Why Floss?

Posted on Apr 14, 2020 by William J. Claiborne, DDS MS

As a periodontist, I treat all stages of periodontal (gum) disease. Over the years, I’ve helped patients save natural teeth and restoring their ability to enjoy healthy, confident smiles.

When people come close to losing their teeth or find themselves in need of replacing them with something more dependable than dentures or partials, I hear nearly every one express the same regrets: “I wish I’d taken better care of my teeth when I could.”

Hindsight may be 20-20, but it’s never too late. I know patients can go from having gum disease and losing teeth because of it to having excellent oral health – and end up having a renewed commitment to their smiles.

In my dental specialty, I know it begins by helping patients to understand how the problem starts in the first place. When people know the HOW, they can implement measures to bypass the repercussions of gum disease.

I’ve found that most people actually have very little awareness of how the inside of their mouth looks. We smile with lips and front teeth that show very little (if any gums). So, it stands to reason that, if a smile looks good, it’s probably healthy.

Until dental offices began using intra-oral cameras, it was sometimes challenging to convince patients that they needed treatment for a condition that didn’t hurt. There were not obvious signs initially, so nothing is wrong – right?

Intra-oral cameras are able to give patients, while seated in the treatment chair, clear, enlarged views of specific areas in the mouth. When an individual has this firsthand view of spongy, receded gums, the decision to treat often go from IF to WHEN.

Although it helps to be able to show patients the signs of gum disease, these emerged signs are indications of long-standing periodontal disease. By the time these signs appear, the early stage of gum disease, gingivitis, is past.  This is unfortunate, since early-stage gum disease can be halted with prompt measures.

Gingivitis causes the gums to become tender and swollen in some areas. You may see blood in the sink when brushing. These signs indicate that oral bacteria has accumulated in the mouth beyond the means of your immune system’s ability to manage it.

Twice daily brushing and flossing are important steps in keeping bacteria levels in the mouth under control. Brushing sweeps away built up bacteria on the surface of teeth, which is a sticky film known as plaque. Plaque, just over the course of a couple of days, can harden on teeth where build up is allowed to remain. This cement hard mass of bacteria is tartar, or also known as calculus.

The reason your mouth feels ‘fuzzy’ and you feel your breath is bad when it’s dry is because saliva has been depleted and oral bacteria is running rampant. Add sugary foods and beverages and acidic colas and you super-charge oral bacteria further.

Yet, try as we might, there are simply angles in the mouth that are difficult to reach with a toothbrush, manual or electric. Say you have an area of jumbled or crooked teeth. Even as you adjust the angle of the toothbrush differently to maneuver the bristles into these areas, it is often difficult to continually keep these areas clean.

This is where flossing comes in, and important step in daily, oral hygiene.

Flossing grabs those bits that are left behind. If not removed, these left-behind pieces begin to rot and add to bacteria levels in the mouth. Oral bacteria gets its strength in numbers. The more there are, the more rapidly they multiply.

If you looked at a stand of floss under a microscope AFTER flossing your teeth, you’d have a jolting view of exactly what you do NOT want crawling around and breeding in your mouth. These living and breeding organisms can be highly destructive as they amass.

As research has shown for many years, your overall health is intricately linked to your oral health. The bacteria of gum disease has been linked to a long list of serious health problems, including heart disease, stroke, arthritis, some cancers, diabetes, and preterm babies. Studies are underway to track gum disease bacteria to the path of Alzheimer’s disease.

Obviously, the small amount of time taken to floss daily – and to do it correctly – is worth the advantages of lowering the risk of developing cavities, gum disease and other diseases and conditions.

Yet, I still find myself trying to convince some people that daily flossing is an advantage. It DOES make a difference! According to the Delta Dental Oral Health and Well-Being Survey (http://www.ada.org/en/publications/ada-news/2014-archive/october/survey-finds-shortcomings-in-oral-health-habits): “Only four of 10 Americans floss at least once a day, and 20 percent never floss.”

Perhaps this is one reason why over 47 percent of American adults have some level of gum disease, which is also the leading cause of tooth loss. While brushing twice daily helps to remove oral bacteria buildup (a sticky film known as plaque) from tooth surfaces, bits of food caught between teeth aren’t easily dislodged by the bristles of a tooth brush.

Over recent years, a few studies have shown minimal benefit from flossing. Yet, upon closer scrutiny, flaws in the studies were quickly argued.

It has been noted that the flossing technique can be what makes the action less effective, rather than the act of flossing itself. For example, the American Dental Association recommends curving the floss along the sides of each tooth and firmly, but carefully, motioning it up and down. This moves the floss gently down to reach slightly below where the tooth connects with the gum tissues, getting at the ‘hiding’ spot for much oral bacteria accumulation.

Keeping oral bacteria levels under control takes a commitment, yet requires just minutes a day. For our patients, we help them develop an at-home care regimen to maintain a healthy mouth and fresh breath between regular dental check-ups.

Be aware of the signs and symptoms of periodontal disease. Knowing them will allow you to react quickly to minimize the extent of damage and treatment needed to rid it. They include:

• Tender or swollen gums
• Gum tissues that turn red
• Gums that are tender to the touch
• Gums that bleed easily
• Spitting out blood when brushing or flossing your teeth
• Frequent bad breath
• Pus pockets that form between teeth and gums
• Teeth that loosens or shift
• Painful chewing
• Gums that pull away from your teeth (recede), making your teeth look longer than normal

These are all warning signs that bacteria overload is occurring in your mouth. It is a disease, and will only worsen without treatment.

If you suspect you have any stage of gum disease, call 828-274-9440 to schedule a thorough periodontal examination.