Plaque is a complex mix of many different bacteria that build up on your teeth over time unless you remove them. If left they will cause the gum to become inflamed and within 7 to 10 days, gingivitis develops. If this is not treated or controlled it leads on to periodontal disease.
Periodontal disease is the most common disease known to mankind and causes the loss of the majority of teeth. It has been associated with an increased risk of heart disease, low birth weights and prematurity and possibly rheumatoid arthritis. Smoking is a risk factor. If you are diabetic the risk of developing gum disease is 3 – 4 times that of a non-diabetic and 10 times higher if you smoke.
Gum disease is not a classic bacterial infection. It is the body’s reaction to toxins produced by bacteria in dental plaque. In other words, you can’t catch it from someone else but it can develop if left unattended.
The disease progresses when plaque remains due to an inadequate tooth brushing technique. Gums bleed on brushing (that is NEVER normal), there is loss of bone supporting the teeth, gums recede and spaces develop between the gum and the adjacent teeth. Calculus or tartar forms below the gum and over time forms down the root. More bone loss and pockets develop. The spaces under the teeth then enlarge, it is harder to remove all the plaque and so the cycle continues and leads to tooth loss unless treated by a dentist or hygienist. For diabetics, high blood sugar levels promote bone loss while the disease itself is associated with poor and delayed tissue healing. Teeth may start to become loose in their sockets.
Periodontal treatment can vary from relatively simple such as ultrasonic scaling below the gum to remove bacteria (biofilm) and calculus (tartar). Plus following an effective oral hygiene regime – to complex surgical and bone grafting procedures, or extractions.
The Chooseabrush™ concept allows you to identify the precise size of each interdental space where the gum has receded and use the ideal brush diameter. Studies have shown that the pattern of interdental brush diameter is unique to each individual. It follows that using only one or two brush diameters will not control plaque effectively and can create a false sense of care. Do not be surprised if you need several different sizes as the picture of a real patient shows.
Whatever treatment is recommended the most important prognostic factor is how well you control your plaque on a daily basis. Since flossing has been found to be ineffective, efficient interdental plaque control with the correct brush diameter using the Chooseabrush™ programme is a significant step forward in periodontal disease control and your dental health.
Do you have bleeding or receding gums or periodontal (gum) disease? Then, let the Chooseabrush™ plan help you reduce the risks of tooth loss and disease progression. You should visit your dentist/hygienist at the maintenance recall intervals they have advised is appropriate to your individual needs. However, if you follow the plan you have created and use brushes every day at least once, you may find that this time interval increases.
Unfortunately, many people with gum recession are rarely completely effective in removing that plaque because they do not have a plan to follow at home. Research has shown that the best aid to clean these spaces and maintain gum health is the interdental brush. For optimum plaque control you need to use the correct size of brush for the different sizes of spaces in your mouth. These brushes are made in several colour coded sizes by different manufacturers. It is important you continue to use TePe brushes because there is no standardisation of colour/size between manufacturers.
But how do you remember which colour to use where, particularly when several sizes (colours) are required for really effective plaque control? It is all too easy for you to forget which colour brush to use where. The Chooseabrush™ plan has been developed by a Dental Specialist for you to record the colour brush chosen for each of your interdental spaces. Where there is insufficient space to use a brush, put an ‘X’ on the chart. This plan can be placed in front of your bathroom mirror and is easy to follow because the left side of the chart is on the left side as you look at it.
Using the Chooseabrush™ plan you have created it is very easy for you to control the plaque between your teeth on a daily basis and therefore to reduce your risks of further bone loss and gum recession.
Remember it is how well you control your plaque every day that counts.
Have you ever wondered about the numbers that your dentist reads out to his nurse when they are probing around your gums, and wanted to understand what they might mean? They are scores called a Basic Periodontal Examination (BPE) and are the UK’s equivalent of a World Health Organisation programme that began in the 1980’s called the Community Periodontal Index of Treatment Needs (CPITN).
This examination uses a special probe that has coloured depth bands and a ball-ended tip so that it should not hurt when it is placed into the space between your gum and tooth, which is called a pocket.
The depth that this probe can enter your gum is measured. Put simply, the deeper the pocket the more gum disease you have. The ball tip can detect calculus (tartar) below the gum. Removal of this calculus by your dentist or hygienist is an important part of controlling gum disease. The other part is your personal responsibility, based on how well you control your plaque every day using your toothbrush, and if you use the correct interdental brushes to clean the spaces between your gums and teeth.
The BPE uses six numbers, one in each of three sections of your mouth comprising molars and premolars on each side, and incisors and canines as the central number. This applies to both the upper and the lower jaw making six scores in all. Each score is called a sextant. The severity of periodontal disease is graded from 0 to 4*. The maximum score in each sextant is recorded.
0: There are no gum problems in that part of your mouth and all your pockets are within the normal range of up to 3mm.
1: Your gums bleed on probing. This is a local inflammation called gingivitis and if left can progress and cause your teeth to become loose. It is caused by poor plaque control in that part of your mouth.
2: Calculus. This could be both above or below the gums and needs to be removed by scaling your teeth.
3: Pockets of 3.5 to 5.5mm. This is called early periodontal breakdown and means that some of the bone that supports your teeth has been lost to gum disease.
4: Pockets of 5.5 to 8.5mm. This is called moderately severe periodontal breakdown and means that up to half of the bone that supports your teeth has been lost to gum disease.
4*: Pockets greater than 8.5mm. This is severe periodontal breakdown and means that most of the bone that supported your teeth has been lost. Some of these teeth may need extracting.
You should ask for your BPE scores each time you visit your dentist. It is your legal right to have them. Write down what they are and keep your records. You should expect the scores to come down with treatment. Your eventual aim is to have a zero score in each sextant.
You need to ask your dentist or hygienist why this is happening. It may be:
