How To Clean Dental Implants Including All on 4, 6, Zirconia Bridges

Dental Implants are NOT teeth.  They are a “replacement” for teeth.  Because of this, cleaning dental implants is different than cleaning your natural teeth.  The biology of the gums around an implant is very different than what is found around natural teeth.

Of course you have to brush, but should you floss, Waterpik or use other cleaning adjuncts?

You might be surprised at what I have to say in this video!!!

Upper/Lower “All on 12.” A connected bridge like this requires more than just brushing and flossing. Note the design contour on the gum side of the bridge.

Some cleaning methods can promote bone loss around an implant (Peri-Implantitis) making it worse.

Underside of one of the prettau bridges shown in the x-ray image. Note the smooth, convex surface design.

Home care of your single tooth, full mouth implants, Prettau zirconia bridge, all on 4, 6,  etc  are covered in the video.  3D lab design is critical for making your teeth easy to clean and self-cleansible.  Connected teeth bridges and abutments are also discussed.

Final Full Mouth Prettau Implant Bridges that are shown on this post. Ramsey Amin, DDS

Your comments, questions and concerns are welcome.

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry

66 thoughts on “How To Clean Dental Implants Including All on 4, 6, Zirconia Bridges”

  1. Two questions:
    1. If my Zirconia all on 4 breaks within one month;(The dentist found a crack in it and it came apart in his hand) Should the whole prothesis be restored?

    2. Can I brush my Zirconia all on 4 with regular toothpaste? (Crest, Colgate etc.) I also do a waterpik as well.

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  2. I have fixed upper zirconia bridge on 6 implants. My teeth are not flush with my gums. I now have an overbite and flossing is difficult as I have a “u” shape to thread through. Is this right?

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  3. I have temporary prosthesis all on four, I have sharp constant pain in my lower right implant, dentist did an X-ray and can see no infection and he said the implants are good, but it’s causing me severe pain. The temporary has been there for a couple of months but only recently started hurting.

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  4. Hi, I have 4 lower implants and the same on the top with a full bridge. I noticed that my bridge has started moving and has lifted up on the bottom but my implants are not loose. Why has this happened?

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    • That sounds stressful since implants restorations are so expensive. I have a full upper upper on 8 implants, 15 years old now, all cemented with “temporary cement” , must be some strong stuff, it’s never been removed, never moved. Is yours screwed in or cemented?

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  5. I have all on 6 upper and lower arches. I am in my temp teeth at this point 8 months after surgery. It looks like I do not have teeth on the top unless I give a big smile and also my upper lip is sunk in and if I do not smile it looks like I have no teeth at all. My finals will be crystal ultra and I am concerned that I will not have enough upper lip support as the temp teeth seem to hang forward over my gums already. My Dentist told me he is not sure just how much lip support I will get as an end result? Is there any way to make sure before I go to the final teeth. Thank you

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  6. I had all on 6 on top completely done no problems. I had one implant on bottom done and failed twice. I’m on my third try. I am three weeks in and have no pain but I have fluid like absess on top of my implant. Should I be worried?

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  7. Is it reasonably normal for an “all on 4” to have one rear implant set lower than the other three. Set so low that it is difficult to attach the screw on abutment. What could be the reason for this?

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  8. I have the 4 IN 1, after 7 years I noticed small stains in the surrounding fake gum area of the tooth. Went in for my 6 month cleaning with Eon Clinic’s and they cleaned them but within a week these stains started showing again. The brush with tooth paste and I use the water pic daily, what can I do to make these go away. I only have one cup of coffee a day and now I use a straw to keep it off my teeth. I don’t drink soda or eat or drink anything dark in color. Please help very frustrated.

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      • After having an acrylic bridge over your implants is it safe to replace with zirconia bridge in the future? Can zirconia damage the implant itself? I had mine done at clear choice but my acrylic bridge has had to be repaired 3 times
        So i was thinking of zirconia but was told they have higher risk of damaging the implants ?

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      • I have the same question. Mine are zirconia, up and down (full mouth of these suckers). I’m frustrated that even with brushing and water-pikking they are looking dingy and I see small stains ‘in between’ teeth at the ‘gum line.’ I just called my peri’s office thinking I could come in for a check-up (had perms for a little over a year) and they could throw them in the autoclave while I’m there. The chick said cleaning would be $600! $300 per arch. Um, what?? I spent $56,000 on these things and they can’t clean ’em up for me when I go in for an office visit? That’s nuts and I’ve pulled a Karen and asked my treatment mgr to give me a cal. In the meantime, is there something other than just brushing/pikking I can use to whiten them back up again – that doesn’t cost $600 either! Thanks!

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        • Hmmm…zirconia doesn’t stain easily. Are you sure they are zirconia?

          Can you upload a picture to a public Google Drive?

          It seems very weird to take out the virgins to clean them. That would be a charge to remove and reinstall which typically is not necessary unless circumstances. I’m assuming use an electric toothbrush and you do not smoke. Oral-B makes the best electric toothbrush 🪥

          Typically see staining in acrylic fuse and metal hybrid.

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        • Zirconia when done well has no porosity.

          My hygienist years is an implant specific cleaner called airflow. There is nothing better than that device for cleaning. It does not need to be removed to do this. Very few offices have invested in this technology

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          • They are absolutely zirconia. And it’s not staining on the fronts of the teeth, but a couple of what look like stains anyway, in between some on the upper/lower plate that are right/left of the front 4.

            Is the airflow cleaner available for purchase by a non-dentist-type person?

  9. I have all 12 implants in and am ready to have both upper, & lower Zirconia arches made. What is the best method for the dentist to measure my gums to fit and work with new arches? Do they make “impressions” like they did for temporary false teeth, or is there another “computer” generated method to measure the gums?

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    • My dentist worked directly with the fabrication lab and put special individual implants on after my full arches were removed and then laser scanned the interior of my mouth and jaw for reference points. They took that back to the lab and the computer designed the implants from the laser measurements. I got to watch it on the screen. Every spot needed to be occupied with a scan result before it could be saved to his laptop. The fit was perfect except for a few very minor adjustments, one of which was my upper right side contacted the lower right side before the left side even had contact. I’m still working on fine tuning that but very close now. I’m just happy the dentures are gone and I can eat normally again.

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  10. I have all 12 implants in and am ready to have both upper, & lower Zirconia arches made. What is the best method for the dentist to measure my gums to fit and work with new arches? Do they make “impressions” like they did for temporary false teeth, or is there another “computer” generated method to measure the gums?

    Reply
    • YES! It is a partnership between you and your dentist. There are very few cases that cannot be cleared up. It will depend on diet, lifestyle, oral hygiene, following through with treatment recommendations. Genetics is only a very small part

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  11. I have a long history of dental procedures. After failure if upper implants with hip bone, I had zygoma implants 2 yrs ago which succeeded. Tho Im small boned & surgery was difficult.

    I had lower implants on bottom 15 yrs ago. Because lower were acrylic, zygoma implants were made with acrylic too.

    Problem now is upper teeth keep falling off. Dentist says best approach is to replace upper & lower with zirconia, also fixing bite by angling lower. Because lower implants are so old, new parts have to used that are bigger than old parts.

    Initial try-ins of new lower are painful. Dentist says it’s gums adjusting to new parts. I think moving to zirconia is good because it will be more stable & clean. Still Im worried about any risk to lower implants.

    Your thoughts? I’m terrified of more dental problems.

    Reply
    • I think you just need to replace both arches into zirconia which is a much more premium material. Keep in mind that needs to be done well. It’s not just about the material it’s about how it’s made, designed and delivered. It is a fusion of skill and art by your dentist and lab technician. Very difficult to do well.

      this would be the go to solution on your case. It’s very strong, durable, doesn’t chip or stain

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  12. Hi

    I had an implant done 2 year back on below molar teeth.From last 2 months I am having a throbbing pain on the gum where the implant had been done.I have shown to a dentist who gave me an antibiotic and an metronidazole gel.But I sometimes still find there is a pain.Please advise on this

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    • Really sad that Clear choice dumps their patients after paying that much money. That is their policy…shameful. They do not maintain their work but somehow people go there. Most dentists don’t want to get involved since they don’t stand behind it themselves but you should be able to find someone.

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      • Thank you, i don”t understand why clear choice charges so much for cleanings of their own work, my husband had implants elsewhere and he is given free cleanings for life, you’te right shameful

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      • After having an acrylic bridge over your implants is it safe to replace with zirconia bridge in the future? Can zirconia damage the implant itself? I had mine done at clear choice but my acrylic bridge has had to be repaired 3 times
        So i was thinking of zirconia but was told they have higher risk of damaging the implants ?

        Reply
        • Not true. Your hybrid dental implant bridge can be easily converted to zirconia! Make sure you see a really good implant dentist for this. It is not a simple thing for a regular dentist!

          Reply
    • What type of special cleaning do you need? I use toothbrush and low abrasive paste then my Waterpik with he implant nozzle to get under. I can’t floss, fingers too big to get in there. Works pretty well for me. Regular Waterpik nozzles do not work! The implant nozzle looks like a candy cane to hook around and under the implant base. They are sold separately on Amazon and are pretty inexpensive.

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  13. Great info and a big thanks! I went to UT Dental School in Houston! I have full arch on bottom with 4 implants. I had bone grafts for the implants and a denture on top. I have taken notes from your video and I am dedicated to maintaining a clean mouth!! What do you recommend for mouthwash, toothpaste for general maintenance! I am unclear on how to keep plaque from forming on my new smile! I am diligent but concerned

    Reply
    • Plaque forms in all of our mouths …including mine!! Use what ever products you like. It is the technique…not the product

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  14. Hello
    Great website with useful information! It’s obvious you love what you do.
    I have a fixed upper porcelain bridge on 8 implants, placed by my periodontist and by my prosthodontist 11 yrs ago. It’s been absolutely wonderful, sometimes I forget it’s there but implants never replace your natural teeth so keep your teeth as long as possible, I say to you everyone who ask .
    My perio has had to go back a couple times and graft gum tissue and once I had a pocket with some bleeding on one implant so he went in there and cleaned. In fact I’m going next month for gum grafts on two implants. I suppose my gums will keep receding around the implants unfortunately, so the entire thing will eventually fail 😢😢 some day. I’m 67, I hope it lasts a few more yrs, unfortunately I notice more and more gum tissue recession, mostly on one side of the restoration , the other side is Ok . My question is, I get cleanings every two months at my periodontist, never missed a cleaning since I the beginning , I’m wondering if perhaps, since my hygienist probes and checks for pockets each time, is that too much probing in your opinion? How often would you recommend probing?
    Thanks in advance.

    Reply
    • probing the implants is fine we just don’t push very much. You likely have genetically thin gum tissue that is prone to recession. There are newer techniques for placing implants within gum and thin bone in order to reduce the chance for gum problems that you are having now. 99% of the patients I treat have some sort of, alteration procedure at the time of placement in order to build and thicken the gums as strong as possible for the long-term. cleanings every 2 months might not be needed though 😉

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    • You are probably just seeing the abutment. If you were seeing the actual implant then that is a different story. That would not be a good thing. Please confirm with your dentist whether this is am abutment or Implant that is exposed

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  15. After 50 plUs years of adventure I had 4 zygomatic implants placed a few months ago and have had the implants uncovered. I am going to receive the temporary bridge in a few weeks. All was well until the prosthodontics dentist warned me I might not like the way I look with the temporary bridge and also I may need a snap on denture so that enough plastic can be used to fill out my lip. I am in a panic thinking I will have to continue with a removable denture. Patricia

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  16. I have a question. I have a denture on my top and 3 implants on bottom with a front bridge. 1 implant on my left side and 2 on the right. I had pain on my right side and went to a periodontist / implant Dentist he took x-ray and said I have a lot of bone loss and a infection. So he gave me amoxicillin and wants me to come back in a week and clean around the implant and put a liquid anti biotic where the infection was. He said it could save my implant for a year or maybe 4 years. It is very expensive and I do not see what it will really do. Can you PLEASE tell me if this is a waste of money being I have bad bone loss and will eventually loose my implant anyway. What do you think??

    Reply
    • If you caught it (infection) early there is a chance for saving the implant, I guess. I was not so fortunate as I waited for about 2 years -just thinking that my gums bleed where there was already infection eating deeper at the bone. Be early!

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  17. Please help me. I am hoping that you can refer a qualified dentist to help me in Colorado Springs’ CO.
    Any names would be so appreciated 😔
    Thank you so much,
    Stephanie
    719-373-4067

    Reply
  18. I have 4 implLants on top and 4 on bottom. My dentist.has had me returning to his office weekly and sometimes twice a week for adjustments. Teeth that
    I was fitted wit h is too big for my mouth and I don’t have room for food. I ant taste food.they arebUlky. They wobble from side to side and iI bitesomething with my middle teeth they fall down I back on both sides. I have trouble talking with them. They just do not fit my mouth. It is so embarrassing as they fall down in my mouth when I am talking to someone. Hews nts to screw. Them in but the way they are made food getsunder them while I a. Eating and I haveto stop eating and wash my teeth. I would love getting adixedzironia bridge on a medal bar. How many more implants would I need and can you give me an approximate estimate on whatI need to have done.

    Reply

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