Proxabrushing, waterpiking,and frequent recall  may be the secret weapons of Periodontists in treating gum disease.  Proxabrushing is extremely effective method of  intraproximal(between your teeth) plaque control for patients who have experience intraproximal bone loss and have spaces between their teeth(black holes).  These spaces are most effectively cleaned by a proxabrush.  Although floss can be used, often patients with recession in between their teeth have exposed concave surfaces that can be hard to clean with floss alone.  The proxabrush, made either by Butler, or Oral B, is esentially a mini brush that is attached at right angles to a plastic or metal handle.  The brush is inserted at right angles to the space between the teeth and pushed in and out.  Slight pressure should be applied to the intraproximal tooth surfaces immediately in front and behind the brush.  This technique is the  easiest  and most effective way to clean in between teeth that have experience gingival intaproximal  recession.  The brushes come in different sizes and shapes to allow cleaning in both big and smaller spaces.  The brushes can be bent to allow better access to the spaces.  Sometimes I find it helpful to bend the brush to be curved (like a smile) so that it doesn’t get caught on the gums as it is inserted.. The point of the brush should be pointed away from the gums.