Georgia Periodontics, P.C.

Oral bacteria that collects under the margin of the gum is the cause of periodontal disease. It is VITAL that the patient remove this plaque once/twice daily, to prevent reoccurrence of the disease. Oral hygiene and regular maintenance appointments are the critical steps of long term success. No matter how successful the initial treatment, without adequate follow-up care the disease will reoccur. The patient must truly take responsibility for his or her own oral health.

New patient with inflamed
gums caused by poor oral hygiene

Patient returns to health
after 6 weeks of excellent
oral hygiene

Brushing and flossing are the two main corner stones of oral hygiene. Most people brush, but few have been shown to remove the plaque properly from under the edge of the gum. The bristles of the brush must slide into the cuff of the gum, like a broom may slide under the edge of the door. The brush should be positioned at a 45 degree angle to the tooth, and move in a small circular motion, or shimmy back and forth. Scrubbing is not recommended, in that it may lead to gum recession. We recommend the use of an electric toothbrush and would be happy to discuss which one would be best for you.

Brush angles under the gum

Brushing lower molars

Brushing upper molars

Electric brushes have been shown to be more efficient than manual brushes. For most people they are easier to use. However, they also must be properly placed around the teeth to remove plaque. They do NOT replace the need for floss.

Sonicare electric brush head

Flossing is the only way to remove plaque from under the gum and between the teeth. Because most periodontal disease starts between the teeth, flossing is even more important than brushing. MOUTHWASHES DO NOT REPLACE THE NEED FOR FLOSSING. Good flossing is a skill that takes practice, but nothing can replace it in preventing periodontal disease. When learned, it should only take 2-3 minutes a day. When flossing it is important to slide the floss slightly under the gum, wrapping around the tooth as far as possible. A clean surface will elicit a "squeaky clean" sound.

Floss between teeth, but not yet under the gum

Floss wrapped under gum

There are many other aids that are available to help with oral hygiene. These include small brushes that can clean spaces between the teeth (proxibrush), and threaders to help guide floss under bridges (floss threaders). Toothpicks may be recommended to help clean furcations . Each patient is individually assessed to see what may help optimize their cleaning efforts. Our office will assist you with these special instruments.

Proxibrush entering space between teeth

Proxibrush cleaning
between teeth

While brushing the 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 several times using small, gentle strokes. Use light pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort.

When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth.

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. 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 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 (waxed 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. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gumline 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 bottom teeth, guide the floss using the forefinger of both hands. Do not forget the back side 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 medicated 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, but will not remove plaque. You need to brush and floss in conjunction with the irrigator. We see excellent results with electric toothbrushes called Sonicare and Braun Oral-B.
Some toothbrushes have a rubber tip on the handle, this is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so discuss proper use with your doctor.

Fluoride toothpastes and mouth rinses if used in conjunction with brushing and flossing can reduce tooth decay as much as 40%. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gumline so these products have not been proven to reduce the early stage of gum disease.

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.

Your periodontist is the best person to help you select the right products that are best for you.

Professional Cleaning

Daily brushing and flossing will keep dental calculus to a minimum, but a professional cleaning will remove calculus in places your toothbrush and floss have missed. Visit your periodontist, as he or she is an important part of your program to prevent gum disease. Keep your teeth for your lifetime