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Flossing is one of those things that everyone knows they should do but probably do not do regularly or correctly. Flossing, along with brushing is one of the most important things you can do to keep your smile healthy. Flossing is a simple 1-2 minute activity that is recommended to after meals. Once it becomes part of your routine it becomes an easy habit to keep. Everyone should floss at least once a day. The most important time of day to floss is before bedtime. When you sleep, saliva flow slows down and if food is left in between teeth, bacteria have a solid 8 hours to break teeth down with their acids without worry of being rinsed away by saliva.

Signs You are Not Flossing Properly?

-Bleeding gums upon brushing or flossing. If your gums are bleeding when brushing or flossing you have a form of periodontal disease called gingivitis. Gingivitis is reversible once you are regularly brushing, flossing, and go for regular professional cleanings. If the supporting tissues surrounding your teeth begin to breakdown then you have a more advanced form of periodontal disease called periodontitis. Periodontitis is not reversible without intervention.

-Build up of plaque and food debris along gum line and between teeth. Flossing is able to reach areas that brushing alone can not reach. Lack of flossing will lead to tooth cavities in between teeth (also called interproximal decay). A good tip is to use a disclosing solution before brushing and flossing. It will color your plaque a color like bright purple. This will give adults and children a good visual to see what areas they might be missing.

Flossing the proper way

Flossing – The Proper Technique

Proper Flossing Technique

-Start with about 18-24 inches of floss. Then wind a good portion of the floss around each middle finger. Make sure to leave an inch or two of floss to use for the actual flossing of your teeth.

-Hold the floss tight between your thumbs and index fingers, slide it gently up and down between your teeth. Do not shoeshine side to side as you can wear notches into the teeth over time. Some teeth with tight contacts may be difficult to floss thru. Try using a thinner Teflon type of floss such as Glide. Be diligent and make sure to get in between the tight spaces.

-Gently curve the floss around the base of each tooth one by one. It is important to ensure you go below the gumline. Never try to snap the floss in between the teeth as this may injure the gum tissues.

-Make sure to use clean sections of floss as you advance around your mouth.

-To remove the floss, use the same up and down movement to bring the floss up and away from the teeth.

Best Types Of Floss

Depending upon your particular needs, there are many types of floss to choose from:

-Dental tape is great for teeth with space between,

-woven yarn floss is for periodontal problem areas,

-thin Teflon floss is for tight contacting teeth,

-fluoride floss is for people who are prone to cavities between teeth,

-Stain removing floss is for smokers and heavy tea/ coffee drinkers,

-all in one or threader floss is for flossing under bridgework.

Any flavor or type of floss that you feel comfortable using and use regularly is fine.

What if I find it hard to floss properly?

Let’s face it, flossing requires dexterity and work for all of us. Under some conditions or even as we age, we may lose some of our natural dexterity. This does not give you a free pass to avoid flossing. There are various aids on the market to deal with this problem. The most popular of these products are called flossers. They allow anyone to floss

Flosser - Reach Access

Flossing Using the Reach Access Flosser

their teeth easily with little to no effort.

-Wishbone type flossers- allow you to wind your own floss onto the holder, maneuver into position, floss.

-Reach access flossers- come with pre- threaded disposable floss ends, even easier to use than the previous type, just bite down, it snaps between the teeth, floss.

-disposable small plastic handled floss, (usually come in a large bag of 100 or so)

-Hummingbird, electric type flosser

There you have it, an easy guide to flossing to help maintain your oral hygiene and your smile for years to come!

 



Periodontal disease (or commonly called gum disease) is a very serious and chronic dental infection of the periodontal tissues that can result in the breakdown of the tissue as well as the loss of bone that surrounds and supports your teeth. This dental infection disease begins when bacteria and plaque form a sticky bio film on your teeth and causes inflammation of the periodontal tissue.  Periodontal disease will continue a downward progression if this is not resolved by maintaining proper dental care and hygiene. Periodontal disease is the leading cause of tooth loss in adults. Scientific studies show that somewhere between 75% and 95% of all adults are suffering from some stage of periodontal disease.

Periodontal disease and tooth decay (cavities) are caused by different types of bacteria, and are considered to be two separate and distinct conditions, however, you can suffer from both issues. Poor oral hygiene promotes the risk of both cavities and periodontal disease. Swollen and receding gums open up the more vulnerable areas of the tooth…The root areas, which, are not protected by enamel and can break down quickly to form root decay.  On the flip side, in patients with significant tooth decay, the broken down teeth allow for food trap areas which keep periodontal tissue chronically inflamed.

Gingivitis

Periodontitis

Stages of Periodontal Disease

The earliest stage of periodontal disease is gingivitis (or simply inflammation of the gum tissues). This is the most mild form of periodontal disease. Symptoms include red, swollen (or puffy) and inflamed gums due to plaque-bacteria build-up. The gums may also bleed easily during brushing or eating of hard foods. During the earliest of stages the periodontal disease process it can be reversed thru proper brushing, flossing and professional dental care to remove the excess bacterial plaque. If the required oral hygiene does not occur, the periodontal disease then progresses  to the next stage. The majority of people with this early form of periodontal disease, do not even know a dental problem exists. This is a crucial period for the patient, as the condition can be reversed (since the bone and connective tissue that hold the teeth in place have not yet been adversely affected) at this point if it is recognized, diagnosed, and properly treated by a dental professional. Gingivitis is commonly seen during puberty, pregnancy, times of high stress, and menopause, as raging hormones can make you more prone to inflammation. As for the rest of the population, poor dental hygiene is generally the most common cause, followed by medication and certain medical conditions.

Periodontitis

As the periodontal disease progresses it is now becoming harder to treat and control. The difference between gingivitis and periodontitis is that gingivitis only infects the gum tissue that surrounds the teeth while the periodontal disease process also invades the bone that provides support and stability for the teeth. The bacteria eventually invades past the initial the gum line area and destruction begins to the point that gums may begin to separate or pull away from the teeth (taking away support and connective fibers with it). What results are called periodontal pockets. These pockets allow for bacteria to invade below the gum line.  They eventually become loaded with toxic plaque and bacteria that moves and works its way deeper. It begins to erode the bone below the gum line. A patient’s bite will be affected (as the teeth shift or loosen) by the lost support which then affects chewing and other daily functions.

Advanced Periodontitis

As the periodontal disease process advances further, the fibers and bone that provide support for the teeth are broken down and  destroyed. At least half (50%) of the bone support (if not more) will have broken down at this late stage of periodontal disease. It does not grow back naturally. Teeth may begin to loosen. Deep root cleanings and surgical intervention are typical at this stage. This may include cleaning with a periodontal microscope, (Perioscope), grafting of tissue, bone, placement of growth factors, (Emdogain), periodontal antibiotic regimen (Periostat), placement of antibiotics directly into pockets, (Arestin), open periodontal flap surgery, and, possibly even tooth removal.

How Do I Know If I Have Periodontal Disease?

Periodontal disease can happen to a person of any age. It is most common among adults. Remember, if periodontal disease is detected in its earliest stages it can be reversed so it is important to see your dentist right away if you notice any of the following symptoms:

-Gums that are red, puffy or inflamed, or tender.

Periodontitis

X-Ray showing Periodontal Disease Progression

-Gums that bleed easily during routine brushing or flossing.

-Teeth that appear longer due to recession of gum tissue.

-Changes in the way your teeth fit together when you bite or chew.

-Pus coming from between your teeth and gums

-Bad breath odor or bad taste in your mouth.

Treatment of Periodontal Disease

Periodontal Disease

Arestin use in Periodontal Disease

The earliest stages of periodontal disease are reversible. This is accomplished thru proper brushing, flossing, and maintaining a regular schedule with your dentist. A professional cleaning by your dentist or hygienist is the only way to remove plaque and tartar especially below the gum line. The hygienist will clean (also called scaling) your teeth to remove the tartar and plaque buildup from above and below the gum line. If the periodontal disease condition worsens, then a root planing procedure may be necessary. Root planing helps smooth irregularities on the roots to make it more difficult for plaque to deposit and stick there. Also makes it easier for you to keep your teeth clean at home. Treatment may also include use of antibiotics.

If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, your periodontitis treatment may require dental surgery. This surgical intervention may include:

-Pocket Reduction Surgery (also called Flap surgery). In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. The procedure generally takes from one to three hours and is performed under local anesthesia.

Soft tissue grafts. Gum tissue is often lost as part of the periodontal disease process making your teeth appear longer than normal. You may need to have damaged tissue replaced to return your cosmetic appearance back to normal. This procedure can help reduce further gum recession, cover exposed roots and give your teeth a more cosmetically pleasing appearance.

Bone graft. This procedure is needed when periodontitis has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.

-Antibiotics and medicaments – A wide array of antibacterial rinses(Peridex), antibiotics taken in pill form, (Periostat) or localized placement directly into the affected pockets(Arestin), can aide in and promote healing of the affected gum tissue.

-Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.

-Enamel matrix derivative application. Another technique involves the application of a specialized gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue. An example of this is the use of emdogain.

To ensure a successful result following periodontal therapy, patient cooperation in maintaining excellent oral hygiene is essential. More frequent professional cleanings can help reduce the likelihood of the periodontal disease ever returning.

By scheduling regular checkups, early stage periodontal disease can be treated before it leads to a much more serious condition. If your periodontal disease is more advanced, treatment in the dental office will be required. Periodontal disease can be managed and controlled for most patients. Following a regular routine of brushing, flossing, and seeing your dentist should be enough for most to keep periodontal disease at bay.