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Giving plaque the brush-off.

GIVING PLAQUE THE BRUSH-OFF

The way some TV adstell it, a cavity-free checkup is the passport to a rosy dental future. Yet nearly 70 percent of all adult teeth are lost not from decay but from periodontal disease--a disorder of the gums, the tissues, and the bones around the teeth. By age 13, four of five youngsters have early signs of the problem, and by age 40 real gum trouble afflicts four out of five Americans. The best defense is proper oral hygiene, but most of us need to brush up on good brushing techniques.

The culprit in periodontaldisease is plaque, an accumulation under the gum line of a nearly invisible film produced by bacteria acting on protein in the saliva and on bits of trapped food. If plaque is not removed by brushing or by other means, it combines with mineral salts in saliva to form a hard deposit called calculus or tartar. As the battleground where bacterial toxins clash with the body's natural defenses, the gums take the brunt of the damage. They become irritated, then recede and pull away from the teeth. They open pockets that collect debris and form a breeding ground for more bacteria. Eventually, the supporting bone erodes; teeth loosen and are lost.

If you've picked up your brushingmoves like an improvised golf swing, chances are you're missing plaque. No single stroke works best for everyone, but many dentists tell you to place the brush at a 45-degree angle against the gum line and the outside surfaces of the teeth. As you go around the teeth, move the brush back and forth gently in short strokes about half a tooth wide, as if you were making the brush shimmy. Do the same inside; then scrub the chewing surfaces.

And the toothbrush itself? Mostdentists recommend one with soft or polished bristles rounded at the end to minimize gum damage. Under a voluntary program, toothbrush makers may use the American Dental Association's (ADA) seal of recognition if they satisfy its Council on Dental Materials, Instruments, and Equipment that a product is "safe and effective." Products currently recognized include brushes from the John O. Butler Co. and Colgate-Palmolive; Pepsodent brushes by Lever Brothers; Reach toothbrushes by Johnson & Johnson; and Oral-B toothbrushes by Coopercare. (Lack of ADA recognition doesn't rule out the adequacy of the brushes of makers who may not have south formal recognition.)

Even with the best conventionalbrush, argues a Minneapolis dentist, George Collis, people seldom get the hang of brushing right. With a novel toothbrush he designed, much guesswork is removed. Two outer rows of soft bristles curve around a center row of short, stiffer ones to cover all surfaces of the teeth snugly. As the brush is moved back and forth horizontally, hugging the gums, the inner bristles clean the chewing surface, while the outer bristles curve around to clean the sides and the gum line. Don't, however, expect brushes or brushing to take the place of flossing, a procedure vital to plaque removal.

The newest weapons inthe battle against gum disease are the antiplaque dentifrices that have recently come on the market. These toothpastes, gels, and mouthwashes contain chemical agents to reach gum areas that brushing and flossing may miss.

The American Dental Associationhas recently prepared guidelines to evaluate the effectiveness of these products. So far no manufacturers are claiming their toothpaste and gel will completely prevent plaque formation; however, many have clinical trial evidence that their products will help reduce plaque and possibly prevent periodontal disease.

The FDA has not approved use ofsome antiplaque agents now being marketed in Europe. However, leading American experts in dentistry are now agreeing for the first time that new antiplaque dentifrices meeting the ADA guidelines will have a "significant impact" in reducing early gum disease.

The universal use of flouride toothpasteshas reduced tooth decay to a rarity. Most dentists do much less drilling and filling than they did just ten years ago. With improved new preventive methods, dentists now hope to bring gum disease under control as well.
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Copyright 1986 Gale, Cengage Learning. All rights reserved.

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Title Annotation:preventing peridontal disease
Publication:Saturday Evening Post
Date:Apr 1, 1986
Words:672
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