8. After cleaning 2 or 3 teeth the part of the floss used is somewhat soiled and loaded with bacterial material. It is desirable to move along the string to a new place by taking another turn around the anchoring finger. This should be repeated from time to time as needed. 9. The floss is held and manipulated with the same fingers as indicated above until after the surfaces of the teeth in the interproximal space between the left central and lateral have been cleaned. 10. In cleaning the rest of the upper teeth, it will now be found more convenient and practical to hold the floss over the ends of the thumb of the right hand as before and over the thumb (instead of the index finger) of the left hand. (Figure 18 (2)). 11. All the lower teeth now should be cleaned in the same way. Most people will find that they can carry out the necessary manipulations most successfully with the floss held over the ends of the second finger of each hand instead of the thumbs or the thumb and first finger as in cleaning the upper teeth. (Figure 18 (3)). 12. After cleaning all the teeth with dental floss, the mouth should be thoroughly rinsed by forcing water vigorously back and forth between the teeth in order to remove material that has been loosened or dislodged but not removed by the floss. After a little experience one can clean all his teeth well with dental floss in from 2 to 3 minutes. 13. It gives a pleasurable sensation of cleanliness to hastily brush the teeth again after cleaning them with dental floss. But this is not essential.

Fig. 18. Best way to hold floss in cleaning the teeth. For upper right (1). For upper left (2). For lowers (3).

Results

The author has instructed and had under observation, a sufficient number of subjects to be able to state positively the beneficial effects that result from the personal oral hygiene herein specified.

1. No new caries lesions develop.

2. Early stage lesions (mostly unrecognized "white spot" partially decalcified enamel that has not broken down) do not progress further or break down.

3. Small shallow cavities do not progress but usually become inactive.

4. Correctly made fillings do not undermine or break down.

5. No new periodontoclasia lesions occur.

6. All early stage periodontoclasia lesions heal promptly. It is almost dramatic the way in which the bleeding from the gingival crevices stops entirely after the first few days. Pus (even microscopic quantities) is no longer present in material from most of the crevices, and greatly diminished in that from others. The delayed or incomplete healing in such lesions is usually due either to calculus or scale on the tooth within the crevice or to irregularities or other conditions on the surface of the tooth which prevent accurate application of the floss. In most such instances, removal of the foreign material from the surface of the tooth at, and within, the gingival crevice by the dentist, followed by the right personal oral hygiene, results in prompt subsidence of the disease.

7. Each advanced stage periodontoclasia lesion and deep "pyorrhaea pocket" is a separate problem. However, cleaning off the tooth at and within the lesion by the dentist at suitable intervals together with faithful application of the personal oral hygiene described herein usually will yield most gratifying results. The beneficial results will depend largely upon the extent of the lesion and the damage already done. In favorable instances suppuration and inflammation of periodontal tissues subside, and loose, drifting teeth usually stabilize.