Image of dental floss with a title: Don't Let Floss Be A Deal Breaker

Dental Floss, Does It Really Matter?

Who would guess a question about floss would arise in a dating relationship? After being married for quite a number of years and finding myself single, I found it incredibly awkward. Not the flossing part, the dating part. Dating is fun, but stress filled.

I met someone very special whom I knew was worth pursuing. I takes time to get to know someone and many conversations. But, inevitably, during those conversations, there are questions that  come up that make you wonder. How did I get here? Do I have to answer that? Do I have a good answer? What if she finds my answer offensive? Lots of second guessing.

One of those moments concerned personal grooming habits.

The question from my fiancee was, “How weird are you, really?”

Well, that wasn’t exactly the question, but it was pretty close.

“So you are a dentist?”

A restating of the obvious.

Check—Head nod. Maybe a little weirdness is required to become a dentist.

“And you are probably a little compulsive about taking care of your own teeth, right?”

Check—Head nod. That’s not weird.

“How important is it really, for me to use floss?”

“Well it’s very important,”—yada, yada, yada. I turned on the canned speech about dental flossing and watched her eyes glaze over a bit. OK, note to self— different approach needed.

“Try something out for me. You’ve got some, right?”

“Yes,” she replied.

“The next time you floss your teeth, run it between some of your back teeth, pull it out and then smell it.

Then tell me whether it is important to— you.”

I just may have shot myself in the foot by being blunt.

I certainly did not expect her to get up from the table, go into her bathroom, and try it right then, but that is exactly what she did. A few minutes later she emerged, with an embarrassed look on her face.

“I thought you were kidding,” she said.

“It stinks!”

“See, it really is important.”

The Joys Of Flossing

Once you or a loved one experiences the “joys of flossing”, it is likely to become a daily ritual. Everybody benefits. Better breath, more closeness. Initially the benefits might be purely social. When you find out later what is really happening in the nooks and crannies of your mouth, it’s no longer just social, it’s a requirement to stay healthy.

Let’s take a look at what floss is, how it’s use got started and why it’s so important.

What Is It?

It’s like fine thread, made up of even finer filaments. It’s used to remove food and plaque deposits from between teeth. It’s most often made of fine extruded nylon, or teflon filaments twisted together in a loose strand.

It ranges from a thick type, called dental tape to extra thin, for really tight teeth. It’s sold plain or coated with wax, with an assortment of flavoring agents, fluoride and anti-bacterial compounds. The flavoring additives encourage use, while the others it’s effectiveness, as you use it to chase bacteria out from between your teeth.

It also comes totally natural. A hand-spun silk floss is currently available using a plant based wax lubricant coating, an alternative to wax coated, man made nylon and teflon.

Silk worm image the source for natural dental floss

Silk worm cocoons made of silk filaments
Courtesy of: http://www.lajeen-db.ps/ar/?p=14742

Silk fiber, produced by silk worms, has the additional benefit of being completely biodegradable. A commercially available, totally natural variety uses Xylitol, as a sweetener with either cranberry or mint as the natural flavoring.

Today’s modern version likely had ancient origins. It’s hard to imagine that ancient man or woman did not occasionally get corn on the cob stuck between their teeth too. Whether they used a splinter of wood like a toothpick, or an un-manicured nail, the offending food morsel was irritating and needed to be removed.

The Invention Of Modern Dental Floss

It’s modern invention is credited to a New Orleans dentist, Levi Spear Parmly in 1819. In his book entitled, A Practical Guide to the Management of the Teeth, Parmly, promoted the benefits of regular use of silk thread to clean between the teeth.

He extolled the benefits of floss as it dislodges the irritating matter from between the teeth and around the necks of teeth, “which is the real source of disease. With this apparatus, thus regularly and daily used, the teeth and gums will be preserved free from disease.”

He goes on to further describe the superiority of flossing, implying that other tooth powders and tinctures will not be needed.

Parmly explains one of flossing’s chief benefits to be “the breath will not be loaded with that putrid effluvium, which besides it’s public annoyance, is the cause of numerous disorders.”

I know that you have had an occasional whiff of another’s bad breath. That is why breath mints, chewing gum, mouthwash and a zillion other commercial items are part of a multi-billion dollar industry.

But, if their breath is that bad, is mine is OK? Good question.

What causes that “putrid effluvium” or bad breath? It is the result of rotting food or gums to be blunt. When food sits in a Tupperware container in the back of your refrigerator for several days the changes are obvious. It didn’t smell bad when I put it in there. The cause? Bacteria.

You may be tempted to open that suspicious container and take a whiff. Then, after verifying it’s foul odor I’ll bet you immediately looked for someone else to confirm how bad it smells. Is it just me? I think it’s just human nature.

Your victim is sure to respond with a “No, thank you, not interested. Just take it out in the yard and dump it or wash it down the garbage disposal.

Why Does Floss Stink After Removing It From Between Your Teeth?

Floss, right out of the container, does not stink. Work a piece of unflavored/unscented floss between your back teeth, rub it around a bit, then remove it. Now test it, smell the floss. Does it resemble the stinky contents of the Tupperware container example mentioned earlier? If it does you might have some work to do.

If you find it does stink after using it to clean between your own teeth, remember the floss did not create the stink, it merely disclosed the problem. The stink was already there and everyone but you knew it. I have had patients refuse to floss again thinking the floss created the odor. No, it was the three day old chicken parts stuck between the back teeth.

The stink results from noxious chemicals produced as protein is broken down by bacteria. The rotting of food trapped between the teeth creates offensive chemicals known as putrescine, cadaverine and methyl mercaptan. These are the chemicals responsible for dead animal smell.

Natural gas, propane and butane are deliberately dosed with methyl mercaptan, with it’s skunk like smell. It’s added to the gases for safety, to help identify dangerous leaks. Why? Because it stinks out loud.

Onions And Garlic Cause Bad Breath

Some foods also have a reputation for creating bad breath, such as onions and garlic. The smell here is due to sulfur containing chemicals released during digestion. It can give off a rotten egg smell, caused by hydrogen sulfide similar to methyl mercaptan. Fortunately after a couple of days, it’s gone. You can combat the smell partially by eating parsley or other dark green leafy vegetables as chlorophyll helps to sweeten your breath.

Persistent bad breath throughout the day is usually an indicator of trapped food and bacteria. It can also be due to severe gum disease. This bad breath odor sticks with you like glue, unless you remove the bacteria and food remnants completely. Even then it may be too late if gum disease has started in the deeper crevices around your teeth.

Why Floss Your Teeth?

If you just grab a piece of floss and go to work cleaning your teeth without thinking about it, you may not achieve  your goal of fresher breath. So, what exactly should your objective be?

Your flossing efforts should be designed to:

1) Remove the obvious food stuck between your teeth. That’s often what prompts the occasional flosser to reach for the floss container.

2) Remove visible plaque (bacteria) caked around the necks of your teeth. This is really more important than just food removal as the bacteria are releasing dangerous toxins that can severely damage the gums and bone around teeth–and the rest of your body.

3) Remove hidden plaque in the “turtleneck” crevice of gum tissue on either side of the tooth neck and  between the teeth. This is the most important goal of flossing because if you are successful here you have already accomplished the steps above.

4) Avoid making hamburger out of your gums in the process of completing the first three steps. This is the key to ever wanting to floss again. If you are causing yourself pain, you may not want to repeat the process. It requires some dexterity, floss control and regular repetition with coaching by your hygienist.

It really is possible to floss, not cause pain and eventually make it a regular daily health habit.

After enough practice, flossing is not hard. But everyone has to go through a learning process. Stick with it and you will realize financial, social and health rewards.

How To Floss Your Teeth

Tear off a piece of floss about 18” long. Any less and it will be more frustrating than it needs to be.

Watch the 45 second video below for a visual demonstration.

Wrap most of the floss around one of your middle fingers and the balance two or three times around the other middle finger. Slippery floss, such as unwaxed teflon floss will slide off you fingers unless you have enough wraps.

Your middle fingers adjust the tension of your floss while you direct the floss between your teeth with your thumbs and forefingers. Adjust the floss to give yourself about an inch to work with.

Start in the middle of your upper front teeth. Use your forefinger on the inside (tongue side) of your teeth and your thumb on the outside (lip or cheek side) of your teeth.

Gently work the floss between the upper front teeth, thinking in terms of wrapping the floss partially around the tooth like the letter “C”. Rub  the floss up and down, along the length of the tooth and count 6 pairs of up and down strokes.

Your strokes should guide the floss from the place where the teeth touch tightly, then toward the gums and back to where the teeth touch again. Each stroke will bump against the gums but should not be painful. You can observe the floss entering the turtleneck of gums at the neck of the tooth, disappearing and reemerging with plaque stuck to it.

Each stroke will begin scraping off layers of bacterial plaque clinging to the tooth. Bacteria are extremely sticky and will only come off the teeth with repeated strokes. The first couple of strokes begin to loosen the plaque and the last couple of strokes may even squeak. Squeaky clean teeth anyone?

Then lean the floss against the other tooth of the pair that are touching together. Partially wrap the floss forming the letter “C” again and repeat the process counting again 6 pairs of up and down strokes.

OMG, I can’t do that, it’ll take me an hour to floss my teeth. Nope, it may take a few minutes, but nowhere near an hour. It might take 2 minutes or less after you have practiced a while.

Watch the 45 second video below for a visual demonstration.

On the upper right side of your mouth your left forefinger will be inside and your right thumb will be outside of your teeth.

On the upper left side of your mouth your right forefinger will be inside and your left thumb will be outside of your teeth.

For lower teeth use just forefingers to direct the floss between the teeth. The right forefinger on the outside of your teeth on the right side, and the opposite on the left.

Practice, practice, practice. If it’s worth doing, it’s worth doing well.

If you have practiced for several weeks and you have given up, a power floss option is worth considering. Whether you think you are uncoordinated, don’t have enough time or you’ll admit to being just a little lazy, look into getting a power flosser.

Power flossers come in several “flavors.” One type is the Waterpik brand “Water Flosser”. It is a pulsing jet of water that if used properly will keep you dry and do a fairly good job of reducing the amount of plaque on your teeth. It has a learning curve, so it also requires practice. This type of power flosser uses water pumped through a nozzle to clean between your teeth. It’s like a car wash for your teeth.

Image of a car wash sign making the comparison of a casr wash to a water jet power flosser

Water jet flossers are like a car wash for your teeth. You can upgrade and use a variety of add-ons to act as a floss substitute.
Courtesy of: Craig Sommer DDS LLC, at SpringsDentist.com

Another variety uses a replaceable stiffened piece of floss with a motorized head that whips and wiggles the “floss” between your teeth. Again it will remove plaque but it is very technique sensitive. You will remove some plaque but may miss some too.

Floss Holders

Image of Hand-held_dental_floss holders

Dental Floss Holders, The Blue One Is My Favorite Of The Two

Floss holders can help give you access to the parts of your mouth you find troublesome. The type with a handle and a piece of floss stretched between two arms can be used with good results. The best ones have the floss perpendicular to the handle.

Can I Use Floss Picks?

My least favorite is the floss pick variety since it does not allow the floss to be partially wrapped around the tooth. The one I am speaking of looks like a small sword made of plastic and with the floss where the handle should be. It’s great to chase food out from between teeth but, in my opinion, it is not a very effective plaque remover.

178px-Floss_pick

It has advantages though, as they are easily carried in a pocket or purse and allow for flossing-on-the-go.

Should I Floss Before Or After Brushing?

I recommend brushing first to loosen up food debris and then flossing. Any residual toothpaste then could be carried on the floss between the teeth to assist in making the teeth squeaky clean. You are removing large quantities of food and bacteria with good brushing allowing floss to finish the job. And if you are a purist follow up with a “Water Flosser”.

How To Floss With Braces

Teeth with braces are a challenge to keep clean. To floss with braces is yet another level of difficulty. Floss threaders help get the floss between the teeth and under the arch wires where the up and down strokes need to be accomplished. It requires a degree of patience until the tricks are learned to floss your teeth effectively.

Image of a Floss_Threader_Picture

Floss Threaders-Put the floss through the loop, thread the loop between the teeth, pull the floss through and then start the up and down motion of floss along the length of the teeth.

Image of between the teeth mini bottle brushes for flossing with braces

Mini bottle brushes for supplementing floss if you have braces. The brushes are worked gently around wires and brackets to remove plaque. Floss is still the best between the teeth plaque remover with braces.

Accessory cleaning devices such as mini-bottle brushes on a handle can be used around the teeth with braces and if the spaces are large, even in between teeth.  Air flossers might help, which use a bit of compressed air with a jet of water to clean between the teeth. The jury is still out on air flossers in my opinion.

I would highly recommend the use of the Waterpik brand “Water Flosser”. Braces wearers need all the help they can get to keep their teeth clean. The goal is to keep cavity free of course, so every positive effort will be appropriately rewarded.

With all of the floss accessories and substitutes available, it is almost impossible to not come up with a winning combination that will keep your teeth virtually plaque free. The benefits of minimizing bacteria stuck around your teeth are extraordinary. Gingivitis with it’s infection of the gum tissue, is off the table. Periodontitis, with it’s destruction of bone that supports teeth is minimized. Cavities that may have been a major problem are also minimized if diet is modified as well. And bad breath fades away.

Floss, while not always easy to use, is effective in controlling dental disease and associated bad breath. Give it a try if you have never used floss. And if you are only a part time flosser, go full time. Floss at least once a day. Maybe you’ll graduate to even twice or three times a day.  Your efforts will meet with great rewards.

Your holistic dentist can coach you to become an award winning flosser. Schedule an appointment today to get a review of your home care efforts. It can pay big dividends socially, mentally and physically.