D3 ◊Page D2 IMPLANT TRIBUNE Dental Tribune Middle East & Africa Edition | 4/2018 odontal tissue needs to be strong. In the case of poor oral hygiene, the implant will fall out eventually. We need to make sure that the patient has good oral health habits. Eden- tulous patients with a lack of good oral hygiene are not good candidates for implants. We have to do several hygiene appointments fi rst before continuing with implant placement. mindset that patients only come when they are in pain. Now, we are moving in this direction of coming at least every year. From a periodon- tal perspective, I would like to see my patients every three to six months, especially during maintenance ther- apy. During the dental appointment, they already look forward to the next appointment. How can we motivate the pa- tient to use oral care products more effectively and regularly? Reuss: First of all, we have a growing awareness of oral health among our patients. That helps a lot in the gen- eral predisposition of patients. When they come to our practice, they have changed their dietary attitude and work out more. They are starting to believe more in prevention. They also come in every six months, while we only saw them every two years in the past. Llorente: In Spain, we still have this Reuss: We understand now that we have to work with patients as a team. We can no longer simply provide treatment. We have to spend extra time educating them, motivating them on how they can maintain and preserve their oral health, which is ultimately their responsibility. Do you also instruct your pa- tients on how to use tooth- brushes, interdental cleaning tools and toothpaste? Reuss: Our dental hygienists focus more on oral care instructions. Their role in prevention is crucial. They es- tablish a close relationship with the patient and make sure that every pa- tient gets the individual tools he or she needs, be it toothbrushes, inter- dental brushes or fl oss. Everything in our offi ce is teamwork. Llorente: Every patient is differ- ent, no doubt, but everyone needs interdental brushes, for example. I brush interdentally every day. As dentists, we need to make sure that we reinforce oral hygiene measures every time the patient visits. With improving oral health habits comes greater satisfaction for the patient. The best thing in dentistry is that we can see the change. We can see how the bleeding stops. And the patient feels it. What do you think about CURAPROX products? Reuss: Products that are easy to use help us progress in our treat- ments quicker and provide patients with the tools to easily establish a positive home care dental regimen. CURAPROX’s products are often gentler than other products, and this meant that it went against the gen- eral trend of the market for the past few years. However, this softness is extremely benefi cial, as it helps to prevent damage to tissue and teeth. What role does the implant design play for oral hygiene? Reuss: Implant prostheses are not easy to clean. The implant has a very thin cylinder compared with the anatomy of the tooth. The design of the implant needs to accommodate the structure of the overall anatomy, as well as the neighbouring teeth. In the case of missing periodontal tissue or of full-arch restorations, we need to have a different implant design. In any case, we use the design most suitable for oral hygiene measures, especially in non-aesthetic areas. 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That is not possible in the upper arch. But we want to have implant surfaces that can be polished easily. Interdental brushes and dental fl oss also need to be used regularly. We work very closely with the laboratory and have clear in- structions. Tissue contact continues to be crucial. Finally, optimal prevention and oral health require an inter- disciplinary partnership. How do you work with other medi- cal doctors towards achieving overall health for your patients? Reuss: As healthcare profession- als, we see patients every day who are sent to us by heart specialists, endocrinologists, and so on. This is because there is an intrinsic relation- ship, proved by many studies, be- tween oral health and overall health. For example, we have patients who have been referred by cardiologists who have detected some form of car- diovascular disease and want their patients to be orally healthy as soon as possible. We also have diabetics referred to us by endocrinologists, often straight out of the hospital. This is because, if they have anything wrong with their mouths, an infec- tion or anything that needs to be addressed, it is essential that this is- sue is resolved so that the diabetes- related issues may also be resolved. Patients need to know about these relationships. Llorente: We always have to contact doctors if the patient has a special need. Interestingly, medical doctors send us their patients with immu- nosuppression and other conditions to get rid of the dental problems. In comparison with other medical dis- ciplines, we can quickly manage to control the infl ammation and regain the microbial balance in the mouth, thereby helping the overall immune system. The dental knowledge of general medical doctors is growing, as they understand the need for a healthy mouth for general health. The interview was originally pub- lished in Prevention International Magazine for Oral Health 1/18.