Gums. What a silly little word for that all-important band of tissue that surrounds our teeth. Actually, the technical word for them is even more peculiar: "gingiva".
"Gingiva". Once upon a time, this word caused me a great deal of stress, if only for a few minutes. One of the requirements for entering dental school is the "DAT", the Dental Aptitude Test. I was strong in most of the sciences, but had concerns over some areas of the exam, yet worked through it all without too much angst. Finally I got to the very last section: Reading Comprehension. This was a particular strength of mine, so I thought, "OK, now I'm home free!" I started reading and- every third word in the passage, it seemed to me, was, you guessed it, "gingiva".
Trouble was, I had never seen this word in my life, up to that time. Near-panic ensued!
In these situations, one has to settle down, and I was able to glean the meaning of this unusual word from the context; we've probably all done that from time to time. Everything worked out fine with the exam, but to this day I wonder where in the world these two oddments, "gums" and "gingiva", came from.
So. We've established in "Gum Tissue Is The Issue" that a disturbance in the delicate balance between three factors: the immune system, bacteria in the mouth, and the biofilms that exist on our teeth, is what sets the stage for the progression of gum disease, or "periodontitis". So far, anyway, we cannot willfully alter our genetics. We also cannot specifically control which species or types of germs inhabit our mouths, although professional treatments can favorably alter the mix in a general way.
It stands to reason, then, that on the teetering three-legged barstool of risk factors for periodontitis, the one the patient has the most control over is the plaque and biofilm that reside on the surfaces of our teeth. This is where we should focus our daily efforts in establishing and maintaining oral health. (As an aside, less cavities result when we do these procedures as well).
Now we know from previous posts all about biofilms and how germs can build up in layers on the hard surfaces on the roots of our teeth. The goal is to minimize the extent to which this happens in the time between our professional cleanings. A toothbrush, even a high-tech electric or sonic one, can only reach the inner and outer surfaces of our teeth, it can't get in between adjacent teeth. Unfortunately, this is where most of the problems of gum disease and also most cavities start. Much has been made of the ability of floss to reach these areas, and it remains one of the best methods. The trick in its use is to wrap it around each tooth, first towards the front and then towards the back, and match the curved contour of the surfaces that we're trying to clean.
Many folks express frustration with this method and there are alternatives. One of the best in terms of ease of use and also solid research to back up the idea are "Soft Pics". These are little flexible, comfortable plastic devices with a rubbery sort of brush on them. It's just a matter of point and shoot, we simply place them between two adjacent teeth and gently push in and out a few times and then move on. After some practice, this doesn't even require a mirror. They are excellent at cleansing our teeth in a very three-dimensional fashion, with minimal effort or demands on our busy lives.
Over the years many, many motivational tactics have been tried in order to influence patients to do these preventive procedures and establish better oral health. Now that we think in terms of biofilms, let me try this one on you: If plaque were building up on your car's windshield instead of your teeth, it would only take about three or four days until you couldn't drive ...
As we finish, let's have a look at these Soft Pics. Here, our hygienists Annette and Jen are playing an obscure dental variant of Texas Hold 'Em...