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Dear Dr. Farnsworth: I have dental implants.  I understand that implants don’t get cavities so why do I need to get cleanings?

To answer this great question, we need to understand the difference between natural teeth and dental implants. With natural teeth there is the crown which is the part of the tooth we see in the mouth and chew on, and the root, the part that is in the bone beneath the gums. Around the root of the tooth is the periodontal ligament and around the crown, in the gums, is a ring of connective tissue. The connective tissue acts as a gasket or barrier to prevent bacteria from burrowing its way down around the root of the tooth.

With dental implants there is also the crown, but under the crown is an abutment that attaches the crown to the implant. In some cases where the implant is supporting or retaining a denture there is a small attachment or bar of metal attached to the on the top of the implant. Most implants are made of titanium, a metal that is considered osteophilic, meaning “bone loving”. This type of metal is used because it allows for the bone to grow directly onto the implant (osseointegration). Around the crown or attachment used to retain dentures is a layer of connective tissue. This tissue is vital to keeping an implant healthy.


Crowns, bridges, attachments and dentures that are supported by dental implants are not susceptible to dental caries or cavities, but they can come under attack by the same bacteria that tries to burrow under the gums.  The end result could be the loss of the implant. Implant health is directly dependent upon the health of the tissue surrounding the implant which is why periodic cleaning and inspection of implants is so important.  In time, bacterial biofilm or plaque will form around implant crowns just as it does around natural teeth. This biofilm needs to be removed at home each day through normal routine brushing and flossing. This same bacteria is what the hygienist is targeting when the implants are cleaned during regular hygiene visits.  If the biofilm is not removed then an infection in the gums around the implant can form, called peri-implantitis. Peri-implantitis can result in loss of the bone around the implant and eventual failure of the implant. Fortunately – and unfortunately – because bone loss doesn’t hurt, many people don’t even know they have peri-implantitis until the implant becomes loose or just falls out one day.

As with most investments, your oral health investment in dental implants needs to be monitored and maintained with appropriate preventive care. Prevention of peri-implantitis is key to keeping the implants healthy, functional and maintaining your investment. Specific continuous check-ups with evaluation of the implant and implant related prosthesis (crown or denture), and elimination of risk factors (e.g. smoking, systemic diseases and periodontitis) are effective precautions. This preventive care regime is essential to keep implants healthy. Ask your hygienist or dentist if there is any additional home care steps you should be taking to keep your implants healthy.

Dr. Rick Farnsworth, D.D.S., of Pro Solutions Dental Group/Jason C. Campbell, D.D.S. Cosmetic & Family Dentistry would love to answer your oral health questions! Email your questions to  You can learn more about services offered at or call 928-776-1208.

As published in The Daily Courier