Research shows that periodontal patients who do not receive proper maintenance lose two to three times more teeth and need active therapy twice as often as those having proper periodontal maintenance. Successful periodontal therapy requires considerable attention to the a patient’s dental, medical, and family histories, clinical presentation, risk factors, and underlying biological processes. Proper periodontal maintenance to enhance the longevity of the favorable results we can achieve in the periodontal practice is simple: every three months for life. At home, a patient can expect to be able to clean 2-3 millimeters beneath the gum surface, while in the periodontal practice, a trained hygienist can clean to 4-5 millimeters below the surface. While home care is of the utmost importance and is described in detail below, it is also important to understand the difference between what we hope to accomplish at home versus what we can accomplish in the periodontal practice. It is also important to be realistic about the limitations of home care and therefore the importance of a regularly scheduled professional periodontal maintenance cleaning.
While brushing the inside and outside surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet. Gently move the brush in a circular motion (or up and down motion) several times using short, gentle strokes. Use light pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort.
To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle back-and-forth strokes over each tooth. Don’t forget to gently brush the surrounding gum tissue.
Next you will clean the biting surfaces of your teeth. To do this use short, gentle strokes. Change the position of the brush as often as necessary to reach and clean all surfaces. Attempt to clean behind the last molars. Try to watch yourself in the mirror to make sure you clean each surface. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing.
If you have difficulty performing effective plaque removal or if you have a habit of brushing too aggressively an electric brush may be recommended.
If you have any pain while brushing or have any questions about how to brush properly, please be sure to call the office.
How to Floss
Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.
Start with a piece of floss (Teflon or waxed floss is easier) about 18″ long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.
To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Do not force the floss or try to snap it in to place. Instead, gently insert the floss between the teeth using a back-and-forth motion and keeping it taught. Bring the floss to the gum line then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section. To clean between the back teeth, guide the floss using the forefinger of both hands. Do not forget the backside of the last tooth on both sides, upper and lower.
When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.
Caring For Sensitive Teeth
Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long, but only if the mouth is kept clean. If the mouth is not kept clean the sensitivity will remain and could become more severe. If your teeth are especially sensitive, consult with your doctor. They may recommend a specific toothpaste or mouth rinse made especially for sensitive teeth.
Choosing Oral Hygiene Products
There are so many products on the market it can become confusing and choosing between all the products can be difficult. Here are some suggestions for choosing dental care products that will work for most patients.
Automatic and “high-tech” electronic toothbrushes are safe and effective for the majority of the patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly and help remove loose plaque, food debris, and possibly inflammatory agents but will not remove much attached plaque. You need to brush and floss in conjunction with the irrigator. Electric flossing devices and special floss holders are also available for those having difficulty manipulating loose floss.
Some toothbrushes have a rubber tip on the handle, this is used to assist in cleaning the gums after brushing. There are also tiny brushes (inter-proximal toothbrushes) that are more effective than floss at cleaning between your teeth below the gum line. Discuss proper use with your doctor or hygienist.
Anti-plaque rinses, approved by the American Dental Association, contain agents that may help bring early gum disease under control. Use these in conjunction with brushing and flossing. Read Brushing Tips for more information.
Our office can help you select the right products that are best for you.