Sometimes the obvious escapes everyone except the first one to see the obvious. Then Bill Domb from California closed in the loop for us. For at least thirty years we would eliminate even the most stubborn gingivitis, i.e. a stubborn teenager who would not brush their gums above ortho brackets, by having that person in once a week and using NaBiCarb prophylaxis. Then Bill Domb (www.nt4bg.com
) suggested "packing" the gums with baking soda. The easiest way? Use "whitening trays" for about a thirty second application, then floss and brush. If they don't like Arm & Hammer, sell 'em the same NaBiCarb you use in your ProphyJet. It raises the pH above neutral, kills the most stubborn pathogens. Only dilemma here is why it took us thirty years to see the obvious. If the Prophy Jet would clear up gingivitis, why not have the patient use NaBiCarb the way Domb suggests?