In addition to regular visits to a dentist, the best prevention for periodontal disease takes place at home. Healthy habits and good oral hygiene, including daily brushing and flossing, are critical in preventing gum disease and maintaining good oral health after periodontal treatment.
Tooth Brushing
Correct tooth brushing is the first defense against periodontal disease. Here are some tips for making sure you brush correctly:
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Use a soft-bristled brush that fits the size and shape of your mouth. Place the brush where the gum meets the tooth, with bristles resting along each tooth at a 45-degree angle.
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Place the brush where the gum meets the tooth, with bristles resting along each tooth at a 45-degree angle.
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Move the brush back and forth gently. Use short (tooth-wide) strokes.
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Begin by brushing the outer tooth surfaces, followed by the inner tooth surfaces, and then the chewing surfaces of the teeth.
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For the inside surfaces of the front teeth, gently use the tip of the brush in an up-and-down stroke.
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Brush your tongue to help remove additional bacteria.
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Flossing should finish the process. A mouthwash may also be used.
If brushing after each meal is not possible, rinsing the mouth with water after eating can reduce bacteria by 30%.
Toothbrushes. A vast assortment of brushes of varying sizes and shapes are available, and each manufacturer makes its claim for the benefits of a particular brush. Look for the American Dental Association (ADA) seal on both electric and regular brushes.
Electric toothbrushes, particularly those with a stationary grip and revolving tufts of bristles, can be helpful, especially for people with physical disabilities. However, in general, studies have reported no major differences between electric and manual toothbrushes in their ability to remove plaque. If a regular toothbrush works, it isn’t necessary to buy an expensive electric one.
The most important factor in buying any toothbrush, electric or manual, is to choose one with a soft head. Soft bristles get into crevices easier and do not irritate the gums, thereby reducing the risk of exposing teeth below the gum line compared to hard brushes.
Be sure to rinse your toothbrush with water after each use. Toothbrushes should be replaced every 1 – 3 months. Worn bristles are less effective at removing plaque, and old toothbrushes may become breeding grounds for bacteria. To prevent the spread of infection, never share toothbrushes.
Flossing
The use of dental floss, either waxed or unwaxed, is critical in cleaning between the teeth where the toothbrush bristles cannot reach. To floss correctly:
- Break off about 18 inches of floss and wind most of it around the middle finger of one hand and the rest around the other middle finger.
- Hold the floss between the thumbs and forefingers and gently guide and rub it back and forth between the teeth.
- When it reaches the gum line, the floss should be curved around each tooth and slid gently back and forth against the gum.
- Finally, rub gently up and down against the tooth. Repeat with each tooth, including the outside of the back teeth.
Here are some tips in choosing the right floss or flossing device:
- Use a floss that does not shred or break.
- Avoid a very thin floss, which can cut the gum if brought down with too much force or not guided along the side of the tooth.
- A floss threader may be helpful for people who have bridgework. Made of plastic, it looks like a needle with a huge eye, or loop. A piece of floss is threaded into the loop, which can then be inserted between the bridge and the gum. The floss that is carried through with it can then be used to clean underneath the false tooth or teeth and along the sides of the abutting teeth.
- Another handy device for cleaning under bridges is a Proxabrush, which is an interdental cleaner. This is a tiny narrow brush that can be worked in between the natural teeth and around the attached false tooth or teeth.
- Special toothpicks such as Stim-U-Dent may be used for wide spaces between teeth but should never replace flossing. Standard toothpicks should never be used for regular hygiene.
- Electric water piks may also be helpful.
Toothpastes and Mouthwashes
Toothpaste. Toothpastes are a combination of abrasives, binders, colors, detergents, flavors, fluoride, humectants, preservatives, and artificial sweeteners. Avoid highly abrasive toothpastes, especially if your gums have receded. The objective of a good toothpaste is to reduce the development of plaque and eliminate periodontal-causing bacteria without destroying the organisms that are important for a healthy mouth.
Ingredients contained in toothpastes may include:
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Fluoride. Most commercial toothpastes contain fluoride, which both strengthens tooth enamel against decay and enhances remineralization of the enamel. Fluoride also inhibits acid-loving bacteria, especially after eating, when the mouth is more acidic. This antibacterial activity may help control plaque.
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Triclosan. Triclosan is an anti-bacterial substance that may help reduce mild gingivitis.
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Metal salts. Metal salts, such as stannous and zinc, serve as anti-bacterial substances in toothpastes. Stannous fluoride gel toothpastes do not reduce plaque, even though they have some effect against the bacteria that cause it, but slightly reduce gingivitis.
- Peroxide and baking soda. Toothpastes with these ingredients claim to have a whitening action, but while they may help remove stains there is little evidence they whiten the actual color of the teeth. In addition, these substances appear to offer no benefits against gum disease.
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Antibacterial sugar substitutes (xylitol), and detergents (delmopinol)
Mouthwash. Antimicrobial mouthwash help prevent and reduce plaque and gingivitis. Fluoride mouthwashes help provide additional protection against tooth decay:
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Antimicrobial mouthwashes, such as Listerine, reduce plaque and gingivitis. Chlorhexidine (Peridex or PerioGard) is an antimicrobial mouthwash available only by prescription to specifically target gingivitis-causing bacteria. It is often prescribed before or following periodontal surgery. Chlorhexidine can temporarily stain teeth.
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Fluoride mouthwashes (Act, generics) are helpful in preventing cavities.
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Breath-freshening mouthwashes containing cetylpyridinium (Scope, Cepacol, generics) have limited effects on plaque.Mouthwashes that contain alcohol (such as certain Listerine products) are dangerous for children under age 12. Fluouride mouthwashes should not be used by children younger than age 6.
Lifestyle Changes
Eat Healthy. A well-balanced and nutritious diet is important for good oral health. Limit between-meal snacks and be sure to brush and floss after every meal. It is also important to drink lots of water to help increase saliva and flush away plaque.
Quit Smoking. Smoking is a main risk factor for periodontal disease. For smokers, quitting is one of the most important steps toward regaining periodontal health.
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