Periodontal Basics (or why Brushing and Flossing are so important!)

By Dr. Elizabeth Fleming
January 20, 2014
Category: Uncategorized
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So your dentist tells you that you have gingivitis, or worse yet, that you have bleeding pockets.  What does that mean and what can you do about it?

Bleeding or inflammation in any part of your body is not good.  Your goal for your mouth would be to step up your brushing and flossing techniques to eliminate the bacteria and plaque that cause these problems.  The response in your mouth to the bacteria and plaque is for the gums to become inflamed.  This residual plaque, which is a sticky film of bacteria, is the root of many dental problems. It produces acid on your teeth, causes decay, and should be removed at least every 24 hours.

The majority of the tooth surface can be cleaned by using a toothbrush.  Use either a soft bristle manual toothbrush using a circular motion for 2 minutes throughout your mouth or a good electric toothbrush with a small bristle head for 2 minutes.  My favorite electrics are Rotadent or Sonicare.

If you only use your toothbrush and don’t floss at least once/day, you will miss about 35% of the tooth surfaces and could end up with “flossing cavities” between the teeth, in addition to bleeding gums, which can lead into deepening pockets and more periodontal disease.

An added benefit of daily flossing would be in reducing bad breath!  Getting rid of the plaque and bacteria from between your teeth, keeps the acid production down, and reduces your chance of getting cavities.  Once the flossing removes the decomposing food, normally broken down by bacteria which produce acid, your rate of decay will be less and so will the bad breath!  But it must be done every 24 hours, or the plaque solidifies on the teeth, and then can only be removed by the dental office at your next cleaning.  We call solidified plaque tartar or calculus.

When calculus is present on your teeth, it is a major cause of gum inflammation and bleeding.  The longer it is present, the more likely the bone may become involved.  This is when the pocket depths increase as the bone is shrinking away from the calculus, and the gums are becoming more inflamed due to the calculus.  The biggest problem: gum inflammation can be reversible with good brushing and flossing, but once the bone becomes involved, it is not reversible and it is called periodontal disease.  With a diagnosis of periodontal disease, your cleanings would be done at 3-4 month intervals, since periodontal disease is not curable.  The goal would be to keep the plaque and inflammation under control to  maintain the current level of bone.  The best way to do this is with proper homecare: Brushing 2x/day and Flossing once/day, in addition to having regular cleanings at your dental office.

Remember: Daily plaque removal is good smile insurance!

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