WE have always been told—and it is a proven fact—that 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 contact can process the foods we eat, such as carbohydrates and starches, and in this process can produce acids that dissolve enamel. So, for those susceptible to these types of cavities, flossing is exceedingly important for keeping decay between the teeth under control. Additionally, for those who have had their fillings or other dental restorations on tooth structure lost to decay between the teeth, it is imperative to effectively and frequently clean the surfaces between the teeth to reduce the incidence of new decay in these areas.
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).
Besides all the health benefits of flossing, another motivator is that it makes breath fresher. Fresh breath is difficult to achieve when loads of necrotic, odorous plaque are left under the gums and between the teeth for long periods. Since patients with bad breath often do not notice their own halitosis, they may not even be aware that their breath is offensive. A simple test to see if you have a problem is 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. No one has ever had bad breath worsen by having a cleaner mouth.
How do you floss safely, easily, and effectively? You’ve already chosen your floss, so the following is the same information I share with 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 thumbs are close enough to touch. This allows the floss to be directed and controlled—using both thumbs when flossing the upper teeth, or the index fingers when flossing the lower teeth—while using only gentle motions throughout.
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, 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 a slight rocking motion until you feel the tooth surface is clean. You have just flossed the front of the tooth and cleansed 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. Remember, you are not just cleaning the front of one tooth, but also the back of the next one, as well as cleaning some of the sulcular debris from both sides of the gum tissue between the teeth (the interdental papillae).
Then move on to the lower teeth, again flossing systematically to ensure no surfaces are 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 due to tight contacts, rough fillings, or sharp edges between the teeth, 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 is a good enough reason to include flossing as an important part of your daily health maintenance regimen.
