Moderate Periodontitis
Gum boils or abscesses may develop. Teeth look longer as gums begin to recede. Front teeth may begin to drift, showing spaces. Bad breath and bad taste develop. There is both horizontal and angular bone loss. X–ray pockets between teeth and gums range from 4–6mm deep.
Advanced Periodontitis
Teeth may become mobile or loose. Bad breath and bad taste are constant. Roots may be exposed and are sensitive to hot and cold. There is severe horizontal and angular bone loss which shows up on an X–ray. Pockets between teeth and gum are now in excess of 5mm deep.
Tooth brushing is one of the most important aspects of good oral hygiene. Others include flossing, good diet and visiting the dentist regularly. Brushes should be replaced often, usually after three to four months or after a bad cold or flu. Ideally, one should brush after each meal, but at least mornings and before bedtime should be made part of one’s normal routine.
Other common questions are what types of bristles should a toothbrush have. If one uses a synthetic soft bristled toothbrush that is replaced often, it will not cause this irritation.
Sequence of Brushing
Each person has their own method of brushing, however, an easy technique is to divide the mouth into six sections. Place the toothbrush slightly on the gums or gingivae at a 45 degree angle and partly on the tooth. Gently brush back and forth. After brushing in this fashion, move the brush further down away from the gums and onto the rest of the teeth. Go further anteriorly until you reach the next one third. You should now be on the anterior six teeth.
Repeat the procedure. Move on to the four back left teeth, repeating the back and forth motions. Once completed, brush the left four posterior teeth, on the biting or occlusal surfaces. Roll to the inside tongue or lingual side of the teeth. Again, place the brush at a 45 degree angle on the gums and tooth. Follow this procedure now going from left to anterior to right upper back teeth. This is now repeated by dropping down to the lower teeth. Follow the same instructions.