Oral Hygiene Tips From Washington DC Periodontist Dr. Karl A. Rose


Brushing and Flossing

What is “Watching” A Tooth?

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While brushing the outside surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet. Gently move the brush in a circular motion several times using small, gentle strokes. Use light pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort.

When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth.

To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle back-and-forth strokes over each tooth. Don't forget to gently brush the surrounding gum tissue.

Next you will clean the biting surfaces of your teeth. To do this use short, gentle strokes. Change the position of the brush as often as necessary to reach and clean all surfaces. Try to watch yourself in the mirror to make sure you clean each surface. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing.

If you have any pain while brushing or have any questions about how to brush properly, please be sure to contact us.

How to Floss

Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.

Start with a piece of floss (waxed is easier) about 18" long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.

To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gumline then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section.

To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the back side of the last tooth on both sides, upper and lower.

When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.

Choosing Oral Hygiene Products

There are so many products on the market it can become confusing and choosing between all the products can be difficult. Here are some suggestions for choosing dental care products that will work for most patients.

Automatic and "high-tech" electronic toothbrushes are safe and effective for the majority of the patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush and floss in conjunction with the irrigator.

Some toothbrushes have a rubber tip on the handle, this is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so discuss proper use with Dr. Rose.

Fluoride toothpastes and mouth rinses if used in conjunction with brushing and flossing can reduce tooth decay as much as 40%. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gumline so these products have not been proven to reduce the early stages of gum disease.

Anti-plaque rinses, approved by the American Dental Association, contain agents that may help bring early gum disease under control. Use these in conjunction with brushing and flossing.

Your periodontist is the best person to help you select the right products that are best for you.

Caring for Sensitive Teeth

Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long, but only if the mouth is kept clean. If the mouth is not kept clean the sensitivity will remain and could become more severe. If your teeth are especially sensitive consult with Dr. Rose. He may recommend a medicated toothpaste or mouth rinse made especially for sensitive teeth.

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Professional Cleaning

Daily brushing and flossing will keep dental calculus to a minimum, but a professional cleaning (maintenance care) will remove calculus in places your toothbrush and floss have missed. Visit a periodontist such as Dr. Karl A. Rose as they are an important part of your program to prevent gum disease. And with their help, you can keep your teeth for your lifetime.

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Our Dental Maintenance Program

Maintenance Care is Different than "Getting your Teeth Cleaned"

We Don't "Watch" Or "Keep An Eye On" Problems — That's Often Tantamount To "Watchful Neglect"

In our program, we employ the best methods of monitoring changes in our patients' teeth, bones and gums so as to know if potential problems become problems. For example, if periodontist Dr. Karl A. Rose has a concern about ongoing gum recession, he/she will make plaster models of the patient's teeth so that objective, quantifiable assessments of the gum stability/recession can be made over time and with precision. Doing so doesn't rely on any one person's memory of such a difficult matter to assess. We rarely say "We'll watch it" because we know that it is impossible to track subtle changes over long periods of time - especially for hundreds of susceptible patients. In this example, a hard copy record provides an irrefutable comparison method for tracking changes.

Each Patient's Maintenance Program is Individualized

Dr. Karl "Tony" Rose

Although the standard, every-six-month cleaning and exam has been the default dental maintenance program for many decades, we find it appropriate for only some patients. Patients are unique individuals and most are not well served by default prescriptions. We believe in customized, patient-specific maintenance care programs. This is the case regarding "cleaning" frequency as well as clinical and x-ray examination frequencies. Similarly, programs for monitoring of gum recession and tooth position changes must be customized and established.

For example, the default maintenance program calls for taking of x-rays that show decay in the head-of-the tooth (called Bitewing x-rays) every six months. Some of our patients have x-rays made on a five year basis, for they do not need more frequent x-rays. Some receive a twenty-film set of x-rays (called a Full Mouth Series) every year — because that is what is necessary to responsibly manage their level of disease susceptibility. Similarly, some patients see us one time a year for cleaning and examination; others see us every four weeks, for their needs are greater. The former group enjoys their relative freedom from dental problems. The latter group, which needs the increased level of care, considers their monthly appointment like a hair appointment — just a regular part of their life.

Excellence and Pride

Dr. Rose has been caring for people since 1976. A long history of our care excellence and experience exists and remains a source of pride. In fact, he has learned that "Experience Does Count".

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We Support Our Patients In Their Quest For Dental Health

We know that patient-performed plaque removal is the cornerstone of long-term dental health and stability. Studies show that most patients' plaque removal performance deteriorates with time. The studies also show that periodic training, with continued behavioral-modification support, helps keep patients performing self-care at an optimal level. Studies also show that most patients don't clean 100% effectively and that periodic professional cleanings are needed for them to stay healthy. This is especially the case regarding patients who have had periodontal problems in the past.

With every maintenance session, our patients' plaque removal effectiveness is assessed. Whenever a patient has lost plaque removal effectiveness, re-instruction, or maybe the introduction of new techniques for accomplishing plaque removal are reviewed. Dr. Rose has an unshakable commitment to patient performed plaque removal because we know that plaque-free mouths stay healthy and require minimal dental care.

We also know that life is busy for many people. This can cause people to delay appointing for their needed maintenance care. Periodontal & Implant Associates of Greater Washington has the supportive systems and staff to help people make and keep their needed maintenance care. In other words, we work hard to not have our patients "fall through the cracks". We are adequately staffed to offer a variety of appointment time options for patients so that they can be seen as has been prescribed — no long term waits for care appointments. If appointments are needed and not yet made, our office will follow up with patients if they forget to schedule their care. Yet, we will not "hound" patients to do so, for we know that our patients are adults and all peoples' priorities are fluid over time and must be respected.

Periodontists Are The "Industrial" Tooth Cleaners

Periodontal & Implant Associates of Greater Washington hygienists rarely "tickle the teeth". That means that their cleaning methods are thorough and effective enough to manage patients with the most recalcitrant, Periodontal Disease. Patients routinely report how exceptional our maintenance care is.

We Are Dedicated To Communicating With Our Colleagues

Every time a patient is seen for maintenance in our office a memo is sent to other dentists who may also be providing care for the patient. This is not something that most dental offices do. We do this because Periodontal & Implant Associates of Greater Washington is dedicated to complete and seamless co-therapy with our colleagues. By accomplishing this goal, the patient receives the best care available.


Is Follow-Up Care For Periodontal Treatment Important?


Dental Implant Warranty When In The Periodontal & Implant Associates of Greater Washington Maintenance Program

Within our maintenance program, we have our dental implant patients and their special maintenance care needs. Periodontal & Implant Associates of Greater Washington warranties the dental implants that are placed by Periodontal & Implant Associates of Greater Washington periodontists for patients who participate in the our dental implant maintenance program. Consult a Periodontal & Implant Associates of Greater Washington staff member for details about this program.

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Call For An Appointment

Any person can become a part of the Periodontal & Implant Associates of Greater Washington Maintenance Program. They don't have to be referred to us by another dentist. In fact, many of our maintenance patients see only us for dental maintenance care. Because these patients are kept so healthy, they hardly need future dental care. When patients develop a problem that requires another dentist's care, we refer them to their dentist, or if they don't have one, to only the best practitioners.

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