Keeping Your Gums Healthy

According to the National Institute of Dental and Craniofacial Research, “gum disease develops when plaque is allowed to build up along and under the gum line.”  Gingivitis, the mildest form of gum disease, is reversible with proper dental care. However, the latest news about flossing not being as beneficial as was once thought seems confusing. And given that a study conducted by the Centers for Disease Control and Prevention found that 50% of Asian Americans had gum disease, we asked Dr. Wayne Aldredge, President of the American Academy of Periodontology, about ways to keep our gums healthy.


 Can oral irrigators/water piks replace flossing?

Although oral irrigators are not comparable replacements for flossing, they are helpful in removing food and debris from between teeth, restorations, and orthodontic devices like braces. Regular flossing scrapes debris from tooth surfaces in areas that brushing cannot reach. Water devices, however, simply rinse. The right instrument to include in a regular hygiene routine can depend on the patient’s unique situation, including whether a patient has implants, braces, crowns, bridges, or issues with dexterity. Also the amount of space each person has between his or her teeth will vary by individual. Periodontists, dentists, hygienists, or dental assistants can help patients determine which tools are best in keeping the spaces around their teeth and gums clean.

What is the general consensus in the dental community about oil pulling?

For all of oil pulling’s hype, here’s what we know for sure: Oil pulling cannot replace brushing, flossing, and seeing a dentist regularly. While swishing with oil may remove a nominal amount of plaque and bacteria, doing so cannot remove these products in a way that reduces periodontal disease risk. For those who are already experiencing gum disease, treatment from a periodontist is the only way to halt the infection. Oil pulling does not address what’s happening within the underlying structures of the mouth, and serious infections can wreak havoc as many as five millimeters below the gum line—way below what oil pulling can reach.

Are there benefits or is it just a fad?

There have been a few studies that indicate oil pulling’s effectiveness in removing bacteria from the mouth (See here and here.) But once again, is it removing enough bacteria and plaque to reduce the risk of gum disease?

There are a number of holistic approaches that patients may use to complement their more conventional hygiene habits, and the best advice I can give is to always run these approaches by your dentist or periodontist.

Should you include mouthwash in your oral healthcare routine?

Brushing and flossing at least twice a day are essential, but dental rinses can certainly be incorporated to help fight the build-up of plaque that can lead to gum disease. With everything, including determining the best toothbrush or floss or mouthwash to use, a dentist or periodontist can help you choose the best hygiene, treatment, and maintenance plan for your individual case and assess how well you are maintaining your periodontal health.   

Besides brushing and flossing, what else can you do to care for your gums?

It’s important for people to understand their risk factors for developing periodontal disease. Of course there are the things you cannot control, like age and family history, but there are risk factors that you can manage, including smoking, nutrition, and stress level. All of these components can affect your risk for developing periodontal disease.

Also, because the early stages of periodontal disease are often painless, patients may not recognize that infection is lurking beneath the foundations of their smiles. Patients should see their dental professionals for regular check-ups, which should include a comprehensive periodontal evaluation every year. Knowing your risk for periodontal disease and discussing it with a periodontist is a vital step in caring for your gums.

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