Self Care Recommendations As with all patients, plaque removal on a daily basis is imperative for Andy. Instruction in the use of a manual brush to ensure that the basics are a part of Andy's daily routine is the first step. Use of a high quality, soft brush is recommended for patients of this type. Many new advances in the manufacturing process of manual brushes have now made more efficient mechanical plaque removal possible. One example of a newly designed brush is the CrossAction™ by Oral-B™. It has been shown to remove 25% more plaque than the leading brush. 34 When selecting a manual brush for this patient, it is most important that you have a wide variety of brushes to show him while he is in the office. Allowing patients to hold a brush and see how it feels in their own hand will assist both of you in making the choice that is best for that patient. If you determine that Andy can not adequately remove plaque with a manual brush, self-care recommendations might include a power-assisted brush. The use of these brushes may enhance plaque removal in the posteriors, improve gingival health, and improve Andy's motivation. Studies have shown that power-assisted toothbrushes are effective in reducing plaque, gingival bleeding and probing depths in patients with periodontal disease. 27-33 click to review current self care evaluation Flossing needs to be emphasized and Andy should be encouraged to clean interproximally once a day. Floss that has a pleasant flavor and ease of use might foster compliance (e.g., SATINfloss™). If larger embrasure spaces are present after periodontal therapy, an interdental brush would be recommended.