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| Frequently Asked Questions |
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| What is Gum Disease? |
Periodontal Disease is the inflammation and destruction of the gums and bone that surround your teeth.
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| What causes it? |
Not brushing and flossing - right? Absolutely - but why?? Because you're not getting the plaque off of your teeth.
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| What's Plaque? |
Bugs! Not food, not debris, not deposits. Living bacteria. Yeastie beasties that are in your mouth all of the time. They don't cause much trouble until they form colonies and stick to your teeth. When this happens, your body's defense mechanisms try to fight back the bacterial enemy.
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| Then What? |
In most people, the fight occurs primarily in the gum tissue with the only problem being chronic inflammation of the gums. This is called Gingivitis. It's not good, but it's not terrible. Other people aren't so lucky. In susceptible individuals, the battle spreads into the bone underneath the gums and the bone is destroyed. This is called Periodontitis. It is definitely not good. Unfortunately, you have it. Fortunately, you can do something about it.
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| Life is not fair! |
Not everybody gets periodontitis. Not everybody has to brush and floss effectively to keep from losing bone. You see, two things are necessary for periodontitis to occur: one is plaque and the other is susceptibility (and you are susceptible). If you get the bugs off your teeth once each day, you can control the disease. And it's not just your teeth that are at risk. Recent research suggests the bacteria associated with periodontal disease may be linked to more serious illness such as cardiovascular disease, strokes, ulcers, pnemonia, premature birth, and low birth weight. Good oral hygiene may not only save your teeth - it may save your life!
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| Is only ONCE a day enough? |
Yes!! It takes bacteria about 24 hours to recolonize on your teeth. So, if you brush and floss once a day, you can effectively maintain your health. Do it more often for your mouth to feel clean and your breath to smell fresh, but so it at least once a day - thoroughly - for your health.
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| Is there a secret to good home care? |
Sorry, no secret. And it's not all that easy either. But you can learn how! It may take several appointments, so don't get discouraged. If you stick with it, you'll get there! Here are a few tips:
Make home care a habit by doing it at the same time everyday. There may be some added benefit to doing it before bed, but the key is consistency, so make it the most convenient time for you. In the shower, after breakfast, after lunch, after exercising, after dinner, before bed, in bed - same time. EVERYDAY. No excuses. Just do it! Consider the shower as an opportune time. You clean your hair, your body and your mouth!
Be systematic. Learn your way around your mouth. Imagine you're trying to clean a bunch of ivory pegs (your teeth) sticking out of two horseshoes (your jaws) that are inside a jar (your head). When you're brushing, do the outside of the upper teeth then the inside of the uppers; then the outside of the lowers and the inside of the lowers. When you're flossing, start in the back and work towards the middle. Then go to the other side and come forward again to the middle. Actually, use any system you want as long as you don't miss any teeth.
FOCUS! Pay attention to what you're doing, where you're doing it and if you're being effective. This could be the most important tip of all!
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| Which brushing technique should I use? |
Good question. Get a hold of this:
There is no "right" or "wrong" way to brush! It doesn't matter how you get the bugs off. Just get them off. Nevertheless, a few tips:
- Use a soft brush. A hard one can damage the gums. You need to be thorough but not forceful. You don't need to use a lot of pressure.
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Make sure you get the area where the tooth meets the gum. Don't use the same stroke every time - go in different motions. Pretend you're scrubbing the mold off tile - but remember - don't press hard, just be thorough.
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Spend longer on the insides and in the back. Spend at least twice as much time on the insides and the back because these are the most difficult sites to get clean.
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Consider investing in a quality electric toothbrush. They're not essential, however most people do a better job with them. A small round head is often useful to clean where the tooth meets the gums. Ask for a demo!
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Don't forget to brush your tongue. It really helps "freshen up".
Ask your dentist or hygienist to check how you're doing by staining your teeth with red dye. Nobody can accurately assess how you're doing unless they stain your teeth with disclosing solution.
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| How about flossing? |
It's no fun, but it is a necessary evil. The bacterial battle is mostly fought in between the teeth where the toothbrush won't reach, so you've got to get those bugs off. Proper flossing must be demonstrated in the dental operatory but here are a few tips:
- Sea-saw back and forth to get through where the teeth touch. Go down gently into the gums but never gouge them. Be nice!
- Wrap the floss around the tooth in a C-shape and put firm pressure against the tooth. Be mean!
- Each time you go between two teeth, rub the sides of both of them.
- Try to make the floss touch as much tooth surface as possible. You can do this by keeping your fingers close together, instead of far apart, as you push back or pull forward.
- If flossing is difficult for you, consider using a floss aid.
- If you have missing teeth, gauze can work better than floss! Ask for a demo. Have a dentist/hygenist watch you try all this!
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| Anything else I can do? |
How did you guess? Perhaps the most beneficial aid for people with gum disease is a small toothbrush for in between the teeth called a Proxabrush. You simply must try it. You'll love it! It will help you keep your teeth! Some tips:
- Only use it in spaces where it goes through relatively easy. Don't force it.
- Consider using a thin toothpick in the tighter spots.
- Make sure you're moving it in and out as much as you can.
- When you get good at using it from the outside, try going through from the inside also.
Become a fanatic. Have one at the office, in the car, in your purse or briefcase. Use it while you're watching TV, in the shower or whatever.
- Dip the proxabrush in Chlorhexidine (Peridex) while you're using it.
- Just use it!
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| Anything else? |
The least effective aid, but still useful, is the Waterpik. It feels great and does some good but it doesn't get the bugs off as effectively as the other aids. Consider it the "icing on the cake" but don't use it instead of other stuff.
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| Whew! That's a lot to do. How long should it take? |
Well at first, it may take awhile. But shoot for efficiency. With practice you should be able to do it all in 10 - 15 minutes maximum. No kidding!
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| What else do I need to know? |
Smoking causes more bone loss at a faster rate and limits the potential for healing. Of course, it also causes lung cancer, heart disease and emphysema. So if you smoke, do yourself and your teeth a big favor.....
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| What does periodontal treatment usually involve? |
Good question. Until now, we've primarily dealt with your oral hygiene. This takes care of the bugs above the gums. In a healthy mouth, the gums are firmly attached to the tooth with very little spaces in between. But when you have Periodontitis, bone has been lost creating spaces or "pockets" between tooth and gums. It is the Periodontist and Hygienists's job to clean these pockets below the gums.
There are basically two approaches. One consists primarily of "deep cleaning" to try and detoxify the contaminated root surfaces under your gums. This technique is very good for when the "pockets" - or spaces between the tooth and gums - are relatively shallow. It can be done with or without anesthesia (an injection in the mouth) depending on the patient's level of tolerance. Typically, it is better to use anesthesia so the patient is completely comfortable during the procedure, The more bone that has been destroyed, the deeper the pockets and the harder it is to clean. It's always easier to clean what you can see so when the pockets are really deep, ideal treatment consists of reflecting the gum tissue back so we can visualize the root surfaces. This second approach is referred to as periodontial surgery. However, it is a relatively benign procedure. In addition to facilitating the cleaning of the roots, this approach allows us to attempt to "grow back" new bone. In more involved cases, it really is the best way to go, but there is a cost!? It requires profound commitment on the part of the patient.
Ideal hygiene on a daily basis and regular maintenance cleaning are essential for proper healing. If the patient is not 100% committed, surgical intervention is usually not the treatment of choice. Regardless of which approach you decide to take, the quality of the result is determined by two factors - your level of home care and regular maintenance cleanings. Most periodontal patients require cleanings every 3 months! The time frame can vary but for the majority of people, 3 months maintenance is the name of the game!? The importance of maintenance therapy cannot be overstated. Remember, you never get rid of gum disease. You cannot "cure" it - you can only keep it "in check." So you have to brace for the long haul, which essentially means the rest of your life! It's your disease. You are the co-therapist. Together we can get it under control and keep it that way. Remember, the bacteria associated with periodontal disease have been linked to more serious illness.? A healthy mouth is a part of a healthy life!
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