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TRIBUNE PHOTO: SCOTT KEITH - Dr. Samuel Greenstein with one of his patients at Gentle Dental in Progress Ridge TownSquare. We all know that brushing your teeth daily is vital for oral health. But do you take the time to grab that string of floss out of the medicine cabinet and dig it deep into your gums?

Chances are, at your next dental visit, the hygienist will be able to tell quickly if you’re neglecting this important task. Periodontal dentists and hygienists take a close look at gum health. They will see if there’s evidence of periodontal disease.

“That’s the main focus our hygienists spend time with our patients on,” Gennell Gentile, Gentle Dental regional hygiene manager Pacific Northwest, said. “It is so important to have a healthy mouth, and that begins with your gums.”

When you think of silent diseases, gum disease comes to mind. Neglect of the gums can lead to infection, bleeding gums, soreness and tenderness.

“You may not even realize you have an infection,” she said, noting periodontal disease can lead to loss of bone and loss of supporting structures. “So if you lose the bone in your mouth, that’s how people can lose their teeth over time.”

According to Gentile, 30 to 35 percent of extractions are caused by periodontitis, which is gum disease. She said healthy, supporting tissues in the mouth can be eaten away; teeth can either fall out or need to be extracted.

Periodontal disease (gum disease) is caused by plaque, which, according to Gentile, is a sticky film of bacteria that is always forming on our teeth. She added, “If teeth are not cleaned well, plaque bacteria can cause your gums to become inflamed and pull away from your teeth. This forms a space called a pocket and trap plaque that cannot be removed with tooth brushing.”

Tooth brushing only reaches above the gum, Gentile said.

“We need some sort of way to get underneath the gum line — by flossing, we’re at least accessing the areas where the plaque is hiding beneath the gum.”

Oral health can indicate the state of our overall health. “Periodontal disease increases the risk of heart disease, heart attack, stroke, diabetes, pre-term birth,” she said. “It’s a great responsibility that hygienists and doctors have, by seeing their patients and really taking a close look at the clinical findings, medical and dental histories, X-rays, perio charts and correlating all the information for whole body health.”

Gentile added, “Ninety-five percent of Americans with diabetes have periodontal disease. If we see a patient who has a lot of bleeding, and even with good home care they can’t get it under control, we would possibly recommend that they see their doctor and be checked for diabetes.”

A major symptom of periodontal disease is bleeding with flossing. Look for blood when you spit into the sink while brushing or flossing.

“Your gums should be pink and tight,” she said. “You should be able to brush and floss them with no bleeding.” Other symptoms can include red, swollen or tender gums. You may also notice your teeth shifting as you bite down. That’s because of the loss of tooth support.

“Regular brushing and flossing habits should be taught to children at an early age to help prevent gingivitis or any form of periodontal disease,” she said.

The American Dental Association recommends daily brushing and flossing two times daily. “I recommend more. It’s not going to hurt the patient, it can only help them.” Gentile said.

Gentile suggests you brush your teeth before going to bed, because when you go to bed, your saliva is reduced. When awake, saliva helps wash away substances such as bacteria. It’s also a good idea to brush between meals.

There’s no cure for periodontal disease. Left untreated, it will advance. “It’s a manageable disease like diabetes, but it’s not curable,” she said. “There are therapies that we offer and follow-up care.”

Gentile stresses the importance of good oral health. “By taking care of your mouth, you’re taking care of your overall body.”


Don’t skip flossing. Flossing is the most effective way to remove plaque and food particles from between your teeth. Get about 18 inches of floss. Wind most of the floss around the middle finger on one hand, and the rest around the middle finger on the other hand, leaving about 1 inch to floss your first tooth. Use your thumbs and forefingers to gently pull the floss from the gumline to the top of the tooth to scrape off plaque. Rub the floss against all sides of the tooth. Unwind to fresh floss as you floss each tooth.

Scott Keith is a freelance writer with the Portland Tribune and the Pamplin Media Group. If you have a health tip, or a story idea, contact Scott at scott[email protected]

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