we will:

- Check your cleaning habits
- Check your bite
- Take a CBCT ( x-ray) to ensure that the implants have fulled healed and integrated
- Provide anti-clenching ( if required)
- Take final photos

Ongoing maintenance into the future is important for the success and longevity of your implants. You should continue to floss at least once a day with the x-floss and brush twice a day to maintain your oral health. Not maintaining your cleaning habits will increase the chance of of your implants failing.

The correct way to clean your teeth using the following products:

X-Floss: Count 4 teeth to the right from the middle top or bottom teeth and place the piece of x-floss between the gums and the bridge so that you are in one of the sections (there are 3 sections given that there are 4 implants). With both hands use a flossing motion to remove any build up of food that may have got stuck underneath the gap of the prosthesis. Do the same for the other side, top and bottom.

Regular Tooth Brush: To be used twice daily to brush your teeth and more importantly the area where the gum tissue meets the prosthesis. This is important for gum health, keeping your breath fresh and removing any food that might have got stuck.

Interdental Brushes: These smaller brushes should be used in the gaps between the gum line and prosthesis where a regular toothbrush may not be able to fit. You do not have to use toothpaste on these brushes, as they are used to remove small parts of food; however you can for freshness.

Waterpik: The waterpik shouldn't be used as an alternative to flossing, it should be used in conjunction with it. The waterpik can be used multiple times a day to keep the mouth refreshed, especially after eating. It should be placed on the gum line where the bridge (teeth) and gums meet. This helps avoid food building up under the bridge. Flossing can also be used after this.

NOTE: Every case is different but usually return for a check-up every 6 months like you would a regular dental check-up.

If you are experiencing any issues including pain, bleeding, or severe discomfort- please contact our clinics at 1300 255 400 or your local doctor immediately.

Dr Maria explains in detail how to clean your All On 4 Plus® Dental Implants. Cleaning and maintenance of your implants and bridges are essential for you to keep your teeth for many years to come without any problems.

Read the most common questions regarding cleaning and their answers below: