Oral Hygiene Instructions

For patients with periodontal disease 

Because we aim for the best possible outcomes from periodontal therapy, our patients receive customized oral hygiene instructions when they begin treatment.

Dental plaque is the primary cause of gum disease. In order to remove the plaque in the most efficient manner, a daily routine is paramount. A good routine to follow includes:

Tooth brushing 

Hold the bristles of your soft toothbrush directed to the point where the tooth meets the gum. Make small side to side motions to disrupt the bacteria. Only cover 2-3 teeth at a time and them move the brush and work your way around. Be sure to get all surfaces; following a routine helps. For example, start on the upper right molars that are facing the inside of the cheeks, and then after getting to the upper left molars, go to the “inside” and brush where the tooth meets the roof of the mouth. On the lower, be sure to get the inner (or tongue side) of all the lower teeth.  The biting surfaces or “tops” of the teeth also need brushed.  Tooth brushing should take place twice a day, or as directed by Dr. Pitman and Dr. Ntounis. Electric toothbrushes are safe and can be used by most patients without difficulty. They make your job easier! Ask Dr. Pitman or Dr. Ntounis about which type they recommend for you.


For teeth that do not have spaces between them, use the “c-shaped flossing” technique. Gently work the floss between the teeth, wrap the floss around one tooth and gently move the floss up and down 5+ times to disrupt the bacteria between the teeth and under the gumline. Do this for every tooth that fits tight next to its neighbor, once a day.

Interproximal brushes 

For teeth that have space between them, custom sized brushes are more effective than floss and you don’t have to floss these teeth! Many of our patients love TePe. Use the brush by inserting it between the teeth and move it in and out 2-3 times to disrupt the bacteria on both sides of the neighboring teeth, as well as the grooves between the roots of your teeth. These brushes should be used 1-2 times a day, and the brushes may last up to 1 week.

Mouth rinse 

An antibacterial rinse reduces the overall bacterial load in your mouth by reaching your tongue, palate, floor of your mouth and the lining of your cheeks.  Listerine (and many store brand rinses) have the ADA seal of acceptance to reduce gingivitis and plaque. You can read more about the ADA seal of acceptance here:



Patients with exposed roots may experience tooth sensitivity and have a higher risk for root decay. Protecting the exposed roots can decrease sensitivity and reduce the chance of root cavities. For this reason, most periodontal patients benefit from using a prescription strength toothpaste (Prevident 5000) in addition to an over the counter toothpaste. Ask Dr. Pitman and Dr. Ntounis if you need a prescription toothpaste at your next visit.

Oral Irrigators 

Mechanical removal of the bacterial film is best performed using floss or interproximal brushes. For patients who are unable or unwilling to use floss or interproximal brushes, an oral irrigator can help reduce the bacteria by flushing high pressure water between your teeth and gums.  Ask us about an oral irrigator at your next visit. 

Tongue Cleaners

You may be surprised how many bacteria live on your tongue! Rinsing and brushing your tongue will help, but a tongue cleaner (tongue scraper) will remove it the best. You’d be surprised how much fresher your breath is if you start cleaning your tongue every night!

Check your work! 

Dental plaque can be hard to see. Using a plaque dye (disclosing solution) can help show you the areas with bacteria on your teeth. You can buy this at most drug stores, or request it at your next visit to our office.

For patients with gum recession or soft tissue grafting 

Brushing should always be done with a soft bristled toothbrush and a small movement; avoid the “scrubbing” and “back and forth” technique. Instead, gently sweep the bristles from the gumline up to the biting surface of the teeth.  A pressure sensitive electric brush may also be useful to help alert you if you’re applying too much pressure.

When flossing, be careful to not traumatize or cut the gums. After complete healing from your grafting, resume the “c-shaped” flossing technique.


For patients with dental implant prostheses 

Dental implants do not have the same “seal” around them as teeth do. For this reason, a special kind of floss is needed.  “Super floss” is fluffier and grabs onto the bacteria that can accumulate on the abutment (connector) and underside of the crown better than regular floss. Super floss is used in the “c-shaped” technique (see above); be sure to extend it as far below the gum and crown as it goes comfortably. This should be done at least once per day.

Patients will implant bridges or full arch prostheses should use a combination of tooth brush, interdental brush, super floss and an oral irrigator. Check with Dr. Pitman or Dr. Ntounis on which methods are best for you and your mouth.



We are here to help guide you in your journey towards a healthy mouth, which leads to improving your overall health! Call us if we can review any of these steps or if you have questions. Our team passionately promotes oral health and happiness!