In August, the Associated Press (AP) published a story questioning the research evidence for the effectiveness of dental floss. The Federal Government even went so far as to remove flossing from their dietary guidelines, citing lack of research evidence.    Despite the lack of published research results, the American Dental Association, the American Academy of Periodontology and the Surgeon General all support interdental cleaning as part of healthy home care and I concur.  In my 32 years of experience, I have observed that the people who use some form of interdental cleaners accompanied by brushing their teeth have healthier mouths.

There are different types of interdental cleaners: floss, irrigators, interproximal brushes, gum stimulators (plastic or wood sticks) and rubber tips. Generally, the most effective is the standard dental floss as it can get into the tightest areas.  My only caution about flossing is if you’re feeling pain while you’re flossing, then you’re probably being a little too aggressive. The floss should go between the teeth and be pulled toward one tooth and then the other while gently pushing up and down to clean the side surfaces of the teeth.  This technique dislodges and scraps off food and bacterial plaque that get trapped where the toothbrush will not reach. The longer this plaque stays on the tooth the more damage it does to the gums and teeth. Interdental cleaning is particularly important for those who wear braces or other dental appliances that tend to trap particles not easily removed by the toothbrush.

Plaque is full of bacteria. These bacteria release acids which demineralize the protective tooth surfaces leading to cavities in these difficult to detect and difficult to treat areas between the teeth.  The bacteria in plaque can also cause bad breath and gum disease.  The body reacts to the prolonged presence of bacteria by a protective inflammatory reaction called gingivitis.  If gingivitis is not treated by good homecare and dental visits it can eventually proceed to periodontal disease, which will cause loss of gum and bone around the teeth and eventually loss of teeth.  We also know there is an association between periodontal disease, heart disease, diabetes, respiratory disease and some other medical conditions.

In summary, I recommend flossing to my patients because flossing is a low-risk and low-cost procedure that has many benefits.  Flossing can help prevent cavities and periodontal disease which in turn keeps health care costs lower and your smile brighter!

Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, he is on the faculty of Spear Education, a member the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association.  Dr. Gallegos practices dentistry in Middleburg, VA.

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