Think Twice Before You Toss the Floss

For hundreds of years, flossing has been a common oral hygiene practice throughout the world. Dentist Levi Spear Parmly invented dental floss in 1815, but there is evidence that even in prehistoric times people were using horse hair to clean between their teeth. A few months ago, however, the U.S. Department of Health and Human Services removed their recommendation to floss after the Associated Press questioned its effectiveness.

In order for the government to officially recommend a practice, it must be sufficiently researched, and they acknowledged that the evidence from research that compares brushing alone with brushing plus flossing was “weak,” “unreliable,” and had a ”potential for bias.” This is not a surprise, since most studies lasted only a few weeks or a few months, which is typically not long enough for gum disease or tooth decay to become evident. In those studies, flossing technique was not taken into account, and technique can render flossing either completely useless or extremely valuable. Many people incorrectly use the floss in a sawing motion or just pop it in and out between their teeth. While this might get out bothersome food that is trapped, it does not clean the bacteria-laden plaque off the teeth. If you’re unsure of the correct flossing technique, please refer to the steps at the end of this post.

For those of you that don’t floss regularly, this news probably came as a moment of sweet vindication. If you do floss regularly, this news will probably not cause you to stomp into your bathroom, rip open the drawer, and throw your floss away. That’s because it’s already a habit, and you enjoy leaving the dentist without hearing that you need additional treatment for your gums or teeth.

No matter which side you are on, here is some advice from a dentist who truly has your best interest in mind: Keep flossing. When this new announcement came out, Dr. Bailey, all of our hygienists, and I looked around at each other in bewilderment and just had to laugh! Whether the current research proves it or not, every single day we see the very stark differences in oral health between patients who floss regularly and those who do not. In those who aren’t regular flossers, their gums are red, puffy, and they bleed when we floss them or use our probe to measure them. These are all signs of inflammation and active infection caused by bacteria that is not being cleaned off the teeth and from under the gums. We commonly hear from these patients, “Of course my gums are bleeding, you’re sticking a little metal probe in them!” I promise you, though, when we do the same thing to patients who are regular flossers and whose gums are not inflamed, there is no bleeding! If left untreated, this inflammation can lead to gum disease, bone loss, and eventual tooth loss. When a non-flosser starts to floss, we can see obvious positive changes in their gum health at their next cleaning appointment 6 months later.

Another difference we see every day between flossers and non-flossers is the progression of decay. When an x-ray reveals the very beginnings of decay between teeth, it is in the enamel layer (the white, hard, outer part of your tooth). When the decay is contained within the enamel, a filling is not yet needed. This is because there is a very good chance that with daily flossing and twice-a-day brushing (with toothpaste containing fluoride), the decay will not progress past the enamel. Once it does progress into the softer layer beneath the enamel, the dentin, a filling must be done since the decay cannot be halted at that stage. In patients who are (or become) daily flossers, many times we can observe those areas where the decay is contained in the enamel for years and never have to treat them with a filling. In patients who do not floss, it is very likely that those areas will progress to the point of needing a filling at some point in the next year or so.

Flossing doesn’t take a lot of time, it is inexpensive, and the benefits of flossing we see every day at the dental office are undeniable. So please, don’t toss your floss! Steps for the Correct Flossing Technique

Take about 18 inches of floss from the container. Wrap each end of the floss around your middle fingers. Grab the floss between your thumbs and index fingers. Slide the floss down past the contact point of two teeth, and create a C-shape against the side of one of the teeth. Pull the floss up and down so it’s able to clean along the side of the tooth (use gentle strokes, and stop when you feel resistance so you don’t harm your gums), then create a C-shape against the side of the other tooth, and do the same thing. Continue the process until you’ve covered all the top and bottom teeth (even behind the last tooth on each side!) Rinse with either water or mouthwash and you’re finished!