Paste, wrap, and shimmy: a regimen for the prevention of gum disease

The body of evidence showing a possible correlation between gum infection and systemic diseases is well documented and growing. At the same time, the prevalence of gum infection is increasing in the general populace. Gum infection and disease are routinely seen in patients who adhere to regular dental hygiene regimens and see their dentists on a regular basis. One of the reasons typical daily dental care does not eradicate gum disease (gingivitis) is that the usual home care regimens do not attack a major underlying cause of gingivitis: the layer of biofilm in the sulcus surrounding the tooth's root. This biofilm harbors and protects the bacteria that cause gum disease and root decay. Research has shown that there are no "magic bullets" in the form of rinses, pills, or special tools that effectively destroy the bacteria and its protective calyx. Therefore, daily dental regimens must be changed until the absence of gum infection and inflammation becomes the standard of care. The Paste, Wrap, and Shimmy method is presented in a way that can be understood by all patients. It can be reproduced and used as a teaching supplement by the dental team. The method is conceptually simple and inexpensive, but not intuitive or easy. It must be coached and reinforced; however, if implemented, it can be very effective. The author's office has increased the length of new patient and recurring hygiene visits so that the method can be properly taught through repetitive practice and visual presentations. Prevention is not insurance-driven, so dentists most often provide it as a free service. The rewards are significant, however, and on initial exposure to this method, patients routinely ask: "Why haven't I been shown this before?" They will also have an expectation that the learning process will be repeated at each visit until they are free of infection.