Chapter 5
After implant treatment
After ‘one month implant’ placement
Question 1
I understand that the ‘one month implant’ can become one’s own tooth but can this tooth
be decayed or get pyorrhea?
Answer 1
The implant would not be decayed and get pyorrhea (periodontal disease).
The reasons are as follows.
The tooth surface is made of enamel and causative bacteria for dental caries(streptococcus mutans and streptococcus sobrinus are representative) give off an acid tomelt the enamel.
They reach the cementum that below the enamel and even to the dentin to melt them,and then to the dental pulp where nerves pass.
Then a toothache occurs and people will dash into a dental clinic in a hurry.
The implant body will not be melted by the acid that is given off from the bacteria,
subsequently it is hardly possible for the implant to be decayed.
Also, it does not get periodontal disease.
The periodontal disease is caused by intraoral pathogens (mainly porphyromonas
gingivalis, treponema denticola, and tannerella forsythensis).
They cause mild gingivitis at first and it will become periodontitis.
It will become so-called periodontal disease when they proliferate and expand into
periodontal tissues※ (overall phrase includes such as periodontal ligament, cementum,
alveolar bone and the so-called jawbone).
After the progress of periodontal disease, a tooth will come off when the periodontal
tissues are destroyed and become too weak to support the tooth.
However, the implant body is directly planted into the jawbone and there is no nutrition
to provide for periodontal pathogens to proliferate, therefore pathogens would not havea chance to proliferate.
Question 2
Please tell me about aftercare for the implant placement.
Answer 2

(1) No special care is required.
If you brush your teeth as usual, you would be fine.
However, I will explain that brushing your teeth is extremely important.
① Reason to say “Please brush your teeth as soon as you wake up“
The oral is the perfect breeding grounds for bacteria such as periodontal pathogens andcausative bacteria for dental caries.
Bacteria proliferate exponentially because the oral is always in suitable temperature forbacteria to proliferate, temperature of the body (about 37 ℃), and there are a lot ofnutrition included in saliva (food remnants).
There are 100 to 200 million pathogens per 1 ml of saliva, thus how hard you brush yourteeth before you go to bed, pathogens will have bred by the next morning.
Therefore, it is important to wash these pathogens away as soon as you get out of yourbed. If you wash the pathogens away, your oral can maintain cleanliness since saliva isneutral.
As previously explained, these pathogens are a cause of lifestyle related diseases.
② Reason why it is important to brush your teeth right after meals.
There are a lot of food remnants of a meal on teeth or in the space between teeth aftermeals.
This will become a culture medium for pathogens.
These pathogens proliferate exponentially.
For example, causative bacteria for dental caries (streptococcus mutans) give off acid tomelts enamel and to decays a tooth.
③ For the same reason, it is important to brush the space between teeth, hence I
recommend you to clean the space with dental floss or an interdental brush.
④ Of course, these pathogens also attach to a toothbrush, consequently you shouldwash them away from the brush and dry it.
⑤ In regard to an implant, you should try to brush your teeth in the same way.
(2) Periodic maintenance (called ‘recall’)In addition to the daily tooth brushing, I recommend you to go the dentist every three orfour months in order to receive maintenance periodically.
Maintenance of implant such as to check condition of the implant and oral with adentist and a hygienist is a key for the implant to last long.