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

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

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


  1. Sherry M Bult

    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.

    January 7, 2021 at 11:55 am Reply
    1. Is the All on 4 bridge zirconia or acyrlic?

      January 7, 2021 at 1:28 pm Reply
  2. 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?

    October 7, 2020 at 9:49 am Reply
  3. 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?

    October 7, 2020 at 9:49 am Reply
  4. Sherika Robinson

    Can you ever get rid of periodontal disease?

    March 6, 2020 at 9:00 pm Reply
    1. Ramsey Amin

      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

      March 12, 2020 at 12:55 am Reply
  5. Kathleen McNamee

    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.

    February 16, 2020 at 5:45 pm Reply
    1. Ramsey Amin

      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

      March 7, 2020 at 6:03 pm Reply
  6. Shiban Deb


    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

    February 8, 2020 at 7:24 am Reply
    1. Ramsey Amin

      Something is wrong. See another DDS for a second opinion

      February 8, 2020 at 4:01 pm Reply
  7. Dale Carr

    Wondering if there are any other dentists who can do my twice yearly cleaning of Clear Choice 4 on 4 dental implants.

    October 21, 2019 at 6:31 pm Reply
    1. Ramsey Amin

      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.

      December 2, 2019 at 1:56 am Reply
  8. Wendy

    I’m interested in the All on 4 or All on 6. How do I find an experienced dentist/oral surgeon in Colorado Springs, CO?

    September 17, 2019 at 4:55 pm Reply
  9. Linda Bancroft

    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

    July 23, 2019 at 7:09 pm Reply
    1. Ramsey Amin

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

      July 30, 2019 at 5:20 am Reply
  10. Martina

    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.

    October 25, 2018 at 12:06 am Reply
    1. RamseyAminDDS

      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 😉

      October 28, 2018 at 5:59 pm Reply
  11. Jenny

    I had all on 4 implants 4 weeks ago. On my upper in the back, the screw is now visible a little. Is that normal?

    October 20, 2018 at 2:03 am Reply
    1. RamseyAminDDS

      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

      October 23, 2018 at 5:28 am Reply
  12. Rosemary

    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??

    March 16, 2018 at 1:13 pm Reply
    1. milo

      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!

      May 17, 2018 at 3:11 am Reply
  13. stephanie friedman

    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,

    February 16, 2018 at 2:28 pm Reply
  14. Janell

    This is a routine test comment.

    January 30, 2018 at 7:46 pm Reply
    1. RamseyAminDDS

      Test reply

      January 31, 2018 at 11:47 pm Reply
  15. Joel

    Test comment

    January 29, 2018 at 5:49 pm Reply
  16. Dollie Rials

    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.

    January 17, 2018 at 1:13 pm Reply
    1. RamseyAminDDS

      Do you have over dentures or a fixed bridge? N one of this sounds normal For my fixed bridge patients we transition them through temporary provisional teeth to test everything before moving to the final. This way “bulkiness” can be tested before ever making something final. If the implants are spaced out enough you likely have enough implants to do a fixed bridge although 6 implants is better on the upper jaw.

      January 29, 2018 at 1:13 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!