Are you doing the right thing? Asepsis is the answer.

By: Dr. Ali Mehdi (BSc, BDS, Fellowship | Oral and Maxillofacial Surgery)

Oral Implantology is the fastest growing segment of clinical cosmetic dentistry, and many general dentists are learning surgical implant placement, effectively making it a focus of practice for numerous general dentists and reducing its monopoly by the specialists. With its rising popularity, the onus of responsibility lies on the clinicians to make sure no cross contamination/infection occurs. For this to happen, a higher standard of sterilization/asepsis has to be maintained in the dental office.

While regular clean techniques are practiced for general dental procedures, no surgical procedure should be performed without holding yourself to a higher standard of asepsis. Dentists and their staff should ensure this by following general guidelines and ensuring proper training prior to embarking on the sensitive practice of dental implants.

In my experience, I have come across several very successful clinicians who claim and feel that a clean technique is enough for dental implants since the mouth is a generally dirty environment. They also, perhaps rightfully, claim that they haven’t seen any complications so far, the question I would ask here is, how would they like it to be done for themselves. Would a clinician be ok if their dentist wears regular non-sterile gloves while operating, or adjusts the head lamp/light without proper barriers? I wonder if they’d be fine if the assistant touches non-sterile equipment and then uses the same gloves in their mouth during the procedure?

It is understandable that the mouth is an inherently dirty environment, but we don’t always realize that the oral flora for each person is unique to them and the mouth is used to their presence and thus they do not really affect any post-surgical healing. What we don’t sometimes realize is, that it’s our responsibility to not introduce any pathogens that are not residents of the specific oral cavity. When we touch a patient’s skin and reintroduce the glove in the mouth, we inadvertently introduce skin pathogens which do not belong there. Similarly, if a clinician adjusts his headlamp or the unit light, he may introduce bacteria from other patients that may have come to reside on their loupes or the light handles from previous surgeries. While we cannot control patient mediated factors, which matter in post-surgical healing/complications, we can however, ensure are that our own procedural practices are at the gold standard.

Every clinician has studied these cross-infection control guidelines, but this part of our education is usually the first we find ourselves getting complacent in. In any case where a flap is raised, and bone is exposed, the standard of cleanliness required raises exponentially and we owe it to ourselves and our patients to follow strict guidelines to ensure proper techniques.

Stay tuned for the next part of this blog, where I will discuss exact requirements and procedures to ensure maximum asepsis in your implant practice.


Ali Mehdi
BSc, BDS, Fellowship (Oral and Maxillofacial Surgery)
Certified in, Oral implantology, Soft tissue handling and cosmetic repairs, ATLS, 8+ years Implant career

I graduated from Dental school over 9 years ago and found myself gravitating to surgical dentistry from the very start. During my internship, I laid my focus on oral surgery and truly found my calling. In January 2011, I started my training in Oral and Maxillofacial surgery in the biggest and most well respected public-sector hospitals/university in Pakistan. After over four years of gruelling but exciting training, at King Edward Medical University, I finished my fellowship in mid 2015 and soon after moved to Vancouver, Canada.

During my training, I focused on gaining prowess in post trauma facial reconstruction, oro-facial pathologies and TMJ surgeries. However, I continued gaining experience in oral Implantology since my graduation in 2008, and kept abreast of all modern implant procedures through continued education and certifications and have thus gained over 8 years of clinical implants experience. I now find myself engrossed in oral Implantology and am ecstatic to be a part of Hiossen family in Canada.

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