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How and why to take care of your gums – advice from a dentist

An interview with dr. Michaela von Geijer, a practicing dentist and odontological expert at TePe Munhygienprodukter AB

Why is cleaning between your teeth so important?

You have a lot to gain from giving your teeth a few minutes of attention every day. Plaque accumulated between the teeth can cause gingivitis (bleeding and inflamed gums). If you do not start to remove the plaque it can lead to periodontitis (gum disease and tooth loosening). In other words, periodontitis starts between the teeth. With a toothbrush you are able to clean three of the five surfaces of the tooth, but that is only 60%. You need to use something more as 40 % will not be cleaned with only using a toothbrush.

There are many different interdental cleaning devices. What to recommend?

According to scientific evidence patients with gingivitis and periodontitis should be recommended interdental brushes. Those are the most effective devices for interdental plaque removal. BILD på olika interdental produkter

Is it enough to use interdental brushes once a day?

Always follow the advices from you dentist. For most patients once a day is enough and as a dentist I would be very happy if patients would follow this advice and do a proper cleaning once a day. A thorough cleaning involves using both a toothbrush and an interdental cleaning device.

Important features of an interdental brush then. How to choose the most effective one?

Buy high quality products that will clean more efficiently, last longer and do no harm the tooth or the gingiva. Important features are plastic covered wire and filament coverage. The filaments should cover as close to 100 % as possible to avoid damage of teeth and gingiva. 

Interdental brushes are available in many sizes and with different handles. Which size and version to choose?

As the spaces between your teeth are of different sizes you will most likely need more than one size. Never force a brush into an interdental space but there should be a certain resistance. Let your dentist help you to decide which size to use where. Your dentist can also inform you if you have problems with your gums and where in the mouth. After the dental visit you will be able to continue by your own at home.

So if I am doing a good cleaning I don’t need to visit my dentist so often?

It is individual how often a patient should see their dentist but regular visits are very good. By seeing your dentist regularly they can help to discover problems already at early stages and take action before the problems become more serious.

When to recommend floss?

Floss should be used by patients with big and healthy papillas when there is no space for an interdental brush. Usually young patients. Sometimes a combination is to be recommended, floss in the front and IDB to be used between the other teeth. Floss is for many difficult to handle in a correct way, therefore a flosser with handle might facilitate the usage of the floss. 

Picks – when to use them?

Picks are an “on the go” product which is perfect to use during the day, for example after lunch to “pick” away food. Picks can be used by everyone if you have enough space between your teeth. An easy, comfortable and efficient tool. For a proper cleaning interdental brushes should be used in the evening together with the toothbrush. 

A customer with braces. What to recommend?

Tooth cleaning is more complicated during orthodontic treatment since a lot of plaque accumulates around the brackets, wires and also between the teeth. Development of white spots on the teeth during the treatment is very common and is irreversible. Be careful with what you eat and how often and then practice of course daily cleaning with toothbrush and interdental brushes to avoid those white spots and plaque accumulation. When cleaning the brackets, always point the interdental brush away from the gingiva ( as displayed in the pictures below) Bild-

A customer with periodontitis and bleeding gums?

As mentioned earlier, plaque accumulation causes gingivitis (gum inflammation). As a first step, start with good oral hygiene, use a toothbrush and interdental brushes every day. Contact your dentist to get the correct diagnosis, treatment and detailed instructions for home care maintenance.

Periodontitis is a very common disease. How many are suffering from it?

More than 50% of the population suffers from periodontitis. Severe periodontitis has a negative effect upon self-esteem , quality of life, speech and nutrition. The relatively silent nature of the early stages of the disease, combined with low awareness of gingival health, leads to many patients seeking help too late. Gingivitis, smoking and diabetes are the strongest risk factors for periodontitis.

Can interdental brushes be used by patients with tooth implants?

Yes – it is even more important for these patients to take good care of the implants. Clean along the the gum line with a toothbrush and use an interdental brush between the implants. This is the place where plaque will accumulate. Use interdental brushes with plastic coated wire to avoid harming the implant or gingiva.

Healthy teeth. What to use?

A golden opportunity to take good care and prevent oral diseases. Prevention is the key massage! Brush your teeth twice a day using fluoride toothpaste. Clean between your teeth once a day. If you have enough space or bleeding gums, use interdental brushes. Avoid snacking between meals and try to drink water when thirsty.

Can children and teenagers use interdental brushes?

Normally children and teenagers are not advised to use interdental brushes. At a young age the papilla usually fill the space between the teeth. Floss is what I recommend but there are of course exceptions. Consult your dentist.

Will an infection in the mouth have an impact on the rest of the body?

Yes, the mouth is a part of the body and periodontitis is associated with many different systemic diseases. For example, a two way association with diabetes and a strong association with cardio vascular diseases have been discovered. Many studies are currently being published regarding the associations between oral health and general health.