Many of us grew up with toothpaste commercials, which ended with “brush your teeth every day and have your teeth cleaned every six months”.  In addition, most Dental Insurance Plans only cover one or two cleanings per year.  One would imagine that a cleaning every six months is enough to maintain everyone’s optimum oral health.   However, this is not the case since treatment must be based on everyone’s individual needs.  In order to understand this we need to look a little closer at gum disease and how to prevent it.     Gum disease or periodontal disease, as dentists call it, is an infectious process caused by billions of bacteria found in dental plaque and tartar. All of us have dental plaque, which commonly forms at the gum-line. There is no way to prevent its formation on our teeth, but we can learn to remove it.   The first stage of gum infection is called gingivitis and is characterized by puffy red gums, which bleed easily when touched.  The good news about gingivitis is that it completely reversible with proper treatment.  If gingivitis is left untreated it becomes destructive.  The infection progresses to the underlying bone supporting the teeth.  As the disease progresses, the gums peel away from the teeth,  teeth begin to loosen, gum abscess and bad breath become common, and teeth are ultimately lost.  Reversing bone loss around teeth is tricky and not always predictable.  In addition, there is recent evidence that implicates gum disease in disorders such as chronic lung disease like asthma and emphysema, diabetes, heart attack and stroke.  The key is to prevent gum disease and maintain healthy teeth and gums.         Back to our original question of “how often do we need our teeth cleaned?”  The answer is “It depends”.  Since gum disease severity, and progression depends on each individual’s ability to remove plaque and the immune system’s response to bacteria, and speed of plaque and tartar buildup. The time interval between cleaning may vary from one individual to another and within one individual at different times.       How do dentists custom tailor your treatment?  It all begins with proper diagnosis of the stage of gum disease.  This is accomplished with thorough measurement of gum and bone levels around each tooth, taking careful note of any bleeding and abscessed areas: the sign of infected and inflamed gums, tooth mobility, your bite and   X-ray evaluation. This evaluation should be done at every check-up.      If gum problems are discovered the first step is non-surgical treatment.  This consists of thorough instruction on brushing and flossing techniques, and a series of gum treatments using ultrasonic and hand instruments to remove plaque, tartar and bacterial toxins from the teeth and gums.  In addition, now there are several medicines that help treat gum disease as well. It may take multiple visits to thoroughly complete this phase of treatment.   How the patient responds to the treatment determines whether they are placed on a maintenance program or further therapy is necessary which may consist of antibiotic therapy and/or a surgical approach to further clean out the gums.   During each maintenance visit the hygienist and dentist evaluate the gums for signs of infection and plaque levels.   This determines the time length between visits and need for additional gum treatment.  Some require two months between visits; others can be seen every six months.  It depends.       So remember, brush, floss and see your dentist for regular custom tailored cleanings and gum evaluation to keep your mouth and body healthy.