WebMD Health - Dental

Jul 21, 2010 7:16 PM

Flossing Teeth: No More Excuses!

Do you floss? Or, like many people, do you always seem to find a reason not to?

A 2008 survey found that only 49% of Americans floss daily, and 10% never floss. That's most unfortunate, dentists say, because flossing is even more important than brushing when it comes to preventing periodontal (gum) disease and tooth loss.

"If you were stuck on a desert island and a boat could bring only one thing, you'd want it to bring floss," says Samuel B. Low, DDS, professor of periodontology at the University of Florida College of Dentistry in Gainesville, and president of the American Academy of Periodontology. "But I'm convinced that the only time some of my patients floss is an hour before showing up in my office."

Dentists say they hear all sorts of excuses for not flossing. Yet they insist that simple workarounds exist for just about all:

Excuse #1: Food doesn't get caught between my teeth, so I don't need to floss.

Flossing isn't so much about removing food debris as it is about removing dental plaque, the complex bacterial ecosystem that forms on tooth surfaces between cleanings. Plaque is what causes tooth decay, inflamed gums (gingivitis), periodontal disease -- and, eventually, tooth loss. Flossing or using an interdental cleaner is the only effective way to remove plaque between teeth.

Excuse #2. I don't know how to floss.

Flossing isn't easy. Low calls it "the most difficult personal grooming activity there is." But practice makes perfect.

Here's how the American Dental Association describes the process:

  • Start with about 18 inches of floss. Wrap most of it around the middle finger of one hand, the rest around the other middle finger.
  • Grasp the floss tightly between your thumbs and forefingers, and use a gentle shoeshine motion to guide it between teeth.
  • When the floss reaches the gum line, form a C shape to follow the contours of the tooth.
  • Hold the floss firmly against the tooth, and move the floss gently up and down.
  • Repeat with the other tooth, and then repeat the entire process with the rest of your teeth ("unspooling" fresh sections of floss as you go along).

Don't forget to floss the backs of your last molars. "By far, most gum disease and most decay occurs in the back teeth," Low says.

Excuse #3. I'm not coordinated enough to floss.

Many tooth-cleaning options exist for people whose manual dexterity is compromised by poor coordination, hand pain, paralysis, and amputations -- or simply by fingers that are too big to fit inside the mouth.

One option is to use floss holders. These disposable plastic Y-shaped devices (some equipped with a spool of floss) hold a span of floss between two prongs to allow one-handed use.

Another option is to forgo floss and clean between teeth using disposable toothpick-like dental stimulators (Stim-U-Dents, Soft-Picks, and so on); narrow spiral brushes (interproximal brushes); or the conical rubber nubs (tip stimulators) found at the end of many toothbrushes or mounted on their own handles.

Excuse #4. I don't have time to floss.

Effective flossing does take a while -- once a day for a "good three to five minutes" according to Low. But even 60 seconds of flossing is of enormous benefit. As with exercise, bathing, and other daily activities, the key is to make flossing a habit.

"If you make time for your personal hygiene, you can find time to make for flossing," says Maria Lopez Howell, DDS, a dentist in private practice in San Antonio.

She recommends keeping floss in plain view, alongside your toothbrush and toothpaste. If you're too tired to floss before bed, floss in the morning or afternoon. Or keep floss on hand and use it when you find the time.

Mark S. Wolff, DDS, PhD, chairman of the department of cardiology and preventive medicine at New York University School of Dentistry in New York City, keeps a stash of dental stimulators in his car. "I use them when I am stuck in traffic," he says.

Excuse #5. It hurts when I floss.

If flossing causes gum pain or bleeding, odds are you have gingivitis or gum disease -- precisely the conditions for which flossing is beneficial.

"Flossing should not be a painful experience," Wolff says. "But stopping flossing because of bleeding [or pain] is just the opposite of what you should be doing." The good news? With daily brushing and flossing, gum pain and bleeding should stop within a week or two. If either persists, see a dentist.

Excuse #6. My teeth are spaced too close together to floss.

If unwaxed floss doesn't work for your teeth, you might try waxed floss or floss made of superslippery polytetrafluoroethylene (sold under the brand name Glide).

If the spacing between your teeth varies (or if you have significant gum recession), yarn-like "superfloss" may be a good bet. It stretches thin for narrow spaces and fluffs out to clean between teeth that are more widely spaced.

If you're having trouble finding a workable floss or interdental cleaner on your own, your dentist should be able to offer guidance -- and may even offer free samples.

Excuse #7. The floss keeps shredding.

In many cases, broken or fraying floss is caused by a cavity or a problem with dental work -- often a broken or poorly fabricated filling or crown. Consult your dentist.

Excuse #8. I have dental work that makes flossing impossible.

Try floss threaders. These monofilament loops make it easy to position floss around dental work.

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