The Use of the Toothbrush in the Treatment of Periodontitis

Any treatment for periodontitis cannot be considered successful if, after a few weeks, the gingival tissue returns to an inflammatory condition with the support­ ing tissues tender and hyperemic and the teeth bathed in suppuration.

Abstract

1. T o cause tissues supporting the teeth to return to a state of health. After suc­ cessful treatment the gingival tissues should be a pale coral pink with a firm, well-stippled “ orange peel” surface and should be resistant and insensitive to trauma. The teeth should be firmly held in position and there should be no sup­ puration. To accomplish this objective, all forms of local irritants must be re­ moved or corrected. 2. T o perform all. dental operations which will help maintain supporting tis­ sues in a healthy condition. T o accom­ plish this, the treatment should include occlusal equilibration, correction of im­ proper contact areas, contouring of poor dental restorations, and perhaps a gingivectomy to reduce pockets that are so deep that the patient cannot maintain oral health. 3. When necessary, to correct the diet and all systemic conditions which tend to interfere with the health of the oral tis­ sue. 4. T o teach patients the importance of and the technics for maintaining the supporting tissues of the teeth in a healthy condition by adequate home care. 5. To convince patients of the impor­ tance of regular and frequent follow-up examinations. Any treatment for periodontitis cannot be considered successful if, after a few weeks, the gingival tissue returns to an inflammatory condition with the support­ ing tissues tender and hyperemic and the teeth bathed in suppuration. Adequate treatment must include procedures which will maintain health for months and, with periodic help from a dentist, for years. Maintenance of health depends al­ most entirely upon removal or correction of the causes of disease. If supragingival calculus is not completely removed, if food impaction continues, if diet is in­ adequate, or if any local or systemic factor which lowers the resistance of the periodontium remains uncorrected, healthy oral structures cannot be main­ tained. Even if all known etiologic factors are removed but oral care is then neg­ lected by the patient, in a few months the oral condition will be unsatisfactory. Most periodontists agree that proper toothbrush technic is an effective, simple and inexpensive aid in maintaining the oral cleanliness so essential to oral health. This paper is limited to a discussion of the use of a toothbrush in periodontitis, which is an important part of the fourth principle mentioned above.