A gentleman in his late 50s presented to have his upper wisdom tooth extracted. At the time he reported that his wife had noticed bad breath and that he had to clean food out from between the teeth after meals.
He brushed twice and used floss sticks daily. He was using using a mouthwash to help freshen his breath.
Clinically he presented with generalised mild periodontal inflammation of the interdental tissues and generalised early periodontitis. He had generalised interdental plaque and calculus especially around the lower front teeth.
Simple scaling was carried out to remove the calculus and allow effective brushing and access with correctly fitting interdental brushes. Some bleeding can be noted after the scaling.
After scaling was completed, a custom interdental brush chart was created. On checking the interdental brushes for each space, the true extent of inflammation was apparent.
This is yet another case that goes to highlight the limits of detection of the true extent of periodontal disease until correctly fitted interdental brushes have been used.
The bleeding will resolve with regular use of the interdental brushes and gum health will be restored.