The importance of flossing

Tue, Aug 22nd 2017, 10:49 AM

Periodontist Dr. Antoine Clarke encourages flossing as one part of a regular hygiene routine that also includes brushing teeth at least twice a day and flossing at least once a day. He says the main purpose of flossing is to decrease plaque (bacteria).
"The long-term benefit number one is it [flossing] decreases plaque that builds up around teeth. Plaque induces inflammation that leads to gingival inflammation, swelling and can also cause tooth decay," said Dr. Clarke who practices out of Rose North House on Collins Avenue
"I've been practicing for over 20 years and I've seen the benefits with [people who floss] and those who don't -- those that come in with regular oral hygiene habits -- that use toothbrushes, interdental cleaners and go for regular checkups, and those that don't."
Dr. Clarke is one of many dental professionals who advocate flossing even in the face of reports over the years that have cited research that says that flossing may not be as important as some experts have made it out be, and who say that the medical benefits of dental floss are unproven. Whenever those reports surface, he says he's never bothered much. He only makes it a point to speak to his patients and remind them of its importance.
"Patients need to always floss at least a minimum of once a day. There is always a tight spot or spots in every individual that need urgent care, and if we leave food particles, plaque, between the teeth or around the gum, you develop either dental caries [cavities], or periodontal disease. It minimizes those two diseases right there."
The United States (U.S.) federal government has recommended flossing since 1979, first in a surgeon general's report and later in the Dietary Guidelines for Americans issued every five years.
The American Dental Association and the American Academy of Periodontology (AAP), for specialists in gum disease and implants have cited that flossing prevents buildup of gunk known as plaque, early gum inflammation called gingivitis and tooth decay.
"The main purpose of flossing is to remove plaque [bacteria]. Some individuals don't have the manual dexterity to get between the teeth. Some individuals over the years may have had numerous restorations -- amalgams, filling, composites, crowns, veneers, bridges -- all these things floss needs to be able to clean. In the absence of floss, those individuals would develop dental decay, which is on the rise. Also what we consider recurrent decay, which is also at a higher increase."
The periodontist said periodontal disease is influenced and takes place over a period of time, and is also influenced by multiple factors. He said the AAP recommends that studies need to be more detailed as relates to the efficacy of daily flossing.
Over the years, the one thing he's noticed, he said, is that many people floss incorrectly, moving the floss in a sawing motion instead of up and down the sides of the teeth. According to Dr. Clarke, the wrong way to floss is tying the floss between your fingers and not having control. He said the other wrong way to floss entails using it like a saw between the teeth.
The right way, he said, is to roll off at least 10 inches of floss, wrap it around the two index fingers so that you can control it, wrap the floss around the tooth and proceed in an up and down motion.
Dr. Clarke says patients should continue to include flossing as part of their daily oral hygiene habits.
"Flossing from the early 60s has been one of the main adjuncts in keeping bacteria and oral diseases under control, and is probably one of the least expensive mains in maintenance therapy -- $3 for a box of floss or $600 to $2,000 for a yearly visit to the dentist," said Dr. Clarke.
The AAP also recommends flossing as one part of a regular hygiene routine that also includes brushing your teeth at least twice a day, and flossing at least once a day.
The AAP in association with the ADA recommends that patients need to floss in conjunction with other home care products.
"Regular dental oral hygiene and care is based on a number of things -- not just flossing," said Dr. Clarke. "Flossing alone does not show any strong scientific evidence to prevent any of those things. Flossing is one of a few dental cleaners that helps in dental hygiene," he said. "The AAP shows that the interdental cleaners is an essential part of periodontal care and maintenance, and that includes floss, small brushes, special wooden or plastic picks, sticks or water flossers -- all of these are adjuncts to help."
When flossing first gained acceptance, no proof was required of remedies. Dentist Levi Spear Parmly is credited with inventing floss in the early 19th century. By the time the first floss patent was issued, in 1874, the applicant noted that dentists were widely recommending its use.
The ADA has been promoting floss universally since 1908.

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