Implant Care: An Interview with Dr. Michaela von Geijer, DDS

Having a dental implant installed in the mouth is becoming increasingly common worldwide since it is a solution for patients with missing teeth or severe periodontitis. It is estimated that 12–18 million implants are sold worldwide every year, from more than 100 different brands. In Europe, the number of sold implants is estimated to be 5.5–5 million.1 Getting a dental implant is a relief for many patients and improves their quality of life. However, it is important to note that the implant and surrounding tissue must be cared for thoroughly to stay healthy. TePe provides an implant care kit for just that purpose. We are asking Michaela von Geijer, Doctor of Dental Surgery and employee of TePe, more about the products in the kit, how to use them properly and the issues surrounding having dental implants.

Very common. According to the latest Clinical Practice Guideline from 2023 nearly half of our patients (43%) will get peri-implant mucositis and 1/5 (22%) will get the

severe form peri-implantitis, with bone loss.2

Yes, even though plaque accumulation is the etiological factor for the disease, certain risk factors contribute to the progression, such as a history of severe periodontitis.3 Other risk factors are, for example, smoking, not well-managed diabetes, low socio-economic status, location of the implant, bone quantity and quality, and potentially genetics.4

The first stage, peri-implant mucositis, should be treated with professional cleaning and thorough cleaning at home. The second stage, peri-implantitis, is really challenging to treat. The Clinical Practice Guidelines from 2023 recommend a step-wise approach. The fact is that we don’t really know how to treat it. There are different suggestions on how to approach the disease, but we can’t guarantee a successful outcome for the patient. In the worst-case scenario, we need to remove the implant. That is why prevention is so important.

Number 1: thoroughly cleaning at home along the gumline. Number 2: attend maintenance care regularly at the dental office. Number 3: contact the dental office

if bleeding occurs or if the tissue close to the implant looks or feels strange.

That is a tough one to answer in a few sentences. Encourage them at every session. A plaque discloser might be a good educational tool to use. We must share our knowledge and try to find the patient’s internal motivation to keep the implant healthy. Every improvement matters.

Depending on risk factors, that must be tailored individually, but at least twice a year is recommended. 

I’ve had two or three other brands of electric handpieces but I am most comfortable with Bien-Air. I feel the bearings last longer and certainly more than air-driven. I like the weight and texture of the Bien-Air handpiece and the size of the head is smaller than some others. I feel any electric handpiece is better than air-driven in my hands, and I’ve been using Bien-air electric handpieces in my practice for many years. I couldn't imagine switching back to air.  

The kit contains a leaflet with instructions and illustrations on how to use the products. But our role as professionals is very important, we must show, guide and instruct the patient on how to use the products. Practice with the patient during every maintenance visit. In this way we encourage the patient and can pinpoint and

adjust the way the products are used.

In my opinion, this is a must for all patients with implants because of its unique angle neck. It can be challenging to clean lingual along the gumline, and with this tool it is easier to reach that hard-to-reach area.

Sometimes there is a need for a very firm, dense and rounded tuft for precision cleaning along the gum line or around implant surfaces.

This is perfect for buccal cleaning. The slim brush head aids cleaning the implant surfaces along the gumline.

Initially, the tissue might be sensitive, so these extra soft brushes are very comfortable to start with. Cleaning in-between implants is even more important than cleaning in between teeth because the tissue around implants is more sensitive to plaque accumulation. The clinical practice guidelines from 2023 recommend interdental brushes for proximal cleaning. The kit includes interdental brushes in six sizes with an extra soft bristled brush with plastic-coated wire and a user-friendly

handle design for gentle and safe cleaning. Later, when the tissue is less sensitive, it is possible to switch to the original interdental brushes, which come in 9 sizes (ISO size 0–8), and TePe Angle™, in 6 sizes (ISO size 0–5).

This floss is ideal for cleaning under the pontic, and is also an option for cleaning proximal sites or to combine it with interdental brushes. The sturdy ends facilitate insertion, and the spongy mid-section effectively removes plaque.

Really take the time to instruct your patients on how to use the products, it will pay off in the long run. It will give more success for the clinic, us dental professionals,

and most importantly, the patients.