October 2013 Professional Oral Care Newsletter

Dental Implants

Once considered experimental, today dental implants are a $1 billion dollar industry and the preferred method for single tooth replacement. Yet while the placement of implants has advanced, best practice for maintaining this investment has not. The data indicates that mucositis occurs in about 50% of sites around implants and peri-implantitis in 12-40% of sites.

In this month's newsletter, new research and expert advice from Susan Wingrove, RDH and Michael Tischler, DDS can help you help your patients have optimal oral health around implants.

Benefits of the Waterpik® Water Flosser for Implants

By Susan Wingrove, RDH

Dental hygienists provide home-care recommendations based on research and the individual implant treatment cases. Home-care implant protocol often consists of; brushing twice daily, floss or a water flosser, interdental brush, and if recommended the use of rubber-tip stimulator. This routine may be cumbersome and time consuming for many leading to non-compliance.

With implants, one thing is clear; access or lack of access makes using floss difficult and in limited cases, a realistic goal. A study comparing the Water Flosser and floss revealed that the Waterpik® Water Flosser with the Plaque Seeker® Tip used at medium pressure around implants was 145% more effective at reducing bleeding than traditional floss.1

Research studies indicated that the Water Flosser can be confidently recommended for inflammation and bleeding reduction around implants.1,2 These studies using a Water Flosser with implants for oral hygiene reveal that Waterpik® Water Flosser is the only Water Flosser to date to be proven safe and effective with dental implants.1,2

The Waterpik® Water Flosser with the Plaque Seeker® Tip on medium pressure around implants is ideal for single implants to reduce bleeding. For patients with full fixed prosthesis or bar-retained implants the Pik Pocket(TM) Tip with a diluted antimicrobial rinse in 1:2 water dilution2 may be advantageous for this type of patient.

Water flossing in conjunction with an antimicrobial rinse has proven to be extremely helpful for inflammation and in prevention of peri-implant disease.3 Evaluate and recommend home-care devices/products based on solid research studies that they are proven safe for implants.


  1. Magnuson B et al. Comparison of the effect of two interdental cleaning devices around implants on the reduction of bleeding: A 30 day randomized clinical trial. Compendium Cont Dent Educ 2013; Vol34 (Special issue 8): 2-7.
  2. Felo, A et al. Effects of subgingival chlorhexidine irrigation on peri-implant maintenance. Am J Dent 1997; 10:107-110.
  3. Wingrove, S. Peri-Implant Therapy for the Dental Hygienist: Clinical Guide to Maintenance and Disease Complications. Wiley-Blackwell 2013; 8:138-139.

Susan Wingrove is an international speaker, clinical dental hygienist and regeneration researcher. Susan is the designer of Wingrove Titanium Implant Set, A.C.E. probes, Queen of Hearts instruments and author of the textbook: Peri-Implant Therapy for the Dental Hygienist: Clinical Guide to Maintenance and Disease Complications, from Wiley-Blackwell publishers.

Waterpik® Water Flosser: 145% More Effective than String Floss for Implant Patients

The Effect of a Water Flosser with Plaque Seeker Tip® on Gingival Bleeding for Implant Patients


To compare the efficacy of a Waterpik® Water Flosser to string floss for implant patients


Subjects were randomized into 2 groups: Group 1 used a manual toothbrush and a Waterpik® Water Flosser with the Plaque Seeker Tip® (WF) and Group 2 used a manual toothbrush and string floss (SF). There were 22 implants in each group and the primary outcome was the reduction in the incidence of bleeding on probing. Subjects brushed twice a day and used either the WF or SF once a day.


There were no differences between the groups at baseline. At 30 days, 18 of the 22 (81.8%) implants in the WF group showed a significant reduction in BOP compared to 6 of the 18 (33.3%) from the floss group. The WF group experienced 145% better reduction in gingival bleeding around implants vs. the string floss group (p=0.0018).


The Waterpik® Water Flosser is significantly more effective than string floss for improving gingival health around implants and is safe to use.

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