Know Your Flow: Implant Maintenance

You're listening to The Dr. Phil Klein Dental Podcast Welcome to the show. I'm Dr. Phil Klein. Today we'll be discussing implant maintenance and the solutions that are currently available for your dental practice. Our guest is Dr. Kelly Tanner, a visionary leader who helps dental teams achieve personal and career growth. She lectures extensively and has impacted more than 100,000 people with her speaking engagements. Before we get started, I would like to thank our sponsor, Action Group. Action is a leader in the dental industry based on its technical innovations in x-ray and digital imaging, high-frequency ultrasonic technology, pharmaceuticals, and precision instruments. So thank you, Action, for your continued support with Viva Learning CE webinars and podcasts. Dr. Tanner, it's a pleasure to have you on Dental Talk. Thank you so much. So nice to be here with you. So why do you think most dental practitioners struggle with implant maintenance? That's a great question. Many of them struggle because they don't feel confident how to approach the care of dental implants. I'll tell you just among the dental hygiene community, we didn't know for years. whether they touch them, probe them, let the doctor only look at them if it was going to burn our brains if we took an instrument to them. So just to feel confident in what it is that we should be doing and have a protocol set up around them. And then, too, in that, to take those courses, to learn more about what the up-and-coming information is around how we should approach those, what the standardized protocols are, what they are not. anymore. But I think really just knowing and feeling confident to jump into them to say, this is exactly what I know that we need to do when we see an implant. We need to know how long ago it was placed, what argumentarium that we knew what we need and what we require in our practice. And then what are steps to success to continue that patient along this healthcare continuum? I mean, when you think about it years and years ago, when implants first emerged, it wasn't a big deal. this whole topic of implant maintenance because there weren't that many implants installed. But at a rate of 3 million implants a year, fast forward 10, 15 years, we're looking at a lot of implants that are out there. That number continues to grow. So it is a big deal now to make sure that these implants stay in the mouth. How can a dental practice become more proficient in implant maintenance? The implant maintenance itself, I think, again, as mentioned before, is about how to know how to proceed truly. Like when you have this, if then, then this, if this, what's the protocol in your practice. And it's that confidence that you're building from going to courses, keeping up with literature, the standard of care, what is available in your state to utilize in terms of like. laser therapy for dental hygienists in certain states? Can they use, can they utilize that type of device to care for implants? And then just going out to say, okay, if this is the standard of care that we want for our patient, how then do you back into that as a practice? And again, you know, to that long-term care solution for that patient. So it's knowing how to proceed, keeping up with what there is with hands-on workshops or whatever it is that not just doctor. should go to, but also team members, hygienists, and also dental assistants. So they can all speak that same standardized language across the office. So isn't it important that the dental hygienist can identify implantitis because they're the ones that are seeing the patient on the regular recall visits. They're not called recall anymore. What's the new word? Recare? Well, it's preventive care. There's a lot of different terms for it. Even recall is like it's a bad car, so you're recalling it back. Yeah, right. That's why I knew that went out of fashion a long time ago, but I always use terms that date me almost on every podcast. I hear you with that. Yeah, but it's hard to change when you're an old dog. What I'm saying is the dental hygienist is really going to be the one seeing the patient on these regular visits where they come back for hygiene appointments. So the training... not only is in maintenance of it, but in identifying it? I think it all begins at the morning huddle, personally. I think it goes with doing those chart reviews in the morning to ask Dr. X, this implant was placed however many months ago. Would you like for me, I plan to go ahead and probe this today. Would you want to come in to see the implant before probing? Or what would that protocol be? Again, being comfortable in that protocol for what the office is doing, what everyone looks like, what they're looking for to, again. build that confidence for that long-term care. And then so in that morning huddle, it's planned for the day what is going to happen with that patient. So with periodontal disease, with the periodontitis that can happen around the implant, it starts off sometimes as mucositis. And that's the part where I think, you know, periodontitis is a little more straightforward because there's loss of bone. But what do we do when it doesn't look right? What do we do when it's puffy? And that's, I think, where we start getting cringy about how do I start with this and what do I do? And using the armamentarium that we have now in terms of Susan Wingrove's titanium scalers, which are amazing because you're using the same type of material on the, you know, it's material, material compatible. And then you have one of my favorites are the implant protect tips from Action. I don't know if you guys have ever heard of those. They are pure, the only pure titanium tip that's on the market. And what I absolutely love about using those is that one, I can use them on a piezo, which is in. for use around dental implants because it's low vibration. You're not going to be disturbing that environment too much unless it's specifically where you're placing that tip. And those tips are made for the specific size of debridement for those threads. So if you're having medium threads, thinner threads, thicker threads, they're made for that specific size. And then, of course, you always wanna make sure. starting off with the assessment that you have the right probes that you're going to use that are clearly demarcated, that are plastic probes or, you know, something that is along those lines. And then I love to... I'm debriding the implant, when I notice that there's calculus, when I notice that there's biofilm and or cement, I can use that Aaron Go device through Action and use my perio nozzle. It's like a little shoehorn. And you guys, if you've never seen this, you need to go to Action's website and it fits right below the gen. It fits in these really thin pockets and it irrigates it from the base up. It's such a cool action. I can have confidence in that every time. So you certainly mentioned some useful tools. gadgets and companies that our audience could look into. How do you suggest hygienists implement this technology? What's the best way? Yeah, I think to start, it's what do you have? Based on your protocol and what you want to deliver, first figure out the tools that you need, just like any other, I say project, but anything that you're, if you're doing an exam, what tools do you need to do an exam? Take inventory of what you have, replace your plastic probes. This is one little tip that I realized throughout the years. I don't know if you guys know this, but when you have those replaceable implant um probes that screw on the end of your handle they have those little demarcations for the probe depths those if you're putting them in the ultrasonic scaler those eventually those black lines kind of jiggle off in the scaler so they'll it seems like your eyesight's going bad and that's not happening to any of us because we're all getting younger right right but actually what it is is those little lines that are getting dimmer and dimmer because they're being vibrated off in the ultrasonic and through processing so make sure that you're keeping an eye on your plastic probe that those lines are in place so you can see them. assess the way you need to. And then I always say too, if you're recommending certain home care modalities to your patient, give them whatever product that you're recommending, give them RemenPro, give them closest, whatever it is that you're recommending to that patient. And then also too, when you're looking at the devices that you're using. What is it that's going to, and this is a whole other topic, what is it that's going to make your job easier while giving the patient the best benefit? Do you want to use air polishing? Do you want to use GBT? Do you want to use a piezo? Because you know that's the best thing to use. And are you set up for that? So take that inventory and back into what your protocol is specific to what you and doctor and team feel like is most appropriate. Yeah, and I guess they could reach out, our listeners who are interested in upgrading their systems to help address implantitis, reach out to the companies that manufacture these devices. Oh, for sure. There's companies, you know, my personal favorite is Action. I love them. They have a nice website. And if you have any other questions and... Of course, I think there's EMS and there's all different types of manufacturers, but you can personally reach out to me at drkellytanner.com as well for questions or things that I have personally experienced in this. And then if I don't know the answer, I'll put you to who can help you. Thank you so much, Dr. Tanner. We appreciate your insight. And I know we have another series of podcasts on Know Your Flow. One is going to be on infection control. We look forward to that and also prophylaxis. So yes, until then, thank you so much. Okay. Thank you. Take care.