Winter is the time for illness – you may have already had one of the two to three common colds that adults are expected to experience annually.[i] As people spend longer indoors, the risk of infection increases, with viruses preferring the lower temperatures.[ii]
Among the sore throats and blocked noses, it can be easy for patients to develop sinusitis. For patients undergoing implant treatment, education on the link between implant care and sinusitis must be highlighted by the dental practitioner to minimise the chance of infection and subsequent treatment failure.
Sinusitis explained
Chronic sinusitis is experienced by 11% of UK adults.[iii] The sinuses are connected to the external environment through the nasal passages. The mucous lining and paranasal cavities – air pockets – can become inflamed.[iv] This blocks the sinus drainage and impairs the body’s natural defences, allowing mucus, bacteria, viruses or fungi to build-up in a moist, fertile environment – this causes infection.iv The symptoms are well known: a blocked or runny nose, reduced sense of smell, a high temperature. It can also cause headaches, coughs, toothaches, halitosis, and pain, swelling and tenderness around the cheeks, eyes or forehead.[v]
Infectious implants
More than 40% of sinusitis infections in the maxillary sinuses stem from a dental infection;[vi] the close proximity of the teeth to the sinus floor allows odontogenic infections to easily enter from the oral cavity.[vii] Odontogenic sinusitis is a result of varying dental pathologies, such as recent treatments, infections, or trauma.[viii]
Implant treatments are a common cause of odontogenic sinusitis. Peri-implantitis inflames the surrounding tissue of an implant and can lead to recession of the alveolar bone and a loose implant.[ix] It is this inflammation that makes implant treatment, and poor oral hygiene, a risk hazard for sinusitis, with infectious bacteria spreading into the air cavities. Research has also found that the same cytokines found in peri-implant breakdown are connected to many other systemic conditions and diseases, from periodontitis to cardiovascular disease.ix Limiting the chance for peri-implantitis can better protect overall health too.
Oral health hazards
Sinusitis can have several effects on oral health. It can affect other teeth, with the irritation from the maxillary sinuses radiating back to the upper teeth and causing sensitivity, toothache and pain.viii Odontogenic sinusitis can therefore cause more dental problems for patients.[x]
Further impacts on the oral cavity include halitosis. If the infection reaches the throat, it can release a foul malodour that can be hard to combat without antibiotics.x Similarly, patients may take medications to treat sinusitis that can cause xerostomia. Antihistamines are one example, drying out the oral cavity and leaving the teeth – and any recent implant – less protected without the optimal amount of saliva to buffer harmful acids. Xerostomia can increase the risk of tooth decay and yeast infection, so vulnerable patients should be encouraged to use special gels or chew sugar-free chewing gum to keep saliva levels up.[xi]
Maintaining excellent oral hygiene is essential before, during and after implant treatment. Preventative measures should begin before any implant placement and persist in the following years for maximum success.[xii]
Immaculate implants
For implant patients, minimising the risk of odontogenic sinusitis can be achieved through a consistent oral hygiene routine that protects the implant. By cleaning all the surfaces and surrounding teeth and gingivae, peri-implantitis can be avoided. However, a study revealed that, whilst 90% of participants learned how to clean their implants, it was found that only 40% actually practised it whilst supervised by a practitioner.xii This can lead to neglect or improper cleaning methods. Practitioners must therefore demonstrate to implant patients how best to care for their implants.
To protect patients who have undergone implant treatment, recommending the Curaprox REGENERATE Implant Kit can reduce the risk of infection and enhance the treatment success. It contains a variety of uniquely designed implant cleaning products, such as a CS Surgical Toothbrush, Perio plus Support toothpaste and Perio plus Regenerate rinse for an antibacterial boost. The kit also includes a CS 5460 Ultra-Soft toothbrush, a CS 708 Implant brush and five CPS mixed implant interdental brushes for maximum oral hygiene maintenance. Having the Curaprox range of effective oral hygiene products all in one kit makes this the best way to look after implants.
Sinusitis is common over the winter months. By encouraging effective oral hygiene routines, practitioners can help at-risk patients limit the risk of infection and lead a happier, healthier winter.
For more information, please visit www.curaprox.co.uk and www.curaden.co.uk
Author: Andrew Turner
[i] NHS Cheshire and Merseyside. (2019). Common cold. [online] Available at: https://www.cheshireandmerseyside.nhs.uk/your-health/helping-you-stay-well/self-care/common-cold/ [Accessed 8 Oct. 2024].
[ii] www.medicalnewstoday.com. (n.d.). Does cold weather make you sick: What’s the link? [online] Available at: https://www.medicalnewstoday.com/articles/323431.
[iii] Clarke, C.S., Williamson, E., Denaxas, S., Carpenter, J.R., Thomas, M., Blackshaw, H., Schilder, A.G.M., Philpott, C.M., Hopkins, C. and Morris, S. (2022). Observational retrospective study calculating health service costs of patients receiving surgery for chronic rhinosinusitis in England, using linked patient-level primary and secondary care electronic data. BMJ Open, [online] 12(2), p.e055603. doi:https://doi.org/10.1136/bmjopen-2021-055603.
[iv] Zapata, K. (2023). Sinusitis, dental infection or both. [online] UT Health San Antonio. Available at: https://news.uthscsa.edu/sinusitis-dental-infection-or-both/.
[v] NHS (2019). Sinusitis (sinus infection). [online] NHS. Available at: https://www.nhs.uk/conditions/sinusitis-sinus-infection/.
[vi] Zapata, K. (2023). Sinusitis, dental infection or both. [online] UT Health San Antonio. Available at: https://news.uthscsa.edu/sinusitis-dental-infection-or-both/.
[vii] Molteni, M., Antonio Mario Bulfamante, Pipolo, C., Paolo Lozza, Fabiana Allevi, Pisani, A., Matteo Chiapasco, Sara Maria Portaleone, Scotti, A., Maccari, A., Borloni, R., Felisati, G. and Alberto Maria Saibene (2020). Odontogenic sinusitis and sinonasal complications of dental treatments: a retrospective case series of 480 patients with critical assessment of the current classification. Acta Otorhinolaryngologica Italica, 40(4), pp.282–289. doi:https://doi.org/10.14639/0392-100x-n0457.
[viii] Little, R.E., Long, C.M., Loehrl, T.A. and Poetker, D.M. (2018). Odontogenic sinusitis: A review of the current literature. Laryngoscope Investigative Otolaryngology, 3(2), pp.110–114. doi:https://doi.org/10.1002/lio2.147.
[ix] Radaelli, K., Alberti, A., Corbella, S. and Francetti, L. (2021). The Impact of Peri-Implantitis on Systemic Diseases and Conditions: A Review of the Literature. International Journal of Dentistry, [online] 2021, pp.1–7. doi:https://doi.org/10.1155/2021/5536566.
[x] www.colgate.com. (n.d.). Chronic Sinusitis Symptoms And The Effects On Oral Health. [online] Available at: https://www.colgate.com/en-us/oral-health/respiratory-conditions/chronic-sinusitis-symptoms-effects.
[xi] www.nidcr.nih.gov. (n.d.). Dry Mouth | National Institute of Dental and Craniofacial Research. [online] Available at: https://www.nidcr.nih.gov/health-info/dry-mouth.
[xii] Perussolo, J. and Nikolaos Donos (2024). Maintenance of peri-implant health in general dental practice. British dental journal, 236(10), pp.781–789. doi:https://doi.org/10.1038/s41415-024-7406-8.
