Periodontal disease and decay are both caused by bacterial plaque. Plaque is a colorless film, which sticks to your teeth at the gumline. Plaque constantly forms on your teeth. By thorough daily brushing and flossing you can remove these germs and help prevent periodontal disease.

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2. Adults over 35 lose more teeth to gum diseases,
(periodontal disease) than from cavities. Three
out of four adults are affected at some time in
their life. The best way to prevent cavities and
periodontal disease is by good tooth brushing
and flossing techniques, performed daily.
Periodontal disease and decay are both caused by
bacterial plaque. Plaque is a colorless film, which
sticks to your teeth at the gumline. Plaque
constantly forms on your teeth. By thorough
daily brushing and flossing you can remove
these germs and help prevent periodontal
disease.

3. How to Brush
We recommend using a soft to medium tooth
brush. 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 brushing the outside
surfaces of your teeth. Use light pressure while
putting the bristles between the teeth, but not so
much pressure that you feel any discomfort.

4. 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.

5. Next you will clean the biting surfaces of your
teeth by using 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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 Rotadent and Interplak.

11. 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.

12. 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.

13. 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.