Do you floss?


BECAUSE germs are so abundant under the gums and are so intermingled with sloughed-off epithelial cells from the gingival tissue wall of the sulcus, it is important to do what we can to keep this toxic mixture to a minimum which will consequently reduce the chances of early-stage gum infections (gingivitis) or the more advanced stages of infection and destruction associated with periodontal disease (gum disease). Properly done, flossing can be very effective at dislodging accumulated plaque and cellular debris from the spaces between the teeth, allowing this plaque to be ultimately removed from the mouth, usually by expectoration (spitting it out).

Flossing delivers several important health-maintenance benefits. Since microorganisms (germs), both living and dead, build up between contacts where the teeth touch each other, flossing is important for reducing the possibility and incidence of cavities between the teeth (“interproximal decay” in dentistry terms). Microorganisms at the contacts can process the foods we eat, such as carbohydrates and starches, and in this processing can produce acids that dissolve enamel. So for those who are susceptible to these types of cavities, flossing is exceedingly important in helping to keep decay between the teeth under control. Additionally, for those who have had their fillings, or other types of dental restorations on tooth structure, lost to decay between the teeth, it is imperative to effectively and frequently cleanse the surfaces between the teeth to reduce the incidence of new decay in these areas.

How do we floss properly? The first step is to choose a brand and type of floss that works for you, one you can, and will, use. There is a confusing array of flosses available waxed and unwaxed, dental tape (wider than floss and easier on the fingers for those with tight contacts), flavoured flosses, and even floss in a handheld device that allows flossing to be done with one hand. Although dentists and hygienists have been known to draw swords over the relative merits of waxed versus unwaxed floss, the best floss is ultimately the one that you will use every day. Start trying out various flosses until you find one you like. Whatever self-motivation it takes to include flossing as an everyday component of your oral-cleansing activities do it. I’m sure I’d approve of your choice.
Besides all the health benefits of flossing, one further motivator could be that flossing makes breath fresher. Fresh breath is difficult to achieve when loads of necrotic, stinking plaque is left under the gums and between the teeth for long periods. Since patients with bad breath seldom smell their own halitosis, they may not even be aware their breath is offensive. A simple test to see if you have a problem is simply to floss, then smell the floss. The odour, if present, will become worse as the plaque dries. One thing is for certain, flossing and fresh breath go hand in hand. If you floss and he material smells all right, you are on the right track.  One has never had bad breath worsen by having a cleaner mouth.
If you still need encouragement to floss daily, consider this: the words floss and heart both have five letters. While this observation may seem silly, flossing can keep the inflammation caused by gum disease at lower, safer levels. So if you aren’t flossing for fresh breath and healthier gum tissue, or working to keep your cavities and decay between your teeth under control, then floss for better heart health. Poor oral hygiene is associated with heart attacks.
How do you go about flossing safely, easily, and effectively? You’ve chosen your floss already, so the following is the same information I pass on to my patients. Hopefully, it will work for you.  I instruct my patients to take a nine-inch section of floss and wind it around the middle fingers of each hand until the index fingers or the thumbs on each hand are close enough to touch. This allows the floss to be directed and controlled, by using both thumbs to direct the floss if flossing the upper teeth, or by using both thumb to direct the floss if flossing the upper teeth, or by using the index fingers when flossing the lower teeth (making sure to use only gentle motions throughout the flossing).
With one to two inches of floss in between, start by flossing the front of the last tooth on the upper right. By using a system, you won’t miss anything, and by starting in the same place every time you floss, you flossing will become a habit. Keep the floss taut with your fingers and with your thumbs, direct it between your upper teeth, then guide it through the contact and scrub the front of the last tooth, up and down, with just a slight amount of rocking motion, until you feel the surface of the tooth is clean. You have just flossed the front of the tooth and cleansed the part of the sulcus at that tooth. The next step is to lift the floss over the gum tissue between the two teeth and floss the back of the next tooth, the one directly in front of the first one you flossed. Remove the floss from between the teeth and insert it into the next contact forward. Floss the front of one tooth and the back of the next tooth and move on to the next contact. Please remember you are not just cleaning the front of one tooth, but you are cleaning the back of a next one, as well as cleaning a bit of the debris from both sides of the gum tissue in between the teeth (the interdental papillae).
Then, move on to the lower teeth, again systematically flossing to ensure that no surfaces will be missed. You can floss effectively between the lower teeth by keeping the floss taut and directing it between the teeth using your index fingers. If the floss tears or frays from the effects of really tight contacts, rough fillings, or sharp edges between the teeth, just release one wind of floss from one middle finger and take up the slack by winding it onto the other middle finger.
Assuming you have a full complement of teeth, you can do a very effective job in about a minute and a half, so the potential reward in improved health will be a good enough reason to include flossing as an important part of your daily health maintenance regimen.