Monday, July 23, 2012

Floss Floss Floss

Only about 5% of the US population will floss their teeth on a regular basis. In fact, before I became a dentist and didn't know any better, I rarely flossed either.

People frequently tell me they don't floss and don't want to floss. They often state that they don't want to because it requires too much effort. Yes, it is a pain to floss your teeth, but it's even more of a pain to have to wear dentures. They also state that they don't like to floss because their gums hurt or bleed. The truth of the matter is that they hurt and bleed because they don't floss regularly. This will be explained shortly.
Once when I was serving at Camp Lejeune Marine Corps Base in North Carolina, I worked alongside dozens of dentists. One day I heard the periodontist (a dentist specializing in the supporting structures of teeth) and a Marine have a discussion in the room next to me. The Marine asked the periodontist if flossing was really necessary. The periodontist replied, "you only need to floss the ones you want to keep". That statement made me laugh for quite some time. I often use that line with my patients. My team is  probably tired of hearing that joke by now.

So, why is it necessary to floss? I often explain it this way. If you lined up numerous cars front to back and ran them through a car wash, only the top, right and left sides would get clean. The front and back however would not get clean. The same is true for teeth. The surfaces you do not have access to will not get clean. Any surface that isn't cleaned regularly is significantly more at risk into developing into a carious lesion (a cavity). Therfore, when flossing is not done regularly, cavities will form in between the teeth.

Many believe that flossing makes their gums bleed and hurt. Well, that is partially true. Only unhealthy gums will bleed and hurt. The reason they bleed and hurt is because they are inflammed. Debris that is left below the gumline is similar to having a splinter in your finger. If you don't remove the splinter from your finger, it will get inflammed and eventually infected. This is precisely what happens when debris is left below the gumline. If the inflammation and infection persists for extended periods of time and becomes chronic, then tissue destruction occurs. In other words, the gums and bone pretty much are destroyed. So initially gingivitis (inflammation of the gums) occurs. If allowed to progress, it will become periodontitis (inflammation of the supporting structures of teeth--gums and bone). Periodontitis can lead to tooth loss or even worse medical conditions that are life-threatening (read the blog on periodontitis).

Amongst the people that do floss regularly, I find that many aren't flossing correctly. They are also confused by the choices of available floss. There are many different types on the market. Ask your dentist or hygienist to determine which type is best for you and to demonstrate the proper way to floss.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

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