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interview | Figs. 1 & 2: Dr Lisa Heitz-Mayfield at the 26th EAO Meeting in October 2017, highlighting the importance of infection control. Photos: © DTI tinue to do so. That is the key to prevention: to make sure that the patient has a healthy oral cavity with little plaque and no periodontal disease before one starts. A preventive approach requires several elements to work effectively: regular monitoring and supportive periodontal therapy with professional biofilm control, a healthy and regular at-home oral hygiene routine, and controlling for other risk factors, such as smoking and un- controlled diabetes. By managing these potential issues, dental professionals and patients can work together to help prevent the recurrence of periodontal disease and occurrence of peri-implantitis. How important is it to properly motivate a patient to engage in these preventive measures and under- stand what the role of a good oral hygiene routine is? It is extremely important. Again, it is key that, right at the beginning of the treatment planning phase, patients are informed of the risk of complications if they do not main- tain good oral hygiene supplemented with regular pro- fessional care. Recent literature shows that patients with implants must receive check-ups and supportive care at least twice a year. For patients who have lost their teeth owing to periodontal disease, we know that they are at a higher risk of having similar problems around their im- plants. These patients then really need to understand and be informed of the importance of good oral hygiene and regular preventive, supportive care prior to engaging in the rather costly business of getting an implant. Removing the harmful biofilm from the exposed sur- face of an implant with peri-implantitis, though, can be very challenging. There is a different morphology to it, along with a modified surface that is often rough and tends to harbour the biofilm in a way that it is very diffi- cult to remove. However, as with periodontal disease, it’s much easier to manage and treat peri-implant disease before it becomes too severe. The best way to prevent it is through early detection of the signs of inflammation so that treatment that reverses this process can take place. From a prophylactic point of view, the periodontally healthy patient is the best patient. Do you agree? Of course. It is really important that patients have good periodontal health so that they do not have deep peri- odontal pockets and reservoirs of bacteria that could lead to colonisation of biofilm around the implants. Patients need to come for check-ups on a regular basis so that the early signs of disease can be identified and dealt with. In addition, we should remember that, sometimes, things can go wrong around implants; for example, if a patient has a screw-retained restoration and there is a mechani- cal problem or technical issue, such as a loosened screw, then a problem with bacterial accumulation may arise and peri-implantitis may develop. Though periodontal health is important, regular check-ups of the prosthesis and the patient’s overall oral health are also crucial in preventing not just peri-implantitis but other intraoral issues as well. Thank you very much for the interview. What role does regular professional prophylaxis play in preventing peri-implantitis? contact It comes back to the responsibilities of dental profes- sionals: they need to identify early signs of inflammation, such as peri-implant mucositis, which is an inflammation of the soft tissue, and treat that before it develops into peri-implantitis and initiates bone loss. Evidence shows that management of peri-implant mucositis is a prerequi- site for the primary prevention of peri-implantitis. Dr Lisa Heitz-Mayfield University of Western Australia University of Sydney Perth Periodontal Specialist Perth, Australia heitz.mayfield@iinet.net.au 1 2018 41