So what I recommend is a soft toothbrush or a sensitive toothbrush and putting it under hot water first so it softens the nylon bristles. Then going, as Paul described, into the sulcus -- this is the space between the tooth and the gum -- and removing that plaque. You can do it in a circular motion or going in back and forth slowing, or what I tell patients is to go in at a 45 degree angle to the gum and tooth and brush away. So you're physically removing that plaque.
DAVID FOLK THOMAS: We're running out of time so we'll keep these brief. Quickly toothpaste -- what kind of toothpaste should somebody use?
PAUL KAMEN, DDS: I think the most important ingredient in toothpaste is fluoride as Graz was saying about water. They all pretty much have it, although some of the natural toothpastes don't have it. I was shocked that my own daughter just asked me a couple of weeks ago. "Dad is this particular natural toothpaste OK? I looked at the ingredients. It is without fluoride." So I think that's something I would not recommend.
Other than that we have lots of specialized toothpastes on the market today -- anti-tartar toothpaste, sensitivity toothpaste, whitening toothpaste. I think that if you have those particular problems or you desire a little whitening, there is nothing wrong with using those for it.
DAVID FOLK THOMAS: Graz, what about mouthwash -- Listerine, Scope -- more than keeping your breath minty fresh, right?
GRAZIANO GIGLIO, DDS: A lot of these are just like colored water. You don't need that. You need something that's going to be effective. Listerine, they make it now in different -- Of something that you get over the counter, that's going to fight against periodontal disease and kill the bacteria. It is high in alcohol so there are other rinses that you can use that don't have alcohol in them.
DAVID FOLK THOMAS: And that will, as you said, fight the bacteria.
GRAZIANO GIGLIO, DDS: You need something that is anti-bacterial to go into the sulcus and kill the bacteria. But then within four hours or so, the bacteria recolonizes.