Medical Health Encyclopedia

Periodontitis is a silent disease; individuals rarely experience pain and may not be aware of the problem. A periodontal examination by a general dentist once or twice a year should reveal any incipient or progressive problems. A full mouth series of x-rays is advised every 2 to 3 years. This will alert the dentist to early bone loss and other disorders of the oral cavity.

Dentists now often perform Periodontal Screening and Recording (PSR) using a probe to measure gum pockets. This procedure used to be performed only by periodontists but is now encouraged as part of a regular dental examination. The dentist will identify any areas where deep pocketing has occurred, where the health of the gingiva appears compromised, and where there is undue mobility of teeth. It is the general dentist's responsibility to identify periodontal disease and inform the patient. If the condition is severe, the dentist may want to refer the patient to a periodontist.

Daily Dental Care

Correct tooth brushing, mouth cleansing, and flossing should be everyone's defense against periodontal disease. (It should be noted that good hygiene is probably not sufficient to prevent periodontal disease in many people who are susceptible to this autoimmune condition. Regular visits to a dentist are extremely important in high-risk individuals.)

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Brushing Guidelines. The following are some recommendations for brushing:

• First use a dry brush. One study reported that when people brushed their teeth without toothpaste first, using a soft dry brush, their plaque deposits were reduced by 67% and gum bleeding dropped by 50%.
• No brush of any size, shape, or gimmick is effective if it is incorrectly positioned in the mouth. Place the brush where the gum meets the tooth, with bristles resting along each tooth at a 45-degree angle.
• Begin by dry brushing the inside the bottom row of teeth, then the inner top teeth, and last the outer surfaces.
• Wiggle the brush back and forth so the bristles extend under the gum line.
• Scrub the broad, biting surfaces of the back teeth.
• Dry brushing should take about a minute and a half.
• A paste is then applied and the teeth should be rebrushed in the same way.
• The tongue should be scrubbed for a total of about 30 seconds. A tongue scraper used with an anti-bacterial mouthwash (such as Listerine) is more effective than a toothbrush in removing bacteria.
• One should rinse the toothbrush thoroughly and then tap it on the edge of the sink at least five times to get rid of debris. (It should be noted that detergents in toothpaste that remain on the brush may help prevent bacterial contamination of the brush.)
• Flossing should finish the process. A mouthwash may also be used.