HYGIENE AND PERIODONTICS - The care for the supporting structures for the teeth.

This section will cover what is meant by a cleaning, a periodontal cleaning, a deep cleaning and scaling. In addition, we will discuss different types of toothbrushes and the benefits and advantages and disadvantages of each. We will also cover some additional aids for cleaning teeth, such as flossing techniques, use of toothpicks, rubber tips, mouthrinses and tongue scrapers. There are several misleading ads that talk about the various toothpastes and toothbrushes on the market. It will be our objective in this section to give you some information that can help you make an educated decision as to what you should use that would best serve your own needs. In addition, we will briefly discuss nutrition, since that plays an important factor in the health of the gums and the bone.

CLEANING vs. PERIODONTAL MAINTENANCE - What's the difference?

When do I need a cleaning and when do I need more than a cleaning? The typical "cleaning" patient has 2-3 mm pockets and has little plaque or bleeding. It would be ideal if all of our patients came into the office in this condition. Unfortunately, when it has been a few years since you've had your teeth cleaned, the tartar is on there a little tougher and often below the gumline, not allowing you to acces those areas with your toothbrush and therefore, the bacteria can do some damage to the tissues deep below the gums. If a patient has multiple 4-6 mm pockets, then those are the areas that a deep cleaning will benefit. It is almost impossible for a patient to clean more than 3 mm around a tooth using the typical toothbrush. This means that the bacteria build up and stay deep in those pockets and continue to cause damage. It it critical that those areas are periodically "disrupted" and the bacteria removed.

PERIODONTAL POCKETS - What are they and how do we get them under control?

The periodontal probe was one of the best measuring instruments made available to the dental profession. This small little instrument has revolutionized the field of dentistry and brought periodontal care further along in the last twenty years than in the last one hundred years. By measuring the pockets around your teeth, we can identify where exactly the deeper problem areas are and go after them. We can also show you which areas may need extra attention while cleaning.

TOOTHBRUSHES - Are these electric brushes beter than the manual ones?

Toothbrushes were designed to remove food, bacteria and plaque from your teeth. If you can do that with a manual toothbrush, then you don't "need" an electric toothbrush. For many people, the electric toothbrushes offer a distinct advantage of giving a quicker and more thorough cleaning. However, all electric brushes are not created equal. The Sonicare toothbrush is currently being touted as one of the best and sturdiest toothbrushes on the market for getting deeper into the pockets than any other brush. Most periodontists prefer this brush also. The ORAL B TRIUMPH toothbrush is a nice brush because it has a "smart chip" in it which has a timer, an intensity level, and a pulsating mode. Some of the earlier electric brushes had too many moving parts and very very expensive to maintain and repair. The Braun toothbrush offers a good, sturdy middle-priced brush that works well when the concerns are getting around braces and behind the front teeth, or if the plaque level in not bad below the gums but rather above the gums it seems to build up quickly. [Please note, these observations are from over 20 years of watching and learning from patients at our office.]

FLOSS - Before or after I brush?

Flossing is a good habit to get into. Whether you floss before or after you brush is not as important as whether you floss or not. It is obvious to most dentists whether or not their patients floss. The ones whose gums don't bleed and have 1-3 mm pockets, are generally those who do floss. The others... well there are other factors involved in whether the gums bleed or not, so we won't go pointing any fingers quite yet. Some of these factors will be discussed below... As to how often you should floss, it seems like patients who floss 3 or more times per week show more improvement in gum health than a patient who only once or twice a week. The goal of flossing is to not allow the plaque to build up on the tooth surfaces.

OTHER FACTORS - Nutrition, smoking, age, hormones, heredity and health all play factors in oral health.

The number ONE bad habit you can do that will affect your gums (negatively) is smoke. There are numerous studies that correlate smoking and gum disease, bone loss and oral cancer. A person is FIVE times more likely to have periodontal disease if they smoke, than if they don't. Smoking constricts the blood vessels and doesn't allow them to heal well, it prevents flushing of the tissues with antibodies which also slows healing. Vitamin C is probably one of the most important vitamins that you can take to help your gums heal faster and improve the circulation in you body. In some rare instances, there are cases where people will be negatively affected by the added intake of Vitamin C, so we advise that you discuss it with your doctor as well if you have any questions. Heredity plays a bigger part in overall cavity rate and periodontal condition that any other factor. Unfortunately, it isn't a factor that we have control over, however, it does explain why some people seem to be able to eat all the sugar and candy they want and not take care of their teeth while someone else who hardly eats any sweets will end up with cavities and gum disease. Diabetes and other health conditions can play a role in our bodies resistance to infection. If you have questions about specific situations going on with your health, please discuss this with us when you are in the office. Medications, especially oral contraceptives, blood thinners and steroids can affect how your body responds to factors that might not impact a healthy person not taking those would respond.

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